How much does a nursing home cost in North Dakota?
The median nursing home cost in North Dakota is $12,304 per month for a private room and $11,528 per month for a semi-private room, based on the CareScout 2025 Cost of Care Survey released March 2026. That's roughly $147,643 per year for a private room.
North Dakota nursing home costs run 22% above the national median despite being rural — a reflection of labor shortages and low facility density.
2026 North Dakota senior care costs at a glance
| Care type | North Dakota median/month | National median (CareScout 2025) | Difference |
|---|---|---|---|
| Nursing home (private) | $12,304 | $10,798 | +14% |
| Nursing home (semi-private) | $11,528 | $9,581 | +20% |
| Memory care (est) | $5,900 | $7,750 | −24% |
| Assisted living | $4,729 | $6,200 | −24% |
| Non-medical caregiver (hourly) | $34 | $35 | −3% |
See your exact spend-down timeline for North Dakota
Enter your savings, income, and care type to see how long your money lasts before reaching North Dakota Medicaid asset limits.
Open the North Dakota calculator →Nursing home costs by North Dakota city
Costs vary by metro area within the state. Urban markets typically run 10–25% above state medians, while rural areas can be 10–20% below.
City-level estimates are based on CareScout 2025 metro-area data. Individual facility costs vary 20–40% from these medians depending on amenities, staffing ratios, and room type.
North Dakota Medicaid for nursing home care
North Dakota Medicaid covers nursing home care for residents who meet both medical eligibility (need for skilled nursing care) and financial eligibility (limited assets and income). Understanding the rules before you need them can save your family hundreds of thousands of dollars.
North Dakota Medicaid 2026 asset limits
Individual applicant: $3,000 in countable assets (2026)
Married couple, one spouse applying: Community spouse may keep up to $162,660 under the federal Community Spouse Resource Allowance (2026 maximum), plus the home, one vehicle, and personal belongings
The 5-year look-back period in North Dakota
North Dakota Medicaid reviews all asset transfers made within 60 months (5 years) of your application date. Gifts to family, property transfers below market value, or large unexplained withdrawals trigger a penalty period that delays Medicaid eligibility — during which you must private-pay.
North Dakota's 2026 penalty divisor is approximately $12,304 per month (~$405 per day). A $50,000 transfer that violates the look-back rule would create roughly a 122-day penalty period during which North Dakota Medicaid will not cover care costs.
This is why elder law attorneys consistently advise families to begin Medicaid planning at least 5 years before nursing home care is needed.
Find a North Dakota elder law attorney
The National Academy of Elder Law Attorneys maintains a state-by-state directory of certified elder law attorneys.
Find a North Dakota attorney →What makes North Dakota different
North Dakota's HCBS Aged and Disabled Waiver covers nursing-facility-level care for seniors, administered by the Aging Services Division within the Department of Health and Human Services. North Dakota is one of the few remaining 209(b) states — meaning it can set more restrictive Medicaid income limits than the federal SSI standard, and the state's nursing-home Medicaid income limit is approximately $1,174 per month (FPL-based, far below the $2,982 used by most states). The state layers two additional programs on top of Medicaid: Service Payments for Elderly and Disabled (SPED) and Expanded SPED for residents who don't qualify financially for Medicaid, plus a Basic Care Assistance Program (BCAP) cash supplement that helps low-income residents afford licensed basic-care facilities.
Sources: state Medicaid agency program documentation and CMS spousal-impoverishment standards. See our methodology page for the broader data sources used across this site.
How North Dakota compares to neighboring states
Cost differences across state lines can be substantial. Some families consider relocating for care, particularly if adult children live across a border.