North Dakota Medicaid Look-Back Period

When someone applies for Medicaid coverage of nursing-care services in North Dakota, HHS looks back five years to determine whether any transfer during that window disqualifies the applicant. The rule isn't limited to cash gifts — any transfer made without receiving fair market value in return counts, and the agency's own fact sheet points to a land-and-equipment gift to adult children as a real-world example. Families should hold onto deeds, appraisals, account records, contracts, invoices, and payment proof for the entire review period.

HHS defines nursing-care services broadly for this purpose, covering nursing homes, hospital swing beds, other medical institutions, intermediate-care facilities, and home- and community-based settings alike. That means a plan to request in-home services instead of facility care doesn't sidestep the same transfer-history review. Because any exception or permitted transfer depends heavily on the specific facts, it's worth applying the statute and HHS guidance to the actual transaction rather than assuming a generic gift rule will apply cleanly.