North Dakota doesn't issue a separate memory care license. Memory care is regulated as an approved service inside an existing facility license, such as a basic care facility license. This guide explains how that works, what to verify on a visit, what it costs, and who pays.

In This Guide

How North Dakota Regulates Memory Care

When you start calling facilities, "memory care" gets thrown around as if it were one licensed thing you could shop for and line up side by side. In North Dakota it isn't. The state never created a separate memory-care license. Instead, it regulates memory care as an approved service inside a facility license it already issues, with the clearest rules written for basic care facilities. Knowing that before your first tour changes what you look for, because it tells you where the real protection lives: in whether a facility is actually approved to provide that specialized care, not just advertising it.

Here's the structure. Residential long-term care in North Dakota is licensed through the North Dakota HHS Health Facilities Unit, and the state licenses two distinct residential categories. An assisted living facility, licensed under North Dakota Century Code chapter 50-32, has at least five living units, is operated as one entity to serve five or more people who aren't related to the owner or manager, and provides or coordinates individualized support services to help residents stay as independent as possible. A basic care facility, a separate North Dakota category licensed under North Dakota Century Code chapter 23-09.3, provides room and board to five or more unrelated residents who need health, social, or personal care but don't require regular 24-hour medical or nursing services. To count as basic care, it must also do one of three things: keep response staff available at all hours for residents' scheduled and unscheduled needs, hold itself out to the public as an Alzheimer's, dementia, or special memory care facility, or be attached to a nursing home or assisted living facility, with its staff available to meet the needs of all residents. The state's specific memory-care approval rules are written into the basic care rules, covered next.

For basic care facilities, the rules are spelled out in the Administrative Rules of North Dakota that govern that license (NDAC 33-03-24.1). Under those rules, a facility may be licensed and held out to the public as providing specialized care for residents with Alzheimer's disease, dementia, memory loss, or traumatic brain injury, and the rules address both secured and unsecured settings for those residents. The effect is that "memory care" in North Dakota isn't only a marketing label you have to take on faith. When a facility is approved to provide that specialized care, that approval sits inside a state license, and a family can ask one direct question: is this facility approved to provide specialized dementia care, and is its setting secured or unsecured?

So a North Dakota memory-care setting carries something you can check with the state, not just with the facility. If your loved one's dementia comes with heavy medical needs, the underlying license still matters, because a basic care or assisted living facility may not be set up to provide the around-the-clock nursing a person eventually requires. A specialized dementia designation is a service inside a residential license, not a substitute for a nursing home.

What to Confirm Before You Choose

Once you know specialized dementia care is a designation rather than a separate license, the next question is what to confirm before you choose. North Dakota's rules frame this conservatively, so the most useful approach is to verify the things the state actually addresses and to ask the facility to describe the rest in concrete terms.

Start with approval. Because memory care here is a service designation within an existing license rather than a separate license, confirm directly that a facility is approved to provide that specialized care, rather than relying on how the place markets itself. A place that markets "memory care" but can't show you that it's licensed to provide specialized dementia care is telling you something.

Then look at the setting. The basic care rules address both secured and unsecured settings for residents with Alzheimer's, dementia, memory loss, or traumatic brain injury. That distinction matters for a person who may wander, so ask whether the unit is secured, how exits are managed, and how the layout supports a resident who moves and needs to stay safe at the same time. When you ask about staff preparation, ask the facility to describe its dementia training and staffing in concrete terms.

What to confirm Why it matters
The facility is approved to provide specialized dementia care Memory care is a designation within a license, not a separate license, so approval is what you verify rather than a "memory care license"
Whether the setting is secured or unsecured The rules address both, and the difference is central for a resident who may wander
The underlying license type (basic care, assisted living, or nursing home) It tells you the level of care the setting is built to provide, and whether nursing-level needs are covered
How staff are trained for dementia Ask for specifics on what the training covers and who receives it
How the unit plans for wandering and behavior This is where dementia care most often succeeds or fails day to day

The wandering and behavior items deserve the closest read, because they're where dementia care most often succeeds or fails day to day. A strong unit is built so a resident can move and stay safe at once, and it has staff who can de-escalate distress without reaching for a locked door or a sedative as the first answer. If the facility can walk you through how it would handle your loved one's specific wandering or behavior, that's a far better sign than a glossy brochure.

What It Costs and Who Pays

Cost is usually what families brace for, and there's no clean single number for memory care in North Dakota. The state doesn't publish one, and because memory care here is delivered as a designation within other settings rather than as a separately surveyed type, the industry surveys that track senior-care prices don't break it out the way they break out assisted living overall.

What you do have is a solid anchor for the base. Per the CareScout 2025 Cost of Care Survey (the successor to the Genworth survey, the most recent state-level data), assisted living in North Dakota runs a median of about $4,729 a month (roughly $56,745 a year), which sits below the national median of about $74,400 a year. Memory care costs more than that base, here as everywhere, because specialized dementia care means more staff time, dementia-specific preparation, and often a secured setting built for safety. How much more depends on the facility, its size, and how much care your loved one needs. Treat memory care as a premium on top of that assisted-living figure, and be wary of any source quoting one precise statewide memory-care number.

For context on the rest of the care continuum, the same survey put a semi-private nursing-home room in North Dakota at about $138,335 a year (roughly $11,528 a month) and a private room at about $147,643 a year (roughly $12,304 a month), each priced on 365 days of care and both now above the national medians after a jump of about 30 and 27 percent against the 2024 survey. For in-home help, the 2025 survey combined the former homemaker and home-health-aide categories into a single "non-medical caregiver" service, and North Dakota's own figure for it is about $77,792 a year, or about $34.00 an hour at 44 hours a week for 52 weeks, a little under the national median of about $35 an hour ($80,080 a year on the same basis). These are industry-survey medians, not government figures, and prices vary across the state and climb as care needs grow. Use them to set expectations, then get a specific written quote from any place you're serious about.

Paying for it is where families often get caught off guard. For a resident of a licensed basic care facility, North Dakota's Basic Care Assistance Program helps qualifying individuals pay a portion of their cost for care. To qualify, a person must be a North Dakota resident, be 65 or older (or 18 or older and blind or disabled), apply and qualify for North Dakota Medicaid, and have a functional assessment of how they handle activities of daily living. Dementia care runs for years and the bill is steep, so it's worth checking eligibility and planning early rather than assuming the whole cost is yours alone to carry.

How to Vet a Memory-Care Setting

You don't have to become an expert in dementia regulation to make a sound decision. You have to confirm the facility is approved for specialized care, understand the setting and the underlying license, and ask the questions the rules hand you.

1
Step 1

Confirm specialized dementia approval

Because memory care here is a designation within an existing license rather than a separate one, confirm directly that the facility is approved to provide specialized care for residents with dementia, rather than trusting its marketing. A place that advertises "memory care" but can't show that approval is telling you something.

2
Step 2

Ask whether the setting is secured

North Dakota's basic care rules address both secured and unsecured settings for residents with Alzheimer's, dementia, memory loss, or traumatic brain injury, so ask which one this is, how exits are managed, and how the layout supports a resident who may wander.

3
Step 3

Check the underlying license

Ask whether the setting is a basic care facility, an assisted living facility, or a nursing home, since that tells you the level of care it's built to provide and whether nursing-level needs are covered. A basic care or assisted living facility may not provide around-the-clock nursing.

4
Step 4

Ask how staff are trained for dementia

Ask what the dementia training covers, who receives it, and whether new staff complete it before working alone. Specific answers are a good sign; vague reassurance isn't.

5
Step 5

Get the costs in writing

Ask for a written breakdown of the base rate, what memory care adds, how care levels get reassessed as dementia progresses, and what triggers an increase. Bring the contract home and read the refund and discharge terms without a salesperson in the room.

Tour at least a couple of places. The goal isn't a flawless one. It's a facility whose specialized dementia approval you've confirmed, whose setting and license you understand, and whose plan for wandering and behavior you've checked against what's actually happening inside the building.

Frequently Asked Questions

Is there a memory care license in North Dakota?

No. North Dakota doesn't issue a stand-alone memory care license. Memory care is regulated as an approved service inside an existing facility license, such as a basic care facility license, and a facility needs the department's written approval before providing it. The facility itself is licensed by the North Dakota HHS Health Facilities Unit, with specialized dementia care provided as a designation within that license.

How does North Dakota regulate dementia care?

Under the rules that govern basic care facilities (NDAC 33-03-24.1), a facility may be licensed and held out to the public as providing specialized care for residents with Alzheimer's disease, dementia, memory loss, or traumatic brain injury, and the rules address both secured and unsecured settings for those residents. Because this is a service designation rather than a separate license, families should confirm a facility is approved to provide that specialized care, ask how staff are trained for dementia, and review how it secures the environment and plans for wandering.

How do I confirm a facility really offers memory care in North Dakota?

Confirm directly that the facility is approved to provide specialized dementia care rather than relying on how the place markets itself. Then ask whether the setting is secured or unsecured, what the underlying license is, how staff are trained for dementia, and how the unit plans for wandering and behavior, and check those answers against what you see on a visit.

How much does memory care cost in North Dakota?

There's no reliable single statewide figure for memory care alone. Use the assisted-living base as your anchor, about $4,729 a month per the CareScout 2025 survey, and expect memory care to run higher because of the added staff time, dementia preparation, and secured setting it often requires. The advertised rate is usually a base that rises as care needs grow, so get a written breakdown from any place you're considering.

Does North Dakota Medicaid pay for memory care?

It can help in some settings. For a resident of a licensed basic care facility, North Dakota's Basic Care Assistance Program helps qualifying individuals pay a portion of their cost for care; a person must apply and qualify for North Dakota Medicaid, among other requirements. Because a basic care or assisted living facility may not provide around-the-clock nursing, a resident with heavier medical needs may eventually move to a nursing home, where Medicaid's nursing-facility coverage can apply for those who qualify. It's worth checking eligibility early rather than assuming the entire bill is private-pay.

Learn More

Care TypesMemory Care by StateMemory care is specialized assisted living for dementia. What it costs, who pays (Medicare doesn't), and how the rules change by state, with a guide to yours. Care TypesAssisted Living in North DakotaAssisted living in North Dakota runs about $4,729 a month in 2026. How the state licenses assisted living and basic care facilities, and what Medicaid pays. Care TypesNursing Homes in North DakotaNursing homes in North Dakota in 2026: a semi-private room runs about $138,335/year, above the national median. What it costs, who pays, and how to choose. Care TypesHome Care vs. Home Health in North DakotaHome care vs. home health in North Dakota: home health is skilled care Medicare covers; home care is non-medical help it won't. It decides who pays. Care TypesCost of Senior Care in North DakotaWhat senior care costs in North Dakota in 2026: assisted living about $56,745 a year, a nursing home about $138,335. See every setting and how to pay. Care TypesAssisted Living vs. Nursing Home in North DakotaAssisted living vs. nursing home in North Dakota: about $4,729/mo private-pay assisted living vs. $138,335/year skilled nursing, and who pays differs sharply. Care TypesAssisted Living vs. Memory Care in North DakotaAssisted living vs. memory care in North Dakota: cognition and safety drive the choice. North Dakota AL runs about $4,729 a month; ask for memory care rates.
CaregiverCaregiver Burnout: Signs and SupportHow to recognize caregiver burnout, why it happens, and what actually helps, from respite care to evidence-based programs like REACH II and Powerful Tools. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house.

Find personalized help confirming a North Dakota facility's specialized dementia approval and secured setting at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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