Updated September 6, 2026. Quick answer: In South Dakota, a Medicaid nursing-facility resident’s Personal Needs Allowance is $100.00/Month; the amount of their own income they keep for personal use each month, with the rest going to the facility as the patient-pay amount toward the cost of care. That is well above the $30/month federal floor set in 1988 and never raised since. South Dakota Administrative Rules (ARSD) 67:46:06:05: Deduction for personal needs states the figure directly.
Why South Dakota’s figure isn’t the federal floor
Federal Medicaid law requires only a $30-a-month personal needs allowance as a floor; a state is free to set its own, higher figure by statute, regulation, or agency policy. South Dakota has done exactly that, setting $100.00/Month, effective rule as currently in force amended effective June 30, 2024 (51 SDR 3).
What the allowance covers, and what it doesn’t
The personal needs allowance pays for the things a facility’s daily rate doesn’t cover: clothing, haircuts, snacks, a phone or television, small personal purchases. It is deducted before the rest of a resident’s income is applied to the facility bill as the patient-pay (or post-eligibility treatment of income, PETI) amount. It is not extra money on top of what Medicaid already pays the facility; it is the one slice of a resident’s own income that Medicaid rules guarantee the resident, not the facility, keeps.
| Citation | South Dakota Administrative Rules (ARSD) 67:46:06:05: Deduction for personal needs |
| What it says | “An applicant or recipient residing in a nursing or intermediate care facility is allowed: (1) A deduction of one hundred dollars per month to cover personal needs; (2) If earning income, an additional deduction for personal needs up to a maximum of the first seventy-five dollars of gross earned income per month; and (3) If paying court-ordered child or spousal support, an additional deduction for personal needs up to the amount of child or spousal support actually paid out, not to exceed the court-ordered amount.” |
Figures verified against ARSD 67:46:06:05 (sdlegislature.gov API text) and 42 U.S.C. 1396a(q) on September 30, 2026; the year the federal $30 floor was first set (stated as 1988) was not re-checked.
Every citation on this page was read directly from the state’s own Medicaid agency, administrative code, or official eligibility manual this session. General information, not legal or financial advice; a figure this specific can change with a budget cycle or a rule amendment, and a facility or state caseworker has the final say on any individual case.