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Nursing Homes in Montana
Based on population data, Montana is home to the sixth-oldest state population in the nation. It’s home to 228,718 seniors citizens who represent about 20% of the state’s 1,068,778 residents. An aging population means there’s increasing demand for skilled nursing facilities, home health providers and other forms of long-term care. Montana currently has 70 licensed nursing homes that accommodate more than 3,776 residents at any given time.
Skilled nursing facilities provide intermediate to advanced medical care to individuals who are recovering from surgeries or medical events or are coping with multiple medical conditions. In Montana, these facilities typically charge $7,665 for a semiprivate room and $8,273 for a private room, which is slightly less than the national average.
This guide explores the cost of nursing homes in Montana as well as possible alternatives. It also takes a look at Medicaid long-term care benefits, financial assistance programs, nonprofit resources and state regulations that govern skilled nursing facilities. These materials are designed to help you make an informed decision regarding your current or future needs.
The Cost of Nursing Home Care in Montana
According to Genworth Financial’s Cost of Care Survey for 2020, a semiprivate room in a Montana nursing home costs $7,665 per month, which is $91 less than the U.S. median of $7,756. Montana performs favorably when compared to most neighboring states, excluding South Dakota where average rates are about $650 lower. Seniors in Wyoming pay almost $600 more per month of care, and rates are approximately $1,000 higher in Idaho, coming in at $8,669. With an average cost of $12,167 per month, nursing homes in North Dakota are 58% more expensive, which equates to a monthly price difference of $4,502.
Nursing homes in Montana’s largest cities typically charge anywhere from $7,756 to $9,429 per month. Rates are on par with the U.S. average in Billings at $7,756. Great Falls is moderately more expensive at $9,125, which is almost 20% more than the state median, and at $9,429, rates in Missoula exceed the state median by $1,764, or 23%. Rapid City, South Dakota, is one of the most affordable metropolitan areas in the Northern Plains at $7,452. Nursing home rates in other major cities, including Casper, Idaho Falls and Bismarck, exceed the state median by $791 to $2,981.
Missoula
$9429
Great Falls
$9125
Billings
$7756
Casper, WY
$8456
Idaho Falls, ID
$9064
Bismarck, ND
$10646
Rapid City, SD
$7452
With an average monthly cost of $7,665, skilled nursing is the most expensive form of long-term care in Montana by a significant margin. In-home care provided by homemakers or home health aides costs $5,138, or $2,527 less per month. Assisted living is more affordable still at $4,213, which represents an estimated monthly savings of $3,452. Adult day care costs about half as much as assisted living at $2,115. However, the services that these community-based facilities provide are minimal, especially when compared to nursing homes.
In-Home Care
$5138
Home Health Care
$5138
Adult Day Care
$2115
Assisted Living Facility
$4213
Nursing Home Care
$7665
Does Medicaid Cover Nursing Home Care in Montana?
In Montana, people aged 65 and older make up 19.3% of the population, and on average, about 7,800 of these seniors are enrolled in Medicaid every month. Many of these older adults are on Medicaid because they require care in a nursing home. Using both state and federal funding, Montana Medicaid covers the cost of room and board in these facilities, including a private room when deemed medically necessary. Medicaid covers many care services within these communities, including activities programs, local transportation, light housekeeping and social programs. Medicaid can also cover the cost of skilled nursing services in community settings. Seniors account for 5% of total Medicaid enrollment in the state.
There are 71 licensed nursing facilities in Montana with a total bed capacity of 6,274. The state determines the number of beds, including swing beds, needed every year in its Long-Term Care Facilities Plan. The trend in Montana is moving away from nursing facilities and into aging in place, and Medicaid helps pay for this transition through the Big Sky Waiver. In addition to skilled nursing, the waiver covers a wide range of supportive services, therapies, modifications and case management services.
Medicaid Eligibility in Montana
Seniors in Montana who require a nursing home level of care and earn less than what that care costs are eligible for Medicaid coverage. There are also financial limits on the assets you can hold, excluding your home and vehicle. A single applicant can’t have more than $2,000 in assets, and a couple can’t have more than $4,000. When only one person in a married couple is applying, the asset limit is $148,620 for the non-applying spouse.
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | Income must be less than nursing home costs | $2,000 | |
| Two People | 1 | Income must be less than nursing home costs** | $2,000 | $148,620 |
| Two People | 2 | Income must be less than nursing home costs | $4,000** |
*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient's monthly income must be put toward the cost of nursing home care.
**Assets are limited to $2,000 per spouse
In addition to the financial requirements, the Medicaid applicant must need the level of care offered by licensed nursing facilities in the state. This is determined by a care assessment performed by Mountain Pacific Quality Health (MPQH). Your loved one must also:
- Be a resident of Montana
- Be a U.S. citizen or documented resident
- Be aged 65 or older
How To Apply for Medicaid in Montana
You can apply for Montana Medicaid by visiting https://apply.mt.gov. You’re required to create an account. If you prefer to apply over the phone, you may call (888) 706-1535. You can also visit your local benefits field office and speak with a Medicaid representative in person.
Information You Will Need
Before you begin the Medicaid application process, make sure you have the following information available:
- Social Security number
- Proof of Montana residency
- Proof of age, such as a birth certificate
- Financial information, such as bank account and investment statements
- Insurance information, including policy numbers and benefit amounts
- Property deeds
- Financial information for other household members
Additional Medicaid Support & Resources in Montana
Montana seniors who need help applying for Medicaid or with their existing benefits can contact the following organizations for assistance. These resources are funded by the state and federal government, and they’re free at the point of service.
| Resource | Contact | Service |
|---|---|---|
| Montana ADRC | (800) 551-3191 | The Aging and Disability Resources Center in Montana can help you find local Medicaid providers and other Medicaid resources in your community, including licensed nursing homes, in-home care providers and other forms of long-term care. The ADRC offers direct assistance with long-term planning through its Montana Options Counseling service. It also offers vouchers to family caregivers who could benefit from the Montana Lifespan Respite Coalition. |
| Benefits.gov | (800) 362-8312 | Benefits.gov is a federal resource that provides basic information about Medicaid in each state, including Montana. You can learn more about eligibility requirements, what's covered and what other benefits may be available to your family. You can get assistance for your loved one online or over the phone. The hotline is free of charge. |
| Field Offices of Public Assistance | (888) 706-1535 | Montana DPHSS operates 19 Field Offices for Public Assistance throughout the state. These offices can help your loved one apply for Medicaid or a Medicaid waiver as well as other benefit programs offered by the state, including food stamps and cash assistance. You can call your local office for assistance or visit in person with an eligible family member if able. |
Does Medicare Cover Nursing Home Care in Montana?
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it’s most valuable for those who are recovering from an injury, illness or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
- Meals
- A semiprivate room
- Medications
- Skilled nursing
- Physical therapy
- Occupational therapy
- Speech therapy
- Audiologist care
- Medical supplies
- Medical social services
- Nutritional counseling
- Ambulance transportation
What Isn’t Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
Medicare Support & Resources in Montana
The following resources can help you resolve many issues related to Medicare, including problems you may have with a provider or answers to questions about coverage options. The services listed are provided free of charge.
| Program | Contact | Service |
|---|---|---|
| Kepro | (888) 319-8452 | Montana is included in Region 1 of the Beneficiary and Family Centered Care-Quality Improvement Organization BFCC-QIO (KEPRO). It can help your Medicare beneficiary appeal the termination of care or file a complaint about a Medicare provider. It also offers a variety of informational resources that can help you make smart decisions about long-term care for your family. |
| State Health Insurance Assistance Program (SHIIP) | (800) 551-3191 | You can contact SHIIP for free health benefits counseling and advocacy whether you're a Medicare beneficiary or a family member of a beneficiary. Counselors provide unbiased assistance aimed to help you get the most out of your Medicare benefits, including access to long-term care options. SHIIP counselors are highly trained and knowledgeable professionals who know how to be objective. |
| Medicare.gov | (800) 633-4227 | Visit Medicare.gov to learn all about what benefits your loved one has access to and whether there are supplemental options that meet their needs. You can get a lot of information by browsing the site or calling their helpline. There are also live chat representatives available 24/7 to answer any questions you might have about the Medicare system and how it relates to nursing homes and long-term care. |
Other Financial Assistance Options for Nursing Home Care in Montana
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
| Name | How To Apply | How It Works |
|---|---|---|
| Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care. |
| Reverse Mortgages | Learn more about your options and how to apply at ftc.gov | If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
| Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be able to use it to pay for skilled nursing care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not typically be eligible to sign up for a LTC insurance policy. |
Free and Low-Cost Resources for Seniors in Montana
There are many resources in Montana that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Area Agencies on Aging | In Montana, seniors have access to 10 Area Agencies on Aging across the state, which provide a variety of supportive services. These agencies offer seniors education regarding Medicare benefits, insurance fraud, elder abuse and many other advocacy concerns. They can also point seniors toward local assistive services, including transportation to medical appointments, exercise classes, nutrition and meal delivery programs, community centers and local care options. Additionally, seniors can discover their local Ombudsman program through AAAs. |
Cash Assistance Programs
Cash assistance programs in Montana provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Montana seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Meals on Wheels | Montana Meals on Wheels is a food assistance program open to statewide seniors ages 60 and over, along with those who are unable to shop for and prepare meals due to limited mobility. These nutritious meals fulfill seniors' dietary needs and are available on a sliding-fee scale based on income, ranging from no cost to full cost. Congregate meals are served at local senior centers, while home-delivered meals provide seniors with daily socialization and safety checks to help monitor well-being. | |
| Montana Senior Farmers Market Nutrition Program (SFMNP) | 406-926-1625 | In Missoula, MT, the Community Food and Agriculture Coalition partners with the Montana Department of Public Health and Human Services to distribute coupons to low-income seniors aged 60 and older. Seniors are free to redeem these vouchers at over 30 farmer's markets and farm stands throughout the state for fresh fruits, vegetables and honey. Starting May 1st, seniors who meet USDA income limits can sign up for this program, which runs from June 1st to October 31st. |
| Montana Supplemental Nutrition Assistance Program (SNAP) | 888-706-1535 | The Montana Supplemental Nutrition Assistance Program is a food-assistance program for Montana residents who meet the eligibility requirements, which is based on the number of residents per household compared to their respective gross and net monthly income. Qualified recipients can access benefits via their Montana Access Card, a debit card linked to the Electronic Benefit Transfer (EBT) system. In addition to using the card to buy food at certain stores, residents can use it at farmers' markets. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in Montana collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana MonTECH | 406-243-5511 | MonTECH is a statewide assistive technology program that allows people to borrow a wide range of devices, such as wheelchairs, tablets, lifts, walkers and feeding devices, for a set period of time. The organization also maintains community exchange listings. |
Health Insurance & Prescription Drug Coverage for Seniors
Montana seniors who meet certain income criteria can apply to local resources to help them pay for prescription drugs. Eligible residents can also receive assistance through health insurance and other programs to access free or discounted medical services.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Big Sky Rx Program | 866-369-1233 | Administered by the State of Montana, the Big Sky Rx Program helps Medicare beneficiaries pay for prescription medication insurance premiums. |
| Montana Rx Card | As the state's prescription assistance program, the free Montana Rx Card is available to all Montana residents. It provides discounts on prescription drugs when obtained from participating pharmacies. |
Home Repair and Modifications
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in Montana have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Section 504 Home Repair Program | The Section 504 Home Repair Program provides loans and grants to low-income homeowners. Seniors may receive a grant of up to $10,000 to remove health and safety hazards from their residence. Home repair and modernization loans up to $40,000 are available to seniors who can repay them. |
Medicaid Resources
Navigating the Medicaid system is often difficult and confusing. Several Montana resources help older adults by providing advice on Medicaid options, waiver programs and eligibility criteria to help seniors receive the right health care benefits.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Big Sky Waiver Program | The Montana Big Sky Waiver Program is a home- and community-based services Medicaid waiver that provides tailored support services to enable eligible seniors to remain at home or in an assisted living community. The program seeks to prevent or delay admission to a nursing home or other institutional setting. Services may include nursing care, rehabilitation therapies, environmental modifications, attendant care, help with personal care, daily activities and domestic chores, respite care and transportation. |
Social Security Offices
Social Security offices in Montana help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Tax Assistance
Seniors can apply for tax assistance from several Montana resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Elderly Homeowner/Renter Credit Program | Seniors aged 62 and older who own or rent a home in Montana may be eligible for property tax relief. Refunds of up to $1,150 may be credited to a senior's Individual Income Tax. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Montana retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Energy Share | 888-779-7589 | The nonprofit Energy Share of Montana provides emergency assistance to Montana residents facing hardship and who are at risk of losing heating or lighting in their home. All cases are considered on an individual basis. |
| Montana Low Income Home Energy Assistance Program (LIHEAP) | 833-317-1080 | Montana's Low Income Energy Assistance Program can help seniors afford their heating bills during the cold winter months. In addition to paying a portion of energy bills, the program assists seniors in need of emergency furnace replacement. The LIHEAP is open to renters and homeowners, although some income limits apply. Seniors who are already participating in certain other federal programs, including the Supplemental Nutrition Assistance Program and SSI, generally qualify automatically for Montana's LIHEAP. |
Veteran's Services
Montana retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana VA Benefits and Health Care | Montana VA Benefits and Health Care offers comprehensive VA benefit, compensation and pension assistance via five Vet Centers. Advisors can help seniors file claims and appeal adverse decisions. Those with a service-related injury can obtain free medical care from a network of outpatient and community-outpatient clinics in addition to Fort Harrison VA Medical Center. The state has two cemeteries for veterans: Fort Missoula Post Cemetery and Yellowstone National Cemetery. |
Nursing Home Laws and Regulations in Montana
| Topic | Rule |
|---|---|
| Licensing | Long-term care facilities that provide intermediate or skilled nursing are licensed by the Montana Department of Public Health and Human Services, Quality Assurance Division, Licensure Bureau. |
| Staffing | Skilled nursing facilities must meet strict minimum staffing standards for RN, LPN or CNA care based on the number of licensed beds. Minimum requirements may vary for day, evening and night shifts. |
| Staff Training | Nursing homes in Montana may employ qualified nurses and certified nursing assistants who have completed at least 75 hours of training with at least 16 hours of clinical experience. These standards are consistent with federal minimums established by Medicare. |
| Admission Restrictions | Health care facilities that provide skilled nursing must have written policies and procedures for resident admission. Before admitting a resident, the facility must perform a comprehensive needs assessment to determine whether the applicant can be accepted through one of the three admission categories or through an exemption. Prospective residents have a right to appeal a denial by paying a $100 fee for an independent needs assessment. |
| Care Planning | Health care facilities must prepare an individualized service plan for each resident. The initial plan must be reviewed within 60 days of admission or more often if required by the resident's admission category. The plan of care must describe all of the services that the resident will receive as well as the name and type of provider, treatment goals and other pertinent details. |
| Dietary and Nutrition Services | Skilled nursing facilities must follow strict standards for planning, preparing and serving resident meals. Facilities must provide at least three properly timed meals that are nourishing and well-balanced and accommodate residents' dietary needs or preferences. Facilities must employ a full-time dietitian or a similarly qualified professional to prepare menus according to nationally recognized nutritional standards. |
| Specialized Rehabilitative Services | Nursing homes may provide physical therapy and other forms of restorative or rehabilitative care as directed by a physician. |
| Medication and Pharmaceutical Services | Skilled nursing facilities must provide all routine and emergency medications as required by residents. Prescriptions can be filled by an in-house pharmacy or by a contracted provider. The facility must maintain comprehensive medication records for each client, and a qualified pharmacist must review each resident's medication regimen at least four times per year. |
| Activities | Facilities must maintain at least one centrally located common area designed for recreational activities and socialization. |
| Infection Control | When providing personal care, nursing homes must take steps to minimize accidents, injuries and infections. Health care facilities must have written policies and procedures to prevent the transmission of communicable diseases. These policies must include protocols for hand washing, hazardous waste disposal, employee screening and caring for residents who have or are suspected of having communicable diseases. |
| Medicaid Coverage | Montana Medicaid offers long-term care benefits to individuals who require nursing home care and use all of their income, excluding a personal needs allowance, to pay for these services. |
Facilities in Montana
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