A community living home is any family-style residence whose owner or operator is engaged in the business of providing individualized and independent residential community living support for compensation. Community living homes serve at least one but no more than four adult residents unrelated to the owner or operator. Residents receive one or more regularly scheduled health-related services, either administered directly by the owner or in collaboration with an outside healthcare provider. Any setting that is certified or accredited through Chapter 34-20A, Title 27A, or Title 27B is not considered a community living home.

Community Living Home Application  Community Living Home Sample Resident Agreement ARSD 44:82 for Community Living Homes

Community Living Home Fact Sheet

A community living home is licensed through the Department of Health according to SD Codified Laws and is subject to inspections to ensure the resident’s health and safety needs are being met. Community living homes may also work closely with other state and private entities.


  • A family-style home that is not an institutional setting
  • Alternative long-term care living arrangements besides assisted living centers or nursing
  • Residence may be owned, leased, or rented by the provider
  • Less restrictive
  • A cozy home-like environment with a maximum of four adults in the home
  • Personalized care to meet each individual’s identified needs
  • Enhanced quality of life
  • Reimbursed at a daily rate with three tiers

Provider Expectations:

  • Obtain licensure through the SD Department of Health
  • Follow the Administrative Rules of South Dakota for Community Living Homes Article 44:82
  • Must not exceed the maximum number of four residents or less according to license
  • Conduct an evaluation of the resident’s individual community living support needs
  • Develop an individualized care plan jointly with the resident (and family, if applicable)
  • Provide personalized care by qualified caregivers
  • Encourage the resident to self-administer medications or provide assistance by qualified
    personnel or care providers licensed or authorized to administer medications
  • Maintain privacy and confidentiality of resident care and resident care records
  • Promote resident rights
  • Obtain a signed and dated written admission agreement that includes the services available
  • Provide three meals a day according to the physician’s prescribed diet

Medicaid Reimbursement for Community Living Home Services

The provider enrolls through DSS Medicaid Provider Enrollment and DHS Long Term Services and Supports to receive Medicaid Reimbursement for Community Living Home Services.

  • What is included in the rate?
    • Routine intermittent personal care
    • Supervision
    • Cueing
    • Meals
    • Homemaker services
    • Chore services
    • Medication management (to the extent permitted under State law)
    • Other instrumental activities of daily living (transportation for necessary appointments and
      community activities, shopping, managing finances, phone use, etc.)

  • What may be authorized for separate payment?
    • Adult companion services
    • Adult day services
    • In-home nursing services
    • Specialized medical equipment and supplies
    • Nutritional supplements
    • Respite care (when the Community Living Home is the full-time residence of the owner/operator)
    • Extraordinary personal care needs that exceed intermittent daily assistance; for example,
      when the resident requires assistance of more than one person to complete activities of daily

Services must be consistent with the resident’s assessed needs and reflected in the
person-centered care plan.


Jennifer Maeschen, RN
South Dakota Department of Health

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Reimbursement and DHS Enrollment

Mary Rea
South Dakota Department of Human Services

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