Companionship Services in North Dakota Explained: Eligibility, Benefits, and Limits

Aging or living with a physical disability can sometimes bring unexpected challenges, and one of the most hidden struggles is social isolation. Living alone can take a toll on both mental and physical health, leading to anxiety or depression, and sometimes even premature institutional placement.

At ND Home Health, we understand that true health goes beyond physical well-being. It includes feeling connected, safe, and engaged with the world. That is why we offer Companionship Services—a program specifically designed to reduce isolation and help individuals maintain an inclusive, fulfilling life in their own communities.

Here is everything you need to know about what Companionship Services are, who qualifies, and how they can help.

What Are Companionship Services?

Companionship Services provide non-medical care, supervision, and socialization for individuals who live alone or with someone unable to provide care.

Rather than just casually hanging out, these services are highly purposeful. Every companionship activity must be directly tied to a therapeutic goal outlined in the individual’s person-centered care plan.

Example of a Therapeutic Goal:

If an individual is recovering from a stroke, a companion might play a specific board game or do an art project with them. This isn’t just for fun; it serves the therapeutic goal of enhancing fine motor skills while providing meaningful socialization.

What Does a Companion Do?

Companions act as a supportive, engaging presence to ensure the client’s safety and well-being. Allowed activities up to the program limit of 10 hours per month (with general “visiting” capped at 2 hours per week) include:

• Supervision: Keeping the individual safe from harm and being present to intervene if necessary.
• Engaging Activities: Playing games, reading together, going for walks, or simply having a meaningful visit.
• Community Outings: If the individual is physically able, companions can accompany them to activities within their local community that support their care plan goals.
• Incidental Help: While companions do not provide general cleaning services, they can help with light housekeeping directly related to the activity. For example, if you bake cookies or do a craft together, the companion will help clean up that specific mess.

Important Boundaries: What Companionship is Not

To ensure everyone gets the right kind of care from the right professionals, North Dakota has clear guidelines on what Companionship Services cannot cover. This service is focused strictly on socialization and supervision.

Companionship Services do NOT include:

• Hands-on Nursing Care: Companions cannot administer medications, though they may provide verbal reminders or cueing.
• Personal Care Tasks: Tasks like bathing, dressing, feeding, toileting, or transferring/positioning must be handled by a personal care provider, not a companion.
• General Chores: Routine laundry, meal preparation, shopping, money management, or heavy housework are not covered unless they are a direct, incidental part of the social activity.
• Activity Fees: The service does not pay for outside expenses, such as movie tickets or event admission.

Note: You can still receive personal care or homemaker services alongside Companionship Services, but they cannot be provided by the caregiver at the exact same time.

Who is Eligible for Companionship Services?

To qualify for Companionship Services through ND Home Health, an individual must meet the following criteria:

• Living Situation: Must live alone, or live with someone who is not capable or legally obligated to provide care (legally obligated means a spouse, or the parent of a minor child).
• Program Eligibility: Must be eligible for the HCBS Medicaid waiver program, SPED, or EX-SPED. (For SPED/EX-SPED, companionship cannot be your only service; you must need another authorized service to qualify). ND Home Health, also offers private pay as an option.
• Location: Services are provided in the home or community. Individuals living in basic care, assisted living, memory care, skilled nursing, or traumatic brain injury facilities are not eligible.
• Provider Rules: The companion cannot be the client’s legal guardian, spouse, or certain relatives as defined by Family Home Care regulations.

Ready to Learn More?

Social isolation doesn’t have to be an inevitable part of living with a disability or growing older. With the right support, supervision, and engaging therapeutic activities, you or your loved one can thrive safely at home.If you believe Companionship Services could benefit you or a family member, or if you need help navigating the eligibility criteria, please reach out to the ND Home Health team today. We are here to help you live longer and more safely in the home you love.