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Nursing Homes in South Dakota

South Dakota is a surprisingly age-friendly location for seniors who live in nursing homes or the greater community. Of the state's 884,659 residents, 17.2% are aged 65 or older, which is slightly more than the U.S. average, and the Census Bureau estimates that the over-60 demographic will exceed 27% of the population by 2030. Today, the state has 110 nursing homes, although demand for these facilities is likely to increase.

Access to healthcare services in South Dakota is somewhat limited due to the below-average number of physicians. However, the state has more than 60 hospitals, including the Avera McKennan Hospital and University Health Center in Sioux Falls. Another benefit is the state's affordable cost of living, which influences the price of long-term care.

Skilled nursing facilities are suitable for adults who have complex medical conditions or need specialized rehabilitative services. Individuals who are more mobile and independent may opt to receive similar care at home or in an assisted living facility. This guide details South Dakota's age-friendly amenities, the average cost of nursing home care and applicable rules and regulations. It also includes a directory of state and local agencies that provide free or low-cost services and financial assistance.


SeniorAdvice's Guide to Nursing Home Care in South Dakota



Older adults who are looking for a well-equipped retirement destination can turn to SeniorAdvice for detailed information. This exclusive livability index provides a snapshot of an area's overall quality of life based on more than 100 factors. South Dakota earned a SeniorScore of 71, which is just one point shy of the national average. Ratings for the state's most populous cities range from a 71 in Rapid City to 77 in Sioux Falls.

The state received its best rating for Finances with 74 points. Property, sales and income tax rates were considered along with per capita and household income and average senior care prices. The low cost of living and the lack of state income tax both work in seniors' favor. General Quality of Life received a positive rating of 62. The state has 28 urban areas and plenty of wide open space with just 85 people per square mile. However, the climate can be harsh for older adults, with an average low temperature of just 32.8 degrees.

Ratings for Health & Safety and Recreation & Leisure were tied with 58 points each. Favorable rating criteria includes a larger-than-average population of older adults and a high number of local parks. The state also has more than 80 golf courses and approximately 790 churches and religious institutions. South Dakota residents live longer than the typical American, although the state only has an average number of hospitals, home health care workers and nursing homes.



Top Nursing Care in South Dakota




 
 

The Cost of Nursing Home Care in South Dakota



Seniors in South Dakota are in a good position when it comes to accessing affordable long-term care. Nursing homes in the state charge $7,011 per month, which is about 10% lower than the national average. Nebraska's rates are similar at $7,194. Seniors in Wyoming pay $1,247 more per month, and rates are well above the national average in Minnesota ($11,026) and North Dakota ($12,167).

  • South Dakota: $7,011
  • United States: $7,756
  • North Dakota: $12,167
  • Nebraska: $7,194
  • Minnesota: $11,026
  • Wyoming: $8,258

The Cost of Nursing Home Care in South Dakota's Top Cities

Nursing home prices are slightly higher than the state median in South Dakota's most populous cities. Seniors in Sioux Falls pay $7,650 per month, and nursing home prices in Rapid City are $441 higher than the statewide average at $7,452. Rates in Fargo in neighboring North Dakota are considerably higher at $10,942, while the average cost in Sioux City, Iowa is significantly lower at $6,509 per month. 

  • Rapid City: $7,452
  • Sioux Falls: $7,650
  • Fargo, ND: $10,942
  • Sioux City, IA $6,509

Senior Care Cost Comparison in South Dakota

With an average cost of $7,011 per month, skilled nursing is the most expensive form of long-term care in South Dakota. Home health care costs $5,529, and nonmedical in-home care costs $5,339. Memory care and assisted living are $2,463 and $3,373 cheaper per month, respectively. The least expensive option is adult day care received in a community setting for approximately $1,647 per month.

  • Memory Care: $4,548
  • Assisted Living: $3,638
  • In-Home Care: $5,339
  • Home Health Care: $5,529
  • Adult Day Care: $1,647
  • Nursing Home Care: $7,011

Financial Assistance for Nursing Home Care in South Dakota



As you can see above, Nursing Home Care is often the most expensive senior care option – sometimes even 2-3 times the cost of other types of senior living. The primary reason for this is the 24/7 skilled nursing and other medical services that are provided. Thankfully, most people aren't forced to pay for skilled nursing care entirely out-of-pocket. Rather, many qualify for financial assistance programs to help cover the cost of nursing care.

Medicaid is the most comprehensive financial assistance program – but, not all seniors are eligible for Medicaid. And because each state operates its own Medicaid program within federal guidelines, eligibility and benefits vary from state to state. Below, we provide more information on Medicaid in South Dakota.



Medicaid in South Dakota


Although South Dakota is one of the few states that hasn't expanded Medicaid eligibility since 2013, this program still covers 123,964 adults and children, or about 14% of the population. Medicaid provides health and long-term care benefits to 50% of the state's 5,580 nursing home residents. Medicaid is accepted by the majority of the state's 110 licensed nursing facilities, and about 40% of the state's $874.8 million Medicaid budget goes toward long-term care. Skilled nursing may also be covered by Medicaid waivers, such as the HOPE program.

Medicaid Eligibility in South Dakota

Medicaid is a needs-based program sponsored by the state and federal governments. Applicants must meet specific income and asset limits to qualify, and individuals who are requesting long-term services and supports must require a nursing home level of care. Families can learn more about these requirements below.

  • Individuals who require a nursing home level of care can earn up to $2,382 per month or 300% of the federal SSI benefit rate and still qualify for Medicaid. This limit is three times higher than regular Medicaid and programs for the Aged, Blind and Disabled.
  • Single applicants are limited to $2,000 worth of assets, while couples may have up to $3,000.
  • A spouse who's not applying for Medicaid can retain up to $130,380 in nonexempt assets. The nonapplicant may also be entitled to claim a portion of their partner's income as a minimum monthly maintenance needs allowance.
  • South Dakota provides exceptions for many assets, including personal belongings, prepaid funeral expenses, a vehicle and a primary home valued at up to $595,000.
  • Individuals must live in South Dakota and provide proof of U.S. citizenship or legal residency. This includes nationals, permanent residents and legal aliens.

South Dakota provides several application options for Medicaid. Seniors can apply online or send a paper application for long-term care benefits to their local Department of Social Services office by fax or mail or deliver it by hand. For assistance with the application process, seniors can call (800) 3050-3064 or reach out to their local DSS office.



Additional Financial Assistance Options


  • Medicare: For the first 20 days in a skilled nursing facility, Medicare will cover the entire cost of care, and a portion of the costs up until day 100. After 100 days, Medicare won't cover any of the costs. Importantly, seniors must also have a "qualifying hospital stay" that lasts 3 days prior to their admission to a nursing home in order to qualify for Medicare coverage.
  • Aid and Attendance: Aid and Attendance may be available to veterans who receive a VA pension. This benefit is a monthly cash allowance that veterans receive in addition to their standard pension amount. It is intended for veterans in need of long-term care services and may be used to pay for skilled nursing care.
  • Reverse Mortgages: For those who own a home, reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. It's often a good fit for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Keep in mind that reverse mortgage loans do need to be repaid (with interest), typically within 12 months of receiving the loan.
  • Long-Term Care Insurance: For seniors who already have long-term care insurance, the cost of skilled nursing care may be covered. Most policies cover at least a portion of the costs, but it depends on the specific policy terms. It's important to note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a long-term care insurance policy.

South Dakota Nursing Home Care Rules and Regulations



Nursing homes in South Dakota are licensed by the Office of Health Facilities Licensure & Certification, which is part of the Department of Health. It inspects facilities, enforces regulations and ensures that long-term care providers meet quality standards established by Medicare and Medicaid.

Scope of Care

Skilled nursing facilities provide an array of services to help residents achieve their optimal functional capacity. Services may be provided by physicians, physician's assistants, nurse practitioners, licensed or registered nurses and certified nursing aides. Nursing homes provide social and spiritual care and rehabilitative services, such as physical and occupational therapy, and they must appoint qualified staff members to develop recreational activities and suitable nutritional programs.

Care Planning

Nursing facilities must maintain a current plan of care in each resident's medical record. This document must detail all services needed to maintain the resident's physical and mental health as well as their emotional well-being. A comprehensive physical exam must be performed within 48 hours of admission, and follow-up exams are required every 30 days for the first 90 days and every 60 days thereafter. The plan of care must be developed within seven days of the initial assessment.

Pharmacy Services

Nursing homes may manage a full- or part-time pharmacy that's staffed by a licensed pharmacist. Facilities must establish and follow formal policies and procedures for securing medication orders and storing, dispensing and labeling prescription drugs. Medication records must be maintained for each resident and reviewed periodically.

Staff Screening

Nursing homes must check new employees for tuberculosis within 14 days of hiring and follow other risk management guidelines recommended by the CDC. The state doesn't have criminal background check or fingerprinting requirements for direct-care staff.

Staff Training

To become certified, nurse aides must complete a 75-hour state-approved training course, including at least 16 hours of hands-on work experience, and they must pass a two-part competency exam. Nursing facilities must develop a formal orientation program and provide ongoing in-service training for all personnel. These courses must cover a variety of topics, such as fire prevention and response, elder abuse, resident rights and infection control.

Medicaid Coverage

South Dakota's Medicaid program covers the cost of nursing home services for adults who meet income and asset limits and require an institutional level of care. Applicants may be required to put all of their income toward the cost of their care, minus a $60 monthly personal needs allowance.

Reporting Abuse

Reports of abuse or concerns about the care provided in a nursing home should be reported to the Office of Health Care Facilities Licensure & Certification's complaint coordinator. Complaints can be made online, by email, phone or by mailing a written description of the incident to the Department of Health at 615 E. 4th St., Pierre, SD 57501. Instances of suspected abuse must be reported within 24 hours, and facilities must submit a written report to the agency within five business days.


Free Nursing Home Resources in South Dakota



South Dakota Health Care Association

The SDHCA is affiliated with the National Center for Assisted Living and the American Health Care Association, the nation's largest organization for long-term care professionals. It provides training, administers CNAs exams and engages in legislative advocacy. Its Care Conversations program helps families plan for the future and navigate challenging health care decisions. Centenarians can join the organization's Century Club, and artists over age 60 can participate in the annual MasterWorks Art Show.

Senior Legal Service Programs

South Dakota seniors aged 60 and older are entitled to free legal services thanks to funding from the Older Americans Act. Services are provided by East River Legal Services, which works with clients in 33 eastern counties, and Dakota Plains Legal Services, which serves clients in the western part of the state. Pro bono advocates can help with government benefits, estate planning, nursing home admissions, insurance issues and many other concerns.

Dakota at Home

Dakota at Home is the state's Aging and Disability Resource Center. It offers options counseling for long-term care, and it provides free consultations online and over the phone to connect residents to local services that can help them live safely in the community. Services are available to South Dakota residents of all ages, and there are no income limits. It also maintains a county-by-county resource directory.

Coalition on Aging

Based in Sioux Falls, the Coalition on Aging educates members of the community and connects residents to resources that promote healthy, independent living. It provides consumer guides to help residents understand institutional and community-based long-term care alternatives, and it offers information to assist with advance planning. Free informational services are available to seniors, caregivers and their families.



South Dakota Agencies


Department of Human Services Division of Long Term Services & Supports

Address: 3800 E. Hwy 34, c/o 500 E. Capitol Ave., Hillsview Plaza, Pierre, SD 57501
Phone Number: (866) 854-5465
Website: https://dhs.sd.gov/ltss/default.aspx

The South Dakota Division of Long Term Services & Supports funds a wide variety of programs that help disabled adults and seniors aged 60 and older lead safer and more meaningful lives while delaying the need for institutionalization. Seniors can turn to this agency for information about long-term care options, facility licensing, Medicaid waivers and health insurance counseling. Its Long-Term Care Ombudsman Program represents the state's nursing home residents and supports those who are seeking admission.



Area Agencies on Aging in South Dakota


The Division of Long Term Services & Supports operates 21 regional field offices that serve as Area Agencies on Aging in designated counties. These agencies coordinate home- and community-based services at the local level, including nutrition programs, transportation, personal care and caregiver supports. Seniors can also contact their local office to reach the long-term care ombudsman or to report health or safety concerns to Adult Protective Services. The Department of Human Services maintains a downloadable directory of LTSS field offices on its website.



Veteran Affairs Office in South Dakota


The South Dakota Department of Veterans Affairs operates benefits offices in all 66 counties plus several tribal areas. Service officers provide individualized consultations to help veterans and their dependents or survivors navigate complex bureaucratic systems and recover all available benefits. Officers also assist with claims for medical care and government benefits such as Social Security. They can help seniors access long-term care through one of the state's veterans homes, and they even help with final arrangements. The SDDVA provides a complete list of VSO locations on its website.



Social Security Offices in South Dakota


The Social Security Administration manages several important benefits programs for retirees and working-age adults. It handles claims for retirement benefits, Social Security Disability Insurance and Supplemental Security Income. The SSA is also responsible for handling Medicare enrollment and collecting premiums, and it can help low- and moderate-income seniors claim Medicare Extra Help benefits for prescription drugs, which are valued at $5,000 per year. South Dakota seniors can visit SSA.gov to find their local office. Many benefits-related tasks can be completed online.

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