Memory Care in South Dakota

Because of the specialized staff training and resources required to provide high-quality memory care, memory care typically costs more than other types of residential care. On average, memory care will cost 20-30% more than assisted living.

Genworth Financial’s 2019 Cost of Care Survey shows that the average cost of assisted living in South Dakota is $3,500 per month, which is well under the national average of $4,051. Near the state’s western border in Rapid City, the average monthly cost of assisted living is over $400 more than the state median, at $3,948. Much farther east in Sioux Falls, seniors pay approximately $3,356 per month, which is over $100 less than South Dakota’s average.

While the cost of standard assisted living in South Dakota is significantly lower than the average rates paid across the country, state residents can expect to pay around $4,375 per month to receive specialized memory care. This equates to a 25% increase from the state’s assisted living average. Rates will vary depending on the individual’s specific location and chosen facility.

South Dakota Medicaid Programs for Memory Care

Home and Community-Based Options and Person Centered Excellence Waiver

South Dakota’s Department of Human Services administers the Home and Community-Based Options and Person Centered Excellence (HOPE) Waiver through the Division of Long Term Services and Supports. This Medicaid waiver is available to eligible seniors and people with disabilities who would like to receive memory care at home or in a community setting, such as an assisted living facility. This is permitted so long as the individual’s cost of care is 85% or less of what it would be in a skilled nursing facility.

Benefits participants can receive through the waiver include transition coordination, assisted living services, help with activities of daily living, personal care services and meals, among others. While the waiver does not cover the cost of room and board, it can help cover the cost of services for individuals who reside in a safe, secure memory care unit within an assisted living facility and receive specialized care and recreational programming.

• Who Is Eligible: Individuals must require a skilled nursing level care and have a disability or be at least 65 years old to be eligible for the waiver. Additionally, they must undergo a formal needs assessment. To qualify financially, applicants must earn no more than $2,349 per month and have no more than $2,000 in countable assets, not including personal property such as their home or vehicle.
• How to Apply: Those interested in applying may or visit or call their county’s Long Term Services and Supports office.

Non-Medicaid Financial Assistance Programs for Memory Care in South Dakota

Optional State Supplementation

South Dakota provides residents who receive memory care in assisted living facilities with funds to help pay for their care through the Optional State Supplementation program. As of 2015, eligible individuals living in a state-licensed assisted living facility can receive $791 per month to help cover the cost of room and board through payments made directly to the facility. Recipients may keep $60 of their monthly OSS benefit payment to help cover the cost of personal expenses.

• Who Is Eligible: Those who wish to receive OSS must be willing to live in an assisted living center in South Dakota. They must require support but be able to complete activities of daily living with assistance, such as bathing, eating and toileting. Additionally, they must receive SSI or have a net income that’s less than the state supplemental standard of $1,524 per month.
• How to Apply: Interested individuals may apply through their local Department of Social Services office. They can locate a nearby office by visiting the Department of Social Services website and selecting the city closest to them.

More Ways to Pay for Memory Care

In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:

• Long-Term Care Insurance: Depending on the policy details, long-term care insurance may be used to pay for memory care services. It’s best to sign up for a policy early, as coverage will likely be denied if one already has long-term care needs. More information about the intricacies of long-term care insurance can be found at longtermcare.acl.gov.
• Reverse Mortgages: Reverse mortgages allow some homeowners to take out a loan as an advance from the eventual sale of their primary residence. This can be a good way to fund memory care in the short-term, but the loans will need to be paid back after the sale of the home. The most commonly used type of reverse mortgages for seniors is the Home Equity Conversion Mortgage, which is the only reverse mortgage insured by the federal government.
• Veterans Benefits: The Department of Veterans Affairs offers several programs that veterans and their spouses may use to cover health care needs such as memory care. More information about these programs can be found on the VA website.
• Life Insurance: Some life insurance policies allow policyholders to cash out their policy before a qualifying death. There may be some downsides to accessing a life insurance benefit early, so be sure to read more about the process.

Memory Care Regulation

In South Dakota, personal care and memory care services are provided in assisted living facilities, also known as assisted living centers. ALCs are licensed by the South Dakota Department of Health’s Office of Health Facilities. To serve individuals with dementia or other specific conditions, facilities must obtain further certifications. Facilities may have secured units designed to enhance the safety and functionality of residents with dementia, with staff specifically trained to meet their needs. The department inspects each facility annually, with the first inspection taking place prior to licensing.

Each facility must assess and document the needs of new residents when they’re admitted into the facility, after 30 days of residency and on an annual basis going forward. Assessment measurements must be approved by the department, and the facility must also inform residents of the services the department permits it to provide.

Facility Scope of Care

Assisted living facilities must provide residents with individualized care that includes access to facilitated activities, outlets for their spiritual needs and physician services. Skilled nursing and rehabilitation services may be provided for no more than eight hours per day or 28 hours per week.

Residents may also receive services delivered on-site by third party providers, such as hospice agencies certified by Medicare. All third party providers must also adhere to the facility’s policies.

Admission Requirements

While South Dakota’s assisted living centers may admit the majority of individuals in need of memory care, state regulations also require facilities to deny admission to certain individuals. The table below lists the types of individuals centers may accept or deny.

Care Plan Requirements

Care plans must include therapeutic programming for residents with dementia.

Medication Management Requirements

ALCs that accept individuals who require medication administration must employ a licensed nurse to oversee and record the condition of these residents on a weekly or more frequent basis. Staff who are not licensed must undergo medication administration training on an ongoing and annual basis.

Facility Requirements

Secured memory care units must be on the ground level and provide residents with access to a secure outdoor area. Throughout the assisted living center, private units must provide at least 120 square feet of living space, apart from the bathroom and closets. Two-bed rooms must provide at least 200 square feet of living space, and sleeping rooms in suites must offer a minimum of 100 square feet. In older facilities, up to four residents may share a bathroom, but in new facilities, each room must have direct access to its own bathroom.

Staffing Requirements

All facilities must employ a licensed administrator who has at least a high school diploma to manage and oversee the facility. To become an administrator, an employee must complete specialized certification training and a subsequent evaluation within one year.

ALCs must provide a minimum of 0.8 hours of direct care per resident during a 24-hour period, and there must be at least one awake staff member on duty at all times. Facilities that accept residents who require therapeutic diets must employ a registered dietitian.

Secured dementia care units in assisted living facilities must have at least one caregiving staff member present at all times. All staff in the unit must have received specialized dementia care training. Additionally, all AFC staff must receive ongoing training on residents’ rights and safety, nutritional and hydration needs, confidentiality, infection control and other relevant topics.

Medicaid Policy

Assisted living facilities may accept funding from the state through the Medicaid Home and Community-Based Options and Person Centered Excellence (HOPE) Waiver to help residents cover the cost of care services.

Reporting Abuse

Individuals who would like to file a complaint against an assisted living center or memory care provider should contact the South Dakota Department of Health by sending an email to [email protected], or calling 605-367-7499 or 605-367-4640. Anyone who files a complaint will remain anonymous.