Home Care in South Dakota

The average starting cost of home care in South Dakota is $39 per hour, according to A Place for Mom’s proprietary data. Based on our ranking methodology, the top-rated home care agencies in South Dakota are Home Instead - Rapid City, SD, Visiting Angels of Sioux Falls, SD or Home Instead - Mitchell, SD. Home care can help older adults remain in familiar surroundings while receiving support with personal care, meals, companionship, and everyday routines.

From Sioux Falls, Rapid City, Brookings, and Huron to smaller communities, provider availability can differ across the state. Families often compare caregiver reliability, scheduling flexibility, communication, and whether services can adjust as their loved one’s needs change.

Home care provides nonmedical support with activities such as bathing, dressing, meal preparation, light housekeeping, errands, and companionship. Home health care is different because it includes medical services delivered by licensed health professionals. Some companies provide both, but A Place for Mom’s network consists of nonmedical home care providers. A Place for Mom partners with 20 home care agencies in South Dakota to help families compare local options.

Home care in South Dakota costs $39 per hour, compared with the national average rate of $32.^[01] Rates can differ by community based on caregiver availability, travel distance, and demand. What a family pays will also depend on the agency, the services provided, and how often care is scheduled.

Monthly expenses depend largely on the number and length of caregiver visits. A lighter schedule may provide enough time for companionship, meal preparation, errands, or help around the house. Someone who needs regular assistance with bathing, dressing, mobility, or other personal care may need more frequent visits.

• Part-time care (20 hours/week): $3,314 per month
• Full-time care (44 hours/week): $7,290 per month

Home care rates in South Dakota may also be affected by:

• The type and amount of help your loved one needs
• Specialized support, such as dementia care
• The number and length of visits
• Evening, overnight, weekend, or holiday schedules
• 24-hour or live-in care
• Caregiver experience and training
• The availability of caregivers in the local area
• Agency minimum-hour requirements

South Dakota families may use private funds, public benefits, or a combination to pay for nonmedical home care. Depending on eligibility, VA benefits, South Dakota Medicaid Personal Care Agency Services, or the HOPE Waiver may help cover some support delivered at home.

Private pay options

Private pay can give families more control over the agency, schedule, and type of assistance their loved one receives. Families may rely on one payment source or combine several. Common private payment sources include:

• Social Security benefits
• Savings, investments, or pensions
• Long-term care insurance
• Life insurance conversion
• Reverse mortgages

VA benefits

Eligible veterans and surviving spouses in South Dakota may qualify for benefits from the U.S. Department of Veterans Affairs (VA) that help with care at home. Depending on the program, this support may include help with daily activities, temporary relief for family caregivers, or additional pension payments that can be used toward care.

Veterans enrolled in VA health care may qualify for home- and community-based services, including:^[02,03,04]

• Homemaker and Home Health Aide Care, which may provide help with bathing, dressing, eating, mobility, and other daily activities
• Respite Care, which provides short-term support while giving family caregivers time away from caregiving responsibilities

Eligibility and availability can vary based on the veteran’s needs and local VA resources. Some veterans may also have a copay.

VA Aid and Attendance provides additional monthly pension payments to eligible veterans and survivors who need help with daily activities or are largely confined to their homes. Families may be able to use these funds toward the cost of nonmedical home care.^[05]

The South Dakota Department of Veterans Affairs works with County Veterans Service Officers in every county and Tribal Veterans Service Officers on some reservations to help veterans and dependents access earned benefits and file claims.^[06]

Read more: Home Care Options for Veterans: Eligibility and Services

South Dakota Medicaid

Medicaid is a joint federal and state program that helps eligible people pay for health care and long-term services. South Dakota Medicaid may cover in-home support through Personal Care Agency Services and the Home and Community-Based Options and Person-Centered Excellence (HOPE) Waiver.

Personal Care Agency Services can cover medically necessary help such as bathing, grooming, dressing, bladder or bowel needs, assistance with self-administered medications, certain food and nutrition activities, essential household tasks related to a medical need, and maintenance nursing. For adults, South Dakota Medicaid bases personal care services on a needs assessment and case service plan. Agency-based personal care is limited to 500 hours per plan year, but eligible HCBS waiver participants may receive additional services when an assessment shows they need more care.^[07,08]

The HOPE Waiver serves eligible adults age 65 and older and adults age 18 and older with qualifying disabilities who meet financial requirements and need a nursing facility level of care. Depending on the person’s assessed needs, waiver services can include homemaker support, personal care, adult companion services, chore services, respite, meals, emergency response services, and other home- and community-based supports.^[07,09]

HOPE Waiver Structured Family Caregiving may allow a participant to live with a principal caregiver who provides daily personal care and other support. The principal caregiver may be a related family member or qualifying non-relative fictive kin and receives a stipend through a Structured Family Caregiving provider agency. Caregiver eligibility depends on the relationship to the participant and other program requirements.^[09]

Eligibility depends on the benefit. HOPE generally requires age or disability eligibility, South Dakota Medicaid financial eligibility, and a nursing facility level-of-care determination. State-plan personal care has separate assessed-need criteria based on age, activities of daily living, instrumental activities of daily living, or certain recurring nursing needs.^[07,08,09]

Read more: Medicaid Home Health Care and Nonmedical Home Care: Your Questions, Answered

Medicare

Medicare is a federal health insurance program for adults 65 and older and some younger people with disabilities. It may cover limited help with bathing, dressing, grooming, or toileting when your loved one is also receiving qualifying skilled care through Medicare’s home health benefit. Medicare generally doesn’t pay for ongoing personal care, companionship, meal preparation, or housekeeping when those are the only services needed.^[10]

Read more: Does Medicare Cover Home Health Care?

South Dakota does not currently regulate private-pay nonmedical home care providers through the Department of Health. The state also does not require a state license for Medicare-certified home health agencies, although those skilled agencies must meet federal certification requirements. Because A Place for Mom’s network consists of nonmedical home care providers, the information below focuses on that category.^[11]

Does South Dakota require home care agencies to have a license?

No. The South Dakota Department of Health states that nonmedical providers offering services such as bathing, light housekeeping, and meal preparation are not regulated by the department. South Dakota also does not require state licensure for certified home health agencies.^[11]

Does South Dakota conduct inspections of home care agencies?

Not for private-pay nonmedical home care agencies under a state home care licensing program. The Department of Health does publish survey inspection and complaint reports for federally certified home health agencies, but those reports apply to the certified skilled home health category rather than most nonmedical home care agencies.^[11,12]

Some agencies may also seek voluntary accreditation from organizations such as The Joint Commission, which can indicate a commitment to meeting nationally recognized quality standards.^[13]

What are hiring practices for home care agencies in South Dakota?

Because private-pay nonmedical home care agencies are not regulated by the South Dakota Department of Health, there is no state home-care-licensure standard that applies the same background check or training requirements to every nonmedical agency. The 2026 bill that would have created licensing, training standards, and criminal history background check procedures was vetoed and did not take effect.^[12]

South Dakota Medicaid Personal Care Agencies have separate program requirements. They must enroll with Medicaid, undergo an LTSS onsite review, complete any required corrective actions, and sign a Purchase of Services Agreement before providing Medicaid personal care services.^[08]

When comparing agencies, ask about criminal background checks, reference checks, caregiver training, supervision, backup care, and how the agency handles complaints or missed visits.

Choosing a home care agency is easier when you understand how caregivers are selected, how care will be supervised, and what happens when plans change. Look for a provider that communicates clearly, explains its policies, and can offer the services and schedule your family needs. Consider the following as you compare agencies:

• Check the type of oversight. South Dakota does not license private-pay nonmedical home care agencies, so ask each provider how it screens, trains, and supervises caregivers. Medicaid personal care providers and federally certified home health agencies follow separate program requirements.
• Review caregiver screening. Ask about criminal background checks, reference checks, and how the agency handles concerns about a caregiver.
• Ask about training. Find out what caregivers learn before working independently and whether they receive ongoing education.
• Read reviews and testimonials. Look for patterns in feedback about reliability, communication, compassion, and caregiver consistency.
• Request clear pricing information. Ask about hourly rates, minimum service requirements, weekend or holiday rates, overnight care, cancellation fees, and additional charges.
• Confirm available services. Make sure the agency can provide the support your loved one needs, such as companionship, bathing, dressing, meal preparation, light housekeeping, transportation, or dementia care.
• Ask how care is supervised. Find out who manages the care plan, how often supervisors check in, and whom your family should contact if your loved one’s needs change.
• Plan for backup care. Ask what the agency does when a scheduled caregiver is sick, late, or unable to visit.
• Meet potential caregivers. A good personality fit can help your loved one feel more comfortable receiving support at home.

A Place for Mom helps families compare home care agencies and find providers that match their loved one’s care needs, budget, and preferences. In states that require nonmedical home care agencies to be licensed, A Place for Mom verifies the licensing status of agencies in its network twice each year.

Read more: How to Choose a Home Care Agency