STATE PROFILE • Last updated: November 11, 2026
North Dakota Elder Care & Medicaid
North Dakota's senior Medicaid landscape offers home and community-based services through its Aged and Disabled Waiver, alongside traditional nursing home coverage, with specific income and asset limits.
leaderboard
RANKED #15
GRADE B
FEATURED
Medicaid Coverage Guide for North Dakota
Full breakdown of SPED (Service Payments for Elderly & Disabled) for seniors: waiver programs, nursing home eligibility, income and asset limits, spend-down rules, and how to apply.
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Program
SPED (Service Payments for Elderly & Disabled)
Income cap
No cap
Medically-needy
Yes
Elder Care Index Report Card
5-pillar composite scoring vs other states
B
Grade
AFFORDABILITY
GRADE A · 98
QUALITY
GRADE D · 39
STAFFING
GRADE B · 51
ACCESS
GRADE A · 66
MEDICAID SUPPORT
GRADE F · 9
Composite score: 62.8 / 100 (50 = average state)
Methodology arrow_forward
North Dakota At a Glance
Nursing Home Facilities
72
Senior Medicaid Waivers
1
National Rank
#15 / 51
Range #9–#24 when the pillar weights shift
Senior Care Costs in North Dakota
local_hospital
Nursing Home
$9,148/mo
-17.1% vs national avg
- 72 nursing homes · 4,957 beds
- Avg CMS rating 3.15★ (17 rated 5★, 14 rated 1★)
- 4.41 nurse hrs/resident/day (0.93 RN)
Source: CMS Nursing Home Compare
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home_health
Home Health Aide
$27/hr
- Median aide wage $18.80/hr
- ~7,090 aides employed statewide
Source: BLS OEWS
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