South Dakota Residential Alzheimer’s Care (Memory Care): Laws, Costs & Financial Help

Last Updated: March 30, 2024


In South Dakota, residences that offer room and board with personal and health care services are called assisted living centers. Memory care, which is assisted living for people with dementia, is called secured units in assisted living centers. It must be designated by the state’s Department of Health as a safe space that promotes independence while allowing people to do as much as they physically can. Other rules for memory care include:

– Beneficial Therapies must be provided.

– Confinement is not allowed.

– Staff must have training specific to the needs of residents.

A physician’s services must be available for every resident to receive medical care 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.

There are approximately 20 memory care homes in South Dakota. The Office of Healthcare Facilities, under the umbrella of the state’s Department of Health, regulates assisted living in South Dakota. For free help finding memory care there to meet your family’s needs and budget, click here.

 Did You Know? South Dakota ranks in the Top 10 for percentage of senior citizens with Alzheimer’s. About 13% of people there over 65 have the disease, and the number of South Dakotans with Alzheimer’s is expected to increase from about 18,000 in 2020 to 20,000 in 2025.


How Much Does Memory Care Cost in South Dakota?

The average cost of assisted living with memory care in South Dakota is $4,373 per month in 2024. The national average is $5,884 per month, making South Dakota one of the more affordable states for memory care.

In Sioux Falls memory care costs $4,455 per month. Sioux Falls is also the least expensive city in the state for memory care. The most expensive place for memory care is Rapid City, where it costs $5,128 per month. Costs are generally slightly higher in the western Black Hills and Badlands region of South Dakota than in the eastern lakes and prairie areas. Areas including the Cheyenne River and Crow Creek reservations that make up much of the middle of South Dakota have few options for state-sanctioned memory care.

 In South Dakota, free assistance is available to help families locate a memory care home to meet their needs and budgets. Get help here.

South Dakotans who live near the border of a neighboring state might be able to find more convenient and affordable memory care outside the state. The average costs in these surrounding states are higher but they can have more options. South Dakota’s average monthly costs are more affordable than western neighbors. In Montana, it costs $5,804 monthly and Wyoming will run $5,446. To the south, Nebraska’s memory care costs $5,327, and in Minnesota, it is $5,884 monthly. Finally, to the east, in North Dakota facilities average $4,413 monthly.


South Dakota Assisted Living Laws & Regulations

 COVID-19 Measures (updated Oct. 2022)
The additional measures left due to Covid are:
Residents- Their temperatures are checked and patients are also tested regularly.
Visitors- Can visit loved ones, must wear a mask, and temperature is checked upon entry.
Staff- Have temperatures checked upon entry and are regularly tested.

Admissions Process & Requirements

A doctor’s note is required to move into all assisted living in South Dakota. The note is evidence that the new resident doesn’t have a communicable disease, a chronic illness, or a disability beyond what the facility can handle. This could be your doctor or a medical professional who works for the residence. To move in a patient must be able to carry out normal activities of daily living, like eating and bathing, 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 activities of daily living like dressing, toileting, grooming, and bathing with help from only one staff member.

– Eat with help of just one staff member.

– Manage personal ostomy or catheter.

– Behave without putting themselves or others in danger.

Within 30 days of admission, every resident must be assessed for needs by a medical professional who works for the memory care community. The assessment must be renewed annually. The state’s Department of Health approves the assessment checklist, which includes:

– Nursing care needs

– Medication needs

– Ability to perform activities of daily living

– Ability to perform instrumental activities of daily living

– Mental health status

– Ability to walk or move from room to room

– Dietary needs

The cost of assessment might be included with the base rate, or the residence can charge a one-time community fee when your loved one moves in. Community fees cover move-in costs including the assessments and deep cleaning and painting of a new resident’s room. They usually run between $1,500 and $2,500.

Regulations in South Dakota do not require that someone has a diagnosis of dementia before moving into memory care. Alzheimer’s and related diseases including vascular, frontotemporal, and Lewy body dementias are difficult to diagnose, as symptoms change and vary. Expensive tests like PET brain scans are usually required for an accurate diagnosis, but this step is unnecessary because memory care staff should be trained to handle your loved one no matter their specific type of dementia.

And while it might be possible for someone to move into memory care in South Dakota on short notice, this is not a good idea. Finding the right home takes months of investigating residences and asking questions of staff and others who live there. Ideally, you would begin searching for memory care before a move becomes necessary. The sooner you begin investigating options, the more input the person with dementia can have on the decision.


Facility / Residence

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 are 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.

Unlike many other states, there is no legal requirement in South Dakota that memory care residences be designed with dementia-friendly features. A community for people with Alzheimer’s and related diseases should have bright lights and paint colors, an easy-to-navigate layout, and other physical elements that studies have shown are beneficial for those with memory loss. Because it’s not required, however, you’ll want to inspect residences you are considering whether your loved one will be comfortable within the spaces.


Staff & Training

Staffing must be adequate to serve the needs of all 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 the 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


Evictions & Discharges

Someone cannot be evicted from memory care in South Dakota unless their “needs and welfare” cannot be met. Since this is not specific, it gives each facility the ability to have its guidelines. Like in other states, if your loved one develops specific medical needs that staff is not trained to deal with, then an eviction would be necessary. An example of this would be if intravenous feeding becomes necessary, or if your loved one loses the ability to walk and staff is not trained to help non-ambulatory residents.

But what if a person becomes aggressive, or uses abusive language? Is there a stage of dementia that residence staff cannot handle? Every residence defines its own stricter guidelines on the process of evicting. Before agreeing to a move-in contract, it’s very important to be clear on that process, because unfair discharges can be a problem in assisted living throughout the country. Can someone be evicted for nonpayment or late payment of bills? Does the home help find a new place to live that’s appropriate? These are questions to ask early in the process and get the answers in writing. Ideally, there will be 30 days’ notice and a way to appeal the eviction. If your loved one in South Dakota memory care has received an eviction notice and you need to know the next steps, click here.


Financial Assistance for Residential Alzheimer’s Memory Care

HOPE Medicaid Waiver

The Home and Community-Based Options and Person-Centered Excellence 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 long-term care services like activities of daily living, private nursing, and medical devices can be covered. Recipients must be Medicaid-eligible, which includes income under $2,829 per month in 2024, countable assets less than $2,000, and a documented medical need for a nursing home level of care. For more information on HOPE, click here. There can be a waitlist for HOPE because the program only accepts 2,840 enrollees annually. To apply, visit your local Long Term Services and Supports office. Information about Medicaid’s eligibility requirements in South Dakota can be found here. To see if your loved one qualifies for the program, take a fast Medicaid eligibility test here.


Personal Care Services (PCS)

The Personal Care Services is a program in the Regular Medicaid that supports independent living. Through providing additional care benefits, PCS is designed to eliminate the need to move into a nursing home. Benefits are based on an individual’s care needs and can include assistance with activities of daily living, skilled nursing, medication management, and household help. Enrollees can receive a maximum of 200 hours of care annually. Medicaid eligibility requirements in South Dakota are strict. In 2024, for a single person that means income under $943 monthly, countable assets under $2,000, and a documented medical need for assistance with activities of daily living. For more information, even though it is not meant for consumer use, click here. Apply at your nearest Department of Social Services or by calling (833) 663-9673. Information about Medicaid’s eligibility requirements in South Dakota can be found here. To see if your loved one qualifies for the program, take a fast Medicaid eligibility test here.


Veterans Affairs (VA)

Veterans are statistically more likely to develop dementia. Among the reasons for this is that traumatic brain injuries and posttraumatic stress disorder lead to a higher probability of developing the condition. The VA offers many benefits for Alzheimer’s and dementia and different pension types.


VA Pensions

There are three types of VA Pensions available. The benefits change annually and are valid from December 2023 to December 2024. The benefits (and their maximum allowance) are as follows:

1) Basic Pension – This benefit is also known as a death pension. It is for veterans and surviving spouses who are aged or disabled. The qualifying disability does not need to be related to their military service. On an annual basis, the Basic Pension pays:

– Veterans without spouses or children up to $16,551

– Veterans with dependent spouses or children up to $21,674

– Surviving spouses without dependent children up to $11,102

2) Aid & Attendance – Abbreviated as A&A, this is an important program for veterans and their surviving spouses who require assistance with activities of daily living. This means they need assistance with activities like bathing, dressing, and eating. A&A is particularly helpful for people with dementia, especially in the middle and later stages of the disease, when the need for more assistance becomes necessary. A&A is intended to help with the long-term care costs of adult day care, in-home care, assisted living, memory care, and skilled nursing. Based on an individual’s need and the progression of the disease, most of these additional services that support your loved one will become necessary. Annually, the A&A pays:

– Veterans without spouses or children a maximum of $27,609

– Veterans with dependent spouses or children a maximum of $32,729

– Surviving spouses without dependent children a maximum of $17,743

3) Housebound – For veterans and surviving spouses who are permanently disabled and unable to leave their homes, making them require additional assistance. The definition of “home” can include assisted living, memory care, and nursing home. The Housebound pension, like the A&A pension, is meant to help cover long-term care costs. Annually, the Housebound pays:

– Veterans without spouses or children a maximum of $20,226

– Veterans with dependent spouses or children a maximum of $25,348

– Surviving spouses without dependent children a maximum of $13,568

 More information on VA Pensions’ eligibility criteria, payment rates, and the application process are available here.

Veterans Homes

Veterans with dementia might also look into living in a veterans’ home. In addition to nursing care and assisted living, memory care is often provided in veterans’ homes. There is one veterans’ home in South Dakota. The Michael J. Fitzmaurice State Veterans Home is 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, as there are veterans’ homes in Luverne and Fergus Falls, both quite close to South Dakota. In addition to nursing home care and assisted living, memory care is provided. This is a facility that provides long-term residential care for veterans. Neighboring states also have veterans’ homes. Your loved one might consider looking there for more options as there are no requirements that one must live in the state. For example, Minnesota has five veterans’ homes statewide. Additionally, Nebraska has four homes, Montana has three facilities and North Dakota has one. More info.


Other Options

1) Eldercare loans exist for families to cover the costs of moving into memory care while waiting for other financial resources to become available. For example, if one is waiting for a VA pension to be approved or waiting to sell a home. More on bridge loans for memory care.

2) Tax credits and deductions like the Credit for the Elderly and the Disabled, or the Child and Dependent Care Credit (if you can claim your elderly loved one as a dependent). Remember also that medical and dental expenses can be deducted, and that can include assisted living costs.

3) A reverse mortgage can be an option for a married person moving into memory care, if their spouse continues to live in the home. However, if the spouse moves from their home, the reverse mortgage becomes due.