North Dakota Residential Alzheimer’s Care (Memory Care): Laws, Costs & Financial Help

Last Updated: March 24, 2024


North Dakota has unique distinctions for its assisted living facilities and it is important to know what they mean when you are looking for memory care. Assisted living facilities in North Dakota are a term for communities where mostly elderly people live together, but they cannot offer care to people with Alzheimer’s disease or dementia. A basic care facility is the only type of residence that can offer the personal and health care required by people with dementia.

Basic care facilities are licensed by the state’s Department of Health to provide housing, food, and 24-hour support. If a basic care facility offers memory care, also called Alzheimer’s units, they must be licensed based on written policies that specify practices specifically beneficial for people with dementia. Those practices include activities that encourage socialization. Memory care homes need to give residents the freedom “to control their schedules and activities,” as well as eat whenever and wherever they want within the residence.

Basic care facilities provide help with activities of daily living, like eating and bathing, and instrumental activities of daily living like managing money and housekeeping. These homes must also arrange for health care as needed by any resident.

There are about 16 memory care homes in North Dakota. These residences range in size from apartment-complex-style communities serving more than 100 people to smaller home-like settings serving 12 or fewer people at a time. For free help finding the right memory care home to fit your family’s needs and budget, click here.


How Much Does Memory Care Cost in North Dakota?

The average cost of memory care in 2024 in North Dakota is $4,413 per month. This is much less expensive than the national average of around $5,884 per month. The state’s largest city is also its most expensive for memory care: In Fargo, the costs are about $5,009 per month. The least expensive location for memory care is also along the Red River Valley bordering Minnesota: Grand Forks, where costs are about $2,862 per month. In the Missouri Plateau (central North Dakota), memory care in Bismarck costs about $4,850.

  Free assistance is available in North Dakota to help families find basic care facilities and homes for patients with dementia. Regardless of need and budget, there are options for your loved one. Get started here.

It might be possible to find more affordable memory care in states bordering North Dakota, but their costs are similar. Southern North Dakota residents might look in South Dakota, where the average monthly price of memory care is almost the same costing $4,373 monthly. More costly options are to the west, where Montana’s memory care costs run $5,804 per month. Additionally, eastern North Dakotans could look in Minnesota, where the average monthly bill is $5,884.


North Dakota Assisted Living Laws & Regulations

 COVID-19 Measures (updated Oct. 2022)
The additional measures left due to Covid are:
Residents- Their temperatures are checked and patients are also tested regularly.
Visitors- Can visit loved ones, must wear a mask, and temperature is checked upon entry.
Staff- Have temperatures checked upon entry and are regularly tested.

Admissions Process & Requirements

Every patient who moves into a North Dakota basic care facility must be assessed by a healthcare professional who works for the residence within 14 days of moving in. The assessment is used to create an individualized care plan. It must be updated every four months. The assessment covers:

– Health needs

– Ability to socialize

– Functional abilities

– Nutritional needs

– Personal care needs

– Medical history

– Self-sufficiency

– Social interests

– Preferred activities

The cost of the assessment for a new resident might be free when a person agrees to sign a move-in contract, or it may be covered by a one-time community fee. This is a fee that pays for one-time up-front costs like the assessment and also deep cleaning of a new resident’s room. Community fees typically run between $1,500 and $2,500.

Regulations do not require that a person be diagnosed with Alzheimer’s or dementia to move into Noth Dakota memory care. Dementias are difficult to diagnose as symptoms change and vary, and the process includes expensive tests like PET brain scans. The degree of memory loss and what specific actions staff can take to help your loved one will be determined during the assessment.

While it is possible to find memory care on short notice in North Dakota, this is not a good idea. You should start looking at residences before a move is necessary, to allow for time for a thorough investigation, including asking questions of staff and other residents. Also, the sooner you begin your search the more input your loved one can have on the final decision.


Facility / Residence

Unlike most other states, there is no rule in North Dakota about how large a living unit or bedroom must be. The standard minimum size for a single person is about 100 square feet, so you should look for something at least that size (excluding bathrooms and closets). Basic care facilities are required to have a toilet for every four residents, and a bath or shower for every 15 residents. Residents also have the freedom to decorate their rooms as they see fit, within the parameters of residence policies.

Regulations also require a secure outdoor area, because studies show time in the open air is beneficial for people with dementia. There are no other rules regarding dementia-friendly designs, so things like easily navigated layouts and hallways that run circular (to prevent someone with dementia from encountering a dead end) are not required like in other states. For this reason, be sure to thoroughly inspect any memory care home you are considering, with an eye on whether your loved one will be comfortable within the spaces. Soft paint colors and clear sight lines are also ideal.


Staff & Training

An administrator must be in charge of general administration in a North Dakota memory care residence. Administrators must complete at least 12 hours of continuing education annually. There are no staff-to-resident ratios in North Dakota, but someone must always be on-duty and awake. All employees must have annual continuing education that covers:

– Fire and accident prevention and safety

– Managing behavior problems

– Fulfilling mental and physical health needs

– Infection control and prevention

– Resident rights


Staff who prepare food must attend at least two dietary educational programs annually

Staff who run activities for residents must attend at least two activity-related educational programs annually 

Staff who work in memory care must have at least eight hours of dementia-specific training upon hiring and four hours annually


Evictions & Discharges

North Dakota regulations say that every basic care facility may establish its own rules about how and why residents are evicted. A home cannot keep a resident whose medical needs cannot be handled there. For example, if staff isn’t trained to help someone who is non-ambulatory, then a person who loses their ability to walk cannot live there. More specific rules depend on the home. Can your loved one be evicted for nonpayment of bills on time? Does aggressive or insulting behavior get someone evicted?

It’s important to ask these questions before agreeing to a move-in contract because unfair evictions can a major problem in assisted living nationwide. Ask for the reasons your loved one can be evicted. Does advanced notice have to be given by the home (30 days is standard)? What is the process for appeal? Get the answers in writing. If you receive an eviction notice and need to know what the next steps are, click here.


Financial Assistance for Residential Alzheimer’s Memory Care

Medicaid State Plan Personal Care (MSP-PC)

North Dakota Medicaid State Plan Personal Care Services is designed for people who need help with activities of daily living, like eating and bathing, and instrumental activities of daily living like money and medication management. This program enables patients to live independently in their own home, that of a loved one, or an assisted living residence. There are multiple levels of functional need and the goal of this program is to help and support patients from having to move into a more expensive institutionalized nursing home setting. Benefits are based on an individual’s needs with a maximum of 300 care hours per month that can also include shopping, laundry, meal prep, and chore service. To qualify for benefits for Medicaid in North Dakota, there are rigid financial guidelines and a documented medical need. In 2024, these include income under $1,130 per month for a single person, countable assets less than $3,000, and medical assistance for help with activities of daily living. MSP-PC is unique because there is not a waiting list to receive benefits in this program. Click here for information on eligibility for Medicaid in North Dakota. For a printable fact sheet, click here. To apply, contact your local North Dakota Human Services office. Click here for a fast and free non-binding Medicaid eligibility test.


Aged and Disabled Waiver

The Aged and Disabled Waiver (commonly referred to as an HCBS Waiver) is a Medicaid program that aids those who qualify with additional long-term care benefits enabling independent living. The goal of the additional care benefits is to prevent the need for your loved one to move into a nursing home. Benefits can include adult day care, meal delivery service, case management, housework help, laundry, home modifications, respite care, assistive technology, and transportation. Enrollees can reside in their homes, that of a family member, or an assistive living community. There are strict financial limits and a documented medical need. For the eligibility guidelines for Medicaid in North Dakota, click here. In 2024, these include a monthly income of less than $1,130, countable assets of less than $3,000, and the need for a nursing home level of care. For more information, click here for a downloadable booklet about the program. Apply at your local Human Service Zone via this link. A waitlist can apply because there is limited availability in the HCBS Waiver and currently participation is limited to 627 enrollees annually. Click here for a fast and free non-binding Medicaid eligibility test.


Veterans Affairs (VA)

Veterans are statistically more likely to develop dementia. Among the reasons for this is that traumatic brain injuries and posttraumatic stress disorder lead to a higher probability of developing the condition. The VA offers many benefits for Alzheimer’s and dementia and different pension types.

VA Pensions

There are three types of VA Pensions available. The benefits change annually and are valid from December 2023 to December 2024. The benefits (and their maximum allowance) are as follows:

1) Basic Pension – This benefit is also known as a death pension. It is for veterans and surviving spouses who are aged or disabled. The qualifying disability does not need to be related to their military service. On an annual basis, the Basic Pension pays:

– Veterans without spouses or children up to $16,551

– Veterans with dependent spouses or children up to $21,674

– Surviving spouses without dependent children up to $11,102

2) Aid & Attendance – Abbreviated as A&A, this is an important program for veterans and their surviving spouses who require assistance with activities of daily living. This means they need assistance with activities like bathing, dressing, and eating. A&A is particularly helpful for people with dementia, especially in the middle and later stages of the disease, when the need for more assistance becomes necessary. A&A is intended to help with the long-term care costs of adult day care, in-home care, assisted living, memory care, and skilled nursing. Based on an individual’s need and the progression of the disease, most of these additional services that support your loved one will become necessary. Annually, the A&A pays:

– Veterans without spouses or children a maximum of $27,609

– Veterans with dependent spouses or children a maximum of $32,729

– Surviving spouses without dependent children a maximum of $17,743

3) Housebound – For veterans and surviving spouses who are permanently disabled and unable to leave their homes, making them require additional assistance. The definition of “home” can include assisted living, memory care, and nursing home. The Housebound pension, like the A&A pension, is meant to help cover long-term care costs. Annually, the Housebound pays:

– Veterans without spouses or children a maximum of $20,226

– Veterans with dependent spouses or children a maximum of $25,348

– Surviving spouses without dependent children a maximum of $13,568

 More information on VA Pensions’ eligibility criteria, payment rates, and the application process are available here.

Veterans Homes

There is one state veterans’ home in North Dakota. It is located in Lisbon, which is to the southeast and approximately 75 miles from Fargo. In addition to nursing home care and assisted living, memory care is available in a secure unit with specially trained staff. 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, Minnesota has five veterans’ homes statewide. Additionally, Montana has three facilities and South Dakota has one. More info.


Other Options

1) Eldercare 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) Tax credits and deductions like the Credit for the Elderly and the Disabled, or the Child and Dependent Care Credit (if you can claim your elderly loved one as a dependent). Remember also that medical and dental expenses can be deducted, and that can include assisted living costs.

3) A reverse mortgage can be an option for a married person moving into memory care, if their spouse continues to live in the home. However, if the spouse moves from their home, the reverse mortgage becomes due.