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 4,978 beds available participating in the Medicaid program and approximately 800 beds in 36 swing bed facilities throughout the state.
Approximately fifty-four percent of licensed nursing facility beds are funded through the Medicaid program. The average nursing facility rate is $401.74 per day as of Jan. 1, 2025. 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 (Effective Jan. 1, 2025)
- ND Nursing Facility Payment System Booklet - May be printed in booklet form. Under the 'Page Sizing and Handling' heading choose booklet on the Adobe print screen.
- ND PDPM Quick View - Uses charts to help residents and families understand ND PDPM (Patient Driven Payment Model) classifications that will be used beginning January 1, 2026.
- ND Payment System FAQ - Answers questions about North Dakota's nursing facility payment system, which will take effect January 1, 2026.
- Information for Nursing Facility Residents and Providers: Local Contact Agency Referral and Discharge Planning (MDS 3.0 Section Q)
- MDS Appeal Request Form (SFN 247)
- Publications related to Medicaid, Adult and Aging Services, and other HHS divisions
- Long Term Care Deficiency Statements Search
- Summary of Standards for Non-Medical Residential Facilities
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
- Program of All-Inclusive Care for the Elderly (PACE)
- Home and Community-Based Long Term Care Services
Nursing Facility Daily Rate Tool
North Dakota nursing facility daily rates are 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 code 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.