“Assisted living centers” in South Dakota offer room and board with personal and health care services. Memory care, which is assisted living for people with dementia, is called “secured units” in assisted living centers, and must be designed by the state’s Department of Health as a safe space that promotes independence while allowing people to do as much as they are physically capable of. Other rules for memory care include:
– Programming that is therapeutic must be provided.
– Confinement is not allowed.
– Staff must have training specific to the needs of residents.
A physician’s services must be available to every resident in an assisted living center, but someone who needs full-time nursing care should not be admitted. The amount of nursing care allowed is less than eight hours per day.
The average cost of assisted living with memory care in South Dakota is $4,587 per month, which breaks down to about $150 per day and $55,044 annually. Regulations do not require assisted living centers in South Dakota to provide potential residents with a list of costs, so it’s important you ask for this in writing, to file in case of unexpected charges. Assisted living, without the additional services required for memory care, costs South Dakotans about $3,505 per month and $42,060 annually.
The state’s largest city is Sioux Falls, where memory care costs about $4,387 per month and $52,644 per year. Sioux Falls is also the least-expensive city for memory care. The most expensive place for memory care in South Dakota is Rapid City, where costs are about $5,185 per month and $62,220 annually.
A doctor’s note is required to move into assisted living, including memory care, in South Dakota. Written evidence from a healthcare professional must verify that the new resident doesn’t have communicable disease, a chronic illness, or a disability beyond what the residence is able to handle. A person moving in must be able to carry out normal activities of daily living (ADLs), like eating and grooming, with hands-on physical assistance. Additionally, new residents must be able to:
– Turn in bed and raise from a chair or bed without assistance or with the help of just one staff member.
– Get in and out of bed and chairs with help from only one staff member and without mechanical assistance.
– Complete ADLs including dressing, toileting, grooming and bathing with help from only one staff member.
– Feed self with help of just one staff member.
– Manage personal ostomy or catheter.
– Behave without putting self or others in danger.
Within 30 days of admission, every resident must be assessed for needs, and the assessment must be renewed annually. The state’s Department of Health must approve the assessment checklist, which needs to include the following:
– Nursing care needs
– Medication needs
– Ability to perform ADLs
– Ability to perform IADLs
– Mental health status
– Ability to walk or move from room to room
– Dietary needs
Private units or bedrooms in assisted living in South Dakota must be at least 120 square feet for one person or 200 square feet for two people. Two people is the maximum allowed in a living unit. There must be at least one bathroom for every two resident units. Memory care in assisted living for people with dementia must be located on the ground floor, and must have access to a secure outside area.
Staffing must at all times be adequate to serve the needs of residents, including someone awake and on duty throughout the night. Regulations say a minimum of 0.8 hours of direct care from staff must be available to each resident every 24 hours. A licensed administrator must be hired at every residence for overall management, with experience and education that are approved by the Department of Health. Ongoing education for all members of staff in memory care must include:
– Fire prevention and response
– Emergency preparedness and response
– Infection control and prevention
– Safety and accident prevention
– Resident rights
– Confidentiality of residents’ information
– Reporting of certain diseases and incidents
– Nutrition and hydration needs
– Caring for residents with dementia
The HOPE waiver is also called the Home and Community Based Services waiver, or the Elderly Waiver, available through South Dakota Medicaid. This program was designed to lower the number of people who needed to move out of their homes or assisted living into more expensive nursing-home care. Medicaid funds cannot pay for room-and-board costs of assisted living (including memory care), but expenses associated with getting help for activities of daily living (ADLs), private nursing care, and medical devices all may be covered. Recipients must be Medicaid-eligible, including income under $2,349 per month. For more information on HOPE, click here. To apply, visit your local Long Term Services and Supports office.
Veterans are statistically more likely to develop dementia. Relevant in all states including South Dakota is the VA’s Aid & Attendance pension program for veterans and surviving spouses, which is money added to veterans’ and survivors’ basic pensions. Applicants must be at least 65 years old (or disabled) and require assistance with activities of daily living (ADLs) like eating, bathing, and mobility. The cash assistance from these pensions can be used as the recipient wishes, meaning it can go toward the cost of memory care. In addition, the cost of residential care can be deducted from income, effectively reducing the amount of calculable income used to determine the benefit amount. The latest (2020) maximum amount a veteran can receive through A&A is $27,194 per year, and surviving spouses can receive $14,761. Learn more here.
There is a single veterans’ home in South Dakota located in Hot Springs about one hour from Rapid City. Veterans residing in Eastern SD, may be better served by crossing the state border with Minnesota. In addition to nursing home care, assisted living and memory care may be provided in veterans’ homes. Payment is made directly from the VA to the facility. State veterans’ homes are typically reserved for veterans whose need for care stems at least 70 percent from their service. Veterans’ home often have wait lists and how prioritization works for those wait lists in not clear. It is best to contact the veterans’ home directly and inquire about prioritization and availability.
Other ways to help pay for memory care include tax credits and deductions like the Credit for the Elderly and the Disabled, or the Child and Dependent Care Credit (if you claim your elderly loved one as a dependent). Remember also that medical and dental expenses can be deducted, and that might include some assisted living costs.
A reverse mortgage may be a good option for a married person moving into memory care, if their spouse continues to live in the home. Should the spouse move, the reverse mortgage would become due.
Elder care loans are for families to cover costs of moving into memory care, if you need a little help at first but can afford costs after the initial payments. For example, if one is waiting for a VA pension to be approved or waiting to sell a home.