AN ACT to amend and reenact subsection 1 of section 23-09.3-01.1 and subsection 1 of section 23-16-01.1 of the North Dakota Century Code, relating to the moratorium on basic care and nursing facility bed capacity.
HB 1154 extends North Dakota’s moratorium on adding licensed basic care beds and nursing facility beds to the state’s bed capacity. The bill changes the moratorium period from August 1, 2023 through July 31, 2025, to August 1, 2025 through July 31, 2029, while keeping the general prohibition on new capacity in place. It applies to both basic care facilities and nursing facilities, and it preserves existing exceptions that allow new capacity in limited circumstances.
For basic care beds, the bill continues to allow additions if a nursing facility converts beds to basic care, if transferred capacity is relicensed as basic care under existing law, if the provider shows that services are not readily available in a designated area or that nearby beds are at least 90% occupied for the prior 12 months, or if the department approves new beds. For approved new basic care beds, the entity must license them within 48 months. For nursing facility beds, the bill maintains the moratorium but allows exceptions for certain reversion or relicensing situations and adds a new operational limit: a facility may not delicense, relicense, convert, revert, or otherwise reconfigure licensed nursing facility bed capacity more than two times in a 12-month period.
The bill amends sections 23-09.3-01.1 and 23-16-01.1 of the North Dakota Century Code, extending the state’s long-standing bed-capacity moratorium for both basic care and nursing facility beds. It affects providers seeking to expand, convert, or reconfigure long-term care bed capacity, and it gives the Department of Health continued authority to evaluate exceptions based on access, occupancy, and program participation. The measure also tightens administrative control over repeated bed-capacity changes by nursing facilities, limiting how often they can reconfigure beds within a year.
The bill appears to have broad legislative support, passing the House 69-20 and the Senate 46-1. That vote pattern suggests general agreement with maintaining limits on new long-term care bed capacity while preserving targeted exceptions for access needs and facility conversions. The near-unanimous Senate vote indicates especially strong support in that chamber, with only limited opposition overall.
The main point of contention is likely the policy choice to continue restricting growth in long-term care capacity for another four years, which may concern providers or communities that want additional beds or more flexibility in facility planning. Opponents may also object to the added restriction on how often nursing facilities can delicense, relicense, convert, or revert beds within a 12-month period. Supporters, by contrast, appear to favor the moratorium as a way to manage supply, prevent overbuilding, and preserve department oversight while still allowing exceptions where access to care is limited.