Application Process

Jann Neameyer, Admissions Coordinator
P.O. Box 673
Lisbon, ND 58054
701.683.6530

Applications to the Basic Care Unit (169kb pdf), (103kb rtf) and Medical Certificate-VA Form 10-10SH (583kb pdf) of the Veterans Home are made on forms furnished by the Veterans Home. These forms may be obtained from a County Veterans Service Officer (www.state.nd.us/veterans/officers/), from the Veterans Home's Admissions Coordinator, or downloaded from the links above. The forms consist of the "Application for Admission", the "Medical Certificate", and the "Discharge Certificate of Service" from the last period of service in the Armed Services (DD 214). Certification of residency must be completed. In addition, the Criminal History Record Information form, SFN 51156, must be signed by the applicant and processed prior to Admission.

Applications to the Skilled Care Nursing Unit (169kb pdf), (103kb rtf) and Medical Certificate-VA Form 10-10SH (583kb pdf) of the Veterans Home are made on forms furnished by the Veterans Home. These forms may be obtained from a County Veterans Service Officer (www.state.nd.us/veterans/officers/), the North Dakota Veterans Home Admissions Coordinator, or downloaded from the links above. The forms consist of "Application for Admission" (Form 001, Pages 1-3) and the "Discharge Certificate of Service" (DD 214). In addition, the Criminal History Record Information form, SFN 51156, must be signed by the applicant and processed prior to Admission.

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

Priority for admission to the Basic Care Unit:

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:

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

The completed application should be sent to Admissions Coordinator, at the North Dakota Veterans Home, PO Box 673, Lisbon, ND 58054.