HB 1090 Summary

• Establishes nursing home rate-setting procedures for North Dakota, including definitions of operating costs, direct care costs, indirect care costs, and property-related costs for rate calculations.

• Sets price limits on allowable historical operating costs using June 30, 2021 as the base period, adjusted annually by the market basket index for skilled nursing facilities.

• Implements a fair rental value payment mechanism for property costs effective 2023, allowing nursing homes to choose between rate calculations using allowable property-related costs or fair rental value methodology.

• Establishes maximum per-bed property cost limitations ($156,783 for double rooms, $235,176 for single rooms), maximum square footage (950 sq ft per bed), and maximum rental rate (8%) for fair rental value calculations.

• Requires 30-day advance written notice to private-paying residents before rate increases, with exceptions for changes in resident care category or late department rate-setting.