South Dakota doesn't issue a separate memory care license. Dementia care is a regulated memory care unit inside an assisted living center under South Dakota Assisted Living Regulation 44:70. This guide explains what that unit is, what to verify on a visit, what it costs, and who pays.
In This Guide
- Key Takeaways
- How South Dakota Regulates Memory Care
- What a Memory Care Unit Requires
- What It Costs and Who Pays
- How to Vet a Memory-Care Setting
- Frequently Asked Questions
How South Dakota Regulates Memory Care
When you start calling facilities, "memory care" gets thrown around as if it were one licensed thing you could shop for and line up side by side. In South Dakota it isn't. The state never created a separate memory-care license. Instead, it treats dementia care as a defined unit built into the license a facility already holds. Knowing that before your first tour changes what you look for, because it tells you where the real protection lives: in a regulated unit the facility either operates or doesn't.
Here's the structure. Assisted living in South Dakota is licensed by the South Dakota Department of Health through its Office of Licensure and Certification, under South Dakota Codified Laws chapter 34-12 and the Administrative Rules of South Dakota article 44:70. The state uses a single assisted-living-center license rather than the acuity tiers some states layer on, and the rules require a pre-admission written order from a physician or other authorized provider certifying the resident is in reasonably good health, along with periodic resident assessment. Within that single license, the rules carve out a specific thing called a memory care unit.
The rules define a memory care unit as a distinct part of a facility whose physical environment and design maximize residents' functioning, promote safety, and encourage independence for a defined population, staffed by people trained to meet the needs of the residents admitted to the unit. That definition lives in 44:70 for assisted living centers, and South Dakota recognizes a comparable memory care unit inside nursing facilities as well. The effect is that "memory care" in South Dakota isn't only a marketing label you have to take on faith. It's a regulated unit with a definition behind it, and a family can ask one direct question: does this facility operate a recognized memory care unit?
So a South Dakota memory-care setting carries something you can ask about against the rules, not just against a brochure. If your loved one's dementia comes with heavy medical needs, the underlying license still matters, because an assisted living center may not be set up to provide the level of skilled nursing a person eventually requires. A memory care unit is a dementia standard inside assisted living, not a substitute for a nursing facility, though South Dakota recognizes memory care units in nursing facilities too for residents whose needs reach that level.
What a Memory Care Unit Requires
Once you know to ask whether a facility operates a memory care unit, the next question is what that unit actually buys your family. The rules answer that in two places: the environment the unit has to provide, and the staff who work in it.
On the environment, South Dakota defines a memory care unit as a distinct part of a facility whose physical design maximizes residents' functioning, promotes safety, and encourages independence. That's the difference the state is trying to guarantee: a setting built for someone whose memory and judgment are slipping, where safety and a resident's remaining abilities are held together rather than traded off. The rule sets the standard for the environment; it does not publish a single fixed staff ratio or a single training-hour count you can quote back, so when you tour, ask the facility to describe its environment and its staffing in concrete terms rather than expecting one statewide number.
On staffing, the unit must be staffed by people trained to meet the needs of the residents admitted to it. South Dakota frames this as preparation matched to the residents the unit actually serves, not just general assisted living experience. Because the rule describes trained staff without publishing a specific hour count in the unit definition, the right move is to ask the facility directly: what does your dementia training cover, who receives it, and do new staff complete it before working alone on the unit? Specific answers are a good sign. Vague reassurance isn't.
| What the rules require of a memory care unit | What to ask, and what to check on a visit |
|---|---|
| A distinct part of the facility for a defined population | Ask to see the unit itself and confirm it's a recognized memory care unit, not a relabeled hallway |
| An environment that maximizes residents' functioning | Ask how the layout and routine support a resident at your loved one's stage of dementia |
| An environment that promotes safety | Walk the space, see how exits are managed, and check whether it truly supports a resident who may wander |
| An environment that encourages independence | Ask which daily tasks staff support without taking over, and watch how that plays out on the floor |
| Staff trained to meet residents' needs | Ask what the dementia training covers, who receives it, and whether new staff finish it before working alone |
| A pre-admission provider order and assessment | Ask how admission and reassessment work, and confirm you'll have a say as your loved one's needs change |
The safety and wandering items deserve the closest read, because they're where dementia care most often succeeds or fails day to day. A real memory care unit is built so a resident can move and stay safe at once, and it has staff who can de-escalate distress without reaching for a locked door or a sedative as the first answer. Ask the facility to walk you through how it would handle your loved one's specific wandering or behavior. A concrete answer is a far better sign than a glossy brochure.
What It Costs and Who Pays
Cost is usually what families brace for, and there's no clean single number for memory care in South Dakota. The state doesn't publish one, and because memory care here is delivered as a unit within assisted living rather than as a separately surveyed setting, the industry surveys that track senior-care prices don't break it out the way they break out assisted living overall.
What you do have is a solid anchor for the base. Per the Genworth/CareScout 2024 Cost of Care Survey, the most recent state-level data, assisted living in South Dakota runs a median of about $4,350 a month (roughly $52,200 a year), among the lowest in the nation and well below the national median of about $70,800 a year. Memory care costs more than that base, here as everywhere, because a memory care unit means more staff time, dementia-specific training, and a setting built for safety. How much more depends on the facility, its size, and how much care your loved one needs. Treat memory care as a premium on top of that assisted-living figure, and be wary of any source quoting one precise statewide memory-care number.
For context on the rest of the care continuum, the same survey put a semi-private nursing-home room in South Dakota at about $105,850 a year (roughly $8,821 a month) and a private room at about $112,055 a year (roughly $9,338 a month), both below the national medians. In-home care, by contrast, is comparatively expensive in South Dakota, with a home health aide and homemaker services each running about $100,672 a year on a 44-hour-a-week basis, well above the national figures. These are industry-survey medians, not government figures, and prices vary across the state and climb as care needs grow. Use them to set expectations, then get a specific written quote from any place you're serious about.
Paying for it is where families often get caught off guard. Assisted living in South Dakota is largely private-pay for room and board, because Medicaid does not pay the room-and-board portion of assisted living. What it can do is help with the care: South Dakota Medicaid can cover assisted-living services through its HOPE waiver, a home- and community-based services waiver, for residents who qualify, and the state also operates an Optional State Supplement that can provide a supplemental payment to help qualifying SSI recipients with the cost of an assisted living center. Dementia care runs for years and the bill is steep, so it's worth checking eligibility and planning early rather than assuming the whole cost is yours alone to carry.
How to Vet a Memory-Care Setting
You don't have to become an expert in dementia regulation to make a sound decision. You have to confirm the unit, look at the environment and the staffing against what the rules promise, and ask the questions those rules hand you.
- Confirm a recognized memory care unit. Any South Dakota facility marketing "memory care" should operate a recognized memory care unit under 44:70, so ask the facility to show you the unit and confirm its status, and check the facility's licensure with the South Dakota Department of Health rather than relying on marketing alone.
- Ask how staff are trained for dementia. The rules require a memory care unit to be staffed by people trained to meet the needs of the residents admitted to it, so ask what the training covers, who receives it, and whether new staff complete it before working alone. Specific answers are a good sign; vague reassurance isn't.
- Ask how the unit secures the environment for wandering and behavior. A memory care unit's environment has to promote safety while encouraging independence, so ask the facility to walk you through how it would handle your loved one's specific risks, and watch how staff manage exits and distress on your visit.
- Understand admission and reassessment. South Dakota requires a pre-admission written provider order certifying reasonably good health, plus periodic resident assessment, so ask how admission works, how often the facility reassesses, and how you'll be involved as your loved one's needs change.
- Get the costs in writing. Ask for a written breakdown of the base rate, what memory care adds, how care levels get reassessed as dementia progresses, and what triggers an increase. Bring the contract home and read the refund and discharge terms without a salesperson in the room.
Tour at least a couple of places. The goal isn't a flawless one. It's a facility whose memory care unit you've confirmed, whose staff training you've pinned down, and whose plan for wandering and behavior you've checked against what's actually happening inside the building.
Frequently Asked Questions
No. South Dakota doesn't issue a separate memory care license. Dementia care is delivered as a regulated memory care unit built into the licensing of an assisted living center under South Dakota Assisted Living Regulation 44:70, or inside a nursing facility for residents whose needs reach that level. The facility itself is licensed by the South Dakota Department of Health as an assisted living center, with a memory care unit operated inside it.
A memory care unit is a distinct part of a facility whose physical environment and design maximize residents' functioning, promote safety, and encourage independence for a defined population, staffed by people trained to meet the needs of the residents admitted to the unit. That definition lives in 44:70 for assisted living centers, and South Dakota recognizes a comparable unit inside nursing facilities.
Ask the facility to show you its memory care unit and confirm its status, then check the facility's licensure with the South Dakota Department of Health rather than relying on how the place markets itself. Then ask how its staff are trained for dementia and how its environment secures the unit against wandering, and check those answers against what you see on a visit.
There's no reliable single statewide figure for memory care alone. Use the assisted-living base as your anchor, about $4,350 a month per the Genworth/CareScout 2024 survey, and expect memory care to run higher because of the added staff time, dementia training, and secured setting it requires. The advertised rate is usually a base that rises as care needs grow, so get a written breakdown from any place you're considering.
South Dakota Medicaid does not pay the room-and-board portion of assisted living, so that part is largely private-pay. The state's HOPE waiver can cover assisted-living services such as personal care and supervision for residents who qualify, and an Optional State Supplement can help qualifying SSI recipients with the cost of an assisted living center, even though neither covers room and board. Because an assisted living center may not provide skilled nursing care, a resident with heavier medical needs may eventually move to a nursing facility, where Medicaid's nursing-facility coverage can apply for those who qualify. It's worth checking eligibility early rather than assuming the entire bill is private-pay.
Learn More
Find personalized help confirming a South Dakota facility's memory care unit and dementia staffing at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.