The North Dakota Medicaid answer, verified
Limited - North Dakota Medicaid has no assisted-living-specific benefit. The ND Medicaid Waiver for Home and Community Based Services (waiver 0273.R06.00) covers 'adult residential care', waiver personal care, homemaker, respite, emergency response and related supports for people age 65+ and adults 18-64 with disabilities who meet a nursing facility level of care; these supports can be delivered in a residential setting. Whether room and board is excluded could NOT be verified from a North Dakota source this session - see notes. Here is what that means in practice for Hettinger families - eligibility, what waivers cover, and what stays out of pocket.
Assisted living near Hettinger compares against a national median of $6,200 a month - and North Dakota's own median of $4,729, ranked #47 of 50 states.
A semi-private nursing home room runs $9,581 a month at the 2025 national median - the number Hettinger families weighing skilled care start from.
In-home care averages $35 an hour nationally - about $80,080 a year at 44 hours a week for Hettinger households.
The honest North Dakota answer, verified against official sources: Limited - North Dakota Medicaid has no assisted-living-specific benefit. The ND Medicaid Waiver for Home and Community Based Services (waiver 0273.R06.00) covers 'adult residential care', waiver personal care, homemaker, respite, emergency response and related supports for people age 65+ and adults 18-64 with disabilities who meet a nursing facility level of care; these supports can be delivered in a residential setting. Whether room and board is excluded could NOT be verified from a North Dakota source this session - see notes. Eligibility is strict - income and asset limits apply, and there is typically a five-year look-back on gifts and transfers - so families planning a Medicaid path should talk to an elder law attorney early.
Limited - North Dakota Medicaid has no assisted-living-specific benefit. The ND Medicaid Waiver for Home and Community Based Services (waiver 0273.R06.00) covers 'adult residential care', waiver personal care, homemaker, respite, emergency response and related supports for people age 65+ and adults 18-64 with disabilities who meet a nursing facility level of care; these supports can be delivered in a residential setting. Whether room and board is excluded could NOT be verified from a North Dakota source this session - see notes. Whatever your state covers, one rule is nearly universal: waivers pay for care services, and the family still handles living costs - so a Medicaid path still needs a budget.
The 2026 numbers
| Care type | 2025 national median | What it covers |
|---|---|---|
| In-home care | $35/hour | Non-medical help at home - meals, bathing, companionship |
| Adult day care | $95/day | Daytime supervision and activities, evenings at home |
| Assisted living | $6,200/month | Housing plus daily-living help; care-level fees extra |
| Memory care | typically 20-40% above assisted living | Secured dementia care with higher staffing |
| Nursing home (semi-private) | $9,581/month | 24/7 skilled medical care |
| Nursing home (private room) | $355/day | Same care, private room |
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North Dakota: Medicaid, prices and the inspection file
| Question | North Dakota answer |
|---|---|
| Medicaid & assisted living | Limited - North Dakota Medicaid has no assisted-living-specific benefit. The ND Medicaid Waiver for Home and Community Based Services (waiver 0273.R06.00) covers 'adult residential care', waiver personal care, homemaker, respite, emergency response and related supports for people age 65+ and adults 18-64 with disabilities who meet a nursing facility level of care; these supports can be delivered in a residential setting. Whether room and board is excluded could NOT be verified from a North Dakota source this session - see notes. |
| State median, assisted living | $4,729/month (#47 of 50 states) |
| Licensing & inspection records | State licensing details pending verification - ask any community for its current license and inspection history |
North Dakota licenses two separate residential categories rather than one 'assisted living' license - an assisted living facility (a building of at least five living units providing individualized support services, where residents pay for individual services rather than a package and meals are not required) and a basic care facility (which does provide room, board and a package of personal care services). See notes on source vintage.
This guide is research, not advice: an independent summary of published costs and state rules. It is not a care provider, placement agency, law firm or financial advisor - care and Medicaid decisions deserve professional advice for your family's situation.
What this means for Hettinger families
Home care keeps your parent in familiar surroundings and costs less at low hours; communities win on 24/7 coverage, social contact and predictable pricing. The wrong choice is usually the one made in a crisis - which is why running these numbers early matters more than getting them perfect.
This guide is research, not advice: an independent summary of published costs and state rules. It is not a care provider, placement agency, law firm or financial advisor - care and Medicaid decisions deserve professional advice for your family's situation.
Common questions
What is the difference between assisted living and a nursing home?
Assisted living provides housing plus help with daily activities - meals, medication, bathing - at a median $6,200 a month. Nursing homes provide 24/7 skilled medical care at a median $9,581 a month for a semi-private room. The dividing line is medical need: wound care, feeding tubes and ventilators are nursing-home territory.
Does Medicaid pay for assisted living?
It depends entirely on your state: 36 states cover some assisted living services through waivers, 9 cover them in limited settings, and 6 have no assisted living pathway at all. Even where covered, waivers typically pay for care services while the family handles room and board. This guide's Medicaid page gives your state's verified answer.
When should we start looking?
Before the crisis. Good communities near you have waitlists, and emergency placements take whatever bed is open at premium rates. Touring while your parent is stable costs nothing, builds the shortlist, and turns a future emergency into a phone call.
What fees do communities add on top of rent?
Care-level fees (assessed need tiers that can add $500-1,500+ monthly), medication management, and one-time community or move-in fees are the big three. Always compare communities on the all-in monthly number at your parent's assessed level - base rent alone is a marketing figure.
How much does in-home care cost?
About $35 an hour at the 2025 national median - roughly $80,000 a year at 44 hours a week. Since the 2025 survey, non-medical caregivers are tracked as a single category, so quotes for 'homemaker' versus 'home health aide' services should no longer differ much for non-medical help.
Find senior care options near Hettinger
These platforms show communities and home-care agencies near you with pricing guidance. Advisors are free to families - providers pay them, as they do this site.
Disclosure: this is an independent guide. If you connect with a provider through a link here, the platform may pay this site a referral fee. That fee never changes your price - and it never changes what the inspection records say.