How much does a nursing home cost in South Dakota?
The median nursing home cost in South Dakota is $10,190 per month for a private room and $9,444 per month for a semi-private room, based on the CareScout 2025 Cost of Care Survey released March 2026. That's roughly $122,275 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 (CareScout 2025) | Difference |
|---|---|---|---|
| Nursing home (private) | $10,190 | $10,798 | −6% |
| Nursing home (semi-private) | $9,444 | $9,581 | −1% |
| Memory care (est) | $6,100 | $7,750 | −21% |
| Assisted living | $4,900 | $6,200 | −21% |
| Non-medical caregiver (hourly) | $44 | $35 | +26% |
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 CareScout 2025 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 (2026)
Married couple, one spouse applying: Community spouse may keep up to $162,660 under the federal Community Spouse Resource Allowance (2026 maximum), 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 $10,190 per month (~$335 per day). A $50,000 transfer that violates the look-back rule would create roughly a 147-day penalty period during which South Dakota Medicaid will not cover care 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 →What makes South Dakota different
South Dakota's primary Medicaid waiver for seniors is called the HOPE Waiver (Home and Community-Based Options and Person-Centered Excellence) — renamed from the older HCBS Elderly Waiver in 2018 — with approximately 2,800 enrollment slots administered by the Division of Long Term Services and Supports. South Dakota applies a distinctive cost-control rule: HOPE Waiver services in assisted living cannot exceed 85% of what equivalent nursing-home care would cost. Room and board in assisted living is capped at approximately $693 per month for Medicaid-subsidized residents, and families are not permitted to pay supplemental rent above that cap. South Dakota's Dakota at Home Aging and Disability Resource Center handles initial screening at 1-833-663-9673.
Sources: state Medicaid agency program documentation and CMS spousal-impoverishment standards. See our methodology page for the broader data sources used across this site.
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.