---
title: "North Dakota Medicaid Look-Back Period | Funding LTC Marketplace"
url: https://fundingltcmarketplace.com/states/north-dakota/medicaid-look-back-period/
description: "North Dakota's five-year transfer review, state-average nursing-facility penalty method, and hardship-exception process."
last_updated: 2026-10-20
author: George A. Mellendorf, CLTC, LTCP (Central States Insurance Services, Inc.)
publisher: Funding LTC Marketplace
note: Educational content; not legal, tax or financial advice. Markdown copy of the HTML page at the URL above.
---
North Dakota · Look-Back & Penalties

# North Dakota Medicaid Look-Back Period

Last updated 2026-10-20

**Quick answer:** North Dakota Medicaid looks back five years for transfers made without fair market value when someone applies for nursing care services. That includes nursing homes, swing beds, other institutions and home- and community-based care.

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.

## Sources and official resources

- [North Dakota HHS: Medicaid Eligibility](https://www.hhs.nd.gov/healthcare/medicaid/eligibility)
- [U.S. Code: 42 U.S.C. § 1396p (liens, estate recovery, transfers of assets, Partnership disregard)](https://www.law.cornell.edu/uscode/text/42/1396p)

Rules and figures change. Confirm current details with the agency before you act.

[← Back to the full North Dakota guide](https://fundingltcmarketplace.com/states/north-dakota/)