North DakotaSB 20702025 Regular SessionSenateWALLET

AN ACT to amend and reenact sections 50-10.2-01, 50-10.2-02, and 50-10.2-02.1 of the North Dakota Century Code, relating to the rights of health care facility residents.

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Bill Overview

Analyzed Economic Effects

9 provisions identified: 6 benefits, 0 costs, 3 mixed.

Care residents face updated restraint rules

In emergencies or to prevent injury to residents or others, restraints require approval and documentation for a limited time. A doctor, nurse practitioner, or physician assistant must authorize them. Nurse practitioners and physician assistants can also administer chemical restraints, alongside previously authorized clinicians. Other uses or threatened uses of drugs or physical restraints remain prohibited unless an approved treatment plan allows them.

Care residents gain room monitoring options

Care residents can choose technology for calls, virtual visits, and live monitoring without recording, while respecting others’ privacy and safety. Recording devices must stay fixed in the resident’s room, focus on the resident’s area, and include date and time stamps. Residents must give written notice and an installation plan meeting facility standards, which the facility must provide. Each roommate or representative must sign approval; recording approval must meet federal health privacy rules and can limit audio, video, operating times, and focus. Written withdrawal of approval requires disabling the device; a new roommate must approve before monitoring or recording continues. Facilities must reasonably accommodate placement unless it creates an undue burden, try to help when roommates refuse, and post clear recording signs. Residents or initiating representatives pay for purchase, activation, installation, upkeep, repairs, deactivation, and removal—not electricity.

Care residents get transfer notice protections

Facilities can transfer or discharge residents only for listed reasons, including medical needs, resident welfare, danger to others, or closure. Nonpayment of rent or fees and temporary moves during remodeling are also permitted reasons. Involuntary transfer or discharge notices must state the reason, effective date, destination, and state long-term care ombudsman contact information. The law generally requires at least 30 days’ written advance notice, with shorter notice allowed for urgent medical or health-and-safety needs.

Care residents gain money and billing safeguards

Facilities must disclose services and charges in writing before or during admission, with 30 days’ notice before service-cost or availability changes. They cannot demand or accept advance payments or gratuities to secure admission or a waiting-list spot. Residents without a guardian retain control of their finances and can delegate management to the facility. Facilities holding resident money in trust must provide written quarterly accounts explaining transactions to residents or designated representatives. They must return money and refunds due at discharge or eviction within 30 days, and refund overpayments within 30 days after discovery.

Care residents gain privacy and personal control

Residents have rights to dignity, informed consent, participation in care and community life, and freedom from abuse, neglect, and financial exploitation. They can communicate privately, use private phones and electronic devices, and send and receive unopened personal and electronic mail. Private visits with spouses, partners, or significant others have health and safety protections; personal possessions have space and other-resident protections. Resident council meetings are residents-only unless a resident invites someone else. Residents and representatives can view personal and medical records and authorize their release, with confidentiality protections intact.

Care residents get clearer admission rights

These protections cover North Dakota skilled nursing, basic care, assisted living, and approved long-term-care swing-bed hospital settings. Facilities must give residents and representatives written rights at admission, explain them within 30 days, and repeat the explanation annually. The statement includes responsibilities and conduct rules; facilities must follow it and promptly report rights or legal changes. When residents cannot understand, explanations and notices go to an immediate family member or representative. Facilities cannot require residents to waive protected rights or deny or condition admission or care based on payment source. Applicants denied admission can request written reasons, including whether the facility’s special features or service limits caused the denial.

Care residents get complaint and inspection protections

Facilities must adopt, publicize, and explain complaint procedures to residents, immediate family members, and representatives, and protect residents from retaliation. People making good-faith complaints are protected from civil liability arising from the complaint. Public inspection reports, deficiency reports, and correction plans must cover the past three years, up from two. Facilities must disclose where those records, complaint procedures, ownership records, and conflict-of-interest documents are publicly available. They must also notify residents when outside providers are used; conflict-of-interest rules include provider or immediate-family ownership and governing-board ties.

Care residents get recording privacy protections

Facilities cannot deny admission or remove residents because they authorize room recording, and no one may intentionally retaliate or discriminate. Staff need written resident or representative consent, or a court order, to access recordings. Intercepting, sharing, or using device communications requires express written resident or representative consent; federal health privacy rules also apply. Intentional obstruction, tampering, destruction, or disabling without express written permission is a class B misdemeanor. Material from intentional tampering or unlawful devices cannot be used in civil cases, administrative proceedings, or facility surveys. People placing devices or sharing recordings can face civil or criminal liability for privacy violations.

Care residents keep pharmacy choice without penalties

Care residents can choose their pharmacist regardless of the facility’s medication system. Facilities cannot charge fees or offer financial rewards or penalties for choosing a pharmacy other than their preferred one. They also cannot charge for repackaging drugs when that cost can be included in the facility’s cost report.

Sponsors & Cosponsors

Sponsor

Senate Human Services
Affiliation unavailable

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 186 • No: 0

Senate vote • 4/21/2025

Second reading, passed, yeas 47 nays 0

Yes: 47 • No: 0

House vote • 3/26/2025

Second reading, passed as amended, yeas 92 nays 0

Yes: 92 • No: 0

Senate vote • 1/27/2025