# Title 23 — Health and Safety

## Chapter 23-09.3 — Basic Care Facilities

### § 23-09.3-01. Definitions.

As used in this chapter:
1. "Basic care facility" means a residence, not licensed under chapter 23-16 by the
department, that provides room and board to five or more individuals who are not
related by blood or marriage to the owner or manager of the residence and who,
because of impaired capacity for independent living, require health, social, or personal
care services, but do not require regular twenty-four-hour medical or nursing services
and:
a. Makes response staff available at all times to meet the twenty-four-hour per day
scheduled and unscheduled needs of the individual;
b. Is kept, used, maintained, advertised, or held out to the public as an Alzheimer's,
dementia, or special memory care facility; or
c. Is attached to a nursing home or assisted living facility and its staff are available
to meet the needs of all residents and comply with state and federal regulations.
2. "Department" means the department of health and human services.
3. "Services" includes responsibility for resident health and safety, assistance with
activities of daily living and instrumental activities of daily living, provision of leisure,
recreational, and therapeutic activities, supervision of nutritional needs, and
medication administration.
### § 23-09.3-01.1. Moratorium on expansion of basic care bed capacity.

1. Basic care beds may not be added to the state's licensed bed capacity during the
period between August 1, 2025, and July 31, 2029, except if:
a. A nursing facility converts nursing facility beds to basic care;
b. An entity licenses bed capacity transferred as basic care bed capacity under
section 23-16-01.1;
c. An entity demonstrates to the department that basic care services are not readily
available within a designated area of the state or that existing basic care beds
within a fifty-mile [80.47-kilometer] radius have been occupied at ninety percent
or more for the previous twelve months. In determining whether basic care
services will be readily available if an additional license is issued, preference may
be given to an entity that agrees to any participation program established by the
department for individuals eligible for services under the medical assistance
program under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.]; or
d. The department grant approval of new basic care beds to an entity. The approved
entity shall license the beds within forty-eight months from the date of approval.
2. Transfers of basic care beds from one basic care facility to another entity is permitted.
Transferred basic care beds must become licensed within seventy-two months of
transfer. The entity receiving the transferred beds or any new facility may seek to
participate in the basic care assistance program. If the entity can demonstrate that
individuals can be cared for at a more independent level and that this service will delay
entry into the nursing facility, the entity may be approved for basic care assistance
funds.
3. If an Indian tribe acquires basic care beds, the tribal facility must meet state licensing
requirements for those beds within seventy-two months of acquisition. A tribal facility
may seek to participate in the basic care assistance program. Basic care assistance
payments may only be made to a tribal facility that agrees to participate and adhere to
all federal and state requirements of the basic care assistance program including
participation, screening, ratesetting, and licensing requirements.

### § 23-09.3-02. Residential areas - Nongeriatric persons.

A nursing home, intermediate care facility, basic care facility, or any combination of a
nursing home, intermediate care facility, or basic care facility may establish residential areas
specifically for inhabitation by nongeriatric persons subject to any reasonable rules adopted by
the department.
### § 23-09.3-03. Access to pharmacist.

Repealed by S.L. 2001, ch. 432, § 7.
### § 23-09.3-04. Department to establish standards - Licensing - Inspection - Survey -

Prosecute violations.
1. The department shall establish standards for basic care facilities. The department shall
inspect all places and grant annual licenses to basic care facilities as conform to the
standards established and comply with the rules prescribed, as provided in this
chapter. The department may waive all or a portion of a license standard if the
department determines the lack of compliance does not adversely affect the health or
safety of residents.
2. The department shall implement a survey process for basic care facilities which for
purposes of the life safety portions of the survey, all surveys must be announced;
which for purposes of the health portions of the survey, half of the surveys must be
announced; and which for purposes of complaints related to health and life safety, all
surveys must be unannounced. As part of the survey process, the department shall
develop, in consultation with basic care facilities, and shall implement a two-tiered
system of identifying areas of noncompliance with the health portions of the survey.
3. The department shall prosecute all violations of this chapter.
### § 23-09.3-05. License required - Term - Revocation.

No person, institution, organization, limited liability company, or public or private corporation
may keep, operate, conduct, or manage a basic care facility without holding a valid license
issued by the department. The license is not valid for more than one year. Any license may be
revoked by the department for violation of this chapter or the rules adopted by the department.
### § 23-09.3-05.1. Application for license - License fee.

Applicants for a license shall file applications under oath with the department upon forms
prescribed. An application for a license for facilities not owned by the state or its political
subdivisions must be accompanied by a fee of ten dollars per bed. License fees collected
pursuant to this section must be deposited in the department operating fund in the state treasury
and any expenditure from the fund is subject to appropriation by the legislative assembly.
### § 23-09.3-06. Injunction.

The department may apply to the district court of the county in which the basic care facility
is located for, and the court has jurisdiction upon hearing and for cause shown to grant, a
temporary or permanent injunction restraining any person from establishing, conducting,
managing, or operating any basic care facility without obtaining a license under this chapter.
### § 23-09.3-07. Contents of license.

The license must show the name of the owner or manager of the basic care facility, its
location, and the maximum number of persons that may be received and kept in the basic care
facility at any one time.
### § 23-09.3-08. Records kept by basic care facility.

A record of every individual admitted to any basic care facility must be kept at the place
licensed by the owner or manager in the manner and form prescribed by the department.

### § 23-09.3-08.1. Admission of residents to basic care facility - Restrictions - Exception.

1. A basic care facility may not admit and retain an individual unless the:
a. Facility provides, directly or through contract, appropriate services within the
facility to attain or maintain the individual at the individual's highest practicable
level of functioning; and
b. Condition and abilities of that individual are consistent with the national fire
protection association 101 life safety code requirements.
2. Notwithstanding contrary provisions in subsection 1, a basic care facility may retain an
individual in need of end-of-life services if the facility wraps around the individual's
family, or the individual's designee, volunteers, or staff services to support the
individual through end of life. The facility, individual, or the individual's designee may
contract with a person or hospice agency to meet the needs of the individual. A basic
care facility continues to be responsible for the care and services of every resident.
### § 23-09.3-09. Authority to adopt rules.

The department may adopt rules necessary to carry out its responsibilities under this
chapter. Rules adopted by agencies prior to January 1, 1990, which relate to functions or
agencies covered by this chapter, remain in effect until they are specifically amended or
repealed by the department.
### § 23-09.3-10. Rules on services to nongeriatric persons.

The department shall adopt rules under chapter 23-16 for patient and resident care and
quality care review which are not in conflict with any federal laws, and as are necessary to
ensure the appropriate medical, social, and psychological services to nongeriatric persons
residing in a nursing home, intermediate care facility, basic care facility, or any combination of a
nursing home, intermediate care facility, or basic care facility.
### § 23-09.3-11. Department to furnish information when requested.

If called upon by any person, organization, corporation, limited liability company, or
community interested in establishing a basic care facility, the department shall furnish
information concerning the laws and rules governing operation of a basic care facility.
### § 23-09.3-12. Penalty.

Any person who violates any provision of this chapter is guilty of a class B misdemeanor.
