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Assisted Living in North Dakota

Like many areas of the country, North Dakota is seeing an increase in the population of older adults. Census figures show that around 15.3% of the state's 760,000 residents are aged 65 and over. It's projected that by 2030 more than 30% of the population will be aged 60 or above. North Dakota's cold weather may keep some seniors away, but the state has plenty of space and a low cost of living, which may make it an attractive retirement spot.

The Genworth Cost of Care Survey 2019 shows that seniors in North Dakota pay an average of $3,405 a month for assisted living. This is almost $650 less than the national average of $4,051.

This guide has more detailed information about the cost of assisted living in North Dakota, including comparisons with other senior living options and neighboring states. It also looks at factors that impact the quality of life for seniors in the state, including financial assistance programs, assisted living regulations and organizations that provide aid to older adults in North Dakota.


SeniorAdvice's Guide to Assisted Living in North Dakota



North Dakota currently has a SeniorScore of 68%, which is slightly lower than the national average of 72%. The SeniorScore is calculated after analyzing over 100 data points from government and private sources, and it helps show seniors how well different locations cater to the needs and interests of older populations.



SeniorScore™ for North Dakota



The SeniorScore™ is calculated based on over 100 variables, some of which are shown below. The final score is curved based on a linear curving method. For More info visit senioradvice.com/seniorscore.

68

SeniorScore™ Overview

  • North Dakota's SeniorScore™ of 68 is lower than the national average of 72.
56

Health & Safety

  • North Dakota has average access to Medicare registered healthcare providers.
  • North Dakota has an average number of hospitals within the state.
  • North Dakota has an average number of senior living facilities within the state.
  • North Dakota has an average number of home healthcare providers operating in the state.
  • The average life expectancy in North Dakota is 79.5, compared to the national average of 78.6.
  • North Dakota has a high overall property crime rate compared to national averages.
  • North Dakota has an average overall violent crime rate compared to national averages.
58

Recreation & Leisure

  • 34% of the population in North Dakota are seniors, compared to 29% nationally.
  • North Dakota has 94 golf courses in the state.
  • North Dakota has a high number of municipal parks throughout the state.
  • North Dakota has 690 churches in the state.
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Finances

  • The property taxes average 2.85% of total income in North Dakota, which is higher than the national average of 2.79%.
  • The property taxes average 1.55% of property value in North Dakota, which is significantly higher than the national average of 1.09%.
  • The average sales tax in North Dakota is 6.49%, which is lower than the national average of 6.97%.
  • The average state income tax in North Dakota is 1.04%, which is significantly lower than the national average of 3.38%.
  • The mean household income in North Dakota is $63,410, which is lower than the national average of $64,580.
  • North Dakota's median household income is $49,615, which is lower than the national average of $51,560.
  • The average per capita income in North Dakota is $27,254, which is higher than the national average of $25,611.
  • Assisted living costs in North Dakota average $41,445 per year, which are lower than the national average of $42,700.
  • Nursing home costs in North Dakota average $105,392 per year, which are significantly higher than the national average of $92,481.
  • Costs for adult daycare in North Dakota average $18,961 per year, which are higher than the national average of $17,931.
  • Costs for home healthcare in North Dakota average $66,886 per year, which are significantly higher than the national average of $46,197.
  • The unemployment rate is about 3.39% in North Dakota, which is significantly lower than then national rate of 8.26%.
  • The overall cost of living in North Dakota is average compared to national averages.
  • 0.43% of the senior population in North Dakota are financially responsible for at least one grandchild.
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General Quality of Life

  • North Dakota receives an average of 17.4 inches of rain per year.
  • North Dakota has an average annual temperature of 40.6 degrees fahrenheit.
  • North Dakota has an average low temperature of 28.7 degrees fahrenheit.
  • North Dakota has an average high temperature of 51.6 degrees fahrenheit.
  • North Dakota has an average population density of 152 people per square mile.
  • North Dakota has a very high public school quality ranking.
  • North Dakota has a very low public school safety ranking.
  • North Dakota has a high graduation rate of 90.16%.

Health and safety conditions in North Dakota receive a 56%, which is lower than all neighboring states except Montana. The low score is largely due to the state's rural nature. Seniors may have to travel a long distance to access the resources they need, including hospitals and assisted living facilities. This also impacts the state's recreation and leisure score, which sits at 58%, as the spread-out population makes socializing difficult.

The quality of life in North Dakota is also scored lower than its neighbors. This category looks at the general livability of a location, including weather, population density and environment. Although North Dakota's counties have very clean air and a low population, the cold weather means seniors rarely get to enjoy the environment during the winter months, which is one reason why the state's score is just 61%.



Top Assisted Living Facilities in North Dakota




 
 

The Cost of Assisted Living in North Dakota



Assisted living is quite affordable in North Dakota, with seniors in the state paying an average of $3,405 a month. This is more than $600 lower than the national average of $4,051. Although the average cost of assisted living in neighboring states is also lower than the U.S. average, it's less affordable than North Dakota. Seniors in South Dakota pay just $95 more than their neighbors to the north. At the other end of the scale, Montana has an average monthly cost of $3,820, $415 more than North Dakota.

  • North Dakota: $3,405
  • United States: $4,051
  • South Dakota: $3,500
  • Montana: $3,820
  • Minnesota: $3,800
  • Wyoming: $3,780

The Cost of Assisted Living in North Dakota's Top Cities

North Dakota is one of the least densely populated states in the country, and Fargo is the only city that has a population above 100,000. This causes significant differences in the cost of services like assisted living in North Dakota cities, although all cities have an average cost that's lower than the national average. Fargo has the most expensive assisted living at $3,984 per month, while the cost in Bismarck is equal to the state average. Seniors in Grand Forks pay significantly less; assisted living there costs just $1,950 each month.

  • Fargo: $3,984
  • Bismarck: $3,405
  • Grand Forks: $1,950
  • Minot: $3,405
  • West Fargo: $3,984

Senior Care Cost Comparison in North Dakota

In North Dakota, there's quite a large price difference between the different categories of senior living. Adult day care is the most affordable option at $2,059 a month, while nursing home care costs more than five times as much at $11,875. There are two types of care for seniors who prefer to stay in their home, one for people who need personal care and the other for those who need advanced medical care. Both in-home care options cost a little over $5,000 per month. Assisted living in the state sits at the lower end of the affordability scale at $3,405 each month.

  • Assisted Living: $3,405
  • In-Home Care: $5,148
  • Home Health Care: $5,331
  • Adult Day Care: $2,059
  • Nursing Home Care: $11,875

Financial Assistance for Assisted Living in North Dakota



Medicaid State Plan Personal Care Services


Address: 600 E Boulevard Avenue, Department 325, Bismarck, ND 58505-0250
Phone Number: (701) 328-7068
Website: https://www.nd.gov/dhs/info/pubs/docs/medicaid/fact-sheet-medicaid-state-plan-personal-care-services.pdf

North Dakota's Medicaid State Plan Personal Care Services helps people with activities of daily living, such as bathing, dressing and eating. The benefit can be used to pay for care received in certain types of group living environments, including assisted living facilities. Three levels of care can be provided, known as Level A, B and C. Each level has slightly different eligibility requirements and offers a different amount of care. At all levels, a case manager works with participants to determine the care they need.

All participants must be financially eligible to receive Medicaid. For single seniors, this means a monthly income of less than $883 and countable assets of less than $3,000. For married couples, the income and asset limits are slightly higher. The level of care received is based on the functional abilities of the applicant. At Level A, recipients must require help with at least one activity of daily living or three instrumental activities of daily living, which include preparing meals and doing housekeeping. At Level B, participants must be assessed as needing a nursing home level of care, while at Level C, they must also need assistance with at least five ADLs.


Medicaid Waiver for Home and Community-Based Services


Address: 600 E Boulevard Avenue, Department 325, Bismarck, ND 58505-0250
Phone Number: 1-855-462-5465
Website: http://www.nd.gov/dhs/services/adultsaging/homecare3.html

The Medicaid Waiver for Home and Community-Based Services are designed to help people stay in their homes and communities. It can pay for a range of services, including a residential care facility for people with memory loss. This means that seniors living in the memory care unit of an assisted living facility may be able to use this benefit to pay for their care.

To be eligible for the program, applicants must be 65 or older and assessed as needing a nursing home level of care. The payment is available to those under 65 who are designated as disabled by Social Security. Applicants must also meet the financial eligibility criteria of Medicaid. For single applicants, the income limit is $883 per month, and the asset limit is $3,000. Married couples have slightly higher income and asset limits.


VA Aid and Attendance


Address: 2700 State Street, Suite F, Bismarck, ND 58503
Phone Number: (844) 698-2311
Website: https://www.va.gov/pension/aid-attendance-housebound/

The Veteran's Aid and Attendance program offers financial aid to help qualified veterans and their spouses pay for their care. It can be used to reduce the cost of senior care, including care provided by an assisted living facility. Veterans can apply for the benefit to help care for an ill spouse. Applicants must be considered wartime veterans, which means their service must meet certain criteria. In addition, applicants must be at least 65 years of age or be officially disabled.

Financially, applicants must be eligible for a VA pension. The yearly income limits for this benefit differ depending on the number of dependents an applicant has, but start at $22,939 for a single person with no dependents. Applicants must also have a net worth of less than $129,094. At a minimum, participants must need assistance with activities of daily living to be eligible for the program. The benefit can also help people in nursing homes, those with limited eyesight and people who are confined to bed due to illness.


North Dakota Assisted Living Rules and Regulations



The North Dakota Department of Human Services regulates two types of assisted living care in the state. Assisted living facilities are defined by the state as an entity that has at least five separate living units and provides or coordinates individualized support services for five or more individuals. The state also licenses basic care facilities, which provide room and board and health, social and personal care to residents. The regulations for assisted living facilities and basic care facilities are contained in the North Dakota Century Code and Administrative Rules.

Scope of Care

ALFs in North Dakota must provide support services for each resident, including assistance with ADLs. Residents pay for each service individually. There are no admission restrictions for the facilities; ALFs determine their own residency criteria.

BCFs must offer additional services, including meals, health care arrangements, medication services, social and recreational activities, and transportation arrangements. Residents of BCFs must be capable of self-preservation during an emergency and must not have a condition that requires 24-hour care.

Care Plan Requirements

There is no requirement for ALFs to complete a care plan; however, they must evaluate prospective residents to ensure they meet residency criteria. In addition, they must maintain records of the services provided.

BCFs must complete an assessment within 14 days of a resident entering the facility to gather information about their needs and create an individual care plan.

Medication Management Requirements

ALFs and BCFs can assist with medication, including reading labels, opening containers and providing reminders to residents. Caregivers who are certified medication assistants and operating under the supervision of a registered nurse can also administer medication. In addition, BCFs must review each resident's medication regimen at least once per year.

Staff Requirements

There are no specific staffing ratios for ALFs or BCFs, though facilities must have adequate staff available to meet resident needs. ALFs must employ a manager and direct care staff, and if they administer medication, they must also have an RN available.

In BCFs, direct care staff provides personal care services, and there must be at least one awake staff member on duty at all times. Facilities must also have a licensed nurse available to administer medication and provide nursing services.

Staff Training Requirements

Staff in both ALFs and BCFs must complete ongoing training and education. Continuing education can cover a range of topics, including resident rights, emergency response, behavioral problems, infection control and fire and accident prevention.

Medicaid Coverage

Some care in assisted living facilities may be covered by North Dakota Medicaid programs, although the benefit doesn't cover room and board. In addition, North Dakota allows family members to assist with living expenses without affecting the senior's Medicaid eligibility.

BCFs are not certified to participate in Medicaid programs, although some waivers detailed in this guide may help cover personal care costs.

Reporting Abuse

Caregivers in ALFs and BCFs must report suspected abuse, neglect, exploitation or self-neglect of vulnerable adults to law enforcement as well as the Aging Services Division. All members of the public, including residents and their families, can call 1-855-462-5465 or visit the AGD website to make a report or for more information. If vulnerable adults are in immediate danger, law enforcement should be contacted.


Free Assisted Living Resources in North Dakota



Long-Term Care Ombudsman


The long-term care ombudsman advocates for residents of assisted living facilities and other long-term care facilities. Residents or family members can contact the ombudsman if they feel their rights aren't being honored or if they have concerns about the quality of care received. The ombudsman also answers questions about long-term care and can provide referrals to other programs.

Contact: Interested parties can call (855) 462-5465 for more information or email [email protected].


State Health Insurance Counseling


The State Health Insurance Counseling program assists North Dakota residents with navigating Medicare and other health insurance options. Trained counselors can help seniors to understand paperwork and statements, file claims and appeals and review long-term care insurance options for the future. The service is available at no cost to all Medicare beneficiaries.

Contact: Seniors can call (701) 328-2440 for more information or email [email protected].


North Dakota Agencies


Area Agencies on Aging in North Dakota

In North Dakota, Area Agencies on Aging services are provided by Adults and Aging Services. This is a division of the Department of Human Services that administers a range of programs designed to help older adults and adults with physical disabilities. Programs include respite care services, dementia care services and senior living options counseling. Most programs are available to those aged 60 and over, although some have additional financial or medical eligibility requirements. AAS also runs the Aging and Disability Resource Link, which gives information and referrals about senior programs to all North Dakota residents.

Veterans Affairs Offices in North Dakota

The Department of Veterans Affairs provides financial assistance to veterans and their families through the Veterans Pension and Survivors Pension programs. Also, a range of other services is available to help veterans with education, employment and managing disability. The North Dakota Department of Veterans Affairs has staff available to help veterans access all the benefits they are entitled to, including financial and advocacy services that can help those in assisted living facilities. The Department also manages the North Dakota Veterans Home, which is licensed as a basic care facility and may be an option for veterans looking for assisted living.

Social Security Offices in North Dakota

The Social Security Administration administers the Social Security Income program, which distributes benefits to millions of Americans each month. The benefit is available to North Dakotans aged 65 and over who meet the income and resource eligibility requirements. It's also available to people under 65 who meet certain disability criteria.

Social Security benefits can be used to pay for assisted living. Seniors who wish to apply can contact their local Social Security Office or use the online application.

 

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