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Providers urge rate rebasing for adult residential facilities serving dementia and brain‑injury patients; committee pauses for redrafting

2288351 · February 12, 2025
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Summary

Long Term Care Association members told a Senate appropriations subcommittee that adult residential facilities that serve people with dementia and acquired brain injury are reimbursed far below actual costs and urged rate rebasing and short‑term inflators to keep facilities open.

Long Term Care Association representatives told the Senate Appropriations Human Resources Division that adult residential facilities (ARCs) that serve people with dementia or acquired brain injury are operating at rates well below the cost of care and face closure or decisions to stop taking Medicaid residents unless rates are adjusted.

Nikki Wagner, president of the North Dakota Long Term Care Association, said the existing ARC daily Medicaid reimbursement averaged $162.04, while average nursing facility daily cost was about $403.13, a widening gap since the program was piloted in the late 1990s. Wagner told the committee facilities lose "an average of $45.77 per day per Medicaid resident" and said two licensed ARC operators currently decline Medicaid residents because the…

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