Assisted Living in North Dakota
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Families looking for assisted living in North Dakota (ND) have a wide array of communities to choose from, since estimated that there are more than 30,000 assisted living communities serving seniors across the U.S., and over 53 statewide. The state is also home to a rapidly growing number of senior citizens, with adults over 65 making up an estimated 15 percent of the population. A resident in an assisted living community in North Dakota will pay $3,315 per month on average.
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What You Should Know About Assisted Living in North Dakota
Living independently presents challenges as people age, and tasks that were once simple can become increasingly difficult. For those who are ready to take some of those responsibilities off their plates but don't need the intensive structure of a nursing home, assisted living may be the answer.
Assisted living facilities offer a variety of services, including assistance with the activities of daily living (ADLs) and instrumental activities of daily living (iADLs).
ADLs include fundamental and necessary activities such as:
iADLs, on the other hand, are less critical but still important tasks that include:
Assisted Living Facilities (ALFs): ALFs are communities with at least five resident units that offer individualized support services to five or more residents. ALFs are not group homes; they're similar to, but aren't necessarily apartments. Units have lockable entry doors and private bathrooms.
Basic Care Facilities (BCFs): BCFs provide room and board as well as other services including health, personal care and social programs. BCFs host at least five residents. BCFs have more regulations to follow than ALFs, and they're mandated to offer meals, which ALFs are not.
Financial Assistance for Assisted Living in North Dakota
North Dakota has programs to help seniors and adults with disabilities remain independent at home or in their community. Some of them cover assisted living expenses.
Medicaid 1915(c) Waiver for Home and Community-Based Services (HCBS) Program
The HCBS program offers financial assistance to eligible residents at BCFs. The program does not apply to ALFs. Qualified seniors receive residential care in a facility with services that include meals, personal care, social, recreational and therapeutic programs and 24-hour on-site staff.
Who Is Eligible?
To receive benefits from the HCBS waiver program, individuals must be:
- At least 65 years of age
- Enrolled in Medicaid
- Screened at a nursing facility
- Capable of directing self-care
- In a home or apartment setting (no dorms or group homes)
- Able to have needs adequately met in a BCF environment
How to Apply
To apply for HCBS waiver benefits, contact your local county social services office.
The BCAP covers any remaining assisted living and health care costs for qualified beneficiaries after their income is applied, minus a $60 monthly allowance for personal needs.
Who is Eligible?
To qualify for the BCAP, applicants must:
- Be aged 65 years or older
- Be an adult 18 years or older with a qualified disability
- Receive a functional assessment from a social worker
How to Apply
If you’re interested in applying for benefits, complete an application and contact your local social services office.
More Ways to Finance Assisted Living
While many families use their own funds or personal assets to pay for assisted living, there are plenty of additional options to cover these costs. Visit our 9 Ways to Pay for Assisted Living page for more information.
Free Assisted Living Resources in North Dakota
In addition to the Medicaid assistance discussed above, North Dakota has government-funded and private, nonprofit organizations that help seniors with resources, programs and financial aid.
Whether you are considering assisted living, nursing home care or looking for ways to continue independent living, there are numerous sources of assistance.
North Dakota Area Agencies on Aging
Area Agencies on Aging (AAAs) are a nationwide network of over 600 agencies and organizations dedicated to assisting elders and improving long-term care. Contact your local AAA for information on programs for seniors, including North Dakota's SPED program, which provides financial help for in-home and long-term care services.
The following are a list of AAA offices in North Dakota:
The North Dakota Department of Veterans Affairs assists qualified veterans with a host of benefits from medical and dental services to financial and housing assistance, including hardship grants. The VA hosts the North Dakota Veterans Home in Lisbon with 111 basic care and 38 skilled nursing care beds.
Look for your closest VA Center:
The Social Security Administration provides supplemental security income (SSI) and social security disability insurance (SSDI) to qualified adults. North Dakota's local offices can assist with benefits, applications and information on other programs that may be available.
Find your local office:
4207 Boulder Ridge Rd, Bismarck, ND 58503
1-877-319-6044 or TTY: 1-800-325-0778
221 2nd St Nw, Devils Lake, ND 58301
1-701-662-6290 or TTY: 1-800-325-0778
657 N 2nd Ave, Fargo, ND 58102
1-877-335-4114 or TTY: 1-800-325-0778
402 Demers Ave, Grand Forks, ND 58201
1-888-617-0456 or TTY: 1-800-325-0778
300 2nd Ave Ne, Jamestown, ND 58401
1-855-848-7938 or TTY: 1-800-325-0778
1414 20th Ave Sw, Minot, ND 58701
1-866-415-3193 or TTY: 1-701-838-9996
1137 2nd Ave West, Williston, ND 58801
1-701-572-0682 or TTY: 1-800-325-0778
North Dakota has a statewide Long-Term Care (LTC) Ombudsman program. An LTC ombudsman offers confidential assistance to residents of any long-term care facility or home at no cost.
An LTC Ombudsman works as an advocate for individual residents to resolve disputes and concerns; they also provide information and referral services and work to promote long-term care education in the community.
Call toll-free 855-GO2LINK (1-855-462-5465) Option 3 and ask for the Long Term Care Ombudsman Program.
Assisted Living Laws and Regulations in North Dakota
Assisted Living Service Plan Requirements
Care plans are documents that outline the specific needs and services required by an individual resident. They spell out how those needs are addressed, who provides the services and when those services are given.
ALFs are not required to perform an assessment or complete a care plan; however, ALFs must evaluate prospective residents to ensure residency criteria are met. ALFs must also maintain records of given services for all residents.
BCFs are held to different standards. Within 14 days of entering a facility, new residents receive an assessment to help staff members and administrators create an individual care plan.
Assessments involve gathering information relating to a resident’s current needs:
- Health and psychosocial needs
- Ability to perform self-preservation
- Nutritional and personal care needs
- Social and recreational interests
Assisted Living Admission Requirements
North Dakota's admission and retention policies are less restrictive than many other states.
Determining residency criteria is left to individual ALFs, and BCFs may do the same. BCFs must, however, adhere to these guidelines:
- Residents must be capable of self-preservation
- Residents cannot have a condition that calls for 24-hour nursing or health care
Assisted Living Scope of Care
The scope of care defines the services and care that a facility is licensed, or required, to provide.
In North Dakota, ALFs must provide support services for each resident, including assistance with ADLs. Services are not packaged; residents pay for each service individually. Some ALFs may provide health services.
BCF's scope of care goes a step further:
- Assistance with ADLs and iADLs
- Health care arrangements
- Transportation and transfer arrangements
- Monitoring and recording of behavioral or physical changes
- Medication services
- Social and recreational services
- Nursing availability
Residents at BCFs may purchase service packages.
Assisted Living Medicaid Policy
Medicaid does not offer financial benefits for ALF residents; however, those living in BCFs may qualify for the HCBS waiver or BCAP program detailed above. The state caps fees that facilities can charge waiver participants for room and board to $683.
North Dakota does permit family supplementation which means that family members may assist with living expenses without affecting a senior's Medicaid eligibility, provided it's done in an approved manner.
Please note: Not all facilities accept Medicaid as a form of payment. Contact your local communities to learn about their policies.
Assisted Living Facility Requirements
North Dakota sets guidelines concerning bathing and toilet facilities as well as room occupancy and accessibility.
ALFs are not mandated to provide apartments, though many are similar. Living units can be single or double occupancy. All units must include the following:
- Sleeping area
- Lockable entry door
- Private bathroom with sink, toilet and tub or shower
BCF rooms can be designated as single-occupancy or multi-resident rooms for three or more people. There must be one toilet and sink for every four residents and a tub or shower for every 15.
Medication Management Regulations
In both ALFs and BCFs, staff members may assist with medications. Assistance typically includes reading labels, opening containers and giving reminders.
All facilities must adhere to state regulations for medication administration, including those described in the Nurse Practice Act. To administer medication, a staff member must be certified as a level I, II or III medication assistant and operate under the supervision of a registered nurse.
BCFs must also have all residents' medication regimen reviewed by a health professional or pharmacist at least once per year or as needed.
Neither ALFs nor BCFs is mandated to meet specific staffing ratios; instead, adequate staff must be present 24 hours a day to perform expected and unexpected services for residents.
ALFs must employ a manager and direct care staff, and the manager may be the licensee. For ALFs that administer medication, an RN must be available to perform administration or supervise certified medication assistants.
BCFs must staff an administrator as well as a licensed nurse, either through direct employment or contract, to administer medication, provide nursing services and supervise medication assistants. Direct care staff are required to provide personal care and services as needed.
BCFs must have at least one awake staff member on duty at all times.
Staff Training Requirements
North Dakota's training requirements are similar to many other states in that they call for ongoing training and continuing education.
All staff at ALFs must receive training annually on these topics:
- Fire and accident prevention
- Emergency response
- Physical and mental health
- Behavioral issues and strategies
- Infection control
- Resident rights
All ALF managers must complete 12 hours of continuing education annually. BCF employees receive in-service training annually that covers the following:
- Resident health needs
- Behavioral problems
- Infection prevention and control
- Resident rights
- Fire and accident prevention
Any ALF staff member who provides resident activities must attend at least two relevant educational programs yearly. In addition, all ALF administrators are required to complete 12 hours of continuing education per year.
Background Checks for ALR Staff in North Dakota
There are no provisions in North Dakota’s regulations that mandate background checks for ALF employees. Contact your current or prospective home for their policies.
BCFs must check state registries and licensure boards for records of past inappropriate conduct or disciplinary actions before offering a position to a candidate.
Requirements for Reporting Abuse
If you know or suspect that anyone is abusing or neglecting a senior, please contact North Dakota's Vulnerable Adult Protective Services. For immediate assistance in urgent situations, contact your local law enforcement agency.