Selling a skilled nursing facility in North Dakota

North Dakota at a glance

North Dakota has 72 Medicare- and Medicaid-certified skilled nursing facilities with 4,909 certified beds, and on average 92.8% of those beds are occupied, above the national average of 80.3%.

Source: CMS Provider Information file, August 2026. The full North Dakota picture, rates and every building are on SNFRadar, the market record we built and publish free.

What a buyer reads first in North Dakota

The numbers a buyer pulls before the first call, for the typical North Dakota building against the nation. Your own building's are on its SNFRadar page.

Sources: CMS Provider Information file, August 2026 (occupancy, staffing, turnover, star ratings: averages across certified buildings); Medicare cost reports (full-year filings), as SNFRadar compares them (medians, the same figures each building's SNFRadar page is compared against).

What moves value in North Dakota

Occupancy. 92.8% of North Dakota's certified beds are occupied, above the national 80.3%. Full buildings are the norm here, so a buyer will ask why yours is not, or price in the referral strength if it is.

Payer mix and the Medicaid rate. Medicaid pays for 55% of resident days in the median North Dakota building, less than the national 66%. Medicare and private-pay residents carry more of the value here, so buyers weigh referral sources and short-stay results heavily. North Dakota's Medicaid rate files are on SNFRadar.

Revenue and margin. Net patient revenue runs $432 per patient day in the median North Dakota filing, above the national $373, and the median net margin is 3.2%, close to the national 3.6%. Value turns on whether your building beats its state's median, not on the state.

Staffing. North Dakota's buildings average 4.42 nurse staffing hours per resident per day, more than the national 3.86, and nurse turnover runs 48.8% a year against 45.8%. Buyers treat agency use and turnover as a cost they will inherit, so a stable staff is worth showing early.

Inspection record. 45% of North Dakota buildings are rated four or five stars by Medicare and 32% one or two, against 40% and 41% nationally. With strong ratings common here, a weak one stands out, and buyers will ask for the plan of correction before they price.

Size and ownership type. The average North Dakota building has 68 certified beds, against 107 nationally. 6% are for-profit, 90% non-profit and 4% government, and 38% are part of a chain.

Where the beds are

North Dakota's largest counties by certified beds. Each opens that county's buildings on SNFRadar.

How a sale works

1. A first call. What you want from the sale, and when. No listing, no blast.
2. A value from the record. Your building's own numbers and the trades around it. How valuation works
3. Vetted buyers under confidentiality, bidding against each other, not against you.
4. Letter of intent, then the purchase agreement and the operations transfer agreement. The full process
5. Change of ownership. North Dakota's licensure filings plus Medicare and Medicaid, timed so billing does not stop. CHOW and Medicaid

Our recent closings

All five closings, with the press coverage they drew.

Questions owners ask