Nursing homes and assisted living in North Dakota

North Dakota has a type of care that hardly exists in other states: Basic Care. Knowing how it differs from assisted living and from a nursing home will help you choose the right place.

What care settings are called here

The Department of Health and Human Services (ND HHS) regulates these places:

• Assisted Living Facility: this is assisted living. It has apartments or units for five or more people, with support based on what each resident needs. This type of residence needs two licenses: one from Food and Lodging and one from Health Response and Licensure.
• Basic Care Facility: offers a room, meals, and personal care. It has staff who are awake 24 hours a day, but no round-the-clock nursing. It falls in between assisted living and a nursing home. In April 2026, there were 67 in the state.
• Skilled Nursing Home: a nursing home, with nursing care 24 hours a day.

The state publishes lists of licensed assisted living and Basic Care residences. It also offers an official chart that compares the three types. Looking up licenses and inspection results is a practical way to get to know each place.

How Medicaid helps in North Dakota

Medicaid pays for nursing home care for people who qualify. For other options, there are several programs:

• Basic Care Assistance Program (BCAP): pays the part of the cost of Basic Care that the person's income can't cover. The person must have North Dakota Medicaid and pass an assessment. They keep $153 a month for personal expenses.
• HCBS Medicaid Waiver: services at home and in the community. The official document in effect since January 1, 2026, says there is no waitlist.
• SPED and Ex-SPED: state programs that pay for help at home, adult day care, and respite care for people who, with this help, can avoid moving.
• PACE: complete care for older adults who live at home.

According to the state's official chart, assisted living is usually paid for privately or, in part, with long-term care insurance.

Where to apply:

• For services at home: Aging and Disability Resource-LINK, 1-855-462-5465.
• For Medicaid and BCAP: Customer Support Center, (866) 614-6005, or at hhs.nd.gov/applyforhelp.

How much care costs in North Dakota

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): $4,729 a month.
• Nursing home, semi-private room: $379 a day (about $11,528 a month).
• Nursing home, private room: $405 a day.
• In-home caregiver (non-medical): $34 an hour.
• Adult day center (adult day health care): $255 a day.

CareScout does not publish a separate figure for Basic Care.

Who to call

• Long-Term Care Ombudsman (a free advocate for residents): (855) 462-5465, option 3, or (701) 328-4617.
• Aging and Disability Resource-LINK (the state aging helpline): 1-855-462-5465 (1-855-GO2LINK). TTY: 711.
• Eldercare Locator (national helpline): 1-800-677-1116.

Tips for your family

• Ask what license the building has. Many Basic Care facilities share a building with assisted living or a nursing home. According to the state, living in one part does not guarantee a spot in the other.
• If money is limited, ask about Basic Care. It may be an option with help from BCAP.
• Use caregiver support. The Family Caregiver Support Program offers respite care and guidance at no cost. You can ask for it through the Resource-LINK.
• Call before you visit. In such a rural state, it's a good idea to confirm by phone whether there is an opening and what services they offer.

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