North Dakota Veterans Home seeks more operating flexibility, nursing equity and one-time repairs in Senate hearing

The North Dakota Veterans Home asked the Senate Human Resources Committee to approve Senate Bill No. 2007 and several changes to its appropriation, citing persistent staffing shortages, rising pharmacy and medical costs, and deferred facility needs.

Kristen Luedenberg, chief financial officer at the North Dakota Veterans Home in Lisbon, and Dane Bridal, the facility’s administrator, testified in a public hearing held by the committee.

Lede: Luedenberg told the committee the home's current biennium budget is $30,178,230 and said federal and state funding pressures — including changes in what the Department of Veterans Affairs requires the home to pay — are straining the facility’s finances and its ability to staff care positions.

Nut graf: The testimony combined budget detail, operational problems and a list of requested one-time capital projects and policy changes. Officials asked the Legislature to (1) approve multiple one‑time purchases and repairs, (2) add special-fund authority to cover increased bids on a garage/storage project, (3) allow a $400,000 transfer from salaries to operating in the current biennium to cover contract nursing, (4) add language permitting meals for essential staff who shelter in during emergencies, and (5) provide $275,000 in special-fund authority for a nursing equity pay adjustment intended to help close local wage gaps.

The most immediate operational pressures described in testimony were workforce and cost-shifting from the VA. "We have a lot of financial pressures being put on us by the Department of Veterans Affairs," Luedenberg said, explaining that recent VA agreements require the home to pay for some mental-health services, dental care for veterans who are 70% or more service-connected, and routine medical services and medications that were previously covered by the VA.

Luedenberg provided specific figures the committee can use to evaluate the fiscal impact: she said VA per-diem payments vary by resident type and that for veterans with 70–100% service-connected disability the VA pays about $491 per day, of which, after applying rent and other offsets, "we only get roughly $50 a day." For other veterans in the facility she said the home receives about $144 per day and is not required to cover the additional medical costs that the VA now shifts to the home for higher service-connected residents.

Staffing shortfalls and contract labor: Luedenberg described persistent nurse and aide vacancies that have forced the home to rely on contract nursing and overtime. She said the home began the biennium with 12 vacant certified nursing assistant (CNA) positions, two registered nurse (RN) vacancies and one licensed practical nurse (LPN) vacancy; by the end of the reporting period several CNA slots remained open and the RN/LPN vacancies had not been filled. She told senators that contract agency staff often require minimum 13-week guarantees and are currently two to four times the cost of in-house staff.

Capital and one-time requests: The testimony listed multiple one-time requests and project status items the home seeks from the Legislature, including completed and pending work. Highlights provided by Luedenberg: - Mill and overlay project: awarded and completed in fall; expected to be $175,000 under original budget. She also asked the committee to approve $1,100,000 (included in the current biennium spending as one-time funding) noted earlier in testimony as part of capital spending. - Resident garages and storage units: initial bids came in higher than anticipated; current work has footings and walls poured and framing starting; Luedenberg asked for a $175,000 one-time transfer from the Melvin Norgaard fund to cover increased costs and requested an emergency clause so funds could be spent this biennium. - Various equipment and facility replacements: med carts, medication refrigerator, water‑heater replacement for laundry, card access readers, a new skid-steer loader, carpeting replacement, painting and miscellaneous equipment (each item and its requested one-time amount were listed in testimony).

Budget totals and sources: Luedenberg said the home’s current funding sources total approximately $30.2 million and are a mix of special funds ($23,273,156), general funds ($6,378,710) and federal funds ($526,364). She described the governor’s recommendation as including most of the home’s optional items but said she still requested equity funding for nursing staff and a marketing appropriation not included in the governor’s package.

Requested policy language and transfers: Luedenberg asked the committee to remove section 3 of the bill — language related to a monthly housing stipend for the administrator — and to add language permitting a $400,000 transfer from the salaries line to the operating line in the current biennium to cover contract nursing expenses. She also asked for authority to provide meals to staff who shelter inside during blizzards or similar emergencies: "We're requesting to have a section added to our bill, allowing us to provide meals for these essential employees who go above and beyond in times of crisis to support our residents and maintain operations," she said.

Nursing equity proposal: To stem turnover and better match local market wages, Luedenberg proposed a $1-per-hour equity increase for nursing-department staff and asked the committee to add $275,000 in special-fund authority for that purpose. She said market wages in neighboring facilities often exceed what the state can offer; she cited examples — an RN offer $12.14 higher elsewhere and a CNA making $26 per hour who could only be offered $21.11 at the Veterans Home.

Questions from senators focused on scope, reimbursement and prioritization. Senator Mathern asked whether the facility could change rules to provide geriatric psychiatric care for non-veterans; Bridal said the home faces restrictions and would respond after further review. Chairman Devere and other senators pressed on whether marketing made sense while staffing gaps remain; Luedenberg said skilled nursing is full and cash-flowing and marketing is intended to sustain the pipeline into skilled care while also recruiting staff.

Why it matters: The home combines state operations and federal VA relationships that determine both revenue and required services. Committee members heard that shifts in VA billing and per-diem responsibilities materially affect the facility’s finances and that difficulty recruiting RNs, LPNs and CNAs is increasing reliance on expensive contract labor—raising operating costs and increasing turnover.

Ending: Committee staff closed the public hearing on Senate Bill No. 2007 and scheduled the fiscal note (FIRP) for later consideration; no committee vote was recorded during this testimony.