In Montana, the license families see for assisted living is "Assisted Living Facility (ALF)", issued by the Montana Department of Public Health and Human Services, Office of Inspector General, Licensure Bureau. Before move-in, the facility must complete and document its own needs assessment of the new resident, and the Category A rules do not require a physician exam. A resident must get a written 30-day notice, with the reason and appeal rights, before a move-out.
Key facts
- The median monthly cost of assisted living in Montana was $6,075 in CareScout's 2025 Cost of Care Survey, or $72,900 a year, $125 below the national median of $6,200 a month. (CareScout, 2026)
- Montana's Big Sky Waiver can pay for assisted living services in licensed facilities, but the program has a waiting list and does not pay room and board. (Montana Department of Public Health and Human Services, 2024)
- Montana's assisted living rules do not require a TB test for new residents; they require written infection control policies for communicable diseases. (Admin. R. Mont. 37.106.2855, 2022)
- Category A residents must take their own medicines with only staff help, while in Category B a licensed professional or a person delegated the task under the Nurse Practice Act gives them. (Admin. R. Mont. 37.106.2848, 2002)
- Memory care is the Category C license, and before admission the facility must give the resident's legal representative a written disclosure of its approach, move-in and discharge criteria, staff training and fees. (Admin. R. Mont. 37.106.2896, 2022)
Montana calls assisted living an assisted living facility (ALF) and licenses it in four categories: A (help with daily activities), B (adds nursing care), C (severe cognitive impairment, or memory care) and D (mental illness). The Department of Public Health and Human Services licenses ALFs under Administrative Rules of Montana 37.106.2801 to 37.106.2899I and Montana Code 50-5-226, and the facts below cover the main Category A license, with Category B and C differences noted.
Rules change and communities can set stricter policies. Before you sign, confirm the details with the community and the Montana Department of Public Health and Human Services, Office of Inspector General, Licensure Bureau. This page is general information, not legal advice.
The rules at a glance
| Medical assessment before move-in | Before move-in, the facility must complete and document its own needs assessment of the new resident, and the Category A rules do not require a physician exam. Category B and C residents also need a certification from a licensed health care professional within 21 days of admission. [4][5][6] More on this |
|---|---|
| TB test | Montana's assisted living rules do not require a TB test for new residents; they require written infection control policies for communicable diseases. A 2008 state TB Program risk tool for assisted living suggests a two-step skin test at admission for adults in low-risk settings. [7][8] More on this |
| Notice before a move-out | A resident must get a written 30-day notice, with the reason and appeal rights, before a move-out. Allowed reasons are care needs beyond the facility's services, behavior that repeatedly and substantially interferes with other residents, severe cognitive decline, an unstable medical condition, unpaid charges or closing; shorter notice for a medical emergency, immediate danger or a stay under 30 days. [9] More on this |
| Who may give medications | Category A residents must take their own medicines with only staff help, while in Category B a licensed professional or a person delegated the task under the Nurse Practice Act gives them. A licensed medication aide I (not a nurse) may inject insulin from a labeled, preset or predrawn device, under a nurse's general supervision. [10][11][12] More on this |
| Memory care and dementia | Memory care is the Category C license, and before admission the facility must give the resident's legal representative a written disclosure of its approach, move-in and discharge criteria, staff training and fees. All direct care staff need two hours of dementia training at hire and every year, and Category C staff need extra documented training. [13][14][15] |
| Long-term care ombudsman | Montana's Long-Term Care Ombudsman Program, in the Department's Senior and Long Term Care Division, helps people in assisted living, including residents moved without proper notice, and can be reached at (800) 332-2272 during normal business hours. [16] Official page More on this |
| Medicaid help | Montana's Big Sky Waiver can pay for assisted living services in licensed facilities, but the program has a waiting list and does not pay room and board. A person must be financially eligible for Medicaid and need nursing facility level of care; referrals go to Mountain Pacific at (800) 219-7035. [17][18] Official page More on this |
What assisted living costs in Montana
The median monthly cost of assisted living in Montana was $6,075 in CareScout's 2025 Cost of Care Survey, or $72,900 a year, $125 below the national median of $6,200 a month. [19]
A median is the middle of the rates communities reported, so many charge more or less. Rates differ between regions and by the care a resident needs, so ask each community for its full fee list in writing. More: assisted living costs in every state, a monthly budget and the costs that aren't in the base rate.
How to check a community in Montana
The Department's public Find a Provider search lets families look up a licensed assisted living facility by name, address, city, zip code or county, with Assisted Living Facility as the license type. Search Montana's records. [2]
The licensing agency: Montana Department of Public Health and Human Services, Office of Inspector General, Licensure Bureau. [1] Our guide on how to read an inspection report explains what to look for.
Put Montana's paperwork on a date
Parent Move Plan counts every task back from the move-in day, including the medical assessment and TB screening the community will ask for, so nothing lands in the last week.
Get your first 3 days freeFrequently asked questions
How much does assisted living cost in Montana?
The median monthly cost of assisted living in Montana was $6,075 in CareScout's 2025 Cost of Care Survey, or $72,900 a year, $125 below the national median of $6,200 a month. A median is the middle of the rates communities reported, so many charge more or less, and rates differ between regions and by the care a resident needs.
What medical assessment does Montana require before moving into assisted living?
Before move-in, the facility must complete and document its own needs assessment of the new resident, and the Category A rules do not require a physician exam. Category B and C residents also need a certification from a licensed health care professional within 21 days of admission.
Does Montana require a TB test for assisted living?
Montana's assisted living rules do not require a TB test for new residents; they require written infection control policies for communicable diseases. A 2008 state TB Program risk tool for assisted living suggests a two-step skin test at admission for adults in low-risk settings.
How much notice must an assisted living community in Montana give before a move-out?
A resident must get a written 30-day notice, with the reason and appeal rights, before a move-out. Allowed reasons are care needs beyond the facility's services, behavior that repeatedly and substantially interferes with other residents, severe cognitive decline, an unstable medical condition, unpaid charges or closing; shorter notice for a medical emergency, immediate danger or a stay under 30 days.
Who can give medications in assisted living in Montana?
Category A residents must take their own medicines with only staff help, while in Category B a licensed professional or a person delegated the task under the Nurse Practice Act gives them. A licensed medication aide I (not a nurse) may inject insulin from a labeled, preset or predrawn device, under a nurse's general supervision.
Who can help with a complaint about assisted living in Montana?
Montana's Long-Term Care Ombudsman Program, in the Department's Senior and Long Term Care Division, helps people in assisted living, including residents moved without proper notice, and can be reached at (800) 332-2272 during normal business hours.
Does Medicaid pay for assisted living in Montana?
Montana's Big Sky Waiver can pay for assisted living services in licensed facilities, but the program has a waiting list and does not pay room and board. A person must be financially eligible for Medicaid and need nursing facility level of care; referrals go to Mountain Pacific at (800) 219-7035.
Sources
- Montana Department of Public Health and Human Services, Licensure Bureau: Assisted Living Facilities (2026) (checked October 22, 2026)
- Montana Department of Public Health and Human Services: Licensing portal, Find a Provider (2026) (checked October 22, 2026)
- Montana Code Annotated 50-5-226, Placement in assisted living facilities (2025) (checked October 22, 2026)
- Admin. R. Mont. 37.106.2821, Resident application and needs assessment procedure (via Montana Secretary of State ARM site), 2022 (checked October 22, 2026)
- Admin. R. Mont. 37.106.2875, Resident health care plan: Category B (via Montana Secretary of State ARM site), 2022 (checked October 22, 2026)
- Admin. R. Mont. 37.106.2895, Health care plan: Category C (via Montana Secretary of State ARM site), 2004 (checked October 22, 2026)
- Admin. R. Mont. 37.106.2855, Infection control (via Montana Secretary of State ARM site), 2022 (checked October 22, 2026)
- Montana DPHHS Tuberculosis Program: TB Risk Assessment, Assisted Living (2008) (checked October 22, 2026)
- Admin. R. Mont. 37.106.2824, Involuntary discharge criteria (via Montana Secretary of State ARM site), effective 2026 (checked October 22, 2026)
- Admin. R. Mont. 37.106.2848, Medications: administration and preparation (via Montana Secretary of State ARM site), 2002 (checked October 22, 2026)
- Admin. R. Mont. 37.106.2885, Administration of medications: Category B (via Montana Secretary of State ARM site), 2022 (checked October 22, 2026)
- Admin. R. Mont. 24.159.915, Responsibilities of a medication aide I (via Montana Secretary of State ARM site), effective 2026 (checked October 22, 2026)
- Admin. R. Mont. 37.106.2896, Disclosures to residents: Category C (via Montana Secretary of State ARM site), 2022 (checked October 22, 2026)
- Admin. R. Mont. 37.106.2816, Assisted living facility staffing (via Montana Secretary of State ARM site), effective 2026 (checked October 22, 2026)
- Admin. R. Mont. 37.106.2892, Direct care staff: Category C (via Montana Secretary of State ARM site), 2004 (checked October 22, 2026)
- Montana Department of Public Health and Human Services: Long-Term Care Ombudsman Program (2026) (checked October 22, 2026)
- Montana Department of Public Health and Human Services: Big Sky Waiver 1915(c) application MT.0148.R07.00, effective July 1, 2024 (checked October 22, 2026)
- Montana Department of Public Health and Human Services: Big Sky Waiver Program (2026) (checked October 22, 2026)
- CareScout: Cost of Care Survey 2025, Ranked Median Costs by State (2026) (checked October 22, 2026)