North Dakota doesn't issue a separate memory care license. Dementia care is a specialized designation built into the state's existing licenses for basic care facilities, nursing homes, and assisted living. This guide explains how that works, what to verify on a visit, what it costs, and who pays.
In This Guide
- Key Takeaways
- How North Dakota Regulates Memory Care
- What to Confirm Before You Choose
- What It Costs and Who Pays
- How to Vet a Memory-Care Setting
- Frequently Asked Questions
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 treats specialized dementia care as a designation built into licenses it already issues: basic care facility, nursing home, and assisted living licenses. 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, provides housing and coordinated support services to help more-independent 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, board, and health, social, and personal care to residents who need more than independent living but don't require around-the-clock nursing care. Dementia care can be delivered within either of those settings, or within a nursing home, as a specialized designation.
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. North Dakota's rules do not publish a single fixed dementia training-hour count you can quote back, so when you ask about staff preparation, ask the facility to describe its dementia training and staffing in concrete terms rather than expecting one statewide number.
| 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 | The state doesn't publish one fixed training-hour count, so ask for specifics rather than a statewide number |
| 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 Genworth/CareScout 2024 Cost of Care Survey, the most recent state-level data, assisted living in North Dakota runs a median of about $5,335 a month (roughly $64,020 a year), which sits below the national median of about $70,800 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 $106,580 a year (roughly $8,882 a month) and a private room at about $116,070 a year (roughly $9,673 a month), both a bit below the national medians. In-home care, by contrast, is comparatively expensive in North Dakota, with a home health aide and homemaker services each running about $91,520 a year on a 44-hour-a-week 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. Assisted living in North Dakota is largely private-pay for room and board, and Medicaid does not pay the room-and-board portion of assisted living. For residents of a licensed basic care facility who also qualify for Medicaid, North Dakota's Basic Care Assistance Program can help cover the cost, and personal-care services for people who would otherwise need nursing-home care are covered through Medicaid's home- and community-based waiver or state-plan personal care. 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.
- 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.
- 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.
- 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.
- Ask how staff are trained for dementia. The state doesn't publish one fixed training-hour count, so 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.
- 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
No. North Dakota doesn't issue a stand-alone memory care license. Dementia care is a specialized designation built into the state's existing licenses for basic care facilities, nursing homes, and assisted living. The facility itself is licensed by the North Dakota HHS Health Facilities Unit, with specialized dementia care provided as a designation within that license.
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.
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.
There's no reliable single statewide figure for memory care alone. Use the assisted-living base as your anchor, about $5,335 a month per the Genworth/CareScout 2024 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.
Medicaid does not pay the room-and-board portion of assisted living, so that part is largely private-pay. For residents of a licensed basic care facility who also qualify for Medicaid, North Dakota's Basic Care Assistance Program can help cover the cost, and personal-care services for people who would otherwise need nursing-home care are covered through Medicaid's home- and community-based waiver or state-plan personal care. 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
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.