Assisted Living Cost in North Dakota
North Dakota is the cheapest state for assisted living in this batch, at $4,729 a month, yet it is one of the priciest states for a nursing home room, at $11,528 a month for a semi-private room. That split is the story of this page: the assisted living median is $1,471 below the national figure, while adult day care at $255 a day is the second highest in the country. The Medicaid section below also carries a warning worth reading: the waiver that pays for assisted living services does not pay room and board, while a separate Basic Care program does. If your parent lives in Bismarck, budget from the Bismarck figure, not the state figure.
Sources: CareScout Cost of Care Survey 2025, released March 2026, ranked state tables and Cost of Care calculator, accessed November 2026; North Dakota Department of Health and Human Services HCBS Waiver and Basic Care Assistance Program information; North Dakota Veterans Home information.
North Dakota assisted living costs, against the national median
The table below is the CareScout 2025 survey for North Dakota, with the national median beside it. The survey collected more than 25,000 provider rates between July and November 2025 and reports medians, the middle price, not averages pulled up by luxury buildings. Assisted living figures are for a private one-bedroom apartment for 12 months of care.
| Care type | North Dakota median | National median |
|---|---|---|
| Assisted living, per month | $4,729 ($56,745 per year) | $6,200 ($74,400 per year) |
| Home care, non-medical caregiver, per hour | $34 ($77,792 per year at 44 hours a week) | $35 ($80,080 per year at 44 hours a week) |
| Adult day health care, per day | $255 ($66,300 per year at 5 days a week) | $95 ($24,700 per year at 5 days a week) |
| Nursing home, semi-private room, per month | $11,528 ($138,335 per year) | $9,581 ($114,975 per year) |
| Nursing home, private room, per month | $12,304 ($147,643 per year) | $10,798 ($129,575 per year) |
The assisted living cost North Dakota median runs $1,471 a month below the national median, which is $17,655 over a full year (74,400 minus 56,745). Home care at $34 an hour sits $1 below the $35 national rate. Adult day care at $255 a day sits $160 above the $95 national rate. A semi-private nursing home room at $11,528 sits $1,947 above the $9,581 national figure, and a private room at $12,304 sits $1,506 above the $10,798 national figure. For the full national picture, read how much does assisted living cost and how much does a nursing home cost.
Assisted living cost North Dakota by place
Place medians come from the same CareScout survey, through its Cost of Care calculator, which reports the closest survey region for each place. All figures are 2025 monthly medians for a private one-bedroom apartment. The spread runs from $5,420 to $6,334, a gap of $914 a month between the lowest and highest North Dakota place in this table. Each place maps to its own metropolitan region, so read these as region figures, not as place-specific surveys.
| Place | Assisted living median per month, 2025 | Against the North Dakota median |
|---|---|---|
| Bismarck | $6,334 | $1,605 above |
| Minot | $5,672 | $943 above |
| Fargo | $5,420 | $691 above |
| Grand Forks | $5,420 | $691 above |
All four places in this table sit above the $4,729 state median, which tells you smaller regions outside these places pull the state figure down, not up. Bismarck at $6,334 sits $1,605 above the state median, the largest place gap on this page, while Fargo and Grand Forks, the lowest places in this table, still sit $691 above it. Do not treat the state median as the price in any of these places: use the place figure, then replace it with three written quotes in that place, with apartment size and care level stated. For how to use competing quotes, read can you negotiate assisted living costs.
What the monthly bill includes, and what it leaves out
The median buys the building and the base service: a private apartment, meals, housekeeping, supervision, and activities, with staff on site around the clock. It does not buy every charge a resident actually pays. Care is priced in levels, and the level rises as help needs grow, so the second year costs more than the first even before any annual rate increase. Medication handling, a higher care level, and a second occupant are commonly billed on top of the base rate, and many buildings charge a one-time community fee at move-in.
North Dakota licenses assisted living facilities through the Department of Health and Human Services, which requires a license from both Food and Lodging and the Health Response and Licensure Section for a setting serving five or more people. An assisted living facility is a building of at least five living units that provides or coordinates individualized support services. Basic care is a separate license and a separate setting: a basic care facility provides room and board plus health, social, and personal care for people who need help with daily routines but are not severely impaired in activities such as toileting, transferring, or eating. Ask at the tour, in writing, which license a setting holds, which services the base rate covers and which are billed as extras, and what each extra costs. The tour checklist on assisted living checklist groups those questions for you.
Medicaid in North Dakota: HCBS Waiver and Basic Care
North Dakota's Medicaid help for assisted living runs through the Home and Community Based Services Waiver, also called the Aged and Disabled Waiver, a Medicaid waiver operated by the Department of Health and Human Services, Adult and Aging Services. A waiver is the state program that pays for care services outside a nursing home. The waiver covers adult residential care, which can be delivered in an assisted living residence, for members age 65 and older or ages 18 to 64 with a disability such as brain injury or dementia. The waiver pays for care services in the setting; room and board is not covered, according to Medicaid planning guides, and the department's public pages do not state the room and board split, so confirm it in writing with the department before you budget. The separate Basic Care Assistance Program is the contrast worth knowing: it helps qualifying people pay for care in a licensed basic care facility, and the state Medicaid manual states the Basic Care program provides room and board along with health, social, and personal care. No official Department of Health and Human Services page states a current waitlist for the HCBS Waiver, so this page makes no waitlist claim. For help sorting the options, the Aging and Disability Resource LINK runs a statewide line at 1-855-462-5465. For the national Medicaid rules, read does medicaid pay for assisted living, and for the full payment map, read how to pay for assisted living. Medicare does not pay for assisted living room charges or custodial care; see does medicare pay for assisted living for the exact boundary.
VA resources in North Dakota
For a veteran parent, two North Dakota routes sit beside the private market. The first is VA Aid and Attendance, a monthly cash benefit added to a VA pension for a veteran or surviving spouse who needs help with daily living; the amounts and rules are on VA Aid and Attendance requirements and veterans affairs assisted living. The second is the state's own veterans home. North Dakota has one state veterans home, the North Dakota Veterans Home in Lisbon, on a 90-acre campus beside the Sheyenne River, with 52 skilled nursing beds and 98 basic care beds. It is a state veterans home, not a private assisted living community, so treat it as a separate application track, not as a price comparison. For VA health care, use VA.gov to find the facility nearest your parent.
North Dakota against the national median, in one row
Assisted living cost North Dakota at $4,729 a month sits $1,471 below the $6,200 national median, home care at $34 an hour sits $1 below the $35 national rate, adult day care at $255 a day sits $160 above the $95 national rate, and a nursing home semi-private room at $11,528 a month sits $1,947 above the $9,581 national figure. North Dakota is a markedly cheaper state for assisted living, an average state for home care, and a markedly pricier state for adult day care and nursing home rooms. At $11,528 a month, a semi-private nursing home room costs $6,799 a month more than the $4,729 assisted living median in the same state, so a parent whose needs are close to the nursing facility line should still price both settings in the same place.
Frequently asked questions
Does the HCBS Waiver pay for room and board?
No, according to Medicaid planning guides; the waiver pays for care services in the setting, including adult residential care in an assisted living residence, but not room and board. The Department of Health and Human Services does not state the room and board split on its public waiver pages, so confirm it in writing with the department. The separate Basic Care Assistance Program does pay room and board in a licensed basic care facility, which is a different setting from assisted living.
What is the difference between assisted living and basic care?
They are different licenses and different settings. An assisted living facility is a building of at least five living units that provides or coordinates individualized support services. A basic care facility provides room and board plus health, social, and personal care for people who need help with daily routines but are not severely impaired in activities such as toileting, transferring, or eating. Ask which license a setting holds at the tour, because the license sets what care the building may provide and which program can pay for it.
Why do Fargo and Grand Forks share $5,420?
Because the two metropolitan regions returned the same figure. The calculator maps Fargo to the Fargo metropolitan region and Grand Forks to the Grand Forks metropolitan region, and each region's 2025 median is $5,420. Neither figure is a price measured in the city itself beyond its region. Budget a move in either city from the region figure until you hold written quotes from communities in that city itself.
Does the $4,729 median cover two people sharing one apartment?
No. The CareScout median is for a private one-bedroom apartment occupied by one person. A second occupant adds a second-person fee set by each community, on top of the median, not inside it. Couples should budget the median plus the community's written second-person fee, plus a care level for each spouse who needs help, since care is priced per person. See average cost of assisted living for a couple for how couples totals are built.
Your next step is to take the place median for the city where your parent will actually live, get three written quotes that state apartment size, care level, and every extra fee, and check the HCBS Waiver, Basic Care, and VA eligibility before you sign. Start with assisted living checklist and assisted living costs.