Application Process

Susie Schlecht
Marketing Coordinator
701.683.6540

Application Forms for Admission

1. Application Form (183kb pdf) Please specify on application basic or skilled unit and complete the form thoroughly; otherwise you will not be considered for admission.
2. Medical Certificate-VA Form 10-10SH (583kb pdf) this form may also be obtained from a County Veterans Service Officer.
3. Discharge Certificate of Service from the last period of service in the Armed Services (DD 214).
4. Certification of residency must be completed.
5. Criminal History Record Information form this must be signed by the applicant and processed prior to Admission.
6. Authorization to Disclose Information Blank (146kb pdf)
7. Authorization to disclose information for VA (147kb pdf)

Priority for admission to the Basic Care Unit

If the Basic Care Unit is at its full capacity, applicants will be admitted to the North Dakota Veterans Home according to the following priority list:

1. Residents of North Dakota Veterans Home Skilled Care Unit in need of Basic Care.
2. Veterans with service-connected disability
3. American ex-prisoners of war
4. Discharged North Dakota National Guard Members who have become disabled in the line of duty
5. Veterans
6. Spouses and surviving spouses of veterans

Priorities for admission to the Skilled Care (Nursing Home) Unit

If the Skilled Care Nursing Unit is at its full capacity, applicants will be admitted to the North Dakota Veterans Home according to the following priority list:

1. Residents discharged from Skilled Care for medical reasons
2. Veterans requiring skilled nursing care due to a service-connected disability or complications from a service-connected disability
3. Residents of North Dakota Veterans Home Basic Care Unit in need of Skilled Nursing Care
4. Former residents of North Dakota Veterans Home Basic Care Unit who have been medically discharged and placed into an outside skilled nursing home
5. Veterans with service-connected disability
6. American ex-prisoners of war
7. Discharged North Dakota National Guard Members who became disabled in the line of duty
8. Veterans
9. Spouses and surviving spouses of veterans