South Dakota Medicaid Penalty Divisor: a Fiscal-Year Private-Pay Average

Updated August 27, 2026. Quick answer: South Dakota pins its divisor to a FISCAL YEAR, which is unusual and worth knowing before you time an application. ARSD 67:46:05:09 divides the uncompensated value of the transferred assets by the monthly state-wide average of long-term care costs for private pay individuals for the state’s current fiscal year. The rule states no amount — the whole of chapter 67:46:05 was read for this page and its 17 dollar amounts are all resource limits and exclusions.

What South Dakota publishes

How the penalty period is calculated

• 67:46:05:09 states the division in one sentence: the period of ineligibility “is determined by dividing the uncompensated value of the transferred assets by the monthly state-wide average of long-term care costs for private pay individuals for the state’s current fiscal year.”
• The fiscal-year anchor is the practical difference between South Dakota and most of its neighbours. States that tie the divisor to the month of application re-price a file whenever the figure moves; South Dakota ties it to a fiscal year, so the question to ask the worker is which fiscal year’s average is being applied, not which month’s.
• South Dakota does not round the remainder away and it does not convert it to money. The rule imposes a PARTIAL MONTH period of ineligibility where the calculation leaves a remainder, “rounded up to a whole day.” The penalty is measured in days at its tail.
• The look-back at 67:46:05:06.01 requires BOTH conditions at once: it runs 60 months back from the first date on which the individual is institutionalized AND applies for long-term care assistance. Entering a facility without applying does not start the clock, and neither does applying without being institutionalized.
• Multiple transfers stack rather than merge. Under 67:46:05:09.02 the periods of ineligibility are consecutive, and where a transfer occurs while a penalty is already running, the new period is ADDED to the one in effect.
• For an applicant the penalty begins on the date they would be eligible for nursing facility or HCBS waiver services but for the ineligibility, or the day after a prior penalty ends, whichever is later. Where both spouses are in a facility or on a waiver and one is already serving a transfer penalty, 67:46:05:09.02 apportions the months EQUALLY between them.
• The hardship waiver at 67:46:05:10 is unusually demanding and worth reading before relying on it. Beyond clear and convincing evidence of deprivation, the individual must demand the asset back or receive its fair market value — and if that fails, must either retain an attorney to bring a civil action for recovery or, where the transfer was theft or exploitation, report it to law enforcement. The facility or waiver provider may file the waiver application with the individual’s consent, and a denial is appealable under chapter 67:17:02.
• The intent presumption can be rebutted, but 67:46:05:11 sets the shape of the argument: the individual must show there were OTHER resources at the time that met their care and maintenance needs, and no evidence of a disability or medical condition that would have required long-term care or expense beyond their means. Medicaid-qualifying trusts are excluded from that rebuttal entirely, and 67:46:05:06 calls the presumption for them irrebuttable.

Once you have the figure above, the Medicaid penalty period calculator does the arithmetic. This page is the South Dakota rate record; the calculator is the class parent.

What this page does not settle

• This page does not tell you South Dakota’s current divisor. The rule delegates it to a state-wide average for the current fiscal year and prints no amount, and this page will not borrow one from a source the state did not publish.
• The negative claim was made across the whole chapter and it survived an instrument repair that reversed the first answer. Chapter 67:46:05 is served as UTF-16; read as UTF-8 it appeared to contain ZERO dollar amounts, which would have been a false and much stronger claim than the truth. Decoded correctly the chapter contains 17, and every one of them is something else: the $6,000 income-producing-property threshold, the $2,000/$3,000 resource limit, and the $1,500 life-insurance and burial-fund exclusions. Section :09 contains none.
• A benchmark daily rate published for another purpose is not this figure. South Dakota’s rule defines a MONTHLY state-wide average for private-pay long-term care, and a daily rate from a cost survey or a provider bulletin is a different quantity computed for a different reason. The current amount comes from the Department of Social Services.
• The rule’s own history stops in 2005 — the last amendment is 31 SDR 107, effective February 1, 2005, on a section first effective in 1989 and transferred from § 67:16:20:02.04 in 1992. That is a stable rule, not a stale one, precisely because the moving number lives outside it.
• Nothing here decides whether a transfer is penalised. 67:46:05:06 presumes any transfer for less than fair market value on or after the look-back date was made to establish eligibility, and puts the burden on the individual to furnish clear and convincing evidence otherwise.

Eligibility is decided by the state agency on the whole file, not by this one number. Nothing here is legal advice, and no one should transfer, retitle or give away property on the strength of a worksheet.

Sources

• South Dakota Administrative Rules, Article 67:46, Chapter 67:46:05, Resources — including 67:46:05:09, Calculating period of ineligibility
• ARSD 67:46:05:09, Calculating period of ineligibility, served by the South Dakota Legislature’s rules API

Each source above was retrieved and read against the state text on August 27, 2026. Every figure on this page was checked against those bytes.