Legal Definition of Assisted Living / Memory Care in Montana

In Montana, assisted living facilities provide health and personal care in a residential or apartment-style setting. There is supervision and security 24-hours per day along with activities for residents. There are three different types of assisted living facilities in Montana that are classified A to C, as of 2024. All three must provide housing, laundry, housekeeping, recreational activities, and help with activities of daily living like eating and dressing. They are defined as:

• Category A homes are for people who can live relatively independently
• Category B is for residents who need full-time nursing care
• Category C is for people with severe cognitive impairment, which include Alzheimer’s disease and related dementias

Category C homes would be considered memory care, with additional requirements including dementia-specific training for staff and appropriate design features like quiet areas with minimal distractions.

Montana assisted living homes are regulated by the Department of Public Health and Human Services’ Quality Assurance Division. It is possible to find smaller, more home-like memory care options.

 

How Much Does Memory Care Cost in Montana?

The cost of assisted living and memory care can vary depending on where in Montana the residence is located. The table below lists the median monthly cost of both assisted living and memory care facilities in different areas of the state as of 2025. Individuals who are in the early to mid stages of dementia may be best suited for assisted living facilities, which are less expensive than memory care, while those with more severe symptoms or who are in the late stages of dementia will likely need memory care.

For context, the median cost of assisted living across the country in 2025 was $6,200/month, and it was $6,075/month in Montana in 2025.

 

Montana Assisted Living Laws & Regulations

Admissions Process & Requirements

A medical assessment is required before moving into any assisted living residence. This assessment evaluates the patient’s thinking ability, ability to perform activities of daily living, mood and personality. The assessment is usually conducted by a medical professional who works at the residence, and the cost of the assessment is often covered by a community fee that includes other up-front expenses like deep cleaning or painting a new resident’s room. Community fees typically cost between $1,500 and $2,500. If a memory care community does not have someone to assess a person moving in, then a private doctor may need to complete this step at the resident’s expense, but this should be made clear well before a decision gets made to move in.

Someone in the early stages of Alzheimer’s disease or dementia could move into a Category A or B residence if the disease does not cause disruptive behavior and they require help with less than four activities of daily living. Eventually, a Category C home will become necessary. To move into a Category C assisted living home, or memory care, a resident must:

– Have a severe cognitive impairment that prevents expressing needs or making basic care decisions.
– Be at risk to wander away from the residence.
– Not pose a danger to self or others.
– Not require restraints or confinement.
– Have a written doctor’s order to move into Category C living.

In Category C residences, the following must be made available in writing to anyone considering moving in:

– Overall philosophy and mission of caring for people with dementia
– Processes for move-in, transfer and discharge
– Process for move-in assessment
– Explanation for how to update health-care plan
– Staff training and education
– Physical environment and design features that are appropriate for people with cognitive impairment
– Level of involvement allowed for families
– Any costs of care or fees

Someone has the following issues may not move into or remain in a memory care facility in Montana:

– If their needs cannot be met there
– If they presents a threat to themselves or others
– If they cannot respond to verbal instruction
– If they have a complex medical condition that cannot be treated there
– If they fail to pay within a reasonable amount of time after appropriate notice

A note from your loved one’s primary care doctor is required to move into memory care in Montana, but this is not the same as an official diagnosis. Someone does not need a diagnosis to enter memory care. Alzheimer’s and related diseases including frontotemporal, vascular, and Lewy body dementias are difficult to diagnose and distinguish because symptoms change and vary. It’s important to match a home to your loved one’s unique needs, not a specific disease.

While it is possible to move into memory care on short notice in Montana, this is not a good idea. Finding the right home is a long process that involves looking at every option and asking questions of residents and staff. Additionally, your loved one will be able to provide more input the sooner the search begins. It is best to start looking before moving becomes necessary.

 

Facility / Residence

Residents’ living units must be at least 100 square feet for one person, and 80 square feet per person if there is more than one. Four residents are the maximum allowed in one living unit. This does not include bathrooms or closets. There must be one toilet for every four patients, and a shower for every 12.

The physical environment or design must be appropriate for people with dementia. This usually means a simple layout with clear sight lines and landmarks that make it easy to navigate, quiet rooms with minimal distractions, and special locks to prevent wandering. Regulations do not require a secure outdoor space, but this is something to look for because being outside has been shown to benefit people with dementia.

 

Staff & Training

A licensed administrator with state-approved education and work experience must be employed at every Montana assisted living residence. The administrator is responsible for day to day operations. Sixteen hours of continuing education annually are required for administrators. Additionally, in category C residences (memory care), eight hours of annual training must be dementia-specific. There are no required staff-to-resident ratios in Montana. An employee with CPR training must be awake and on-duty at all times. All staff receive training relevant to the needs established in residents’ service plans, and in category C residences this includes:

– Helping residents who cannot perform activities of daily living
– Techniques for minimizing dementia-specific behaviors including wandering, hallucinations, and delusions
– Therapies to promote social and emotional stimulation
– Encouraging dignity, independence, privacy and choice
– Managing medications
– Strategies for managing incontinence

 

Evictions & Discharges

Montana does not have statewide regulations about evictions from assisted living. The rules say that a resident must be transferred if they cannot receive adequate care. No one may stay at an assisted living home that is not equipped to handle their condition. For people with dementia, this would mean that as activities of daily living like eating and dressing get harder, staff must have adequate training to help your loved one stay as safe and healthy as possible.

One of the items required to be included in a written resident agreement is the criteria for transfer or discharge. This means the home must explain, in writing, the reasons someone can be evicted. Be sure you understand this document and that it is as specific as possible, because unfair evictions can be a problem in memory care nationwide. File it in case the issue comes up later. For guidance on what to do next if you receive an eviction notice, click here.

 

Financial Assistance for Residential Alzheimer’s Memory Care

Big Sky Waiver for the Elderly and Disabled

Montana’s Big Sky Waiver (BSW) will pay for long-term care services and supports for qualified individuals, including those with dementia, who are in assisted living or memory care (or their own home, the home of a loved one, a group home, or adult foster). Benefits are based on the needs of the individual and they can include nursing services, case management, adult day care, homemaker services, transportation, meal delivery, Personal Emergency Response Systems, respite care and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). The state can assign a professional to provide these benefits, and beneficiaries have the option of “self-directing” some of their care, like hiring a friend or family member to provide personal care assistance.

To qualify for the Big Sky Waiver, applicants must meet two financial requirements – an asset limit ($2,000 for an individual as of 2026) and an income limit ($994/month for an individual as of 2026) – as well as the medical requirement of needing a Nursing Facility Level of Care (NFLOC). It should be noted that a dementia diagnosis does not guarantee a NFLOC designation.

 

 

Veterans Affairs (VA)

Qualified Montana veterans (or their surviving spouses) with dementia can also receive financial assistance through a Veterans Affairs (VA) Pension that they could use to pay for assisted living or memory care.

There are three levels of VA Pensions – Basic, Aid & Attendance (A&A) and Housebound. To qualify for any of them, veterans or their surviving spouses need to meet a net worth limit of $163,699 (effective Dec. 1, 2025 – Nov. 30, 2026), which is calculated by adding the total of their assets to their annual income. Some assets are exempt, like a primary home, primary vehicle and household furniture and appliances. VA Pension applicants also have to meet an income limit to be eligible – their income must be less than the VA Pension they are applying for in order for them to qualify. And veterans must meet a military service requirement, which includes not having received a dishonorable discharge.

To qualify for A&A, veterans or their surviving spouses must also meet a medical requirement, which is one of the following must be true:

• They need help to perform the Activities of Daily Living (mobility, bathing, dressing/grooming, eating, toileting) OR
• They have to stay in bed for at least a large portion of the day due to illness OR
• They are in a nursing home due to loss of mental or physical abilities OR
• Their eyesight is extremely limited (5/200 or less in both eyes even with glasses or contacts; or concentric contraction of the visual field to 5 degrees or fewer)

To qualify for Housebound, veterans must spend most of their time in their home due to a permanent disability.

There is no medical requirement for VA Basic Pensions.

Qualified veterans or their surviving spouses are entitled to their Maximum Annual Pension Rate (MAPR) minus their annual income. The following MAPRs are effective from Dec. 1, 2025 to Nov. 30, 2026:

VA Basic Pension MAPRs

• Veterans without spouses or children: $17,441
• Veterans with dependent spouses or children: $22,839
• Surviving spouses without dependent children: $11,699
• Surviving spouses with dependent children: $15,311
• Two veterans married to each other: $22,839

VA Aid & Attendance MAPRs

• Veterans without spouses or children: $29,093
• Veterans with dependent spouses or children: $34,488
• Surviving spouses without dependent children a maximum of $18,697
• Surviving spouses with dependent children: $22,304
• Two veterans married to each other and one qualifies for A&A: $33,548
• Two veterans married to each other and one qualifies for A&A and one for Housebound: $38,350
• Two veterans married to each other and both qualify for A&A: $46,143

VA Housebound MAPRs

• Veterans without spouses or children: $21,313
• Veterans with dependent spouses or children: $26,710
• Surviving spouses without dependent children: $14,298
• Surviving spouses with dependent children: $17,902
• Two veterans married to each other and one qualifies for Housebound: $26,710
• Two veterans married to each other and both qualify for Housebound: $30,580
• Two veterans married to each other and one qualifies Housebound and the other for A&A: $38,350

Veterans Homes

There are three veterans’ homes in Montana. They are:

• Columbia Falls Montana Veterans’ Home. They are in the Flathead Valley near Glacier National Park and have a 15 bed memory care unit.
• Southwest Montana Veterans Home in Butte which is along the Continental Divide.
• Eastern Montana Veterans Homes in Glendive. This is in the eastern, central part of the state. They have a 16 bed special care wing.

These facilities provide long-term residential care for veterans. In addition to nursing home care, assisted living and memory care are provided. Neighboring states also have veterans’ homes. Your loved one might consider looking there for more options as there are no requirements that one must live in the state. For example, Idaho has three veterans’ homes statewide. Additionally, North Dakota, South Dakota and Wyoming all have one facility apiece. More info.

 

Supplemental Security Income

Dementia patients age 65 and over with limited income and assets may qualify for Supplemental Security Income (SSI). These funds can be used to pay for the cost of assisted living or memory care. As of 2026, the maximum SSI benefit for an individual is $994/month and for a married couple it’s $1,491/month.

To qualify for SSI, applicants must be age 65 and over or have a significant disability, and they must meet an income limit and an asset limit. As of 2026, individuals may meet the SSI income limit if they earn less than $2,073/month OR they get less than $1,014/month from non-work sources, like Social Security benefits or pension payments. They may meet the SSI asset limit if they have $2,000 or less in countable assets. For couples, the income limit is $3,067/month in work income or $1,511/month in non-work income, and the asset limit is $3,000.

 

Other Options

1) Elder care loans exist for families to cover the costs of moving into memory care while waiting for other financial resources to become available. For example, if one is waiting for a VA pension to be approved or waiting to sell a home. More on bridge loans for memory care.

2) Some tax credits and deductions can provide financial relief for seniors with dementia and their families. Seniors with limited financial resources can claim the Credit for the Elderly and/or the Disabled, as long as no one can claim them as a dependent. If someone (like an adult child) can claim the senior as a dependent, they can utilize the Child and Dependent Care Credit, and they can deduct any medical or dental expenses they paid for the senior.

3) A reverse mortgage loan can be a viable option for some senior homeowners who are in need of extra income to help pay dementia care. However, reverse mortgages are not recommended for every senior homeowner who needs extra income, so it’s important to consult with a professional before taking out one of these loans.