Home care · Cass County, ND
Home care in Cass County
Of the 186,000 people in Cass County, about 23,300 are 65 or older — one in eight residents. Most of them intend to stay in their own homes, and most of the care that makes that possible happens quietly, in living rooms, without anyone calling it "long-term care."
Below is what we'd tell a friend in Cass County: what care costs here, who provides it, what the facility alternative actually looks like, and which programs pay.
Cass County, in numbers
Full North Dakota guide →Residents 65+
23,344
12.5% of the county.
Live with a disability
10%
About 18,506 people — the population most likely to need help at home.
Median household income
$70,002
20 hrs/week of care would run about 51% of it.
Certified agencies
8
Medicare-certified home health agencies serving local ZIPs; 6 rated, averaging 3.4★.
Sources: CDC/ATSDR Social Vulnerability Index 2022 (ACS 2018–2022), County Health Rankings 2024, and CMS Care Compare provider files.
What home care costs in Cass County
North Dakota's going rate for agency home care is around $34/hr. Twenty hours a week — four hours a day, five days a week, the most common schedule families start with — comes to roughly $2,900 a month, or $35,400 a year.
Median household income in Cass County is $70,002 — that schedule runs about 51% of it. Manageable for some households here, and still worth checking whether a program can carry part of it.
Who provides care in Cass County
8 Medicare-certified home health agencies serve ZIP codes in Cass County. 6 of them carry a CMS quality star rating, averaging 3.4 out of 5. 7 report offering home health aide services.
Unusually for the industry, 75% of the agencies here are non-profit — often hospital- or county-affiliated. They tend to be steadier on staffing and slower to answer.
One distinction worth getting straight before you call anyone: those are Medicare-certified home health agencies — skilled, doctor-ordered, intermittent care, usually a nurse or therapist visiting for a few weeks after a hospital stay. That is not the same as the hourly, non-medical help most families are actually looking for: bathing, dressing, meals, driving, company. Medicare pays for the first. It does not pay for the second.
The alternative, locally
Cass County has 8 certified nursing homes holding 856 certified beds, averaging 3.8 out of 5 on CMS's overall rating. About 796 people live in them on an average day.
An average of 3.8 stars is above the North Dakota average of 3.2. If a facility does turn out to be the right answer for your family, the options here are better than most counties in the state.
The North Dakota programs that pay for care at home
- HCBS Waiver
- Medicaid State Plan Personal Care
North Dakota runs 2 Medicaid pathways that pay for care at home instead of a nursing home. Each has its own income, asset, and care-need rules, and approval takes weeks to months — so the application is worth starting before the need becomes urgent.
How each North Dakota program works →Caregiver training in ND
75 hrs
Minimum for certified aides (the federal minimum). ND does not license non-medical agencies, so vet carefully.
Choosing an agency in Cass County
- Vet twice as hard. North Dakota does not license non-medical home care agencies, which means anyone can hang a shingle. Ask who runs background checks, whether caregivers are W-2 employees or contractors, whether the agency carries liability and workers' comp, and who supervises the caregiver you'd get.
- Ask what the rate covers. Around $34/hr is typical in North Dakota. A real agency's rate covers a trained, background-checked, insured caregiver plus supervision and backup staffing when your regular person is sick. A rate well under the local range usually means one of those is missing.
- Start the clock early. Cass County is served by 8 certified agencies, so the honest answer to "when can you start?" is often two to three weeks. If you're planning around a discharge date, call before the discharge, not after.
- Ask about Medicaid now, not later. If money is going to be the constraint, ask about HCBS Waiver at the first call. Approval takes weeks to months, and private pay is what bridges the gap — so the sooner the application starts, the smaller that bridge is.
Want to talk it through?
We provide care in the Milwaukee, WI area — but we’re glad to help any family think through the options in Cass County.
Cass County home care questions, answered
How much does home care cost in Cass County, ND?
Agency home care in North Dakota runs around $34/hr for private pay. At 20 hours a week that is about $2,900 a month. For context, median household income in Cass County is $70,002. Rates move with the level of care and the schedule — short daily visits cost more per hour than long shifts.
Does Medicare pay for home care in Cass County?
Medicare pays for skilled home health — a nurse or therapist, doctor-ordered, for a limited stretch, usually after a hospital stay. 8 Medicare-certified agencies serve Cass County. Medicare does not pay for the hourly, non-medical help most families want — bathing, dressing, meals, driving, company. For that, the money comes from private pay, long-term care insurance, VA benefits, or North Dakota Medicaid.
Does Medicaid pay for home care in Cass County?
Yes — for people who qualify. North Dakota runs Medicaid programs that pay for care at home instead of a nursing home: HCBS Waiver, Medicaid State Plan Personal Care. Income, asset, and care-need rules apply, and approval usually takes weeks to months, so apply before you need it.
How are caregivers trained and vetted in North Dakota?
Certified home health aides in North Dakota complete at least 75 hours of training, the federal minimum. North Dakota does not license non-medical home care agencies, so the vetting falls to you: ask about background checks, insurance and bonding, and who supervises the caregivers.
Is home care better than a nursing home in Cass County?
It depends on the level of care needed, not on which one sounds nicer. Cass County's 8 certified facilities average 3.8 out of 5 stars on CMS ratings, against a North Dakota average of 3.2. Round-the-clock skilled nursing is something a facility does that home care cannot. But for help with bathing, meals, medication reminders, and company, care at home usually costs less and keeps someone in their own bed — and most people, asked plainly, say that is what they want.
Does Juniper at Home provide caregivers in Cass County?
Not directly — our own caregivers serve the Milwaukee area of Wisconsin. This page is a free guide for Cass County families: what care really costs here, who provides it, and which programs can help pay.
Bordering counties in North Dakota
Across the state line
Worth knowing if you live near the line: rules, rates, and Medicaid programs change at the border, and an agency an easy drive away may operate under a different set of them entirely.