Nursing Facility Services
Nursing facility services are provided to approximately 2,400 Medicaid-eligible residents who require regular or daily services of a licensed nurse in nursing facilities and swing beds located throughout the state. There are 73 licensed facilities with 4,956 beds available participating in the Medicaid program and approximately 800 beds in 36 swing bed facilities throughout the state.
Approximately fifty-one percent of licensed nursing facility beds are funded through the Medicaid program. The average nursing facility rate is $437.90 per day as of Jan. 1, 2026. The swing bed rate is $399.55 per day as of April 1, 2025.
Since 1990, North Dakota has had a case-mix payment system and rate equalization for Medicaid and self-pay residents in nursing facilities. Rates for all residents in North Dakota nursing facilities are established annually, effective January 1, based on cost reports submitted by the nursing facilities.
- Nursing Facility Rates by Location (pdf) - Includes a list of Nursing Facility base rates.
- ND PDPM Quick View (pdf) - Includes flow-charts and tables to help residents and families understand the ND PDPM (Patient Driven Payment Model) classification process.
- ND Payment System FAQ (pdf) - Includes answers to common questions about North Dakota's nursing facility payment system.
- MDS Appeal Request Form - Link to state form number (SFN) 247. Use this form to submit a classification appeal for a resident in a Nursing Facility.
- Visit the Deficiency Search website to search for a specific nursing facility's deficiency statements.
- Information for Nursing Facility Residents and Providers: Local Contact Agency Referral and Discharge Planning (MDS 3.0 Section Q).
- Local Contact Agency Referral and Discharge Planning (MDS 3.0 Section Q) information can be found on the Money Follows the Person (MFP) webpage. There is also information for Medicaid members with disabilities who are interested in transitioning/moving from Nursing Facilities to homes and apartments in the community. MFP connects people to housing, services, and support.
- Publications related to Medicaid, Adult and Aging Services, and other HHS divisions can be found on the Publications webpage.
- Visit the Summary of Standards for Non-Medical Residential Facilities webpage to read the standards for residential facilities where a significant number of Supplemental Security Income (SSI) recipients reside or are likely to reside.
Skilled Nursing Facilities set their own admission policies; some facilities may choose not to accept Medicaid pending residents. For additional information, please contact the desired Skilled Nursing Facility related to their admissions policies or the North Dakota Long Term Care Association.
Additional Services
- The Program of All-Inclusive Care for the Elderly (PACE) webpage provides information for ND Medicaid members 55 years of age and older who may be eligible for PACE. If you are in a PACE service area, would otherwise need a nursing home level of care, and can live safely in your community at the time of enrollment, you may be eligible for PACE.
- Visit the Home and Community-Based Long Term Care Services (HCBS) webpage to learn how HCBS services can support older adults and individuals with physical disabilities live at home longer.
Nursing Facility Daily Rate Tool
North Dakota nursing facility daily rates include indirect rates, such as property costs, and direct rates that change based on the amount of care and services a resident needs. Beginning January 1, 2026, classification notices will include a three-letter classification based on the North Dakota Patient Driven Payment Model (ND PDPM).
The ND PDPM looks at each resident’s health and care needs. The nursing facility completes an assessment every three months that determines the three-letter classification for each resident. This classification is then used to set the daily rate.
Each letter in the classification represents one part of the ND PDPM:
1 – Speech-Language Pathology (SLP)
2 – Nursing
3 – Non-Therapy Ancillaries (NTA)
The PDPM Daily Rate Tool can be used to find the nursing facility’s daily rate based on the three-letter classification.