South Dakota · Checked October 22, 2026
Non-medical home care is not state-licensed in South Dakota — but the lanes around it are regulated, and the skilled door is a different license.
| Item | South Dakota |
|---|---|
| License / registration | No licence — South Dakota does not license non-medical home care agencies and does not require state licensure even for Medicare-certified home health agencies |
| Issued by | South Dakota Department of Health (DOH), Health Facility Licensure — states expressly that non-medical providers are NOT regulated by DOH; Medicaid personal care: Department of Social Services (DSS), Division of Long Term Services and Supports — official page |
| Application / initial fee | Not published — No state licence exists, so no state licence fee. Medicare certification (CMS-855A enrolment) is federal and carries no SD DOH licence fee on the page reviewed. |
| Renewal | Not applicable — no state licence to renew. |
| Surety bond | No state bond minimum found in the published rules |
| Liability insurance | State sets no minimum (no licence scheme). Because there is no licensure standard, DOH publishes no background-check, training or insurance standard for private-pay non-medical agencies. |
| Timeline | Not published |
| Administrator | No state administrator, training or background-check standard applies to private-pay non-medical agencies — this absence of a standard is itself stated in state-facing guidance. Medicaid Personal Care Agencies are different: they must enrol with SD Medicaid, undergo an LTSS onsite review, complete corrective actions and sign a Purchase of Services Agreement before providing Medicaid personal care services. |
| State extras | Business registration, workers' compensation and voluntary accreditation (e.g. Joint Commission) are market costs, not state requirements. Medicaid route adds LTSS review readiness at no published state fee. |
| Service | Under this license |
|---|---|
| Companionship & supervision | Covered |
| Homemaker help | Covered |
| Hands-on personal care | Covered |
| Live-in / 24-hour care | Not covered by this license |
| Transportation | Not covered by this license |
| Skilled nursing or therapy | Home health license required |
DOH's own examples of unregulated non-medical care: bathing, light-duty housekeeping and meal preparation. Skilled care in the home is delivered by federally certified home health agencies (skilled nursing plus PT, speech-language pathology, OT, medical social services or home health aide services under a physician-established written plan of treatment) — federal certification, not state licensure.
In substance a separate federal route, not a state licence: DOH states 'South Dakota does not require state licensure for certified HHAs.' Entry is Medicare enrolment on Form CMS-855A through the fee-for-service contractor CGS Administrators, OCR Assurance of Compliance, and a Health Insurance Benefit Agreement, with DOH performing federal survey functions (OASIS, HHA Survey Report). Schema value is 'separate-license' only because no 'federal-certification-only' value exists — read this note as controlling.
Watch item, not a current gate: HB 1138 (2026), which would have created state licensing, training standards and criminal-history background-check procedures for non-medical home care agencies, was vetoed and did not take effect. South Dakota therefore remains unlicensed for non-medical home care as of this pass, but the vetoed bill signals the direction of travel — build to licensed standards anyway.
Enrol as a Medicaid Personal Care Agency with SD DSS / Provider Enrollment (1-866-718-0084 per DOH page): LTSS onsite review, any corrective actions, and a signed Purchase of Services Agreement are required before Medicaid personal care services may be provided.
EVV required for Medicaid personal care / home health visits under the federal Cures Act; South Dakota is an open model with Therap as aggregator in national EVV listings. Private-pay-only agencies have no EVV duty.
The state fee above is one line of the real total. Run the true-cost calculator with South Dakota selected — it adds the bond premium, insurance class, screening and the payroll runway your first hires create.
This page is information, not legal advice. Confirm before you file: the agency — not this page — decides your application.
The free checkers give you the verdict and the number. The Kit gives you the working papers: your state's application packet walked through in filing order, the policies-and-procedures binder spec (what your binder must contain — never a boilerplate binder), the administrator self-audit, the insurance & bond spec sheet, the Medicaid gate map, the franchise-vs-independent 10-year worksheets, and the payroll-runway planner.
$49 one-time payment
Included in the $49 HomeCareLicenseCheck Kit
