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Memory Care in South Dakota
Of the almost 900,000 people who call South Dakota home, more than 17% are aged 65 and older. With this large senior population, memory-related conditions are a growing concern in South Dakota. It’s estimated that the number of older adults with Alzheimer’s disease will increase by 11.1% between 2020 and 2025 to 20,000 people. It’s also the fifth leading cause of death in the state, with 495 deaths attributed to the condition in 2019.
South Dakota offers a number of benefits for people living with Alzheimer’s and other forms of dementia. The cost of memory care in the state is low, averaging just $4,188 per month. Affordable care, coupled with a low cost of living and a retirement-friendly tax system, means that retirement savings will last longer in South Dakota. Quality hospitals can provide care when needed and there are specialty centers, such as Sanford Neurology Clinic, for those with Alzheimer’s disease.
Memory care can either be offered on its own in a community designed especially for those with dementia or Alzheimer’s, or, more often, it’s provided as a service in a separate wing of an assisted living facility. Memory care programs are designed specifically for those with memory impairment, and the facilities often coordinate social activities and schedules specifically for the needs of those living with Alzheimer’s or dementia.
This guide has information about the cost of memory care in South Dakota, along with the cost of other senior living options in the state. It also contains an overview of financial assistance available, rules and regulations governing memory care and resources that can help you as you age.
The Cost of Memory Care in South Dakota
When trying to decide how to pay for memory care, one of the first questions that comes up is "How much does it cost?" With the impact of inflation, it's more important than ever to have up-to-date information when making a financial plan for senior living. To help shed light on real senior living prices, Caring.com has compiled proprietary cost data from its network of over 75,000 senior living providers to offer insight into the average cost of memory care in South Dakota and its 1 cities.
The Cost of Memory Care in South Dakota's Top Cities
South Dakota has relatively few cities, but costs vary throughout the region. While the state average memory care cost is $5,350 a month, Sioux Falls seniors pay an average of $4,832. Kansas City, KS, seniors also pay $4,832 a month, while costs in Omaha, NE, average $5,998. Des Moines, IA, stands out among these cities for cost. Memory care in Iowa's capital city averages $8,550 a month.
South Dakota
$5,350
Sioux Falls
$4,832
Omaha, NE
$5,998
Kansas City, KS
$4,832
Des Moines, IA
$8,550
Inflation's Impact on the Cost of Memory Care in South Dakota
Memory care has gotten more expensive in South Dakota, partly due to recent inflation. From 2022-2024, prices have risen from $5,394 to a projected $5,635 a month in 2024. This is a modest 4%, relative to the national 19% increase during the same period, from $4,863 to $5,792. Some states have seen very small increases, such as Montana, where costs rose from $6,033 to $6,200 (3%) by 2024. North Dakota is an exception, at 79%, or from $3,641 to $6,510. Idaho and Nebraska both increased by less, 21% and 23%, respectively.
| Location | 2022 Cost (Historical) | 2023 Cost (Current) | 2024 Cost (Estimated) |
|---|---|---|---|
| South Dakota | $5,394 | $5,350 | $5,635 |
| U.S. Average | $4,863 | $5,369 | $5,792 |
| North Dakota | $3,641 | $5,899 | $6,510 |
| Montana | $6,033 | $5,822 | $6,200 |
| Idaho | $4,255 | $5,170 | $5,151 |
| Nebraska | $5,594 | $5,997 | $6,914 |
The Costs of Other Types of Senior Living
Memory care is just one of several options seniors in South Dakota have. Memory care's $5,350 a month average is more than $950 higher than assisted living ($4,443) and far above the cost of independent living ($2,652).
Assisted Living
$4,443
Memory Care
$5,350
Independent Living
$2,652
Does Medicaid Cover Memory Care in South Dakota?
Note: For the purposes of this guide, when we say “Memory Care” we are referring to memory care provided in a “social setting,” such as an Assisted Living Facility. This is the most common way to receive Memory Care and is the best fit for all but the frailest seniors. Sometimes the actual service of memory care can be provided in a Nursing Home (“medical setting”), so the financial assistance options will be very different. To learn more about the financial assistance options available for memory care provided in a nursing home, read our guide to Nursing Home Care in South Dakota.
In South Dakota, Medicaid doesn’t cover memory care directly. However, it offers a waiver program that can be used to provide memory care in assisted living environments. This is known as the HOPE Waiver, which stands for Home and Community-Based Options and Person Centered Excellence Waiver.
The HOPE Waiver is designed to help people stay living at home or in the community and covers a range of services to achieve this goal. The primary benefit provided is assistance with activities of daily living, however recipients can also receive homemaker support, delivered meals and home modifications. Not all benefits are available in all living settings.
What Memory Care Services Are Covered by Medicaid in South Dakota?
In South Dakota, the waiver program pays for memory care and other services provided in an assisted living setting. The exact services a recipient can access is based on their personalized care plan and are bundled into the assisted living category. For example, a recipient residing in a memory care community can’t receive separate homemaker, personal care or chore services because these are all covered under assisted living.
Memory Care Waiver Programs in South Dakota
Home and Community-Based Options and Person Centered Excellence Waiver
The HOPE Waiver was previously known as the HCBS Waiver or Elderly Waiver. It’s designed to help people stay living in the community even if they need a nursing home level of care. In addition to requiring a high level of care, applicants must be aged 65 or older, or aged 18 or over and have a qualifying disability. Participants must also meet the program’s financial eligibility criteria.
All applicants must complete a needs assessment to determine the care they require through the program. Recipients must also receive one or more waiver services at least once per month.
The program has a wide range of services available for eligible seniors, including personal care, meal preparation, chore services, social and recreational programming and medication assistance. The waiver doesn’t cover 24-hour skilled care, room and board or items of comfort or convenience. In general, the amount covered is no greater than the average cost of nursing home care, but there’s an exceptions process that may provide additional funds.
The HOPE Waiver program has an enrollment cap. Applicants may be able to go on a waiting list, but this isn’t always the case in South Dakota. For more information, or to apply for the program, contact your local Department of Social Services office or the Dakota at Home resource center at (833) 663-9673.
How to Know if You’re Eligible for Medicaid in South Dakota
Medicaid eligibility in South Dakota is based on a number of factors, including your age, income, assets and disability status. The exact eligibility requirements differ depending on your circumstances, but those applying for the HOPE Waiver must be:
- A South Dakota resident
- A U.S. national, citizen, permanent resident or legal alien
- Aged 65 and older, or aged 18 and older with a qualifying disability
- Assessed as needing a nursing home level of care
- Under the income limit of $32,904 per year for singles and $65,808 for married couples who are both applying
- Under the asset limit of $2,000 for singles or $3,000 for married couples who are both applying
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | $148,620 |
| Two People | 2 | $65,808*** | $3,000 |
* Depending on the facility setting, a recipient may not be able to keep income up to this level.
** Income limit is for applicant only.
*** Income is limited to $2,742 per month per spouse.
Not all assets are counted when calculating Medicaid eligibility. Personal belongings, an automobile and certain burial trusts aren’t included. In addition, a person’s primary home isn’t counted if they intend to return, or if their spouse still lives there. When only one spouse applies for Medicaid, the non-applicant spouse may also be eligible for the Minimum Monthly Maintenance Needs Allowance. This allows them to keep part of the applicant’s income to ensure they can meet their needs.
How to Apply for Medicaid in South Dakota
You can apply for Medicaid in South Dakota by submitting a completed application by mail, fax or in person to a local Department of Social Services office. Application forms can be downloaded from the website or requested from a local office. Currently, there’s no online application process for long-term care programs.
Information You Will Need
The Department of Social Services requires documentation to assess your application. The exact type differs based on your circumstances, but you generally need proof of:
- Identity and date of birth
- Citizenship
- Income
- Assets, such as insurance, burial accounts or trusts
- Housing costs
- Existing health insurance, such as a Medicare card
How to Get Help Applying for Medicaid
Local offices of the Department of Social Services are the primary source of assistance for people applying for Medicaid in South Dakota. The department also has a website that can answer common questions and the state-run Senior Health Information and Insurance Education may also be able to provide assistance.
| Program | Contact | Services provided |
|---|---|---|
| Department of Social Services local offices | (605) 773-4678 | Local offices of the Department of Social Services handle Medicaid applications and are able to answer questions about the process. Team members can also help you complete an application. Although interviews aren’t required to apply for Medicaid in South Dakota, you can request one through your local office if you feel it will make the application process easier. |
| Department of Social Services website | Online | The Department of Social Services’ Medicaid website has detailed information about the program and how to apply. This includes frequently asked questions that can help you determine your eligibility and understand your benefits and responsibilities. |
| Senior Health Information and Insurance Education | Local phone numbers available online | SHIINE provides counseling and education about health insurance to people over age 65 in South Dakota. Although the program is designed to help people navigate the Medicare program, counselors may be able to provide assistance with other health insurance programs, such as Medicaid. |
Does Medicare Cover Memory Care in South Dakota?
The short answer is that no, Medicare does not cover the cost of memory care in South Dakota. As was mentioned above, this doesn’t apply to Memory Care received in a Nursing Home. Since it is the most common to receive memory care in a “social setting” (such as an assisted living facility), Medicare won’t be a viable financial assistance option for most seniors who need Memory Care. However, Medicare will still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.
For more information about when Medicare can be used to pay for Memory Care in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in South Dakota.
Other Financial Assistance Options for Memory Care in South Dakota
Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Memory Care affordable.
| Name | How To Apply | How It Works |
|---|---|---|
| Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Memory Care. |
| Reverse Mortgages | Learn more about your options and how to apply at ftc.gov | If you own a home, you may be able to use a reverse mortgage to help pay for Memory Care. 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. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
| Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be able to use it to pay for Memory Care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Memory Care will not typically be eligible to sign up for a LTC insurance policy. |
Free and Low-Cost Resources for Seniors in South Dakota
There are many resources in South Dakota that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| South Dakota Area Agencies on Aging | South Dakota's Area Agencies on Aging offer vital programs to help older adults live quality lives at home. Services include adult day care, hot, nutritious meals delivered or available at day programs and homemaker services that provide help with daily activities, such as light housekeeping, laundry, grocery shopping and meal preparation. AAA services in South Dakota also include coordinated medical and nonmedical transportation. |
Cash Assistance Programs
Cash assistance programs in South Dakota provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| South Dakota Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
Financial Assistance for Senior Care and Senior Living
Whether living in their own home or in a senior living community, South Dakota seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based 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 aims to help seniors delay or avoid moving into a nursing home. Eligible seniors can receive a variety of services and supports at home or in the community, from personal care to nutritional supplements to specialized medical equipment. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help South Dakota seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| South Dakota Adult Nutrition Program | Funded by government funds and private donations, the South Dakota Adult Nutrition Program aims to provide food security for seniors while encouraging socialization. The program helps promote the health and well-being of residents aged 60 years and older by providing access to proper nutrition. Hot meals are served on weekdays in various adult nutrition locations throughout the state. The congregate setting also serves as a daily fellowship opportunity for seniors. Home-delivered meals are also available. | |
| South Dakota Meals on Wheels | South Dakota Meals on Wheels serves seniors statewide through independently run food assistance programs and support services. Most programs, whose eligibility criteria may vary, are open to seniors aged 60 and over, offering services for free or at a low cost based on a sliding-fee scale. These include home-delivered meals for immobile seniors and nutritious congregate meals served in a social environment. Additional services vary by location, but may include pet meal delivery, transportation assistance for medical appointments and errands, and emergency meal delivery during rough weather conditions. | |
| South Dakota Commodity Supplemental Food Program (CSFP) | 605-773-3413 | The South Dakota Commodity Supplemental Food Program assists low-income seniors 60 and older to access healthy foods. Using federal funding, state agencies distribute USDA foods to public and nonprofit private local agencies, where eligible seniors can receive them. This program isn't designed to provide a complete diet, and local agencies can provide referrals to other nutrition and welfare programs to bridge the gap. |
| South Dakota Supplemental Nutrition Assistance Program (SNAP) | South Dakota's Supplemental Nutrition Assistance Program helps seniors and low-income state residents purchase healthy food. Program participants receive debit cards they can use to buy SNAP-eligible foods at grocery and convenience stores, though funds aren't intended to replace an entire food budget. To qualify, seniors must demonstrate a net monthly income at or below the state's poverty line, which as of 2023 is $1,133 for a single-member household. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in South Dakota collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
| Program Name | Phone Number | Description |
|---|---|---|
| South Dakota iCanConnect Deaf-Blind Equipment Distribution Program | 800-825-4595 | Through the National Deaf Blind Equipment Distribution Program, Relay South Dakota distributes free communications equipment and software. Eligible seniors may receive braille devices, screen readers, specialized keyboards and other assistive devices they need to stay in touch with loved ones. |
Home Repair and Modifications
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in South Dakota have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| South Dakota Weatherization Assistance Program (WAP) | Low-income households in South Dakota may qualify for free energy-efficiency upgrades. This program may pay for home weatherization projects such as sealing cracks, installing insulation and repairing heating systems. Funds are limited, so there may be a waiting list for seniors seeking services. |
Social Security Offices
Social Security offices in South Dakota help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| South Dakota Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Tax Assistance
Seniors can apply for tax assistance from several South Dakota resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
| Program Name | Phone Number | Description |
|---|---|---|
| South Dakota Sales & Property Tax Refund for Senior & Disabled Citizens | 800-829-9188 | The South Dakota Department of Revenue offers sales and property tax refunds to eligible residents. This refund is calculated based on an applicant's income. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. South Dakota retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| 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 distributes financial support for energy bills during the winter months. To qualify, seniors must submit documentation proving their household's income falls under maximum requirements and they're responsible for paying their home's heating costs. As of 2023, a single-person household is eligible for LIHEAP with a $6,795 maximum income. LIHEAP payments go directly to the heating company. The associated Energy Crisis Intervention Program provides immediate assistance for seniors facing disconnection notices. |
Veteran's Services
South Dakota retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| South Dakota VA Benefits and Health Care | South Dakota VA Benefits and Health Care provides senior veterans with VA claims assistance and benefits. Health care is available at multiple veteran's medical facilities throughout the state. Vet centers are also located in multiple South Dakota cities to offer counseling and referral services. For an immediate crisis, veterans can reach help by dialing 988 and pressing 1. South Dakota is also home to three national cemeteries. |
Memory Care Laws and Regulations in South Dakota
In South Dakota, memory support services are generally provided in assisted living centers in memory care units. The South Dakota Department of Health regulates assisted living centers and enforces various laws regarding aspects such as scope of care, staff hiring and training, medication management and care planning.
| Topic | Rule |
|---|---|
| Scope of Care | Memory care facilities provide assistance with daily living activities, medication management, infection control, as well as housing, three daily meals and housekeeping and laundry services. They must also provide specialized programming and secured indoor and outdoor areas to meet the needs of those with dementia. |
| Care Plans | Memory care facilities are required to create personalized written care plans for residents to ensure safe and effective care from the day of admission. Care plans must be provided upon admission, 30 days after admission and at least annually and should address personal care, as well as the resident’s medical, dietary, emotional, physical and cognitive needs. |
| Medication Management | A pharmacist must review the drug regimens of all memory care residents who are on prescription medications. Medications must be stored in a locked storage area in their original containers. Medications can be administered by registered nurses or unlicensed personnel who have completed resident-specific medication administration training. Residents who have the cognitive ability to self-administer medications, including insulin injections, may do so, and they may store medications in their rooms. A physician, physician’s assistance or nurse practitioner must evaluate their ability to self-administer medications as least quarterly. |
| Staffing | South Dakota doesn’t have minimum staffing ratios, but facilities must have enough qualified staff members to provide safe and effective care at all times. Facilities are prohibited from hiring individuals who have been convicted of abusing another person. All staff members must complete a formal orientation program within 30 days of their hire date and an ongoing education program annually. Topics that the training should cover include nutritional and hydration needs of residents, accident prevention, infection control, problem solving techniques for residents with cognitive impairments and resident rights. Any staff members who work in memory care units must have specific training regarding the unique needs of residents in that unit. At least one caregiver must be on duty at all times. The facility must have a plan for increasing staffing during times of resident illnesses. |
| Medicaid Coverage | Medicaid covers memory care through the HOPE waiver, which is a Home and Community Based Services program. Applicants are subject to the waiver’s income, asset and residency guidelines. |
| Reporting Abuse | Memory care facilities are required to have a grievance process that enabled residents to file complaints verbally or in writing regarding care or lack of care, the behavior of other residents and infringement of the resident’s right. Complaints may also be filed with the state’s Long Term Care Ombudsman office by calling 866-854-5465. |
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