Assisted Living in North Dakota
What It Costs Across North Dakota
Finding the right assisted living community for your loved one in North Dakota means understanding the financial landscape. While the statewide median for assisted living is around $3,391/month, costs can vary significantly depending on the source and specific year of data, with some 2024 reports suggesting a higher average of $5,050/month across the state. In major cities, you'll find a range: Fargo's monthly costs might be around $4,299 or closer to $3,654, while Bismarck averages approximately $4,386 or $3,610. Grand Forks shows the widest variation, with some reports indicating $7,000/month and others as low as $2,200 or $3,019. Generally, costs can be lower in more rural areas compared to larger urban centers. Keep in mind that specialized memory care typically adds an extra 20% to 30% to these costs.
Will Medicaid Help Pay?
North Dakota does offer assistance through its Home and Community Based Services (HCBS) Waiver, also known as the Aged and Disabled Waiver. This program is designed to help seniors receive care in assisted living facilities or at home, aiming to prevent or delay nursing home placement. The waiver covers services like personal care, case management, housekeeping, meal preparation, non-medical transportation, and specialized equipment. However, it's crucial to understand that the HCBS Waiver *does not cover the cost of room and board* in an assisted living facility. To be eligible, your loved one must already be a Medicaid recipient, require a nursing facility level of care, and be at least 65 years old (or 18+ and disabled). For 2026, a single applicant's income limit is typically around $1,174/month, with assets limited to $3,000. For married couples, these limits are higher. If income exceeds these limits, North Dakota has a "medically needy pathway" where high medical bills can help an individual qualify after spending down excess income. Be aware that the waiver program has a limited number of slots, so a waitlist is possible as it is not an entitlement program.
How to Find a Good Facility
As of March 2024, North Dakota has 74 licensed assisted living facilities with approximately 3,020 units available. When searching, look for facilities that provide individualized support services, including assistance with daily activities. A good facility will offer a clear, written agreement detailing rent, services, payment terms, and refund policies. A typical rental package often includes meals, housekeeping, activities, transportation, and laundry. Your loved one has specific rights as a resident, which the facility must provide and explain upon admission. Assisted living facilities in North Dakota are licensed by both the Food and Lodging and the Health Response and Licensure Section of the Department of Health and Human Services (HHS). You can access the two most recent inspection reports for these facilities through the inspection search page on the North Dakota Health and Human Services website. For any concerns or questions about resident rights, the Long-Term Care Ombudsman Program is a valuable resource.
Last updated: March 2026. Sources: Genworth 2024, state licensing agency.