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

In North Dakota, memory care is generally provided in basic care facilities. Oftentimes, facilities that offer memory support services have additional training requirements for staff and security features compared to basic care facilities that don’t provide specialized services. As a result, memory care typically costs about 20-30% more than traditional basic care. The following cost comparisons are based on average assisted living costs as published in Genworth Financial’s 2019 Cost of Care Survey with a 25% increase to account for additional care requirements. Exact costs vary widely depending on a facility’s location, pricing structure and amenities.

Memory Care Costs in Nearby States

On average, memory support services cost $4,256 per month in North Dakota, which is about $800 less than the national average, making it among the most affordable states in the country for this level of care. In South Dakota, monthly fees are slightly higher at $4,375. Montana, Minnesota and Wyoming are a little costlier at $4,775, $4,750 and $4,725, respectively, but are still considerably lower than the national average.

$4256

North Dakota

$5064

The United States

$4775

Montana

$4375

South Dakota

$4750

Minnesota

$4725

Wyoming

Cost of Other Types of Care in North Dakota

In addition to memory services, North Dakota seniors have several other types of care options to choose from. Assisted living, which also features personal care services in a community setting, costs $850 less per month on average at $3,405. Nursing home care provides around-the-clock skilled nursing and personal care services in an institutional setting and is the most expensive at $11,875 monthly. For seniors with mild dementia who wish to remain in their own home, in-home care is nearly $900 more per month than memory care at $5,148, and skilled home health care fees average $5,331. The most cost-effective senior care option is adult day care, which is a source of respite care that offers daytime social interactions, nursing and memory care in a community setting and averages $2,059 per month.

$4256

Memory Care

$5148

In-Home Care

$5331

Home Health Care

$2059

Adult Day Care

$3405

Assisted Living Facility

$11875

Nursing Home Care

The Cost of Memory Care in North Dakota’s Top Cities

Comparing Costs Across North Dakota

North Dakota as a whole is a relatively economical memory care option, and in some cities, care costs are particularly budget-friendly. Grand Forks, the third largest city in the state, is the least expensive option, with memory services averaging half the statewide norm at $2,438 per month. In the capital city of Bismarck, costs are on par with the state average at $4,256. Of the major cities, Fargo is the most expensive for memory care at $4,980. In the nearby cities of Rapid City, South Dakota, and St. Cloud, Minnesota, memory care costs $4,935 and $4,439 per month, respectively.

$4256

Bismarck

$4980

Fargo

$2438

Grand Forks

$4935

Rapid City, SD

$4439

St. Cloud, MN

Financial Assistance for Memory Care in North Dakota

Medicaid Home and Community Based Services Waiver

North Dakota’s Medicaid Home and Community Based Services Waiver pays for services that enable seniors who qualify for nursing home level care to continue living in a community setting, such as a memory care facility. It covers residential care directly as well as the cost of case management, nonmedical transportation and specialized equipment.

Who Is Eligible?
To be eligible for this waiver, applicants must be at least 65 years old or disabled according to Social Security Disability criteria. They must be eligible for Medicaid and screened at a nursing home level of care. Additionally, their care needs must be met within the scope of the waiver.

How to Apply
For more information or to apply for this waiver, applicants should contact their local Human Service Zone.

Basic Care Assistance

The Basic Care Assistance program covers a portion of participants’ memory care costs when they live in a licensed basic care facility. Program participants pay all of their income, minus $100 per month for personal needs, to the basic care facility to cover the cost of their care. The program sends funds directly to the facility on the resident’s behalf.

Who Is Eligible?
To be eligible, applicants must be residents of North Dakota and meet Medicaid’s age and income guidelines. They must complete a functional assessment and need a supervised environment, and they must be unable to prepare meals, self-administer medications or do housework and laundry.

How to Apply
To apply, seniors must complete an application for assistance through the Human Services website, or they can apply in person at their local Human Service Zone.

Optional State Supplement

Low-income seniors in North Dakota who qualify for the federal Supplemental Security Income benefit may also qualify for the optional state supplement. For those residing in memory care facilities, the state establishes a standard for the total SSI payment. The federal SSI payment plus any countable income is deducted from the state standard, and the rest is paid to the beneficiary.

Who Is Eligible?
To be eligible for the optional state supplement, applicants must meet the federal SSI program guidelines.

How to Apply
Seniors can learn about the state supplement and apply for SSI benefits over the phone by calling 1-800-772-1213, online through the disability benefits website or in person at their local Social Security office.

Free and Low-Cost Memory Care Resources in North Dakota

ResourceContactServices
Alzheimer’s Association Minnesota-North Dakota Chapter1-800-272-3900The Alzheimer’s Association’s Minnesota-North Dakota Chapter operates five offices throughout North Dakota and provides an array of informational and supportive services for local seniors and families who are affected by Alzheimer’s. It operates a 24-hour helpline, facilitates support groups and provides in-depth personalized care consultations to help with decision making and planning for future care needs. It also organizes events and has a nationwide emergency response service for members who wander and are missing.
Dementia Care Services Program701-258-4933The state-funded Dementia Care Services Program is administered by the South Dakoka Human Services Department. This free program provides care consultations and education services for families of loved ones living with Alzheimer’s or other dementias. Some services it offers include needs assessments, education for informal caregivers, information regarding dementia symptoms and the benefits of early detection and treatment and referrals to appropriate care and support services.
North Dakota Senior Services Providerswandm@restel.netNorth Dakota Senior Services Providers is comprised of 30 nonprofit agencies throughout the state. The agencies operate senior centers and provide various other services depending on the region, which may include information and referrals, wellness screenings, nutrition education and transportation. Specialized services, such as legal assistance and health insurance counseling, are also available.
North Dakota Family Caregiver Support Program855-462-5465The Family Caregiver Support Program is a federally funded program that helps unpaid caregivers of elderly family members and those with Alzheimer’s or dementia. It provides information about local community supports and services, respite care, counseling and support groups, training and supplemental services to assist with costs associated with incontinence supplies and assistive devices. Services are free to those who qualify.
State Health Insurance Counseling Program701-328-2440The SHIC program offers free, unbiased help with Medicare, Medicaid and other types of health insurance. Its counselors answer questions and help with understanding paperwork and bills that a client receives after a doctor visit or hospital stay, sorting and reconciling statements, filing claims for denied coverage and reviewing long-term care options. Counselors have no connection with insurance companies or products.
Long-Term Care Ombudsman Program855-462-5465The state’s Long-Term Care Ombudsman Program advocates on behalf of seniors living in assisted living and memory care communities and helps resolve complaints to the resident’s satisfaction. The office receives, investigates and addresses concerns regarding resident safety and care in memory care communities, provides referral services and promotes family and community involvement in long-term care facilities.

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.

Scope of CareMemory 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 PlansWithin 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 ManagementMemory 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.
StaffingThe 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 CoverageNorth Dakota Medicaid covers memory services via the Home and Community Based Services Waiver and the Basic Care Assistance program.
Reporting AbuseIncidents 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.