Nursing Homes in Montana

Based on population data, Montana is home to the sixth-oldest state population in the nation. It’s home to 228,718 seniors citizens who represent about 20% of the state’s 1,068,778 residents. An aging population means there’s increasing demand for skilled nursing facilities, home health providers and other forms of long-term care. Montana currently has 70 licensed nursing homes that accommodate more than 3,776 residents at any given time.

Skilled nursing facilities provide intermediate to advanced medical care to individuals who are recovering from surgeries or medical events or are coping with multiple medical conditions. In Montana, these facilities typically charge $7,665 for a semiprivate room and $8,273 for a private room, which is slightly less than the national average.

This guide explores the cost of nursing homes in Montana as well as possible alternatives. It also takes a look at Medicaid long-term care benefits, financial assistance programs, nonprofit resources and state regulations that govern skilled nursing facilities. These materials are designed to help you make an informed decision regarding your current or future needs.

The Cost of Nursing Home Care in Montana

According to Genworth Financial’s Cost of Care Survey for 2020, a semiprivate room in a Montana nursing home costs $7,665 per month, which is $91 less than the U.S. median of $7,756. Montana performs favorably when compared to most neighboring states, excluding South Dakota where average rates are about $650 lower. Seniors in Wyoming pay almost $600 more per month of care, and rates are approximately $1,000 higher in Idaho, coming in at $8,669. With an average cost of $12,167 per month, nursing homes in North Dakota are 58% more expensive, which equates to a monthly price difference of $4,502.

Nursing homes in Montana’s largest cities typically charge anywhere from $7,756 to $9,429 per month. Rates are on par with the U.S. average in Billings at $7,756. Great Falls is moderately more expensive at $9,125, which is almost 20% more than the state median, and at $9,429, rates in Missoula exceed the state median by $1,764, or 23%. Rapid City, South Dakota, is one of the most affordable metropolitan areas in the Northern Plains at $7,452. Nursing home rates in other major cities, including Casper, Idaho Falls and Bismarck, exceed the state median by $791 to $2,981.

With an average monthly cost of $7,665, skilled nursing is the most expensive form of long-term care in Montana by a significant margin. In-home care provided by homemakers or home health aides costs $5,138, or $2,527 less per month. Assisted living is more affordable still at $4,213, which represents an estimated monthly savings of $3,452. Adult day care costs about half as much as assisted living at $2,115. However, the services that these community-based facilities provide are minimal, especially when compared to nursing homes.

Financial Assistance for Nursing Home Care in Montana

Most people do not pay for skilled nursing care entirely out-of-pocket. Rather, they utilize financial assistance programs to help cover the cost of nursing care. Of public financial assistance programs, Medicaid provides the most comprehensive coverage of nursing home care. But not all seniors are eligible for Medicaid. And because each state operates its own Medicaid program within federal guidelines, eligibility and benefits vary from state to state. Below, we provide more information on Medicaid in Montana.

Montana’s Medicaid Program

In Montana, Medicaid and the Children’s Health Insurance Program cover more than 263,499 individuals. Approximately 20% of the state’s population and 60% of nursing home residents qualify for coverage. Traditional Medicaid covers primary and emergency medical care, diagnostic services, prescription drugs, vision and dental, and its long-term care division provides a variety of added benefits for individuals who require a nursing home level of care.

Medicaid is the primary source of funding for roughly 2,265 of the state’s 3,776 nursing home residents. The state also provides funding for nursing home alternatives, such as assisted living, in-home care, and skilled therapy, through home- and community-based programs like the Montana Big Sky Waiver. While Medicaid provides essential medical services to low-income residents, it includes a number of other benefits. One in every four Medicaid dollars in Montana goes toward long-term care, including programs that allow disabled adults and seniors to receive supportive services at home or in a residential setting of their choice.

Medicaid Eligibility in Montana

Due to Montana’s targeted enrollment policies, nursing home residents must use all of their income for skilled care before they can qualify for Medicaid long-term care benefits. In other words, the cost of the nursing home must equal or exceed the resident’s monthly income minus a personal and/or spousal minimum monthly needs allowance. Medicaid is available to U.S. citizens, permanent residents and legal aliens who meet age and income criteria and require a nursing home level of care. Individuals can apply online or by calling (888) 706-1535.

Alternative Financial Assistance Options

• Medicare: Medicare will cover the cost of one’s care in a skilled nursing facility for the first 20 days of their stay, and a portion of the costs up until day 100. After 100 days, the individual is responsible for all costs. Seniors must also have a “qualifying hospital stay” of at least 3 days prior to their admission to a nursing home in order to qualify for Medicare coverage.
• Aid and Attendance: 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 skilled nursing care.
• Reverse Mortgages: If you own a home, you may be able to use a reverse mortgage to help pay for nursing 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. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
• Long-Term Care Insurance: Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Montana

Montana provides a variety of free resources to help with long-term care planning, healthy aging and senior rights. Here are a few of the most helpful services for individuals who are interested in nursing home care or similar services.

Resource	Contact	Service
Area Agencies on Aging	(800) 551-3191	Montana has 10 regional Area Agencies on Aging that connect seniors and families to age-related resources in their community. They assist with transportation, home-delivered meals, in-home care and nursing home placement. The state’s Aging and Disability Resource Centers can provide information about Medicare premium and copay assistance and benefits like food stamps, LIHEAP and Big Sky Rx.
Montana Senior and Long-Term Care Division	(406) 444-4077	Managed by the Department of Health and Human Services, the Senior and Long-Term Care Division oversees a variety of programs that benefit older adults statewide. It supports Alzheimer’s research, healthy aging programs, respite care grants, insurance counseling programs and senior meals among other programs.
The Long-Term Care Ombudsman Program	(800) 332-2272	Montana has 30 specially trained volunteer ombudsmen who support residents who live in nursing homes, assisted living facilities and other licensed health care institutions. These advocates resolve disputes, provide impartial advice and help residents understand their personal and legal rights.
Montana State Health Insurance Assistance Program	(800) 551-3191	The State Health Insurance Assistance Program is a one-stop shop for answers about Medicare. Trained volunteers can help with long-term care planning, billing concerns, benefits and plan comparisons to help seniors understand and maximize their coverage while preventing waste and fraud.
Montana Legal Services Association	(800) 666-6899	Seniors and families who need advice about long-term care planning, health care decision-making or advance directives can contact this pro bono law office for assistance. The association offers information, self-help guides and comprehensive legal representation for low-income residents facing certain civil issues.
Montana Geriatric Education Center	(406) 243-2453	Operated by the University of Montana in Missoula, this federally funded research institution provides online and in-person training for seniors, caregivers and professionals who are in the long-term care industry or are interested in healthy aging.

Nursing Home Laws and Regulations in Montana

Licensing	Long-term care facilities that provide intermediate or skilled nursing are licensed by the Montana Department of Public Health and Human Services, Quality Assurance Division, Licensure Bureau.
Staffing	Skilled nursing facilities must meet strict minimum staffing standards for RN, LPN or CNA care based on the number of licensed beds. Minimum requirements may vary for day, evening and night shifts.
Staff Training	Nursing homes in Montana may employ qualified nurses and certified nursing assistants who have completed at least 75 hours of training with at least 16 hours of clinical experience. These standards are consistent with federal minimums established by Medicare.
Admission Restrictions	Health care facilities that provide skilled nursing must have written policies and procedures for resident admission. Before admitting a resident, the facility must perform a comprehensive needs assessment to determine whether the applicant can be accepted through one of the three admission categories or through an exemption. Prospective residents have a right to appeal a denial by paying a $100 fee for an independent needs assessment.
Care Planning	Health care facilities must prepare an individualized service plan for each resident. The initial plan must be reviewed within 60 days of admission or more often if required by the resident’s admission category. The plan of care must describe all of the services that the resident will receive as well as the name and type of provider, treatment goals and other pertinent details.
Dietary and Nutrition Services	Skilled nursing facilities must follow strict standards for planning, preparing and serving resident meals. Facilities must provide at least three properly timed meals that are nourishing and well-balanced and accommodate residents’ dietary needs or preferences. Facilities must employ a full-time dietitian or a similarly qualified professional to prepare menus according to nationally recognized nutritional standards.
Specialized Rehabilitative Services	Nursing homes may provide physical therapy and other forms of restorative or rehabilitative care as directed by a physician.
Medication and Pharmaceutical Services	Skilled nursing facilities must provide all routine and emergency medications as required by residents. Prescriptions can be filled by an in-house pharmacy or by a contracted provider. The facility must maintain comprehensive medication records for each client, and a qualified pharmacist must review each resident’s medication regimen at least four times per year.
Activities	Facilities must maintain at least one centrally located common area designed for recreational activities and socialization.
Infection Control	When providing personal care, nursing homes must take steps to minimize accidents, injuries and infections. Health care facilities must have written policies and procedures to prevent the transmission of communicable diseases. These policies must include protocols for hand washing, hazardous waste disposal, employee screening and caring for residents who have or are suspected of having communicable diseases.
Medicaid Coverage	Montana Medicaid offers long-term care benefits to individuals who require nursing home care and use all of their income, excluding a personal needs allowance, to pay for these services.