How much does a nursing home cost in South Dakota?
The median nursing home cost in South Dakota is $7,290 per month for a private room and $6,550 per month for a semi-private room in 2026, based on the Genworth Cost of Care Survey. That's roughly $87,480 per year for a private room.
South Dakota nursing home costs run 25% below the national median.
2026 South Dakota senior care costs at a glance
| Care type | South Dakota median/month | National median | Difference |
|---|---|---|---|
| Nursing home (private) | $7,290 | $9,733 | -25% |
| Nursing home (semi-private) | $6,550 | $8,669 | -24% |
| Memory care | $5,250 | $6,244 | -16% |
| Assisted living | $3,950 | $4,995 | -21% |
| Home health aide (hourly) | $30 | $33 | -9% |
See your exact spend-down timeline for South Dakota
Enter your savings, income, and care type to see how long your money lasts before reaching South Dakota Medicaid asset limits.
Open the South Dakota calculator →Nursing home costs by South Dakota city
Costs vary by metro area within the state. Urban markets typically run 10–25% above state medians, while rural areas can be 10–20% below.
City-level estimates are based on 2026 Genworth metro-area data. Individual facility costs vary 20–40% from these medians depending on amenities, staffing ratios, and room type.
South Dakota Medicaid for nursing home care
South Dakota Medicaid covers nursing home care for residents who meet both medical eligibility (need for skilled nursing care) and financial eligibility (limited assets and income). Understanding the rules before you need them can save your family hundreds of thousands of dollars.
South Dakota Medicaid 2026 asset limits
Individual applicant: $2,000 in countable assets
Married couple, one spouse applying: Community spouse may keep up to $148,620 under the Community Spouse Resource Allowance, plus the home, one vehicle, and personal belongings
The 5-year look-back period in South Dakota
South Dakota Medicaid reviews all asset transfers made within 60 months (5 years) of your application date. Gifts to family, property transfers below market value, or large unexplained withdrawals trigger a penalty period that delays Medicaid eligibility — during which you must private-pay.
South Dakota's 2026 penalty divisor is approximately $242 per day. A $50,000 unexplained transfer would create roughly a 207-day penalty period, costing your family approximately $50,301 in private-pay costs.
This is why elder law attorneys consistently advise families to begin Medicaid planning at least 5 years before nursing home care is needed.
Find a South Dakota elder law attorney
The National Academy of Elder Law Attorneys maintains a state-by-state directory of certified elder law attorneys.
Find a South Dakota attorney →How South Dakota compares to neighboring states
Cost differences across state lines can be substantial. Some families consider relocating for care, particularly if adult children live across a border.