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This state has boundless opportunities for budget-friendly indoor or outdoor recreation and plenty of free attractions and activities for the whole family, as well as 37 casinos. According to a 2017 Gallup poll, South Dakota ranks highest among states for many categories, including overall wellness. With a low cost of living, reasonable healthcare costs, and no income or estate tax, South Dakota is a great place to retire.

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How to Pay for Assisted Living in South Dakota

Determining how to finance assisted living often starts with the question, “What’s the cost?” In today’s economy, where inflation plays a significant role, having current data is crucial for senior living financial planning. has gathered cost information from its expansive network of over 75,000 senior living providers. This data offers a glimpse into the average expenses for assisted living in South Dakota and 3 additional cities within South Dakota.

How Inflation Has Impacted the Cost of Assisted Living in South Dakota

Assisted living costs have risen 9.6% across the U.S. from 2022 to 2023 due to inflation. However, South Dakota is one of the few states where prices decreased, falling 1.6%, in stark comparison to surrounding states that all experienced increases in 2023. In North Dakota, assisted living expenses jumped nearly 14%, while Wyoming’s prices grew 26.8%. Costs in Nebraska soared from $4,480 to $5,043, while Minnesota experienced a small jump from $4,399 to $4,433.

Prices are predicted to fluctuate more heading into 2024, based on trends, with North Dakota’s jumping an additional 5.2% but Minnesota’s average falling to $4,314.

Location 2022 Cost (Historical) 2023 Cost (Current) 2024 Cost (Estimated)
South Dakota $4,514 $4,443 $4,732
U.S. Average $4,070 $4,459 $4,802
North Dakota $3,047 $3,472 $3,653
Nebraska $4,480 $5,043 $5,304
Minnesota $4,399 $4,433 $4,314
Wyoming $3,944 $5,000 $5,325

Assisted Living Costs in South Dakota's Top Cities

Costs vary significantly across the cities of South Dakota, from Aberdeen’s average of $2,795, well below both the state and U.S. norm, to $4,297 in Rapid City, making it important for seniors to plan carefully. Sioux Falls, averaging $3,500, offers a middle ground for individuals who want to live in a big city, while costs in Minneapolis, MN, just over the border, average $4,432, surpassing most locations in South Dakota.

The Cost of Other Types of Senior Living

Expenses vary based on the type of care needed in South Dakota. Independent living, at $2,652, is the most affordable option, likely due to the reduced staffing requirements, whereas assisted living requires additional personal care staff, reflected in the higher $4,443 cost. Memory care is highly specialized, leading to it having the highest average price overall at $5,350, so families may want to consider other levels of care first if possible.

Financial Assistance for Assisted Living in South Dakota

There are no federal or state programs in South Dakota that help pay for the costs of room and board in assisted living. However, there are several ways to get assistance paying for the cost of personal care, nursing, and housekeeping services.

The HOPE Waiver

Seniors may qualify for financial assistance with services received in assisted living, like private duty nursing, aides and homemaker services, through the HOPE waiver, formerly known as the Home and Community Based Services waiver program. The transition to the new name brings with it a change to income guidelines allowing elderly residents to participate in work activities and keep up to $75 of that income in addition to their personal maintenance allowance.

The waiver covers personal care and nursing services, but not room and board. The costs for room and board to Medicaid subsidized residents is capped at $693 a month and families are not allowed to assist in paying any additional rent charges to the facility. Facilities must be licensed as a Medicaid provider to provide services or house residents participating in the waiver program.

Who is Eligible?

Elder residents in South Dakota must be 65 years or older to qualify for Medicaid, unless they are blind or disabled. Applicants must be assessed to determine that they would need nursing home level care if not for the assistance program paying for services they can receive in the assisted living center.

Income limits also apply – monthly income cannot exceed $2,250 (or $4,500 for a married couple) and assets cannot be greater than $2,000 ($3,000 for a married couple). Assets could be protected under community spouse laws if only one person in the marriage is applying for assistance.

How to Apply

To initiate a relationship with a dedicated Medicaid specialist through the state of South Dakota, reach out to your nearest Department of Social Services and a specialist will assist you in applying. You can also call the Dakota At Home Hotline at 1-833-663-9673 to discuss long term care options in the state.

Social Security Insurance

Seniors may qualify for SSI payments that can be used to help pay for assisted living costs. In 2018, the monthly benefit payment for an individual is $750 and $1,125 for a couple. Assisted living centers in South Dakota may take this money as payment for the services they provide and room and board. People that enroll in this program will receive a portion of their income every month, called a Personal Needs Allowance (PNA). As of 2018, the PNA in South Dakota is $80 and is given to the SSI recipient at the beginning of every month. If a resident is employed, up to an additional $75 will be added to their PNA.

South Dakota offers an additional payment to elders living independently or to assisted living centers to help pay for services for eligible seniors, named the Optional State Supplementation (OSS) program. The additional payment to an independent senior is $15 a month. The OSS program will pay an additional amount of $779 to an assisted living center, as well as the participants monthly SSI payment. For this program, couples are treated as two individuals and so the payment would simply be doubled.

Who is Eligible

To qualify for the OSS program, residents must already be enrolled in SSI. Participants need to have no other income to pay for assisted living costs that the current SSI payment is not high enough to cover.

How to Apply

Call your nearest office and make an appointment to speak with a representative:

Social Security Office Address Phone Number
Huron 200 4th St SW, Rm 105, 57350 (800) 772-1213
Sioux Falls 5021 S Nevada Ave
Sioux Falls SD 57108
(877) 274-5421
Rapid City 2200 N Maple Ave #301
Rapid City, SD 57701
(800) 772-1213
Aberdeen Federal Bldg, 115 4th Ave SE #111
Aberdeen, SD 57401
(800) 772-1213
Watertown 514 Jenson Ave S
Watertown, SD 57201
(800) 772-1213
Yankton 1818 Broadway Ave #2
Yankton, SD 57078
(800) 772-1213

More Ways to Finance Assisted Living

Some additional ways to finance assisted living costs include:

  • Veterans Benefits: Veterans can take advantage of several different pension programs to help cover the cost of assisted living. For more information, see the article on
  • Life Insurance Policies: Even if a spouse or loved one hasn’t died, certain types of life insurance policies can be used to pay for assisted living. More information is available at
  • Long-Term Care Insurance: Long-term care insurance is a type of insurance policy that pays for long-term care when it becomes necessary, including the cost of assisted living. For more information on the benefits and drawbacks of this financing method, visit
  • Reverse Mortgages: Reverse mortgages allow seniors to access the equity from a home that they own, and these funds can be used to pay for assisted living. The U.S. Department of Housing and Urban Development offers a federally insured reverse mortgage program.

Free Assisted Living Resources in South Dakota

In South Dakota, a multitude of resources are available to support seniors during their retirement years. has gathered data on various local entities, initiatives, and agencies, and organized them according to the type of care they provide for effortless navigation.

Area Agency on Aging

Your local Area Agency on Aging is a valuable resource for retirees, offering guidance on financial aid, in-home care, and long-term care planning. They also link seniors and caregivers to community resources.

Program Name Phone Number Description
South Dakota Area Agencies on Aging South Dakota’s Area Agencies on Aging provide essential programs for seniors to maintain a high quality of life at home. These services encompass adult day care, convenient meal options, and homemaker assistance for daily tasks like cleaning, shopping, and cooking. Additionally, AAA in South Dakota offers coordinated transportation for medical and nonmedical needs.

Cash Assistance Programs

In South Dakota, financial aid programs are available to support low-income seniors in maintaining their home-based living. These programs offer tax relief, essential service discounts, and assistance with home heating and cooling expenses.

Program Name Phone Number Description
South Dakota Lifeline Program 800-234-9473 The LifeLine Program provides discounted telephone service, allowing participants to maintain communication with their loved ones via landline or mobile phones.

Financial Assistance for Senior Care and Senior Living

Seniors in South Dakota, whether residing independently or in a senior living facility, have access to various local financial aid options. These entities assist in offsetting certain in-home or long-term care expenses and link them to beneficial community resources.

Program Name Phone Number Description
South Dakota Home & Community-Based Options and Person Centered Excellence (HOPE) Waiver 605-773-3656 The Home & Community-Based Options and Person Centered Excellence Waiver provides seniors with the opportunity to receive a range of services and supports in their own homes or communities. This program aims to help seniors delay or avoid moving into a nursing home by offering personal care, nutritional supplements, and specialized medical equipment. Eligible seniors can access these services to maintain their independence and quality of life.

Food Assistance Programs

In South Dakota, various local initiatives are dedicated to promoting senior health through balanced nutrition. They offer services like meal delivery, communal dining, and food banks, ensuring elderly residents have access to affordable, nutritious food.

Program Name Phone Number Description
South Dakota Adult Nutrition Services The South Dakota Adult Nutrition Program ensures food security for seniors and promotes their health and well-being. With government funds and private donations, the program offers hot meals on weekdays at adult nutrition locations across the state. Seniors can also receive home-delivered meals. This program encourages socialization and provides a daily fellowship opportunity for residents aged 60 years and older.
South Dakota Commodity Supplemental Food Program (CSFP) 605-773-3413 The South Dakota Commodity Supplemental Food Program helps low-income seniors aged 60 and above access nutritious foods. With federal funding, state agencies distribute USDA foods to local public and nonprofit private agencies, where eligible seniors can receive them. While this program doesn’t offer a complete diet, local agencies can provide referrals to other nutrition and welfare programs to fill any gaps.
South Dakota Meals on Wheels South Dakota Meals on Wheels provides food assistance and support services to seniors across the state. Programs are available to seniors aged 60 and over, offering free or low-cost services based on income. These include home-delivered meals for immobile seniors and nutritious congregate meals in a social setting. Additional services vary by location and may include pet meal delivery, transportation assistance, and emergency meal delivery during inclement weather.
South Dakota Supplemental Nutrition Assistance Program (SNAP) South Dakota’s Supplemental Nutrition Assistance Program (SNAP) assists low-income residents and seniors in purchasing nutritious food. Participants receive debit cards to buy SNAP-eligible items at grocery and convenience stores. However, it’s important to note that SNAP funds are not meant to cover the entire food budget. To qualify, seniors must demonstrate a net monthly income at or below the state’s poverty line, currently set at $1,133 for single-member households in 2023.

Free Used Medical Equipment

In South Dakota, numerous groups are addressing the steep expense of new medical equipment. They gather gently used items like wheelchairs, ramps, and walkers, providing them to local seniors and individuals in need.

Program Name Phone Number Description
South Dakota AT4ALL – Sioux Falls 866-274-2594 This program offers pre-owned durable medical equipment to South Dakotans in need, including wheelchairs, scooters, and patient lifts. The available equipment may vary, but all items are thoroughly sanitized and refurbished before being provided to seniors.
South Dakota iCanConnect Deaf-Blind Equipment Distribution Program 800-825-4595 Relay South Dakota offers free communications equipment and software through the National Deaf Blind Equipment Distribution Program. Seniors who qualify can receive braille devices, screen readers, specialized keyboards, and other assistive devices to stay connected with their loved ones.

Home Repair and Modifications

In South Dakota, numerous programs are available to aid seniors and individuals with disabilities in financing home modifications and repairs. These programs, offering grants or loans, have diverse eligibility requirements specifically designed for retirees.

Program Name Phone Number Description
South Dakota Weatherization Assistance Program (WAP) Low-income households in South Dakota may be eligible for no-cost energy-efficiency upgrades. This program covers home weatherization projects like sealing cracks, insulation installation, and heating system repairs. Limited funds may result in a waiting list for seniors in need of these services.

Social Security Offices

In South Dakota, Social Security offices provide essential services to seniors and individuals with disabilities. They offer guidance on retirement benefits, disability allowances, and Supplemental Security Income.

Program Name Phone Number Description
South Dakota Social Security Social Security provides income for retirees and individuals unable to work due to disability. Funding is derived from payroll taxes paid by employers, employees, and self-employed individuals. Upon retirement, monthly payments are determined by previous earnings.

Tax Assistance

Numerous tax aid resources are available in South Dakota for senior citizens and individuals with disabilities. These include potential exemptions on medical costs, property tax reductions, and other tax relief initiatives.

Program Name Phone Number Description
South Dakota Sales & Property Tax Refund for Senior & Disabled Citizens 800-829-9188 Residents of South Dakota may be eligible for sales and property tax refunds through the Department of Revenue. These refunds are determined by the applicant’s income.

Utility & Energy Bill Assistance

Organizations are available to aid low-income seniors in {} struggling with home maintenance costs, including utility and energy bills. Emergency funding may also be accessible for those at risk of utility service termination due to unpaid bills.

Program Name Phone Number Description
South Dakota Low Income Home Energy Assistance Program (LIHEAP) 605-773-3165 The South Dakota Low Income Home Energy Assistance Program offers financial aid for winter energy bills. Seniors must provide proof of income below the maximum limit and be responsible for heating costs. In 2023, single-person households with a maximum income of $6,795 qualify for LIHEAP. Payments are made directly to the heating company. The Energy Crisis Intervention Program provides immediate help for seniors at risk of disconnection.

Veteran’s Services

Veteran services in South Dakota offer invaluable assistance to retired military personnel. These local entities guide veterans in utilizing their rightful benefits and provide counsel on diverse matters.

Program Name Phone Number Description
South Dakota VA Benefits and Health Care South Dakota VA Benefits and Health Care offers VA claims assistance and benefits to senior veterans. Multiple veteran’s medical facilities provide health care services across the state, while vet centers in various South Dakota cities offer counseling and referral services. In case of an immediate crisis, veterans can dial 988 and press 1 for help. Additionally, South Dakota is home to three national cemeteries.

Assisted Living Laws and Regulations in South Dakota

Assisted Living Resident Agreement

A written service plan must be developed between the resident, the resident’s representative (if applicable) and the administrator or manager, prior to admission into any long-term care facility. There may be no misleading or confusing language in this agreement and it must be updated at move-in, 30 days after admission, and annually.

The comprehensive agreement must include:

  • A complete list of all services the facility will offer the resident, paid and unpaid, and the prices of these services
  • A description of how to the resident will protect their assets as well as a list of all local long-term care advocates and a description of how to file a complaints
  • A description of the facility bed policy, how long the resident plans to stay in the facility, and facility policies regarding move-outs
  • The rights and responsibilities of the resident and and family members in regards to medication arrangements
  • A list of all medical staff the resident has service agreements with and contact information for the resident’s physician.

Any resident with dementia or requiring skilled nursing may require no more than 8 hours of nursing care per day and all services needed and received must be documented in his or her resident agreement. Residents facing end of life that need hospice care must have a service agreement that is periodically reviewed by their physician.

Assisted Living Admission Requirements

There are seven types of long term care facilities in South Dakota, including assisted living centers. These are facilities that provide room, board, and personal care services to residents that live in the facility. Residents must not require steady nursing care and must meet a list of requirements prior to admission, such as:

  • Residents must be able to move without the assistance of mechanical lifts or more than one assistant. A special license is needed for a facility to care for someone who needs help in all activities of daily living (ADLs).
  • While residents may receive staff assistance with cues and supervision during meal times, they must be able to feed themselves.
  • All residents must be able to care for their own catheters, tracheostomies, or other specialized medical equipment, as well as complete their own required injections.
  • No resident may be in need of constant nursing care or medical supervision.
  • All residents must be free of infectious disease and have normal behaviors while in the residence; no behaviors are permitted than endanger other residents.

Assisted Living Scope of Care

There are four different categories of services offered to all residents in South Dakota’s assisted living centers:

  • Meal preparation
  • Personal care services
  • Homemaker services such as making the bed, assisting with self-care like grooming, and household cleaning chores.
  • Chore assistance for residents who need help doing their cleaning tasks

In addition, each care facility is required to provide access to staff and activities to support residents chosen hobbies and spiritual health.

Assisted living centers are able to request licensure to offer optional services. These optional services include medication and eating assistance as well as skilled nursing care not typically offered in an assisted living. Optional licensure is required to accept residents that are on oxygen, are diagnosed with dementia, have a physical impairment, or require 2 aides to assist with all of his or her activities of daily living.

Assisted Living Medicaid Policy

Medicaid is unable to pay for room and board for assisted living. It is possible to contract with outside medical groups to receive services while residing in assisted living, and a Home and Community Based Services (HCBS)/HOPE waiver might be available to help you or your loved ones pay for those services. To learn more about services that you might qualify for and find out about available waivers, call Dakota At Home at 1-833-663-9673.

Assisted Living Facility Requirements

Each bedroom in an assisted living center must provide at least 75 square feet of personal floor space aside from their bed as well as 37 square feet of available space within the facility for activities and recreation per resident. All bedrooms must have a bathroom with a toilet and a sink. You have the right to tour any facility before agreeing to move in, to ensure the facility provides all the services and amenities needed for you or your loved one.

Medication Management Regulations

Residents are able and encouraged to take their own medication whenever possible. To help a resident take medication, orally or otherwise, the assisting aide must have passed the required training. Medication plans are kept for residents; residents that self-administer medication need their plans reviewed every 3 months, while those receiving medication assistance are required to have monthly physician reviews.

Staffing Requirements

There must always be sufficient staff available to provide every resident with hygiene-related activities throughout the day, for at least 48 minutes each day per resident. Staff members on duty must always be awake.

Staff Training Requirements

All facilities must have a formal orientation and continuing education program that includes topics such as:

  • Care of residents and those with unique needs
  • Resident rights and confidentiality expectations
  • Nutrition and hydration importance in the elderly and best practices
  • Infection and disease prevention, including the flu, and safety protocol
  • Accident prevent, resident safety, fire control, and emergency procedures

Background Checks for Assisted Living

There are no background check requirements in the state of South Dakota for assisted living facilities staff. No administrator or operator may knowingly hire somebody with a conviction of abuse against any other person.

Requirements for Reporting Abuse

Residents must be allowed to express their grievances with any facility, fellow resident or staff member without fear of reprisal. Each care facility makes their own policies regarding complaints, and are expected to provide this policy to every incoming resident and their families.

You can file a complaint against a facility with the South Dakota Department of Health in writing, through e-mail or you can call (605) 773-3497. You can also reach out to your local or state Long-Term Care Ombudsman to request an investigation of a complaint against an assisted living center or staff member.

To report elder abuse in South Dakota, call your local law enforcement agency, or ADRC office.

South Dakota COVID-19 Rules for Assisted Living Facilities

Note: The following information was compiled and most recently updated on 2/13/22. Since COVID-19 is a rapidly evolving crisis, be sure to contact your assisted living facility or local Area Agency on Aging for the most up-to-date information.

COVID-19 Rules in South Dakota
Are loved ones allowed to visit residents in their assisted living community? Yes (Conditions Apply)
Are residents required to quarantine after their loved ones visit? No
Are loved ones required to wear masks when visiting residents? Yes
Are Hairdressers and other non-medical contractors allowed in assisted living communities? Yes
Are visitors screened for elevated temperatures before entering the assisted living community? Yes
Are residents allowed to leave the assisted living community for non-medical reasons? Yes
Are residents who leave required to quarantine when they get back to the assisted living community? No (Conditions Apply)
Are assisted living communities required to cancel all group outings? No
Are assisted living communities allowed to host group activities within the community? Yes (Conditions Apply)
Are staff members regularly checked for elevated temperatures? Yes
Are staff members regularly tested for COVID-19? Yes (Conditions Apply)
Are residents regularly screened for COVID-19 symptoms? Yes
Are residents regularly checked for elevated temperatures? Yes
Are residents regularly tested for COVID-19? Yes (Conditions Apply)



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