South Dakota Nursing Home Medicaid

Last updated: August 21, 2026 Jurisdiction: South Dakota

Nursing-facility Medicaid combines financial and clinical rules

South Dakota Medicaid nursing-facility coverage requires both financial eligibility and a nursing-facility level-of-care classification. DHS may assign the classification where a person needs continuing direct care, assistance with an activity of daily living, or qualifying skilled mental-health or therapeutic services; the classification is redetermined annually and may be revisited after a condition change South Dakota nursing-facility manual.

The current 2026 income cap for relevant long-term-care groups is $2,982 per month, and DSS lists a $2,000 individual resource limit. A person whose income exceeds the cap may need an approved income trust rather than assuming a traditional spend-down will work South Dakota DSS eligibility page; DSS spousal-care guide.

PASRR is the preadmission screen

South Dakota’s Preadmission Screening and Resident Review, or PASRR, applies to all applicants to and residents of Medicaid-certified nursing facilities regardless of who is paying. The Level I screen identifies possible serious mental illness or intellectual/developmental disability; a positive screen can require Level II review before placement decisions South Dakota PASRR manual.

A negative Level I allows admission once the facility has the completed form. The only true PASRR exemption described in the manual is an exempted hospital discharge meeting all three listed conditions, including a provider certification that the nursing-facility stay will likely be less than 30 days South Dakota PASRR manual.

Personal needs and patient liability

South Dakota’s Medicaid state-plan supplement provides a basic personal-needs allowance of $100 for an individual and $200 for couples. It also allows specified additions, including up to $75 of earned income for an institutionalized person and certain court-ordered support or trust-maintenance fees South Dakota Medicaid state plan.

After protected deductions, remaining income can go toward the cost of care. DSS’s spousal guide explains that the community-spouse income allowance and other allowable health expenses can affect the resident’s responsibility, so a facility quote is not the same as the Medicaid cost-share calculation DSS spousal-care guide.

What to assemble

Bring financial records, insurance information, proof of income, medical records, and the right PASRR documentation. The PASRR manual requires the referring provider to complete the state screening form, and the facility must retain the relevant outcomes in the resident record South Dakota PASRR manual.

2026 nursing-facility figures: $2,982 monthly LTC income cap; $2,000 individual resource limit; and $100 individual personal-needs allowance. Level of care and PASRR are separate clinical gates South Dakota DSS eligibility page; South Dakota Medicaid state plan; South Dakota PASRR manual.

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Nursing-facility Medicaid combines financial and clinical rules

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