Assisted Living in Montana

Montana is home to small towns and wide prairies, as well as lakes, deserts, and mountains. The land is known for its rugged beauty, and many people own vacation homes and cabins in the backcountry wilderness. Seniors who enjoy outdoor activities such as hunting and fishing find the state an excellent place to retire.

Directory of Assisted Living Facilities in Montana

When choosing an assisted living facility for yourself or your loved one, thorough research of any potential residence is critical. Our comprehensive directory of assisted living facilities in the state of Montana is one of the best ways to start that process. Find information about size, amenities, location, prices, regulations, health insurance, services, and more using the tool below.

How to Pay for Assisted Living in Montana

Determining how to finance assisted living often starts with the question, “What’s the cost?” In today’s economy, where inflation plays a significant role, having current data is crucial for senior living financial planning. AssistedLiving.org has gathered cost information from its expansive network of over 75,000 senior living providers. This data offers a glimpse into the average expenses for assisted living in Montana and 6 additional cities within Montana.

How Inflation Has Impacted the Cost of Assisted Living in Montana

Montana felt the effect of inflation on assisted living costs from 2022 to 2023, a trend expected to continue into 2024. Monthly costs rose $219, from $5,038 in 2022 to $5,257 in 2023, and current costs are higher in Montana than those of neighboring states and the national average. However, inflation has had a lower impact in Montana than in Idaho and Washington, which saw 2022-2023 inflation at 14% and 27%, respectively.

Per projections, Montana’s assisted living costs are estimated to hit $5,599 in 2024, $797 more than the national average of $4,802, so families in Montana should plan accordingly.

Assisted Living Costs in Montana's Top Cities

A careful analysis of assisted living costs in Montana reveals a high degree of cost variance between cities. Assisted living in larger cities such as Billings and Bozeman is more expensive than the state average, with monthly costs averaging $6,615 and $5,968. Missoula’s assisted living costs are below the state average at $4,575, and Great Falls offers some of the more affordable options for assisted living averaging $2,800 per month.

The Cost of Other Types of Senior Living

Senior living costs in Montana depend on the level of care being sought. At an average cost of $5,257 per month, assisted living offers seniors a degree of independence with health supervision and wellness services. Memory care typically involves specialized programs with highly trained caregivers and is the most expensive lifestyle option at $5,822. Geared toward seniors who need little, if any, help in their routine, independent living is the most affordable option at $2,714.

Financial Assistance for Assisted Living in Montana

The Montana Big Sky Medicaid Waiver

Medicaid does not directly pay rental fees for residents of assisted living facilities in Montana. However, the Big-Sky waiver is available on a waitlist for eligible seniors to pay for the costs of services received while living in an assisted living facility. The Big-Sky waiver pays for services received from the facility, or from an approved third party, such as:

• Homemaker and personal care assistance
• Dieticians, physical therapists, and other specialized medical personnel
• Medical supplies and other consumer goods
• Non-medical and medical transportation
• Residential services like security, chore assistance, and activities

Once applying for the program, a person will have an in-person assessment completed within 60 days. The results of that assessment determine an applicant’s place on the waiting list and what supportive services (like home modifications, or a private nurse) the program will provide in the meantime if he or she must spend down their resources in order to be accepted into the waiver program. Applicants of this program must already be enrolled in Medicaid or Social Security, but not already on a different waiver program.

Who is eligible

People that want to use the Big Sky waiver must be at least 65 or be disabled, have been found to have a need for nursing home level care and have a monthly income of no more than for a $771 single person in 2019 or $1,542 for couples. Applicants may have some assets, like a house (valued $585,000-$878,000) and a vehicle, but no more than $2,000 in other resources, or $3,000 for a couple.

How to apply

If you are interested in the Big Sky waiver, reach out to your dedicated Medicaid or SSI case manager. If you have not yet applied for Medicaid or SSI, call or visit your local Area Agency on Aging to apply for the waiver and other programs.

More Ways to Finance Assisted Living

Some additional ways to finance assisted living costs include:

• Veterans Benefits: Veterans can take advantage of several different pension programs to help cover the cost of assisted living. For more information, see the article on benefits.va.gov.

• Life Insurance Policies: Even if a spouse or loved one hasn’t died, certain types of life insurance policies can be used to pay for assisted living. More information is available at longtermcare.acl.gov

• Long-Term Care Insurance: Long-term care insurance is a type of insurance policy that pays for long-term care when it becomes necessary, including the cost of assisted living. For more information on the benefits and drawbacks of this financing method, visit longtermcare.acl.gov.

• Reverse Mortgages: Reverse mortgages allow seniors to access the equity from a home that they own, and these funds can be used to pay for assisted living. The U.S. Department of Housing and Urban Development offers a federally insured reverse mortgage program.

Free and Low-Cost Resources for Seniors in Montana

There are many resources in Montana that assist seniors in their retirement. Assistedliving.org 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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Assisted Living Laws and Regulations in Montana

Montana’s Department of Health Services enforces comprehensive regulations for assisted living communities, called Residential Care Facilities in the state. Policies cover such topics as:

• Training and background check requirements for employees of care facilities
• Services that must be provided to residents
• Resident rights and protections
• Facility and personal space requirements for bedrooms and common areas

Assisted Living Service Plans

A Resident Needs Assessment must be completed with any prospective resident prior to admission into an assisted living facility. This assessment must document:

• Resident’s current height, weight, any skin problems, and health status
• Cognitive patterns like long- and short-term memory
• Mood and behavior, such as depression or aggression
• Medication use, including over-the-counter (OTC) and antidepressants.

This assessment must be performed by an RN. Prospective residents must also complete a resident agreement, like a lease, and a resident service plan, which details the services that are to be provided to the resident. Residents that require a higher level of care may also be required to complete a resident health care plan.

Assisted Living Admission Requirements

Montana provides for several categories of admission into assisted living facilities, and Category A is for the lowest level of care, an assisted living facility. Applicants to these facilities must be sound of mind, pose no threat to other residents, and be generally healthy and capable of independence in daily life. This is verified during the admission process with the resident needs assessment.

Assisted Living Scope of Care

An important factor in these levels of care is how much a resident needs help with Activities of Daily Living, or ADLs. These activities include dressing, eating, toileting, and sitting/standing up. Assisted living facilities provide services on residents with all ADLs, but the level of care to each individual resident is how the facility is categorized. There are four categories that can apply to an assisted living facility in Montana, based on different levels of care the facilities are able to provide to their residents.

• Category A: The lowest classification of need in terms of service, Category A residents must be dependant on assistance for no more than 4 ADLs.

• Category B: Residents in this category can require assistance with more than 4 ADLs, and can be placed into more skilled care for 1 month for an incident but no more than 120 days out of the year. Category B residents must also have health care assessments that are reviewed quarterly by a professional that visits the facility.

Categories C and D and for residents with dementia who wander and those with behavioral issues that endanger other residents, respectively. Any resident may require some assistance with taking medication, such as opening the bottle and recording the time taken, but a doctor’s order is required for all medications, including OTC.

Assisted Living Medicaid Policy

The Montana Department of Public Health and Human Services (DPHHS) Medicaid program does not pay for assisted living room and board in Montana. Waivers are available on a waiting list for people who need help paying for services received while in an ALF, such as physical therapy. Residents may qualify for Medicaids Montana Big Sky waiver based on age (65+) and low income. Income for the applicant can be no greater than 133% of the federal poverty level. These waivers are based on a waiting list and participants require a referral from the area’s social services agency.

Assisted Living Facility Requirements

Newer assisted living communities in Montana may provide units that are single or double occupancy, though in older established residences there may be up to 4 residents in a room. Bedrooms must be at least 100 square feet for an individual room. In shared rooms, all residents must have at least 80 feet of personal living space per resident. Additionally, each resident needs at least 30 square feet of communal living space in common areas such as dining rooms and recreational rooms.

Restrooms must have a toilet and a sink, and there must be a restroom for every four residents. For every 12 residents, there needs to be at least one tub or shower. An emergency call system must be installed in every restroom and bathing area so residents can call for help in the event of a fall or medical emergency.

Medication Management Regulations

Montana has strict medication management laws for assisted living facilities. All category A residents should be able to and must administer their own medications. Category B residents may take their own medication if they can, and should be encouraged by care staff to do so. Direct care staff may assist with opening the bottles and recording the time the medication was taken if they have been trained to do so. Only an RN may assist with the taking of any medication. No resident or staff is ever able to share medication, a doctor’s order is required, even for OTC medications.

Staffing Requirements

There is not a minimum required number of staff at any given time in an assisted living facility in Montana, but there must always be sufficient staff available to meet the needs of residents and for any emergencies that may arise. The minimum amount of direct care staff and their schedules are determined by the ALF administrator. Residents are able to step in and assist with chores and other care activities but may not replace direct care staff. Volunteers are able to perform some direct care but are then subject to direct care training requirements. Volunteers are not able to perform toileting, bathing, medication assistance, or other delegated nursing tasks.

Staff Training Requirements

All direct care staff, including volunteers that perform direct care tasks like feeding and helping in and out of a bed, must be deemed capable by the administrator and fully trained in any activity they perform. The facility administrator is responsible for providing and directing training for all staff. All new employees are required to receive training in areas such as:

• Facility policies and procedures
• A review of the employee’s job description
• Services provided by the facility and how to administer them

If a facility provides CPR as a service, they must have a staff member trained in CPR in the facility at all times.

Background Checks for Assisted Living

The state of Montana Board of Nursing maintains a nurse aide registry that all potential and current employees of assisted living facilities are checked against. The facility administrator may not hire anyone who has adverse findings in the registry. Facility administrators are responsible for other background checks on potential employees.

Requirements for Reporting Abuse

To file a complaint against a nurse aide in an assisted living facility, you can submit a complaint online or call a compliance specialist at (406) 841-2238. To report elder abuse, submit a report online or call 1-800-551-3191.

Montana COVID-19 Rules for Assisted Living Facilities

Note: The following information was compiled and most recently updated on 2/8/22. Since COVID-19 is a rapidly evolving crisis, be sure to contact your assisted living facility or local Area Agency on Aging for the most up-to-date information.

Sources: dphhs.mt.gov www.cdc.gov