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Basic care providers ask for larger inflation adjustments, continued $5/day add‑on and expanded margin
Summary
Representatives of basic care facilities urged the committee to adopt higher inflationary rate adjustments (4% then 3%), keep a $5/day add‑on approved by the House and expand a 3% allowable margin to additional rate components so basic care stays financially viable.
Nikki Wagner, president of the North Dakota Long Term Care Association, and Brad DeYoung, a consultant and CPA who advises senior‑living clients, told the Senate Appropriations Human Resources Division that basic care providers face persistent losses and asked for larger inflation adjustments and policy changes to stabilize facilities that serve older adults and individuals with disabilities.
Wagner said there are 2,097 licensed basic care beds in the state with average occupancy around 72% and that roughly 74% of residents use Medicaid as the payer. She told senators the average Medicaid rate in 2024 was $164.76 while average cost of care was $247.89, leaving an estimated shortfall of $83.13 per day.
DeYoung explained how the state's rate‑setting calendar delays costs: rates set on July 1, 2025 are based on cost data that are effectively two years old, plus an inflation factor and a six‑month CPI adjustment. He demonstrated with facility examples (Tuftee Manor, Golden Manor, Good Samaritan Terrace) that a 2% legislative inflator for 2025–27 would likely leave facilities operating with negative margins if historical inflation continues, and that a 3% inflator or a front‑loaded 4% then 3% sequence would better align payments with projected costs.
What they asked: Wagner and DeYoung asked the committee to (1) provide a 4% inflationary adjustment effective 7/1/2025 and 3% the following year, (2) continue the House proposal for a $5/day add‑on to basic care rates, and (3) expand a 3% margin to more rate components (not only direct care) similar to nursing facility methodology.
Ending: the witnesses offered more detailed financial worksheets and asked to meet with staff for line‑by‑line review; no formal committee vote occurred in the hearing.
