South Dakota Assisted Living
The lack of income tax, a low sales tax rate, and a lower-than-average overall cost of living make South Dakota an affordable retirement destination. Active, older adults have a wealth of natural attractions at their fingertips, with plenty of activities to enjoy during the state’s four seasons. Fresh air and low property crime rates, as compared with national averages, can offset the slightly higher-than-average violent crime rates. Approximately 17.2 percent of the 886,000-plus population is made up of people age 65 or older, making South Dakota home to around 152,500 older adults. This guide details assisted living in South Dakota, including costs, ways to pay for assisted living, and assisted living facility regulations.
The typical resident population in South Dakota's assisted living communities is 71% female. Overall, 88% of residents are ages 75 and older, with 24% of residents ages 75 to 84 and 64% ages 85 and older.
The Department of Health licenses assisted living centers in South Dakota. An ALC means any premise, rest home, boarding home, or agency that operates to provide personal care and services to adults. Additional certifications are required for facilities to admit and provide services for residents with certain conditions.
ALC licenses can include special provisions that allow the facility to provide services such as medication administration, care for the cognitively impaired, care for the physically impaired, oxygen administration, therapeutic diets, hospice care, dining assistance, and two-person assistance for activities of daily living (ADLs).
Agreements between facilities and residents must include the services available at the facility and the associated charges, how to file a complaint regarding abuse, neglect and misappropriation of funds, contact information for the resident’s physician, the bed hold policy of the facility, the responsibilities of residents and their families regarding medication self-administration as well as instructions on how to apply for Medicaid and Medicare.
ACLs cannot retain or admit residents who require more than intermittent nursing care or rehabilitation services. Facilities may admit or retain residents who cannot leave the facility in case of emergency if the building meets specific safety requirements.
Residents may not be discharged unless the facility cannot meet their needs of the resident, if the health of the resident has improved so the resident no longer needs the services available at the facility, or if the resident is a danger to the health and safety of others.
ALCs must provide supportive services individualized to the resident and must coordinate resident access to a physician, physician assistant, or nurse practitioner at least annually. If skilled care is provided, it must be delivered by facility staff or a Medicare-certified home health agency. A call system is required for facilities serving residents who cannot walk independently.
Prior to admission, potential residents must make the results of a physical examination available to the facility. The exam must certify that the applicant is in reasonably good health and free from communicable diseases, chronic illness, a disability that requires services beyond what the facility can easily accommodate, or requires help carrying out ADLs and instrumental activities of daily living (IADLs) beyond limited physical assistance.
Each resident must be evaluated at move-in, 30 days after admission, and annually thereafter to determine if the facility is able to meet the needs of the resident. This evaluation assesses the resident on nursing care needs, medication administration needs, cognitive abilities, IADLs, mental health status, physical abilities, ADL ambulation, and dietary needs.
Any third-party agency that residents contract with must comply with and complement facility care policies.
ALCs must provide at least three meals per day at regular times. If residents require special diets, a dietician must be employed directly or as a consultant to approve special diet needs, written menus, plan individual diets, and provide guidance to dietary staff.
Facilities must have an administrator responsible for the ALC's overall management. The facility must employ assistive personnel to provide personal care assistance and a licensed nurse to review and document resident care and conditions. The nurse can be an employee of the facility or can be contracted. If medication administration is available at a facility, they must employ a licensed nurse to supervise, train, and oversee unlicensed staff who administer medications.
Facilities must provide residents with at least 0.8 hours of contact time per day. At all times, at least two staff persons must be on duty (or one per floor in multi-floor facilities). There must be enough staff awake and on duty to provide for the care of the residents.
Apartment-style units are not required in South Dakota. Facilities constructed or renovated after January 9, 2012, can have up to two residents in a room. Each resident room must have a toilet room with a sink.
There are several requirements that each assisted living community must provide for its residents. The facility must offer both general observations and health supervision to assist in identifying each resident's health condition and ability to function. The facility must assist residents with all ADLs and medication services and assess the need for medication attention or nursing services.
In South Dakota, ALCs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with 68% of communities providing skilled nursing. Many have health care specialists and on-site services, with 50% of communities offering dental care. In addition, 42% of ALCs have hospice services.
Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In South Dakota, 92% of communities conduct depression screenings, and 47% offer mental health counseling. Social work programs are also found in 42% of ALCs. Social workers can provide counseling, conduct assessments, and help ensure residents have access to all the resources they need.
Some assisted living residents live with various medical conditions. In South Dakota, 28% have Alzheimer's disease or another form of dementia. In addition, 51% have high blood pressure, 35% have heart disease, 30% have depression, and 19% have diabetes.
South Dakota Department of Social Services, Division of Behavioral Health, offers services to help people maintain and improve their mental health. There’s a statewide network of Community Mental Health Centers. Anyone in crisis can call the Helpline Center, available 24/7 across the state, or the National Suicide Prevention Lifeline. Further support is available from the National Alliance of Mental Illness (NAMI), which has a South Dakota branch based in Sioux Falls. The nonprofit senior membership organization AARP also maintains comprehensive and freely accessible online information related to senior-specific mental health issues. Mental health support for veterans is available through the South Dakota Department of Veteran Affairs and the Veterans Crisis Line.
ALCs with residents requiring medication administration must employ or contract with a licensed nurse to review resident care and conditions weekly and with an RN or pharmacist who provides medication administration training. Aides who have passed the required training may administer medications.
A pharmacist must review resident drug regimens monthly. The pharmacist must report any potential drug therapy irregularities and make recommendations for proper therapy to the resident’s prescriber and to the facility administration.
Residents are permitted to self-administer medications if they are deemed capable. Every three months, an RN or physician must evaluate the medication record and the ability of the resident to self-administer medications.
Activities of Daily Living (ADLs) Assistance Services
A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglect of household chores.
Residents in South Dakota’s assisted living facilities often receive help with their ADLs. In South Dakota, 7% of residents need help eating. Other commonly used services include bed transfer (13%), toileting (15%), and walking (43%). Caregivers in ALFs help 25% of residents to dress and 58% of residents need help bathing.
The average cost of assisted living care in South Dakota is $3,350. This cost is $1150 lower than the monthly national average of $4,500 per month. The cost of living in South Dakota is more than the national average by 1.0%, with health care costs less than the national average by 2.6% and housing costs more than the national average by 12.8%.
The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from a low of $2,910 in the Sioux Falls area to a high of $3,914 per month in the Rapid City area of South Dakota.
Although all of South Dakota’s neighboring states have higher average monthly costs for assisted living, you may be find other affordable options in neighboring states if you live close to one of South Dakota’s borders. North Dakota is the closest to the cost in South Dakota, with an average monthly cost of $3,391 per month. Nebraska, Minnesota, and Wyoming all have higher average costs at $4,076, $4,508, and $4,169, respectively.
How to Pay for Assisted Living
The South Dakota Department of Health oversees assisted living at the state level. Along with issuing licenses, the agency is responsible for enforcing the regulations outlined in Chapter 1200 of the Rules and Regulations of the State of South Dakota. Specifically, 1200-08-25 contains regulations pertaining to resident admissions, building standards, resident safety, disposal of hazardous waste, resident records, and resident rights. These regulations aim to keep residents safe and ensure they have access to the services they need to stay healthy and avoid isolation.
The Department of Health also conducts inspections and publishes information about federal and state complaints received about assisted living communities operating in South Dakota. Older adults and their family members can use the complaint listing to narrow down their assisted living options.
The South Dakota Department of Health, Office of Health Facilities Licensure and Certification is the main agency responsible for monitoring and regulating assisted living communities throughout South Dakota. The South Dakota Department of Human Services Division of Long Term Services and Supports is responsible for developing the State Plan on Aging. Contact the division for help accessing social services or medical support.
South Dakota also has a long-term care ombudsman to investigate complaints against assisted living communities and other residential care facilities. The ombudsman helps residents understand their rights, advocates for residents and helps older adults and their family members resolve issues related to long-term care.
The field of elder law has developed to protect older adults and their families from scams, abuse, and fraud. Anyone can use an online form to report senior abuse or neglect to Adult Protective Services. Those who believe they may have been a victim of Medicare fraud can contact the Senior Medicare Patrol via the SHIINE program.
The South Dakota Department of Human Services has contracts with East River Legal Services and Dakota Plains Legal Services to provide legal assistance to qualifying older adults. Professionals offer advise on civil law matters, including public benefits, health insurance, housing, estate management, consumer affairs, and age discrimination.
The typical resident population in South Dakota's assisted living communities is 71% female. Overall, 88% of residents are ages 75 and older, with 24% of residents ages 75 to 84 and 64% ages 85 and older.
Assisted Living Facility Definitions
The Department of Health licenses assisted living centers in South Dakota. An ALC means any premise, rest home, boarding home, or agency that operates to provide personal care and services to adults. Additional certifications are required for facilities to admit and provide services for residents with certain conditions.
ALC licenses can include special provisions that allow the facility to provide services such as medication administration, care for the cognitively impaired, care for the physically impaired, oxygen administration, therapeutic diets, hospice care, dining assistance, and two-person assistance for activities of daily living (ADLs).
Resident Agreements and Disclosures
Agreements between facilities and residents must include the services available at the facility and the associated charges, how to file a complaint regarding abuse, neglect and misappropriation of funds, contact information for the resident’s physician, the bed hold policy of the facility, the responsibilities of residents and their families regarding medication self-administration as well as instructions on how to apply for Medicaid and Medicare.
Assisted Living Admission and Retention
ACLs cannot retain or admit residents who require more than intermittent nursing care or rehabilitation services. Facilities may admit or retain residents who cannot leave the facility in case of emergency if the building meets specific safety requirements.
Residents may not be discharged unless the facility cannot meet their needs of the resident, if the health of the resident has improved so the resident no longer needs the services available at the facility, or if the resident is a danger to the health and safety of others.
Assisted Living Services and Service Planning
ALCs must provide supportive services individualized to the resident and must coordinate resident access to a physician, physician assistant, or nurse practitioner at least annually. If skilled care is provided, it must be delivered by facility staff or a Medicare-certified home health agency. A call system is required for facilities serving residents who cannot walk independently.
Prior to admission, potential residents must make the results of a physical examination available to the facility. The exam must certify that the applicant is in reasonably good health and free from communicable diseases, chronic illness, a disability that requires services beyond what the facility can easily accommodate, or requires help carrying out ADLs and instrumental activities of daily living (IADLs) beyond limited physical assistance.
Each resident must be evaluated at move-in, 30 days after admission, and annually thereafter to determine if the facility is able to meet the needs of the resident. This evaluation assesses the resident on nursing care needs, medication administration needs, cognitive abilities, IADLs, mental health status, physical abilities, ADL ambulation, and dietary needs.
Any third-party agency that residents contract with must comply with and complement facility care policies.
Assisted Living Food and Dietary Provisions
ALCs must provide at least three meals per day at regular times. If residents require special diets, a dietician must be employed directly or as a consultant to approve special diet needs, written menus, plan individual diets, and provide guidance to dietary staff.
Assisted Living Staffing Requirements
Facilities must have an administrator responsible for the ALC's overall management. The facility must employ assistive personnel to provide personal care assistance and a licensed nurse to review and document resident care and conditions. The nurse can be an employee of the facility or can be contracted. If medication administration is available at a facility, they must employ a licensed nurse to supervise, train, and oversee unlicensed staff who administer medications.
Facilities must provide residents with at least 0.8 hours of contact time per day. At all times, at least two staff persons must be on duty (or one per floor in multi-floor facilities). There must be enough staff awake and on duty to provide for the care of the residents.
Assisted Living Housing Requirements
Apartment-style units are not required in South Dakota. Facilities constructed or renovated after January 9, 2012, can have up to two residents in a room. Each resident room must have a toilet room with a sink.
What Is Included With Assisted Living Care In South Dakota?
There are several requirements that each assisted living community must provide for its residents. The facility must offer both general observations and health supervision to assist in identifying each resident's health condition and ability to function. The facility must assist residents with all ADLs and medication services and assess the need for medication attention or nursing services.
Health Care Services
In South Dakota, ALCs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with 68% of communities providing skilled nursing. Many have health care specialists and on-site services, with 50% of communities offering dental care. In addition, 42% of ALCs have hospice services.
Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In South Dakota, 92% of communities conduct depression screenings, and 47% offer mental health counseling. Social work programs are also found in 42% of ALCs. Social workers can provide counseling, conduct assessments, and help ensure residents have access to all the resources they need.
Some assisted living residents live with various medical conditions. In South Dakota, 28% have Alzheimer's disease or another form of dementia. In addition, 51% have high blood pressure, 35% have heart disease, 30% have depression, and 19% have diabetes.
State Mental Health Resources
South Dakota Department of Social Services, Division of Behavioral Health, offers services to help people maintain and improve their mental health. There’s a statewide network of Community Mental Health Centers. Anyone in crisis can call the Helpline Center, available 24/7 across the state, or the National Suicide Prevention Lifeline. Further support is available from the National Alliance of Mental Illness (NAMI), which has a South Dakota branch based in Sioux Falls. The nonprofit senior membership organization AARP also maintains comprehensive and freely accessible online information related to senior-specific mental health issues. Mental health support for veterans is available through the South Dakota Department of Veteran Affairs and the Veterans Crisis Line.
Medication Provisions
ALCs with residents requiring medication administration must employ or contract with a licensed nurse to review resident care and conditions weekly and with an RN or pharmacist who provides medication administration training. Aides who have passed the required training may administer medications.
A pharmacist must review resident drug regimens monthly. The pharmacist must report any potential drug therapy irregularities and make recommendations for proper therapy to the resident’s prescriber and to the facility administration.
Residents are permitted to self-administer medications if they are deemed capable. Every three months, an RN or physician must evaluate the medication record and the ability of the resident to self-administer medications.
Activities of Daily Living (ADLs) Assistance Services
A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglect of household chores.
Residents in South Dakota’s assisted living facilities often receive help with their ADLs. In South Dakota, 7% of residents need help eating. Other commonly used services include bed transfer (13%), toileting (15%), and walking (43%). Caregivers in ALFs help 25% of residents to dress and 58% of residents need help bathing.
Cost Of Assisted Living Care In South Dakota
The average cost of assisted living care in South Dakota is $3,350. This cost is $1150 lower than the monthly national average of $4,500 per month. The cost of living in South Dakota is more than the national average by 1.0%, with health care costs less than the national average by 2.6% and housing costs more than the national average by 12.8%.
The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from a low of $2,910 in the Sioux Falls area to a high of $3,914 per month in the Rapid City area of South Dakota.
How Costs Compare In Nearby States
Although all of South Dakota’s neighboring states have higher average monthly costs for assisted living, you may be find other affordable options in neighboring states if you live close to one of South Dakota’s borders. North Dakota is the closest to the cost in South Dakota, with an average monthly cost of $3,391 per month. Nebraska, Minnesota, and Wyoming all have higher average costs at $4,076, $4,508, and $4,169, respectively.
How to Pay for Assisted Living
South Dakota Assisted Living Oversight
The South Dakota Department of Health oversees assisted living at the state level. Along with issuing licenses, the agency is responsible for enforcing the regulations outlined in Chapter 1200 of the Rules and Regulations of the State of South Dakota. Specifically, 1200-08-25 contains regulations pertaining to resident admissions, building standards, resident safety, disposal of hazardous waste, resident records, and resident rights. These regulations aim to keep residents safe and ensure they have access to the services they need to stay healthy and avoid isolation.
The Department of Health also conducts inspections and publishes information about federal and state complaints received about assisted living communities operating in South Dakota. Older adults and their family members can use the complaint listing to narrow down their assisted living options.
Quality and Safety of Assisted Living Facilities in South Dakota
The South Dakota Department of Health, Office of Health Facilities Licensure and Certification is the main agency responsible for monitoring and regulating assisted living communities throughout South Dakota. The South Dakota Department of Human Services Division of Long Term Services and Supports is responsible for developing the State Plan on Aging. Contact the division for help accessing social services or medical support.
South Dakota also has a long-term care ombudsman to investigate complaints against assisted living communities and other residential care facilities. The ombudsman helps residents understand their rights, advocates for residents and helps older adults and their family members resolve issues related to long-term care.
Legal Resources
The field of elder law has developed to protect older adults and their families from scams, abuse, and fraud. Anyone can use an online form to report senior abuse or neglect to Adult Protective Services. Those who believe they may have been a victim of Medicare fraud can contact the Senior Medicare Patrol via the SHIINE program.
The South Dakota Department of Human Services has contracts with East River Legal Services and Dakota Plains Legal Services to provide legal assistance to qualifying older adults. Professionals offer advise on civil law matters, including public benefits, health insurance, housing, estate management, consumer affairs, and age discrimination.
