Home Care in North Dakota

The average starting cost of home care in North Dakota is $33 per hour, according to A Place for Mom’s proprietary data. Based on our ranking methodology, the top-rated home care agencies in North Dakota are FirstLight Home Care of Rugby, ND (313), Home Instead - Fargo, ND or Griswold Home Care for Fargo, ND. Home care can help older adults stay in familiar surroundings while receiving support with personal care, meals, companionship, and household routines.

Provider availability can differ between smaller rural communities and larger markets such as Fargo, West Fargo, Bismarck, Grand Forks, and Minot. Families often compare service areas, travel policies, scheduling flexibility, caregiver consistency, and whether support can increase as their loved one’s needs change.

Home care provides nonmedical help with activities such as bathing, dressing, meal preparation, light housekeeping, errands, and companionship. Home health care is different because it includes nursing, therapy, and other medical services delivered by licensed professionals. Some companies provide both, but A Place for Mom’s network consists of nonmedical home care providers. A Place for Mom partners with 32 home care agencies in North Dakota to help families compare local options.

Home care in North Dakota costs $33 per hour, compared with the national average rate of $32 per hour. Rates can differ by market, and provider availability or travel distance may have a greater effect in rural and frontier communities than in Fargo, Bismarck, or other cities.^[01] What a family pays will also depend on the agency, services, and care schedule.

Monthly expenses depend largely on how often caregivers visit and how long they stay. A lighter schedule may provide enough support for companionship, meals, errands, or household tasks. Someone who needs regular help with bathing, dressing, mobility, or other personal care may need more frequent visits. The estimates below use North Dakota’s average hourly home care rate:

• Part-time care (20 hours/week): $2,795 per month
• Full-time care (44 hours/week): $6,149 per month

Home care rates in North Dakota may also be affected by:

• The type and amount of help your loved one needs
• Specialized support, such as dementia care
• The number and length of visits
• Evening, overnight, weekend, or holiday schedules
• 24-hour or live-in care
• Caregiver experience and training
• Travel distance and local caregiver availability
• Agency minimum-hour requirements

North Dakota families may use private funds, public benefits, or a combination to pay for nonmedical home care. Depending on eligibility, VA benefits, North Dakota Medicaid, or state-funded home- and community-based programs may help cover some support at home.

Private pay options

Private pay can give families more choice over the agency, schedule, and type of assistance their loved one receives. Common private payment sources include:

• Social Security benefits
• Savings, investments, or pensions
• Long-term care insurance
• Life insurance conversion
• Reverse mortgages

Families may rely on one payment source or combine several.

VA benefits

Eligible veterans and surviving spouses in North Dakota may qualify for benefits from the U.S. Department of Veterans Affairs (VA) that help with care at home. Depending on the program, support may include help with daily activities, temporary relief for family caregivers, or additional pension payments that can be used toward care.

Veterans enrolled in VA health care may qualify for home- and community-based services, including:^[02,03,04]

• Homemaker and Home Health Aide Care, which may provide help with bathing, dressing, eating, mobility, and other daily activities
• Respite Care, which provides short-term support while giving family caregivers time away from caregiving responsibilities

Eligibility and availability can vary based on the veteran’s needs and local VA resources. Some veterans may also have a copay.

VA Aid and Attendance provides additional monthly pension payments to eligible veterans and survivors who need help with daily activities or are largely confined to their homes. Families may be able to use these funds toward the cost of nonmedical home care.^[05]

North Dakota families can use the North Dakota Department of Veterans Affairs service officer directory to find free help with federal and state benefit claims.^[06]

Read more: Home Care Options for Veterans: Eligibility and Services

North Dakota Medicaid

Medicaid is a joint federal and state program that helps eligible people pay for health care and long-term services. North Dakota Medicaid may cover medically necessary home health care and personal care or other supports that help eligible residents remain at home.

The state’s Medicaid State Plan Personal Care Services program helps eligible people with bathing, dressing, transferring, toileting, meal preparation, housework, and laundry. Services are based on an assessment and approved plan.^[07]

North Dakota’s Home and Community-Based Services Waiver helps eligible people who would otherwise need nursing home services but can safely receive support at home or in the community. Depending on the approved plan, services may include:^[07,08]

• Personal care, homemaker, and chore services
• Companionship and supervision
• Adult day services
• Home-delivered meals
• Respite care
• Nonmedical transportation
• Emergency response systems
• Environmental modifications and specialized equipment
• Extended personal care and nurse education

Many Medicaid-funded in-home services are delivered by enrolled Qualified Service Providers (QSPs). QSPs may be individuals or agencies, and their approved services, competencies, and enrollment status determine which tasks they can provide. North Dakota also has Family Home Care and Family Personal Care provider pathways, which may allow an approved family member to be paid when the participant, provider, and service plan meet program rules.^[09,10]

Eligibility varies by program. Medicaid financial eligibility, functional needs, and an assessment or level-of-care determination help decide whether services are available and how much support a person may receive.

Read more: Medicaid Home Health Care and Nonmedical Home Care: Your Questions, Answered

Medicare

Medicare is a federal health insurance program for adults 65 and older and some younger people with disabilities. It may cover limited help with bathing, dressing, grooming, or toileting when your loved one is also receiving qualifying skilled care through Medicare’s home health benefit. Medicare generally does not pay for ongoing personal care, companionship, meal preparation, or housekeeping when those are the only services needed.^[11]

Read more: Does Medicare Cover Home Health Care?

North Dakota does not issue a separate state license specifically for private-pay agencies that provide only nonmedical companionship, homemaker help, or personal assistance. The state does license home health agencies that provide nursing and related medical services. Providers paid through North Dakota Medicaid or state home- and community-based programs must follow separate QSP enrollment and service requirements. Because A Place for Mom’s network consists of nonmedical home care providers, the information below distinguishes those businesses from licensed home health agencies.^{[07,09,12,13]}

Does North Dakota require home care agencies to have a license?

No separate license is required for a private-pay company that provides only nonmedical home care. A company that meets North Dakota’s definition of a home health agency must hold a license from the North Dakota Department of Health and Human Services. Licensed home health agencies must provide skilled nursing and at least one other therapeutic service, such as therapy, medical social services, or home health aide services.^[12,13]

Does North Dakota conduct inspections of home care agencies?

North Dakota does not conduct licensing inspections of private-pay nonmedical home care agencies because those businesses do not have a separate state license. Licensed home health agencies are subject to periodic unannounced on-site surveys for license renewal. The department may also conduct announced or unannounced reviews at any time, examine records, interview staff, and visit a patient’s home with permission.^[13,14]

How to check licensing and inspection reports for home care agencies in North Dakota

Because North Dakota does not separately license private-pay nonmedical home care agencies, families cannot verify those providers through the home health licensing list. If an agency also provides licensed medical home health services, use the state’s Home Health Agencies page to review the directory, search current status, and access licensing rules and survey resources.^[12]

For care funded through North Dakota Health and Human Services (HHS), families can use the Qualified Service Provider resources to learn about provider enrollment and find QSPs. QSP enrollment is not the same as a private-pay home care agency license, but it confirms that the provider has met the service-specific requirements for HHS-funded care.^[09,10]

When comparing a private-pay agency, ask about liability insurance, caregiver screening, training, supervision, backup coverage, and the complaint process. Voluntary accreditation can provide another outside review, but it is not a substitute for state home health licensure or QSP enrollment when either applies.

What are hiring practices for home care agencies in North Dakota?

North Dakota does not set one statewide training standard for caregivers employed by private-pay nonmedical home care agencies. Screening, onboarding, and continuing education can vary by company, so families should ask what the agency requires before a caregiver begins working independently.

Different rules apply to QSPs who provide HHS-funded services. QSPs must meet service-specific competency standards and keep required licenses, certifications, or competency documents current. The Individual QSP Handbook says providers must pass applicable screening requirements and may not have convictions that directly affect their fitness to provide care. Competency generally must be updated every 30 months or when a license or certification expires.^[09,10]

When comparing agencies, ask about criminal background checks, abuse and neglect registry checks, reference checks, hands-on skills reviews, supervision, ongoing education, and how the provider responds to missed visits or safety concerns.

Choosing a home care agency is easier when you understand how caregivers are selected, which communities the agency serves, and what happens if weather, distance, or staffing affects a visit. Look for a provider that communicates clearly, explains its policies, and can offer the services and schedule your family needs. Consider the following as you compare agencies:

• Clarify the provider’s status. Ask whether it is a private-pay nonmedical agency, a licensed home health agency, an enrolled QSP, or a company that operates in more than one category.
• Review caregiver screening. Ask about background and registry checks, references, and how the agency handles concerns about a caregiver.
• Ask about training. Find out what caregivers learn before working independently and whether they complete ongoing education or competency reviews.
• Confirm the service area. Ask whether the agency serves your loved one’s community, charges for travel, or has different scheduling limits in rural areas.
• Read reviews and testimonials. Look for patterns in feedback about reliability, communication, compassion, and caregiver consistency.
• Request clear pricing information. Ask about hourly rates, minimum service requirements, travel charges, weekend or holiday rates, overnight care, cancellation fees, and additional costs.
• Confirm available services. Make sure the agency can provide the support your loved one needs, such as companionship, bathing, dressing, meal preparation, transportation, or dementia care.
• Ask how care is supervised. Find out who manages the care plan, how often supervisors check in, and whom your family should contact if your loved one’s needs change.
• Plan for backup care. Ask what the agency does when a caregiver is sick, road conditions are poor, or a scheduled visit cannot happen.
• Meet potential caregivers. A good personality fit can help your loved one feel more comfortable receiving support at home.

A Place for Mom helps families compare home care agencies and find providers that match their loved one’s care needs, budget, and preferences. In states that require nonmedical home care agencies to be licensed, A Place for Mom verifies the licensing status of agencies in its network twice each year.

Read more: How to Choose a Home Care Agency