Nursing homes and assisted living in Montana

In Montana, assisted living is divided into categories based on how much help the person needs. Knowing each residence's category helps you choose a place where your loved one can stay longer.

What care settings are called here

These places are licensed by the Licensure Bureau, part of the Office of Inspector General of the Department of Public Health and Human Services (DPHHS). Its phone number is (406) 444-2676.

Assisted Living Facilities are divided into four categories:

• Category A: for people who need help with at least one daily activity, but not ongoing nursing care.
• Category B: for people with greater health needs. They may need nursing care for longer periods or depend on others for several daily activities.
• Category C: for people with severe cognitive impairment, such as advanced dementia.
• Category D: a small, secure unit of up to 15 residents, for special behavioral needs.

Other care settings:

• Adult Foster Care Home: a family home for up to four people, with personal help and medication management.
• Adult Day Care: an adult day center.
• Nursing facility: a nursing home, which appears as Long Term Care in the search tool.

On the state search portal, you can find licensed providers and their recent inspections. It's a simple way to get to know each place.

How Medicaid helps in Montana

Besides nursing home care, Montana Medicaid has the Big Sky Waiver. It is for people 65 or older, or with a physical disability, who need a nursing home level of care. This program pays for services at home and also for assisted living services at different levels.

The DPHHS says there are waiting lists for the Big Sky Waiver. That's why it's best to apply as soon as you can.

How to apply:

• Medicaid: online at apply.mt.gov, or by phone with the Office of Public Assistance, 1-888-706-1535.
• Waiver information: Senior and Long Term Care Division, (406) 444-4077.

How much care costs in Montana

These are the statewide medians from CareScout's Cost of Care Survey 2025 (data from July to November 2025):

• Assisted living (private one-bedroom unit): $6,075 a month
• Nursing home, semi-private room: $295 a day (about $8,973 a month)
• Nursing home, private room: $315 a day
• Non-medical home caregiver: $38 an hour
• Adult day health care: $267 a day

Who to call

• Long-Term Care Ombudsman (a free advocate for residents): state office, (800) 332-2272; local ombudsman, (800) 551-3191.
• Area Agencies on Aging line: (800) 551-3191. It connects you with the local aging agency in your area during business hours. Montana has 10 agencies.
• Eldercare Locator (national line): 1-800-677-1116.

Tips for your family

• Ask about the license category. If your loved one has dementia or may need more care, it helps to know whether the residence has a Category B or C license, since those serve greater needs.
• Apply for the Big Sky Waiver early, because there are waiting lists.
• Look for respite care for the caregiver. The Lifespan Respite program lists providers in the ADRC directory at montana.my-adrc.org.
• If your loved one is a veteran, ask about the state veterans' homes in Columbia Falls, Glendive, and Butte.

This is general information and does not replace medical or legal advice.