Nursing homes and assisted living in South Dakota

In South Dakota, almost everything starts with one phone call: Dakota at Home. From there, they can guide you on services at home, Medicaid help and support for people who care for a family member.

What care settings are called here

The Department of Health (DOH) Office of Health Facilities Licensure & Certification licenses these places. Phone: 605-773-3356.

• Assisted Living Center: this is assisted living. It provides a room and meals, plus personal care and other services.
• Community Living Home and Adult Foster Care Home: small homes for up to four adults.
• Residential Living Center: provides a room, meals and help with daily living. These places register with the state. They are not licensed.
• Nursing Facility: a nursing home, with nursing care 24 hours a day.

You can check a place's license at sdhls.org/verify. The DOH also publishes inspection reports for assisted living centers. These tools are useful for getting to know each place before you visit.

How Medicaid helps in South Dakota

Besides covering nursing home care, Medicaid has the HOPE Waiver. This program pays for services at home and in the community. It also covers services in an Assisted Living Center, adult day care and structured family caregiving. It does not cover rent or meals.

To qualify, the person must meet these requirements:

• Be 65 or older, or have a disability.
• Need the level of care a nursing home provides.
• Have income of up to $2,982 a month in 2026.
• Have resources of up to $2,000.

How to apply:

1. Call Dakota at Home at 833-663-9673 to ask for an assessment.
2. The Department of Social Services (DSS) decides the financial part. You can apply online at eaportal.sd.gov or at a local DSS office.

The official form offers free help in other languages, including Spanish, at 1-877-999-5612.

How much care costs in South Dakota

These are the state medians from CareScout's Cost of Care Survey 2025 (data from July to November 2025):

• Assisted living (private room, one bedroom): $4,900 a month.
• Nursing home, semi-private room: $311 a day (about $9,444 a month).
• Nursing home, private room: $335 a day.
• In-home caregiver (non-medical): $44 an hour.

CareScout did not publish a median for adult day centers in South Dakota.

Who to call

• Dakota at Home: 833-663-9673, Monday through Friday, 8 to 5 (Central time). It's the front door to services and programs.
• Long-Term Care Ombudsman (a free advocate for residents of residential care homes and nursing homes): reach it at the same number, 833-663-9673.
• Eldercare Locator (national line): 1-800-677-1116.

Tips for your family

• Request the assessment early. The HOPE Waiver requires an assessment before services can start.
• Ask about the caregiver program. The Caregiver Program offers respite care, training and support for people who care for someone 60 or older, or for someone with dementia.
• Look for adult day centers early. The state plan on aging mentions contracted adult day centers in Sioux Falls and Rapid City, and it notes that more are needed.
• Think about transportation. In rural areas, ask Dakota at Home about rides for people 60 and older.

This is general information and does not replace medical or legal advice.