Memory-related conditions such as Alzheimer’s disease are increasingly becoming a public health concern in North Dakota, where nearly 16% of the population, or 122,000 people, are aged 65 and over. According to data published by the Alzheimer’s Association, 15,000 North Dakota seniors were living with Alzheimer’s in 2020. By 2025, it’s projected that this number will increase by 6.7% to 16,000. North Dakota has the 10th highest Alzheimer’s death rate in the United States, with Alzheimer’s as the fourth leading cause of death statewide.

As Alzheimer’s and other types of dementia progress, many seniors transition out of a private home and into memory care. In North Dakota, memory services may be provided in basic care facilities. These communities provide residents with assistance with daily living activities and other supportive services and have specially trained staff and increased safety features inside and in secured outdoor areas.

Memory care can either be offered on its own in a community designed especially for those with dementia or Alzheimer’s, or, more often, it’s provided as a service in a separate wing of an assisted living facility. Memory care programs are designed specifically for those with memory impairment, and the facilities often coordinate social activities and schedules specifically for the needs of those living with Alzheimer’s or dementia.

This guide provides a comprehensive look at the cost of memory support in North Dakota and how it compares with the costs in nearby states and other types of senior care. It also gives an overview of financial and informational resources available within the state, the regulations that govern memory care and the most frequently asked questions.

The Cost of Memory Care in North Dakota

Just 775,000 people call North Dakota home, and of those, around 15% are aged 65 and over. With a relatively large senior population, Alzheimer’s disease and similar memory-related conditions are a growing concern in the state. In 2020, 15,000 people in North Dakota had Alzheimer’s disease, and it’s estimated that this number will rise to 16,000 by 2025.

North Dakota has a number of resources that can help seniors with memory-related conditions, including medical facilities, such as Sanford Broadway Clinic, with geriatric specialists on staff. At $4,239 per month, memory care in North Dakota is more affordable than the national average, and this, coupled with the state’s low cost of living, can help retirement incomes stretch further. As one of the country’s least densely populated states, North Dakota is an attractive retirement choice for seniors who love wide open spaces. It also offers retirees clean air and low levels of crime

Memory care can either be offered on its own in a community designed especially for those with dementia or Alzheimer’s, or, more often, it’s provided as a service in a separate wing of an assisted living facility. Memory care programs are designed specifically for those with memory impairment, and the facilities often coordinate social activities and schedules specifically for the needs of those living with Alzheimer’s or dementia.

This guide provides an overview of memory care costs in North Dakota, as well as the costs of other senior living options in the state. You can also find information about memory care regulations, financial assistance options and free resources that can help you as you age.

The Cost of Memory Care in North Dakota

Note: Memory care in the United States is generally provided as an additional service in assisted living facilities. Currently, the cost of memory care isn’t tracked nationwide, but prices are typically 20%-30% higher than assisted living costs. The figures below are an estimate calculated by adding 25% to the assisted living prices in the Genworth 2021 Cost of Care Survey.

The average memory care price in North Dakota is $4,239 per month, which is significantly lower than the national average of $5,625. North Dakota is also very affordable when compared to its neighbors. Of neighboring states, only South Dakota has lower prices, with seniors there paying $4,188 per month. In Montana, the average price is $5,563, and seniors in Minnesota pay $5,635 per month. This is $1,396 higher than memory care in North Dakota.

$4239

North Dakota

$5625

The United States

$4188

South Dakota

$5563

Montana

$5635

Minnesota

The exact price you pay for memory care in North Dakota depends on where you live. Fargo has the highest prices at $4,800 per month. Costs in Bismarck are also lower than the state average at $4,638. Grand Forks is the most affordable of the state’s big cities, with seniors there paying just $2,750 per month for memory care. 

$4638

Bismarck

$2750

Grand Forks

$4800

Fargo

North Dakota has a variety of senior living options available that may be appropriate depending on your circumstances. Adult day health care and assisted living are the most affordable at $3,383 and $3,391, respectively. Home care and home health care both average $5,689 per month, which is $1,450 more than memory care. Nursing home care is the least affordable, at $11,978 for a semiprivate room and $12,587 for a private room. 

$3383

Adult Day Health Care

$3391

Assisted Living

$5689

Home Care

$5689

Home Health Care

$4239

Memory Care

$11978

Nursing Home (semiprivate)

$12587

Nursing Home (private)

Does Medicaid Cover Memory Care in North Dakota?

Note: For the purposes of this guide, when we say “Memory Care” we are referring to memory care provided in a “social setting,” such as an Assisted Living Facility. This is the most common way to receive Memory Care and is the best fit for all but the frailest seniors. Sometimes the actual service of memory care can be provided in a Nursing Home (“medical setting”), so the financial assistance options will be very different. To learn more about the financial assistance options available for memory care provided in a nursing home, read our guide to Nursing Home Care in North Dakota.

North Dakota Medicaid has two programs that may be able to assist with the cost of memory care in the state. The first is known as Medicaid State Plan – Personal Care Services, or MSP-PC. This isn’t a waiver program, so it’s open to all eligible applicants. However, the services provided through the program are limited to assistance with activities of daily living and instrumental activities of daily living. 

The second program is the Home and Community-Based Services (HCBS) Waiver. This is sometimes referred to as the Aged and Disabled Waiver. This can provide a greater variety of services than MSP-PC, including case management, meals and transportation. Both programs can provide care in homes, adult foster care or assisted living communities, including memory care units. 

What Memory Care Services Are Covered by Medicaid in North Dakota? 

Medicaid State Plan – Personal Care

Medicaid in North Dakota can help seniors pay for memory care through the Medicaid State Plan – Personal Care program. This program is designed to provide assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Care can be provided on an intermittent or ongoing basis. To receive assistance, applicants must reside at home, in the home of a loved one or in certain group living arrangements. This includes some types of assisted living facilities known as basic care facilities. 

There are three different levels of the program available, known as A, B and C, and each has slightly different eligibility criteria. All provide the same type of care, but the number of hours provided differs based on the level.

To be eligible for the program, you must require personal care for at least 30 days. An assessment is performed as part of the application process to determine the amount of assistance you require, and this determines the level of care. At levels B and C, a nursing home level of care is required. Applicants must also be financially eligible for Medicaid. There are no age requirements for the program. 

The benefits of this program are limited to assistance with ADLs and IADLs. Help with ADLs can include dressing, grooming, eating and mobility. Those who need assistance with IADLs can get help with laundry, preparing meals and medication management, among other services.

As this isn’t a waiver program, assistance is available to everyone who is eligible. You can apply through your local Human Service Zones office or call (800) 472-2622 for more information. 

Memory Care Waiver Programs in North Dakota

Home and Community-Based Services Waiver

The Home and Community-Based Services Waiver is designed to help people stay living in their homes or the community. There are a range of services available through the program to keep those who need a nursing home level of care safe, comfortable and healthy. 

The HCBS is available to people of all ages who are financially eligible for Medicaid and meet the medical eligibility criteria. Those under 65 years of age must be designated disabled by Social Services, and those 65 and over must require a nursing home level of care. The program has limited places, and applicants may be placed on a waiting list. North Dakota will also deny a place to someone if it would cost less to care for that person in a nursing home. 

Benefits available to people on the program include case management, chore services, transportation and medical supplies or equipment. The program also covers residential care, which includes the services provided in the facility such as recreational and social programming, supervision, safety and security. However, the program doesn’t cover room and board. 

Applications for the program can be made through the Aging and Disability Resource-LINK. They can be contacted at 1-855-462-5465 for more information. 

How to Know If You’re Eligible for Medicaid in North Dakota

Eligibility for Medicaid in North Dakota is based on a number of factors, including your health, finances and circumstances. Older adults who wish to access Medicaid programs must be:

  • Aged 65 and over
  • A resident of North Dakota
  • A U.S. citizen or lawfully permitted permanent resident
  • Have assets of less than $3,000 if single or $6,000 if married and both spouses are applying
  • Have an income of less than $891 per month if single or $1,205 if married and both spouses are applying

2022 Medicaid Income Limits for Seniors in North Dakota

Income Limits* 

Asset Limits

Single Applicant

$10,692

$3,000

Two-Person Household

(Only One Person Applying)

$10,692 applicant 

$3,000 applicant 

$137,400 non-applicant 

Two-Person Household
(Both People Applying)

$14,460

$6,000

Not all assets are counted when your financial situation is being assessed. Personal belongings, an automobile and irrevocable burial trusts are among the non-countable assets. A person’s primary home is also exempt if they intend to return or if their spouse is still living there. 

If only one person in a couple is applying, the non-applicant may also be eligible for the Minimum Monthly Maintenance Needs Allowance. This lets you transfer income from the applicant to the non-applicant to ensure the non-applicant can continue to pay for their living expenses. 

How to Apply for Medicaid in North Dakota

Applications for Medicaid are handled through local Human Services Zone offices. To apply by mail, request a form from your local office. Forms can also be found on the Medicaid website. Alternatively, you can use the online application portal, and your application will be forwarded to your local office. 

Information You Will Need 

To complete your application, you will need to provide:

  • Identification
  • Birth certificate or driver’s license to prove your age
  • Evidence of your citizenship or residency status
  • Social Security number
  • Proof of income
  • Proof of the value of your current assets
  • Documentation of certain expenses, such as health insurance premiums

How to Get Help Applying for Medicaid 

North Dakota has resources available if you need help applying for Medicaid. Human Service Zone offices are the primary point of contact, as they process applications and have a thorough understanding of programs. The state also produces a guidebook to answer questions about applying. Finally, the State Health Insurance Counseling program can answer questions about health insurance, including Medicaid. 

Program

Contact

Services Provided

Find local numbers online

Formerly known as County Social Services offices, Human Service Zone offices can help people access a range of services and support programs, including Medicaid. Local staff can answer questions, help identify resources you may be eligible for and process applications. 

N/A

This guidebook is produced by the Department of Human Services. It has extensive information about the resources available to help North Dakotans in need, including the Medicaid program. There are also detailed instructions on how to apply and the information you need to supply with your application. 

(701) 328-2440

SHIC is designed to help people navigate the Medicare program, but trained counselors can also answer questions about other health insurance, including Medicaid. 

Does Medicare Cover Memory Care in North Dakota?

The short answer is that no, Medicare does not cover the cost of memory care in North Dakota. As was mentioned above, this doesn’t apply to Memory Care received in a Nursing Home. Since it is the most common to receive memory care in a “social setting” (such as an assisted living facility), Medicare won’t be a viable financial assistance option for most seniors who need Memory Care. However, Medicare will still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for Memory Care in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in North Dakota.

Other Financial Assistance Options for Memory Care in North Dakota

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Memory Care affordable.

How to Apply

How It Works

Aid and Attendance

Learn more and apply online at va.gov.

Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Memory Care.

Reverse Mortgages

Learn more about your options and how to apply at ftc.gov

If you own a home, you may be able to use a reverse mortgage to help pay for Memory Care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

Long-Term Care (LTC) Insurance

Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.

Seniors who already have long-term care insurance may be able to use it to pay for Memory Care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Memory Care will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in North Dakota

North Dakota has a range of services available to help seniors who need memory care services. These are provided by government and nonprofit organizations. Some programs provide financial help, and others assist with advocacy, care and finding local resources.

Program 

Contact

Services Provided

The Basic Care Assistance Program helps residents of basic care facilities pay for room and board. Basic care facilities are a type of assisted living facility, and some provide memory care. Although not a Medicaid program, BCAP is only available to those who qualify for Medicaid. Recipients can keep a certain amount of their income, currently $60 per month, for personal needs. The rest goes toward paying for their care. The government pays any care costs that your income doesn’t cover. 

This program is designed to help people pay for services in the home if they don’t qualify for Medicaid but are struggling to pay. Services covered include personal care, chore services and case management. Although this program doesn’t cover care provided in assisted living facilities, it can pay for adult family foster care. The expanded program offers the same benefits and is available to people who are eligible for Medicaid and Social Security Income. 

(855) 462-5465

The ADRL connects people to services and support that can improve their quality of life. It maintains a directory of services to help you find assistance near you, and resource professionals are available by phone to direct you to local resources. 

(855) 462-5465

The Long-Term Care Ombudsman program advocates for people living in long-term care environments, including nursing homes, assisted living communities and basic care homes. Its primary role is to investigate and help resolve complaints and concerns. Volunteers with the program can also answer questions about long-term care, promote resident and family involvement in communities and recommend changes in facilities. 

(800) 272-3900

The Alzheimer’s Association is a national organization dedicated to helping people with Alzheimer’s disease and related dementias. It has a 24/7 helpline available to provide support and information. The Minnesota-North Dakota chapter has local offices that conduct community classes, support groups and other resources. 

(800) 272-3900

The Dementia Care Services Program is a partnership between the Alzheimer’s Association and the Department of Human Services, Aging Services Division. It provides support to people living with dementia and their caregivers. The main benefit is care consultation, with dementia care experts available to create customized plans that help people navigate their futures after diagnosis. The program also educates physicians and the general public on dementia-related topics.

COVID-19 Rules for Memory Care in North Dakota

The following information is based on research done on several government websites, including health.nd.gov.. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/13/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Rules for North Dakota Communities

Are loved ones allowed to visit to provide emotional support?

Yes

Are relatives allowed to visit for end-of-life care?

Yes

Are residents required to quarantine after visiting with a loved one?

No

Are visitors required to wear PPE (including masks) in order to visit residents?

Yes

Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?

Yes

Are visitors checked for elevated temperatures?

Yes

Are visitors required to answer questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

Rules for North Dakota Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Yes

Are residents who leave required to quarantine when they return?

No (Conditions Apply)

Are senior living communities required to cancel all group outings?

No

Are residents allowed to eat meals together in a common area?

Yes (Conditions Apply)

Are residents allowed to gather in common areas for group activites?

Yes (Conditions Apply)

COVID-19 Safety Measures for Staff and Residents

Rules for North Dakota Communities

Are staff members regularly required to do a temperature check?

Yes

Are staff members regularly tested for COVID-19?

Yes (Conditions Apply)

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Yes

Are residents regularly screened for COVID-19 symptoms?

Yes

Are residents regularly checked for elevated temperatures?

Yes

Are residents regularly tested for COVID-19?

Yes (Conditions Apply)

Memory Care Laws and Regulations in North Dakota

In North Dakota, memory care services are provided in basic care facilities that are licensed to provide specialized services exclusively to those who have Alzheimer’s, dementia and other special memory care needs. These facilities are governed and licensed by the North Dakota Department of Health, which enforces regulations to ensure a standardized level of care.

Memory Care Laws and Regulations in North Dakota

Scope of Care

Memory care facilities may admit and retain residents who require around-the-clock personal care, but they can’t retain residents who need more than intermittent nursing or medical care. They must serve at least three nutritious, well-balanced meals daily, along with regularly scheduled snacks. Facilities must also provide housekeeping and laundry services, assistance with activities of daily living and instrumental activities of daily living, social support and medical care arrangements, transportation and assistive devices.

Care Plans

Within 14 days of admission and at least once every three months, memory care facilities are required to conduct an assessment that covers factors such as personal care needs, capability for self-care and social and activity interests. Memory care facilities must create person-centered care plans with the resident’s input within 21 days following this functional assessment.

Medication Management

Memory care facilities are required to provide assistance to residents in obtaining necessary medications. These medications may be administered by a licensed health care practitioner, licensed nurse or a medication assistant. Residents may self-administer their medications and keep them in their unit with the consent of a licensed practitioner. In the event of a significant medication error, a medication assistant must file a report with the Department of Health.

Staffing

The state doesn’t enforce minimum staffing ratios, but staff members must be available 24 hours per day to see to residents’ scheduled and unscheduled needs. Staff members must complete a training program that addresses topics such as residents’ rights, fire and safety procedures, infection control and managing difficult behaviors. They must also complete at least eight hours of training that covers dementia-related topics, including behavioral symptoms of dementia; alternatives to chemical and physical restraints; positive therapeutic interventions; and addressing care and safety aspects, such as food and fluid intake, pain and wandering. An additional four hours of ongoing training must be completed annually.

Medicaid Coverage

North Dakota Medicaid covers memory services via the Home and Community Based Services Waiver and the Basic Care Assistance program.

Reporting Abuse

Incidents of abuse, neglect or exploitation should be reported to the Department of Human Services’ Long-Term Care Ombudsman by calling 701-328-4617 or 855-462-5465, by emailing dhsagingombud@nd.gov or by completing an online form on the program’s website.

Frequently Asked Questions

How much does memory care cost in North Dakota?

Across North Dakota, monthly memory care fees average between $2,438 and $4,980. The overall state average per-month cost for this level of care is $4,256, which is about 17% lower than the national average. Factors that affect monthly rates include local living costs and facility amenities and pricing structure.

Are there financial assistance programs for memory care in North Dakota?

Memory care expenses may be covered through the state’s Home and Community Based Services Waiver program, the Basic Care Assistance program or via the optional state supplement. Residency, income and asset guidelines apply.

Does Medicare pay for memory care?

Original Medicare covers medical treatment and prescription drug therapy associated with dementia, but it doesn’t cover personal care services in a memory care facility. Beneficiaries may be able to sign up for a Medicare Advantage plan that covers long-term care.

What are the differences between memory care and assisted living?

Both memory care and assisted living provide lodging, meals, personal care and social and recreational programs. In addition to these services, memory care features specialized programming specifically for those with memory-related diseases. This programming may include brain fitness classes and life skills stations.

What types of facilities offer memory care?

Memory care is typically provided in secured wings of assisted living facilities. Alternately, memory care may be provided in free-standing communities that only offer memory support services.