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North Dakota long-term care providers call federal rule an 'impossible staffing mandate'

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North Dakota long-term care providers call federal rule an 'impossible staffing mandate'


BISMARCK — North Dakota health care providers are scrambling to meet new federal standards set for long-term care facilities. Put in motion by a 2023

executive order,

the series of mandates go into effect Aug. 8 despite nationwide concerns — including a lawsuit filed in June by the American Health Care Association against the Department of Health and Human Services and Centers for Medicare and Medicaid Services.

The rule comes in response to high death rates during the COVID-19 pandemic, citing a Centers for Medicare and Medicaid Services, or CMS,

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study

that links fatality rates to high turnover and chronic under-staffing in nursing homes.

Medicare- and Medicaid-certified facilities will be required to have a registered nurse on site 24/7 and increase the number of nurse aids available daily. Rural communities have a year longer to implement the standards than urban communities. Proposed last September and finalized in April, the rule received over 46,000 comments during the 60-day national comment period that closed in November.

“This rule does not only impact nursing facilities, it will impact all sectors of health care and the cost of care in our state,” Nikki Wegner, president of the North Dakota Long Term Care Association, testified in a state Health and Human Services committee meeting on Thursday, July 11.

The association is affiliated with two plaintiffs involved in the CMS lawsuit.

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“This, for us and for the rest of the nation, is really an impossible staffing mandate. There are simply not enough RNs to fulfill this requirement. While the intent behind the rule is to improve care quality, it presents really significant challenges,” Wegner said.

Rep. Kathy Frelich, R-Devils Lake, responded to Wegner’s testimony, referencing her professional experience with long-term care as an outreach specialist at the

North Dakota School for the Deaf and Resource Center for Deaf and Hard of Hearing.

“I would say that quality of care generally isn’t related to your RN. It’s usually related to your CNA (Certified Nursing Assistant) on that level. So, I’m concerned that this is just adding a cost,” Frelich said. “Ultimately, that goes back to the residents.”

Long-term care residents pay an average of $403.19 per day — over

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$12,000 monthly

— a rate Frelich said would “drastically” increase.

Since the height of the COVID-19 pandemic, the number of nursing homes across the state has been in decline. Six facilities closed in just under three years.

According to the

Bureau of Labor Statistics,

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North Dakota would need to add 1,313 nursing home workers to return to pre-pandemic levels.

Data

from the Payroll Based Journal indicates 79% of the state’s facilities would not comply with the registered nurse mandate and only 17% would meet nursing requirements.

The same data shows rural communities in the state would be disproportionately impacted, where 86% wouldn’t meet requirements compared to 65% in urban areas. North Dakota would have to spend a minimum of $4.5 million per year to comply.

Individuals 65 and older make up over 16% of the state population with approximately

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8,220 people

receiving care every day, according to the Long Term Care Association.

Some facilities could be considered exempt from the mandates. The

final ruling

states facilities would have to prove the local workforce is 20% or more below the national average and that administrators made “good faith” efforts to hire and retain staff.

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Tanya Schnabel, administrator for the Wishek Living Center, said most rural facilities would have to apply for an exemption, including hers. She said the process would add to her already full plate of managing the already “concerning” worker deficit.

“We have housing issues here. So, even if somebody wants to move to town to come work for us, there’s no place for them to live that’s affordable. We wouldn’t be able to do it without contract companies right now, because they’re moving here and giving their time to help care for our residents,” Schnabel told Forum News Service.

“This will just probably be the straw that broke the camel’s back,” she said.

Rep. Kelly Armstrong, R-N.D., and 33 other Republicans cosponsored a joint resolution of congressional disapproval introduced by Rep. Michelle Fischbach, R-Minn., in May. Additionally, Sen. Kevin Cramer, R-N.D., sought to delay the rulings by introducing the VA Report on Proposed CMS Staffing Ratios Act, which would require the Veterans Association to study the risks to elderly veterans posed by the new requirements.

North Dakota’s Long Term Care Association is affiliated with the American Health Care Association and Leading Age. Last May, both entities joined four other plaintiffs in filing a

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lawsuit

against the Secretary of the United States Department of Health and Human Services and CMS. According to the filing, CMS exceeded its authority by overriding congressional directives and employing “sweeping” new mandates.

“Hopefully they realize that this will probably kill off some rural facilities. If they close, then people would have to drive to Bismarck or Fargo or Jamestown to see their loved ones. That would be devastating,” Schnabel said.





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North Dakota

And he’s off

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And he’s off


BRECKENRIDGE — Coaches, teammates, friends and family gathered in the south parking lot of Breckenridge High School for another state tournament sendoff.

Friends, family, teammates and coaches joined Berndt for a photo before cheering him on as he rode off in the ceremonial convertible.

Corbin Abner Lee / Wahpeton Daily News

This year, it was Troy Berndt taking the ceremonial convertible ride. He is headed to St. Michael-Albertville High School for the Minnesota Class A State Track and Field Meet on June 4-6.

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Breckenridge track - Berndt, Erlandson and the Haires
Troy Berndt, left, give his supporters one last smile before embarking on his state journey. David Erlandson, next to Berndt, accompanied him in the convertible, and will be with him at the meet on June 4. Tom Haire, driving, and Christy Haire are in the front seats.

Corbin Abner Lee / Wahpeton Daily News

He will be running in the third heat of the 400-meter prelims, scheduled for 4:52 p.m. June 4. There are seven athletes in each heat, 21 total, and nine will advance to the finals at 6:20 p.m. June 5.

The top two finishers in each heat advance, along with the next three best times. Berndt’s personal best time of 50.67 has him seeded 13th, but the 10th-, 11th- and 12th-seeded runners are less than five hundredths of a second ahead of him. The eighth- and ninth-seeded runners are also close, at 50.33 and 50.39, respectively.

Berndt dropped nearly seven-tenths of a second from his previous personal best at the Section 6A West Subsection Meet on May 21, running 51.35, and shaved another 0.68 seconds off at the Section 6A Championships on May 28 with a time of 50.67. If he keeps lowering his time, he will have a shot at reaching the podium against the best runners in Class A.

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Breckenridge track - convoy
Berndt and company taking their spot in the convoy behind Breckenridge Fire Department and Police Department vehicles.

Corbin Abner Lee / Wahpeton Daily News

Results and photos will be available online immediately following the race June 4 and in the June 10 print edition of the Wahpeton Daily News.

Corbin Abner Lee

Corbin Lee is a sports reporter for the Wahpeton Daily News and Richland County News-Monitor. Corbin can be reached by calling (701) 291-3551 or emailing corbin.lee@wahpetondailynews.com.

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Today in History, 1971: Rugby repeats as North Dakota sand greens golf champion

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Today in History, 1971: Rugby repeats as North Dakota sand greens golf champion


On this day in 1971, Rugby repeated as North Dakota’s high school sand greens golf champion behind medalist Dwight Stempson’s winning performance.

Here is the complete story as it appeared in the paper that day:

Rugby Repeats As Sand Greens Golf Champion

RUGBY, N. D. — Rugby repeated as North Dakota high school sand greens golf champion here Wednesday, posting a four-man total of 293 strokes for 18 holes.

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Led by medalist Dwight Stempson’s medalist 36-35 — 71, the Panthers were eight strokes ahead of runnerup Stanley, which had a 301. Following were Garrison 311, Beulah 315, Leeds 322, Ashley 323, Bottineau 328, Pembina 329, Tioga 332, Parshall 341 and Hettinger 342.

See more history at Newspapers.com

Stempson and teammate Bruce Carlson each had one-under par 71s, but Carlson was unable to be at the regional and wasn’t qualified for individual honors.

Rounding out the Rugby totals were Delwin Wilson 40-37 — 77 and Dennett Hutchinson 35-39 — 74. Gary Kirchoffner, 41-39 — 80, was Rugby’s fifth entrant with the best four-of-five scores counted.

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Runnerup Stanley was led by Steve Springan’s 34-38 — 72 and Joe Springan’s 36-38 — 74. Their two-man total of 146 strokes was good enough for the doubles title. Two strokes back with a 148 was the duo of Stempson and Wilson. Stan Saathoff and Mike Stepina of Garrison each had 76s for a 152 total and the Ashley combo of Steve Maier (76) and Dave Kretschmar (78) was fourth with a 154.

Stempson was the driving contest winner with a distance of 280 yards. Chris Knutson of Garrison headed the pitch and putt competition.

Ads featured in The Forum on June 3, 1971. Newspapers.com

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Kate Almquist

Kate Almquist is the social media manager for InForum. After working as an intern, she joined The Forum full time starting in January 2022. Readers can reach her at kalmquist@forumcomm.com.





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10 Small Towns In North Dakota Were Ranked Among US Favorites

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10 Small Towns In North Dakota Were Ranked Among US Favorites


Walhalla keeps the oldest buildings in North Dakota, fur-trade posts from the 1840s still standing near the Canadian line. Medora sits out in the Badlands, where a French aristocrat tried to build a beef empire in 1883. Garrison fishes one of the largest reservoirs in the country, and Jud has turned nearly every wall in town into a mural. The frontier era left marks across North Dakota that most of the Plains has paved over, and these ten towns still carry them. Each one holds a specific piece of the state’s history and geography.

Garrison

Downtown street in Garrison, North Dakota. Image credit: Andrew Filer, CC BY-SA 2.0 via Wikimedia Commons.

Garrison sits on the north shore of Lake Sakakawea, the reservoir the Garrison Dam holds back on the Missouri River and one of the largest reservoirs in the country. Anglers come year-round for walleye, northern pike, and chinook salmon, and the lake also draws boaters, campers, and shoreline hikers. In town, the open-air Heritage Park Museum preserves a one-room schoolhouse, a railroad depot, a country church, and a homesteader cabin from the turn of the last century. Fort Stevenson State Park, three miles southwest, marks the site of an 1860s military post with an interpretive guardhouse, a marina, a campground, and lakeside trails. Garrison leans into its self-declared title as the Walleye Capital of North Dakota with Wally the Walleye, a 26-foot fiberglass fish on Main Street.

Mayville

Mayville State University in Mayville, North Dakota
Mayville State University. Image credit: Tammy Chesney via Shutterstock.

Mayville State University anchors this Red River Valley town in Traill County. The public four-year college opened in 1889 as one of the six original state normal schools authorized at North Dakota statehood, and its calendar still drives the town through Comet athletics, theater productions, and the annual Festival of Trees. Island Park, set along the Goose River where it runs through downtown, holds the town’s main recreation space with picnic areas, playgrounds, and a community pool. The volunteer-tended Rainbow Garden along the riverbank mixes themed plantings with folk-art sculptures. The Mayville Water Park runs its pool and slides from Memorial Day through Labor Day.

Lisbon

Downtown streets of Lisbon, North Dakota
Downtown Lisbon, North Dakota. Image credit: Andrew Filer, CC BY-SA 2.0 via Wikimedia Commons.

Lisbon grew up along the Sheyenne River in Ransom County as a Northern Pacific Railroad town, and its 1889 Opera House, now restored and on the National Register, still hosts theater and music. Brick storefronts from the same era line Main Street. Just south of town, the Sheyenne National Grassland protects 70,000 acres of tallgrass prairie, the largest publicly owned tallgrass prairie in the country, with trails open to hikers, riders, and limited hunting. Prairiewood Vineyard, about six miles out, grows cold-climate grapes and pours tastings on weekends.

Fort Ransom

Fort Ransom Wildlife Management Area in North Dakota
Fort Ransom Wildlife Management Area. Image credit: Danita Delimont via Shutterstock.

Fewer than 100 people live in Fort Ransom year-round, deep in the wooded Sheyenne River Valley. Fort Ransom State Park preserves the site of an 1867 Army outpost built to guard settlers and the wagon route toward the Black Hills, and it now offers camping, paddling on the Sheyenne, and cross-country skiing. The park’s Sodbuster Days each September run horse-powered farming, threshing, and traditional-craft demonstrations, and the Sheyenne Valley Arts and Crafts Festival fills it over the Fourth of July weekend. The town anchors the Sheyenne River Valley Scenic Byway, a 63-mile route through some of the most varied terrain in the state.

Devils Lake

High water at Devils Lake, North Dakota
High water at Devils Lake, North Dakota.

Devils Lake takes its name from the Dakota “Mni Wak’áŋ,” or Spirit Water, and sits beside the largest natural lake in North Dakota. Between 1993 and 2011, floodwaters more than doubled the lake, swelling it from roughly 70 square miles to over 200 and swallowing roads, farms, and woodland as it rose. Today it holds one of the most productive perch and walleye fisheries in the Upper Midwest. Graham’s Island State Park, on the western shore, is the main access point, with cabins, a campground, a swimming beach, and boat ramps. Fort Totten State Historic Site nearby preserves an 1867 military post with sixteen original buildings restored to tell its story through 1890.

Medora

Sunrise over Theodore Roosevelt National Park
Sunrise over Theodore Roosevelt National Park. Image credit: Zak Zeinert via Adobe Stock.

Medora is the gateway to the south unit of Theodore Roosevelt National Park, set in the Badlands of western North Dakota. The Marquis de Mores, a French aristocrat, founded the town in 1883 and named it for his American wife, Medora von Hoffman; his Chateau de Mores hunting lodge still stands as a state historic site with the family’s original furnishings. The Maltese Cross Cabin, near the park visitor center, is the cabin Theodore Roosevelt used during his 1880s ranching years, the period that shaped his later conservation work. Each summer the Burning Hills Amphitheatre stages the Medora Musical, a Western-themed show running since 1965 in a natural bluff theater over the Badlands. The North Dakota Cowboy Hall of Fame keeps permanent exhibits on ranching, rodeo, and Indigenous horse culture.

Walhalla

Downtown streets of Walhalla, North Dakota
Downtown Walhalla, North Dakota. Image credit: In memoriam afiler, CC BY-SA 2.0, via Wikimedia Commons.

Walhalla, founded in 1845 on the banks of the Pembina River, is among the oldest towns in North Dakota. The Kittson Trading Post, built by American Fur Company agent Norman Kittson, stands at the Walhalla State Historic Site and is often called the oldest building in the state; the nearby Gingras Trading Post, the 1840s home and store of Métis trader Antoine Blanc Gingras, holds an equal or older claim. Pembina Gorge State Recreation Area cuts the deepest canyon in North Dakota, carved by the Pembina River, with trails for hiking, biking, and ATVs. Frost Fire Mountain runs downhill skiing and snowboarding in winter and an outdoor theater season in summer.

Valley City

Bridge over the Sheyenne River in Valley City, North Dakota
Sheyenne River in Valley City, North Dakota, the City of Bridges.

Valley City earns its nickname, the City of Bridges, from the eleven bridges that cross the Sheyenne River and its tributaries within the city limits. The Hi-Line Railroad Bridge, finished in 1908 and listed on the National Register, runs 3,860 feet across the valley and stands 162 feet above the water, one of the longest single-track railroad bridges in the country. The town sits at the eastern end of the 63-mile Sheyenne River Valley Scenic Byway, and Valley City State University, founded in 1890, keeps the local calendar busy with Vikings athletics and the annual Hi-Liner Days festival.

Jud

Jud, North Dakota, post office building
Jud, North Dakota, post office building. Image credit: Andrew Filer, CC BY-SA 2.0 via Wikimedia Commons.

Jud holds fewer than 100 residents in LaMoure County and is named for Judson LaMoure, an early state legislator. Since the early 2000s, residents and visiting artists have painted murals across nearly every building in town, including the post office, the grain elevator, the fire hall, and several houses, turning the place into a walkable open-air gallery of prairie wildlife, rural scenes, and abstract patterns. The annual Jud Art Festival each summer brings in regional artists and live music. Most travelers come for the murals and the sight of an entire town organized around one creative project.

Bottineau

Tommy Turtle statue in Bottineau, North Dakota
Tommy Turtle, symbol of Bottineau, North Dakota. Image credit: Bobak Ha’Eri, CC BY 3.0 via Wikimedia Commons.

Bottineau sits a little over ten miles south of the Canadian border as the gateway to the Turtle Mountains. Its mascot, the 30-foot fiberglass Tommy the Turtle, went up in 1978 riding a 34-foot snowmobile and is billed as the world’s tallest turtle statue. Pride Dairy on Main Street is the last small-town creamery still operating in North Dakota, known for its Juneberry ice cream. Lake Metigoshe State Park, about fifteen miles north, offers boating, kayaking, fishing, and winter ice fishing. Bottineau Winter Park, the largest ski area in the state, runs ten runs across 200 vertical feet plus a tubing hill, and Dakota College at Bottineau, established in 1906, anchors the campus side of town.

Where The Frontier Still Shows

What these ten towns share is how much of the frontier they kept. The Missouri River and Lake Sakakawea shaped Garrison. The Sheyenne River Valley runs through Fort Ransom, Lisbon, and Valley City. The Pembina Gorge holds Walhalla on the Canadian border, the Badlands hold Medora, and the Turtle Mountains rise behind Bottineau. Each one still keeps its 19th-century buildings and the kind of small-town institutions that have closed almost everywhere else.

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