Due to its harsh winters, North Dakota can be overlooked as a retirement destination. But, the state’s low taxes and cost of living, especially in the health care field, make it an attractive option for older adults. North Dakota also waives payments on Social Security income, giving people a welcome boost to their monthly budgets. 

Families of older adults can also benefit from North Dakota’s tax credits, which help compensate individuals paying for medical care and companionship services for older relatives. This guide provides more information about North Dakota assisted living communities, including the associated costs and regulations.

North Dakota Assisted Living: Types Of Senior Housing Options

Covering over 70,000 square miles, North Dakota contains rolling prairies, bird-filled wetlands, lazy rivers, and modest mountains. This diversity gives older adults a wide variety of scenic backdrops at the area’s many assisted living communities, ensuring they can find one suited to their needs.

Assisted Living Facilities (ALFs)

Individuals who have difficulty bathing, dressing, or walking without aid may opt to live in an assisted living community, where caregivers are available to provide care and supervision in a safe, residential setting. North Dakota defines an assisted living facility as a facility consisting of five or more residential spaces for individuals who need support with daily activities to remain independent. The Department of Health and the Department of Human Services in North Dakota provide both oversight and licenses for assisted living services.

Difference Between Assisted Living and Basic Care Facilities

An Assisted Living facility is a building comprising at least five living units with individual support services provided for five or more adults.  A Basic Care facility also provides room and board as well as health, social and personal care for five or more adults.  The key difference between the two types of facilities is that the residents in a Basic Care facility must be able to take care of their own self-preservation needs and do not need continuous 24-hour on-site nursing or medical care.

Independent Living Communities

Independent living communities are a good housing option for seniors who can still live independently but want to downsize. Each resident or couple lives in a private unit, and most communities offer social programs so residents can meet their neighbors. Housekeeping, chores, and some meals may be provided, although these may incur an additional cost. Unlike the care given in an assisted living community, assistance with activities of daily living and medication management aren’t available in these communities. 

Nursing Homes

Nursing homes offer the highest level of care of all senior living options. These communities provide around-the-clock supervision and skilled nursing care, and medical help is available. Generally, people in nursing homes have complex medical issues or need more residential care than is offered in an assisted living facility. North Dakota has both skilled nursing facilities (SNF) for people who require 24-hour care and intermediate care facilities (ICF) for people who don’t need as much medical care. The average cost of nursing home care in the state is $11,978 for a semi-private room and $12,587 for a private room.

Continuing Care Retirement Communities (CCRCs)

Many seniors prefer to choose a community that will continue to meet their needs in the future. Continuing care retirement communities have independent living, assisted living, and nursing home facilities on the same property or owned by the same community. This model allows seniors to stay near their friends in familiar surroundings, even as their needs change. The care provided in the assisted living section of a CCRC is the same as in an assisted living community. The difference is that residents can easily move to a skilled nursing room if required. Often, CCRCs are bigger than ACHs, as they encompass more care options. 

Supportive Housing

Supportive Housing is a residential facility designed for older adults or persons with disabilities who are unable to live independently.  These individuals need help with toileting, bathing, dressing, medication management and administration, assistance with meals and housekeeping, and other activities of daily living.  These individuals do not need regular nursing care.  There are several housing options available that range from living in a facility to residents living in their own home or apartment, with community-based support services.

Adult Day Care

Older adults may be able to participate in an adult day care program, instead of staying home alone while their relatives and friends are at work, running errands, or attending appointments. Adult day care programs in North Dakota are intended for relatively healthy older adults who need companionship, supervision, and light support with daily activities.

A second tier of this type of care is available through adult day health care. Typically, ADHC programs cost $3,383 monthly in North Dakota, giving older adults a higher level of care that includes the potential for skilled nursing, physician, therapeutic, and social services.

In-Home Care

There are two types of in-home care available in North Dakota: homemaker services and home healthcare. Homemaker services generally provide personal care and may also help with errands, chores, and housekeeping. Home healthcare can deliver these services and also offer medical care such as skilled nursing and medication management. Unlike assisted living care, in-home care is provided to people in their homes, making it a good choice for those who prefer to age in place. However, it doesn’t give seniors access to the social and recreational programming of assisted living communities. The average cost of homemaker services and home health aides is $5,689 per month.

Cost Of Assisted Living Care In North Dakota

The average cost of assisted living care in North Dakota is $3,391 per month. This cost is $1,109 lower than the national average of $4,500 per month. The cost of living in North Dakota is 1.8% lower than the national average with healthcare costs nearly 13.3% higher and housing costs 4.6% less than the national average. The exact price of care differs depending on where in the state you’re located. The cost of assisted living ranges from a low of $2,200 in the Grand Forks area to a high of $3,840 per month in the Fargo area of North Dakota.

How Costs Compare In Nearby States

If you live close to one of North Dakota’s borders, you may find assisted living in a neighboring state is an affordable option.   South Dakota has a lower average monthly cost for assisted living at $3,350 per month while both Montana and Minnesota have a higher average cost at $4,450 and $4,508.

Quality and Safety of Assisted Living Facilities in North Dakota

Assisted living communities must be licensed by the North Dakota Department of Human Services and the Department of Health. To be considered for licensing, each community must have a minimum of five residential units and maintain certain safety protocols, such as having smoke detectors, emergency lighting, and emergency plans.

Assisted living facilities are also expected to provide individualized services to residents, including health services aimed at reducing illnesses and promoting residents’ overall wellness. Although background checks aren’t required for personnel at assisted living facilities, staff members must be available 24/7 and complete training on important eldercare topics. Continued education and training are expected for all staff members, including managers.

Paying For Assisted Living Care In North Dakota

The average cost of assisted living in North Dakota is around $41,000 per year, so, understandably, you or a family member may be wondering how to pay for care. A range of options is available to fund senior housing in the state. 

Private Funds

Selling a home is a common way for seniors to raise funds for assisted living care. Income from pensions and Social Security may also pay for some care. Other examples of private funds include your retirement accounts, mutual funds, and other investments. 

Long-Term Care Insurance

Long-term care insurance covers personal care, residential care, and other long-term support and services. Each plan is different; however, most offer a daily amount based on the policy that pays for assistance with activities of daily living. Most people buy a policy in their 50s or 60s and access it when required. If you or your family member has a policy, read it carefully to see what care it covers. 

Programs For Veterans

North Dakota has one Veterans Homes around the state, Lisbon. This home provides skilled nursing care to residents of North Dakota who served in the military. The state’s Department of Military and Veterans Affairs also has offices around the state where team members can help people obtain benefits and services. This includes the Aid and Attendance Benefit, which can help qualified veterans fund personal care. 

Elderlife Financial can help you understand how to pay for assisted living.

What Is Included With Assisted Living Care In North Dakota?

The services provided in assisted living communities generally come under three broad categories: personal care, medical care, and amenities. 

Most people move to assisted living communities because they look for easy access to personal care. These services assist with activities of daily living, such as bathing, dressing, walking, and toileting. Communities also provide supervision and can deliver care for unforeseen needs or in cases of emergencies.  

In North Dakota, ACHs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with 68% of communities providing skilled nursing. Many have healthcare specialists and on-site services, with 50% of communities offering dental care. In addition, 37% of ACHs have hospice services.

ACHs may provide specialized care for people diagnosed with Alzheimer’s disease or other forms of dementia. These special care units have additional security measures to ensure residents don’t wander, a common symptom of Alzheimer’s disease. Typically, they also offer programs designed to improve cognitive function and routines that help lower stress.

Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In North Dakota, 89% of communities conduct depression screening, and 45% offer mental health counseling. Social work programs are also found in 46% of ACHs. Social workers can provide counseling, conduct assessments, and help ensure residents have access to all the resources they need.

Amenities refer to other features and services of the community. ACHs offer three meals a day and coordinate activity programs to help residents stay active and connected with others, their families, and the community. North Dakota facilities must also provide transportation and laundry services and may offer housekeeping services. 

Wellness Resources in North Dakota

The Department of Health lists 55 hospitals in North Dakota. These include general-access and critical-access establishments, such as CHI St. Alexius Health Bismarck and Altru Health System – Grand Forks. Sanford Health, which features the country’s largest rural healthcare program, has 47 specialty clinics in North Dakota.

While much of North Dakota is considered rural, many assisted living communities are located in cities with medical facilities nearby, giving people plenty of living options near hospitals and clinics.

Programs For Veterans

The North Dakota Department of Behavioral Health Services offers mental health oversight and services through eight regional centers and a state hospital in Jamestown. The Alzheimer’s Association maintains five offices throughout North Dakota, including in Bismarck and Fargo, to assist people with dementia-related issues. Six National Alliance on Mental Illness branches also provided information on managing and improving mental wellness.

The Transition Into Assisted Living In North Dakota

The decision to move into an assisted living community can be difficult. Generally, you’ll notice changes in your loved ones that suggest they need some assistance. Signs that this environment could be beneficial include increased isolation, loss of mobility, noticeable weight loss or gain, and signs that they’re neglecting household chores. 

Your older family member may be the one to start talking about assisted living. For many seniors, the idea of moving into a home where cooking, laundry, and other chores are taken care of is appealing. For seniors who realize they need help with daily tasks, the addition of personal care may come as a relief. In North Dakota, 11% of residents need help with eating. Other commonly used services include bed transfer (10%), toileting (20%), and walking (58.%). Caregivers in ACHs help 32% of residents to dress, and 57.% of residents need help bathing.

If you think your family member would benefit from assisted living, start by talking about it openly. Highlight the positives of a move, such as social activities, cooked meals, and easily accessible assistance. Some ACHs provide respite care, which may allow your family member to have a trial run. Remember, this should be a conversation, not a lecture. Stay open to their opinion. If they’re not ready to transition to assisted living, talk about the care they need to stay at home.

North Dakota Assisted Living Oversight

Licensing and oversight for North Dakota assisted living communities are jointly maintained by the Department of Health and the Department of Human Services. For detailed information about individual communities or their rights as an ALF resident, people can contact the state ombudsman program and speak with trained volunteers.

Legal Resources

The term “elder law” is often associated with estate planning, trusts, and help obtaining benefits through Medicare or Medicaid. The field has also grown to include cases involving elder abuse, elder neglect, and exploitation. Skilled attorneys can help older adults affected by these issues. The attorney general publishes a list of common scams targeting older individuals and ways to avoid becoming a victim of fraud.

Many resources are available from groups such as the State Bar Association of North Dakota and Legal Services of North Dakota to help prevent abuse and offer guidance and aid in times of need. Nonprofit groups also exist to provide guardians to vulnerable adults without in-state family and friends to speak for them.