In South Dakota, the license families see for assisted living is "Assisted Living Center", issued by the South Dakota Department of Health, Office of Licensure and Certification. Before admission, each resident must have written orders from a physician, physician assistant or nurse practitioner listing symptoms and diagnoses, and a physical examination certifying the resident is in reasonably good health. The facility must give the resident or representative and the state ombudsman written notice at least 30 days before a transfer or discharge, unless the resident's health requires immediate transfer.
Key facts
- The median monthly cost of assisted living in South Dakota was $4,900 in CareScout's 2025 Cost of Care Survey, or $58,800 a year, $1,300 below the national median of $6,200 a month. (CareScout, 2026)
- South Dakota's HOPE Waiver, a Medicaid program for people who need nursing facility level of care, pays an assisted living center a daily rate for personal care and related services, but not room and board. (South Dakota Medicaid Billing and Policy Manual, 2025)
- Within 21 days of admission, each resident needs a documented TB risk assessment and either a two-step TB skin test or a TB blood test as a baseline. (ARSD 44, 2023)
- Unlicensed assistive personnel may give medications after a registered nurse trains them, and in assisted living centers they must be registered with the nursing board. (ARSD 44, 2019)
- Confinement in a memory care unit needs a physician, physician assistant or nurse practitioner order that documents the medical symptoms, must rest on a comprehensive assessment, and its risks and benefits must be told to the family. (ARSD 44, 2024)
South Dakota licenses assisted living centers through the Department of Health under SDCL chapter 34-12 and Administrative Rules of South Dakota (ARSD) article 44:70, and a memory care unit is a distinct part of a licensed center. Residential living centers only register with the state and are not licensed, and adult foster care and community living homes are licensed separately.
Rules change and communities can set stricter policies. Before you sign, confirm the details with the community and the South Dakota Department of Health, Office of Licensure and Certification. This page is general information, not legal advice.
The rules at a glance
| Medical assessment before move-in | Before admission, each resident must have written orders from a physician, physician assistant or nurse practitioner listing symptoms and diagnoses, and a physical examination certifying the resident is in reasonably good health. The facility must also evaluate and document the resident's care needs at admission, 30 days later and every year. [7] More on this |
|---|---|
| TB test | Within 21 days of admission, each resident needs a documented TB risk assessment and either a two-step TB skin test or a TB blood test as a baseline. Two skin tests or one blood test documented in the 12 months before admission count, and an asymptomatic resident with a stay of 30 days or less needs no test. [8] More on this |
| Notice before a move-out | The facility must give the resident or representative and the state ombudsman written notice at least 30 days before a transfer or discharge, unless the resident's health requires immediate transfer. Reasons allowed: needs the facility cannot meet, health improved so services are no longer needed, the resident endangers others, unpaid billed services, or the facility closes. [9] More on this |
| Who may give medications | Unlicensed assistive personnel may give medications after a registered nurse trains them, and in assisted living centers they must be registered with the nursing board. Subcutaneous insulin may be delegated to nursing assistants only when no licensed nurse is available, under a written protocol with five hours of diabetes training, an exam and five hours of clinical or lab instruction. [10][11][12][13] More on this |
| Memory care and dementia | Confinement in a memory care unit needs a physician, physician assistant or nurse practitioner order that documents the medical symptoms, must rest on a comprehensive assessment, and its risks and benefits must be told to the family. Unit staff need specific training, and at least one caregiver must be on duty there at all times. [14] |
| Long-term care ombudsman | South Dakota's Long-Term Care Ombudsman Program, run by the Department of Human Services, works to resolve complaints about the health, safety, welfare and rights of people in nursing homes and assisted living centers, at no cost, and can be reached toll-free at 833-663-9673. [15] Official page More on this |
| Medicaid help | South Dakota's HOPE Waiver, a Medicaid program for people who need nursing facility level of care, pays an assisted living center a daily rate for personal care and related services, but not room and board. The resident owes room and board, which the center collects each month, unless the state subsidizes it. [16][17][18] Official page More on this |
What assisted living costs in South Dakota
The median monthly cost of assisted living in South Dakota was $4,900 in CareScout's 2025 Cost of Care Survey, or $58,800 a year, $1,300 below the national median of $6,200 a month. [19]
A median is the middle of the rates communities reported, so many charge more or less. Rates differ between regions and by the care a resident needs, so ask each community for its full fee list in writing. More: assisted living costs in every state, a monthly budget and the costs that aren't in the base rate.
How to check a community in South Dakota
The Department of Health's provider list lets families search licensed facilities, and its Assisted Living Center Reports page posts survey inspection reports and complaint survey reports for each center. A center must also give its survey results and plan of correction to residents and others who ask. Search South Dakota's records. [4][5][6]
The licensing agency: South Dakota Department of Health, Office of Licensure and Certification. [1][2][3] Our guide on how to read an inspection report explains what to look for.
Put South Dakota's paperwork on a date
Parent Move Plan counts every task back from the move-in day, including the medical assessment and TB screening the community will ask for, so nothing lands in the last week.
Get your first 3 days freeFrequently asked questions
How much does assisted living cost in South Dakota?
The median monthly cost of assisted living in South Dakota was $4,900 in CareScout's 2025 Cost of Care Survey, or $58,800 a year, $1,300 below the national median of $6,200 a month. A median is the middle of the rates communities reported, so many charge more or less, and rates differ between regions and by the care a resident needs.
What medical assessment does South Dakota require before moving into assisted living?
Before admission, each resident must have written orders from a physician, physician assistant or nurse practitioner listing symptoms and diagnoses, and a physical examination certifying the resident is in reasonably good health. The facility must also evaluate and document the resident's care needs at admission, 30 days later and every year.
Does South Dakota require a TB test for assisted living?
Within 21 days of admission, each resident needs a documented TB risk assessment and either a two-step TB skin test or a TB blood test as a baseline. Two skin tests or one blood test documented in the 12 months before admission count, and an asymptomatic resident with a stay of 30 days or less needs no test.
How much notice must an assisted living community in South Dakota give before a move-out?
The facility must give the resident or representative and the state ombudsman written notice at least 30 days before a transfer or discharge, unless the resident's health requires immediate transfer. Reasons allowed: needs the facility cannot meet, health improved so services are no longer needed, the resident endangers others, unpaid billed services, or the facility closes.
Who can give medications in assisted living in South Dakota?
Unlicensed assistive personnel may give medications after a registered nurse trains them, and in assisted living centers they must be registered with the nursing board. Subcutaneous insulin may be delegated to nursing assistants only when no licensed nurse is available, under a written protocol with five hours of diabetes training, an exam and five hours of clinical or lab instruction.
Who can help with a complaint about assisted living in South Dakota?
South Dakota's Long-Term Care Ombudsman Program, run by the Department of Human Services, works to resolve complaints about the health, safety, welfare and rights of people in nursing homes and assisted living centers, at no cost, and can be reached toll-free at 833-663-9673.
Does Medicaid pay for assisted living in South Dakota?
South Dakota's HOPE Waiver, a Medicaid program for people who need nursing facility level of care, pays an assisted living center a daily rate for personal care and related services, but not room and board. The resident owes room and board, which the center collects each month, unless the state subsidizes it.
Sources
- South Dakota Department of Health: Assisted Living Centers, Health Facility Licensure (accessed 2026) (checked October 22, 2026)
- South Dakota Department of Health: Levels of Long-Term Care (accessed 2026) (checked October 22, 2026)
- SDCL 34-12-1.1, Definitions (South Dakota Legislature), 2024 (checked October 22, 2026)
- South Dakota Department of Health: DOH Provider List, SD Healthcare Licensing System (accessed 2026) (checked October 22, 2026)
- South Dakota Department of Health: Assisted Living Center Reports (survey and complaint reports through June 2026) (checked October 22, 2026)
- ARSD 44:70:09:11, Availability of survey results (South Dakota Legislature), 2019 (checked October 22, 2026)
- ARSD 44:70:04:13, Resident admissions (South Dakota Legislature), 2023 (checked October 22, 2026)
- ARSD 44:70:04:10, Tuberculin screening and testing requirements (South Dakota Legislature), 2023 (checked October 22, 2026)
- ARSD 44:70:09:14, Admission, readmission, transfer, and discharge policies (South Dakota Legislature), 2023 (checked October 22, 2026)
- ARSD 44:70:07:07, Medication administration (South Dakota Legislature), 2019 (checked October 22, 2026)
- ARSD 20:48:04.01:09, Requirements for delegated medication administration to a nursing assistant (South Dakota Legislature), 2022 (checked October 22, 2026)
- ARSD 20:48:04.01:11, Medication administration tasks that require a written protocol (South Dakota Legislature), 2022 (checked October 22, 2026)
- ARSD 20:48:04.01:16, Written protocol required for the delegation of insulin administration by the subcutaneous route to a nursing assistant (South Dakota Legislature), 2022 (checked October 22, 2026)
- ARSD 44:70:04:12, Memory care units (South Dakota Legislature), 2024 (checked October 22, 2026)
- South Dakota Department of Human Services: Long-Term Care Ombudsman Program, Dakota at Home listing (2025) (checked October 22, 2026)
- South Dakota Medicaid Billing and Policy Manual: HOPE Waiver, Assisted Living Services (T2031) (2025) (checked October 22, 2026)
- South Dakota Medicaid: HOPE Waiver Fee Schedule, effective July 1, 2026 (checked October 22, 2026)
- South Dakota Department of Human Services: HOPE Waiver, Dakota at Home listing (2026) (checked October 22, 2026)
- CareScout: Cost of Care Survey 2025, Ranked Median Costs by State (2026) (checked October 22, 2026)