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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

North Dakota tourism sites get $4M after music fest declines funds

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North Dakota tourism sites get M after music fest declines funds


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  • North Dakota has awarded $4 million in tourism grants, with $1.5 million going to a ranch.
  • The Black Leg Ranch will use the funds to build a market and eatery, add guest cabins and develop RV sites.
  • This grant money became available after a music festival declined its previously awarded funds.

An agricultural tourism site has been awarded $1.5 million for a planned expansion, part of $4 million in tourism grants announced by the North Dakota Department of Commerce.

The $1.5 million is for the Black Leg Market and Eatery at Sterling, east of Bismarck, which will be part of Black Leg Ranch. The ranch raises cattle and bison and sells meat. It also has a wedding venue, lodging, hunting and a brewery.

The project involves building the Market and Eatery, adding guest cabins and developing full-service RV sites.

The money for the $4 million in the latest round of grants became available after Country Fest, a Morton County music festival, declined the grant money after it decided not to make major changes to the event. 

The Department of Commerce opened a new round of Destination Development Grant applications after Country Fest declined. 

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Other North Dakota grant recipients include:

  • Johnny’s Landing – Casselton, $870,000: To develop a lodging and wellness destination with 14 full hookup RV sites, 12 wellness-focused heritage cabins converted from granaries and grain bins, renovated farmhouse lodging, preserved barn space for agritourism and a conversion of a historic wooden water tower into a sauna. 
  • Great Northern Event Center – Williston, $550,000:To refurbish a historic Main Street property, turning the underground portion of the building into a lounge and other upgrades.
  • The Prairie Experience at The Bins – Lakota, $500,000:For construction of the Bins Coffee and Spirits café, developing three grain bin lodging units and other amenities.
  • Icelandic Rootshús – Mountain,$300,000: The Icelandic Rootshús is a permanent interpretive center, a welcoming place where this work can be experienced in person through learning, studying, and gathering. 

A full list of grant recipients is available on the Department of Commerce website.

North Dakota Monitor is part of States Newsroom, the nation’s largest state-focused nonprofit news organization.



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Fire burns at Pallet Green Recycling storage yard in rural Williston

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Fire burns at Pallet Green Recycling storage yard in rural Williston


WILLISTON, N.D. (KFYR) – UPDATE (5/10/2026 at 11:45 p.m.): A fire broke out at a Williston recycling business Sunday evening, and no one was injured.

Multiple crews responded to Pallet Green Recycling just before 8:30 p.m., according to the Williston Fire Department. Crews arrived at the scene where they fought heavy smoke and flames.

Industrial storage containers were on scene, and officials say it is unclear what, if any, chemical residue was inside them. Officials believe there is no danger to the public.

Williston Fire Chief Corey Johnson said the fire was contained to the business’s exterior storage yard, and crews were not concerned about it spreading beyond the property.

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“Right now, the structures are protected in the area. We’re not concerned about the fire spreading off of the lot,” Johnson said.

Multiple departments from across Williams County responded, and extra water trucks were brought in due to the fire’s remote location.

The cause remains under investigation.

This is a developing story. Your News Leader will provide updates as more information becomes available.

ORIGINAL STORY (5/10/2026 at 9:39 p.m.): Crews responded to a large fire at a storage yard in rural Williston on Sunday night.

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The fire is located at Pallet Green Recycling, according to the business owner.

Sylvia Luebke captured video of the scene from a distance around 8 p.m. The fire sent a large plume of smoke over the area. Luebke said it was still burning as of around 9 p.m.

Williston Rural Fire is working to battle the fire. The department was unable to comment at this time.

The cause of the fire is unknown.

Copyright 2026 KFYR. All rights reserved.

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North Dakota

ND Guard officer in charge of DC special mission

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ND Guard officer in charge of DC special mission


Submitted Photo
U.S. soldiers with the Nebraska and North Dakota National Guards, assigned to Joint Task Force-District of Columbia in support of the DC Safe and Beautiful mission, pose for a group photo at a hotel in Alexandria, Virginia, April 28. N.D. National Guard 2nd Lt. Caleb Hill, front row, far left, served as the officer in charge of the mission when soldiers assigned to JTF-DC responded to the shooting incident at the White House Correspondents’ Association dinner April 25. About 2,500 National Guard members are supporting the DC Safe and Beautiful mission, providing critical assistance to the Metropolitan Police Department to help ensure the safety of residents, commuters and visitors throughout the District. U.S. Army National Guard photo by Staff Sgt. Thomas Norris.

WASHINGTON – U.S. soldiers with the North Dakota, Arkansas and Nebraska Army National Guard, assigned to Joint Task Force-District of Columbia in support of the DC Safe and Beautiful mission, responded to a shooting incident at the White House Correspondents’ Association dinner (WHCAD) at the Washington Hilton in Northwest Washington April 25.

The Guardsmen were at the WHCAD at the request of the U.S. Secret Service (USSS) as an additional patrol unit created specifically for the event, which celebrates the contribution of news organizations and independent journalists alike who provide notable coverage relating to the presidential administration.

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“Our mission was to assist the U.S. Secret Service with crowd control,” said Capt. Kevin Peatrowsky, an operations officer with the Nebraska National Guard (NENG) assigned to JTF-DC.

As the Guardsmen were monitoring their area of operations, they saw USSS agents sprint toward the hotel entrance.

“They were running full speed with their weapons drawn,” said Sgt. 1st. Class Allen Haney, a team member with the Arkansas National Guard. “We immediately followed suit.”

Staff Sgt. Kirsten Confer, a NENG combat medic and battle captain, recalled her response to the incident: “We fell back on our basic training. You run toward danger and move in a way that makes sense for the situation.”

According to Confer, the Guardsmen entered the hotel and immediately began securing the scene and ensured that the guests evacuated safely. At the direction of a federal agent, Confer began a rapid trauma assessment on the suspect which resulted in finding knives and ammunition on the shooter. Simultaneously, the Arkansas soldiers moved outside to provide crowd control at a pedestrian barricade outside the hotel.

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“From there, we assisted wherever we could,” said 2nd Lt. Caleb Hill, a National Guardsman from North Dakota who served as the officer in charge for the mission. “We were initially helping with crowd control. After that, we realized that the USSS had begun rerouting everyone in the hotel, so we moved to the doors. We were controlling entry into the venue, so we had moved a couple more people outside, so we had five inside, eight outside.” Both Arkansas and Nebraska worked well alongside one another and, alongside the federal agencies. Hill also noted that relying on his soldiers allowed him to move to different teams, which helped allow him to plan and coordinate with different agencies.

According to 1st Lt. Jonathan Goins, a platoon leader with the Arkansas National Guard, Arkansas soldiers also helped establish a security perimeter for the staging of the presidential motorcade. Later, the team assisted federal agencies and MPD with crowd control, which helped clear the way for the president and administration officials, he said.

“Guardsmen on this mission represent the very best of the nation,” said U.S. Army Brig. Gen. Leland Blanchard II, the interim commanding general of the District of Columbia National Guard. “The world got a brief glimpse, but I see them each day serving and doing amazing things across the District.”



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