Getting approved for nursing-facility Medicaid in South Dakota takes clearing two separate hurdles: financial eligibility and a nursing-facility level-of-care classification. The Department of Human Services can assign that classification when someone needs ongoing direct care, help with an activity of daily living, or qualifying skilled mental-health or therapeutic services — and the classification gets reviewed again every year, or sooner if a person's condition changes.
On the financial side, the 2026 income cap for the relevant long-term-care groups sits at $2,982 a month, paired with a $2,000 individual resource limit from DSS. Anyone whose income runs above that cap likely needs an approved income trust rather than assuming a conventional spend-down strategy will clear the way to eligibility.