Assisted Living in North Dakota

Get the insights you need to find the right city.

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.

Average Monthly Costs

States near North Dakota

$4,370.00 Minnesota
$4,282.00 Montana
$4,000.00 US
$3,622.00 North Dakota
Genworth lists the average cost of a private, one bedroom unit in an assisted living community in North Dakota as $3,622. This places North Dakota on the lower end of the scale at about $400 under the national average, and about $500 lower than the median cost of assisted living in nearby states.

Compare Monthly Care Costs

When it comes to care options, assisted living is just one of several choices available to seniors. Some care options, like part-time in-home care or independent living, may cost less, while others like memory care or skilled nursing are likely to cost significantly more. Seniors can speak with their medical practitioners to receive guidance on what level of care will best suit their needs and abilities.

Nursing Home Care


In-Home Care


Assisted Living

Average Monthly Costs

Cities in North Dakota

$3,879.00 Fargo
$3,879.00 Bismarck
$3,496.00 Rest Of State
$3,305.00 Grand Forks
When estimating the cost of assisted living, it's important to know that average prices can differ significantly between various parts of North Dakota. The most affordable region in North Dakota for assisted living is Grand Forks at $3,305.

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:

  • Bathing
  • Dressing
  • Grooming
  • Toileting
  • Eating
  • Mobility

iADLs, on the other hand, are less critical but still important tasks that include:

  • Cooking
  • Housework
  • Laundry
  • Transportation
  • Shopping

North Dakota's Department of Health and Department of Human Services licenses two types of assisted living communities.

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.

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:

North Dakota Aging Services Division

1237 West Divide Avenue, Suite #6, Bismarck, ND 58501
(855) 462-5465

Three Affiliated Tribes - Aging Services

404 Frontage Road, New Town, ND 58763
(701) 627-4547

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
  • Functionality
  • 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.

Staffing Requirements

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
  • Safety

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.

Assisted Living Facilities in North Dakota