(Revised 10/1/2025 Release 25.16)
An IMD is a hospital, nursing facility, or other institution of more than 16 beds that is primarily engaged in providing diagnosis, treatment or care of persons with mental diseases. A facility with 16 beds or less is not an IMD. An institution is classified as an IMD if its main purpose is for the care and treatment of mental diseases. An intermediate care facility for individuals with intellectual disabilities (ICF-IID) is not classified as an IMD.
Current listing of IMDs in North Dakota.
Admission at an Institution for Mental Disease (IMD) does not make an individual ineligible for Medicaid. However, Medicaid will not pay for covered services for individuals under age 65 who reside at an IMD unless the individual:
Is 21 and under AND
Has a certificate of need AND
Receives inpatient psychiatric services.
For those who do not meet the criteria for Medicaid to pay for covered services, their Medicaid coverage will be suspended while they are residing at the IMD.
In Medicaid policy, “residing” in an Institution for Mental Disease means that a person is admitted and staying overnight at the facility and is receiving inpatient or residential treatment. Individuals who are present at the IMD only for outpatient services or day treatment are not considered to be residing in the facility. Suspension of Medicaid would not occur if the individual were receiving outpatient or day services at the IMD.
Note: An individual who attains age 21 while receiving treatment, and who continues to receive treatment as an inpatient, may continue to receive Medicaid covered services through the month the individual attains the age of 22.
Note: Individuals eligible under the PACE program will remain eligible for Medicaid covered services regardless of their age while a patient in an IMD.
An individual on conditional release or convalescent leave from an IMD is not considered to be a patient residing in that institution. However, such an individual who is under age 21 and has been receiving inpatient psychiatric services is considered to be a patient residing in the institution until unconditionally released or, if earlier, the last day of the month in which the individual reaches age 22.
An individual on conditional release is an individual who is away from the institution, for trial placement in another setting or for other approved leave, but who is not discharged. An individual on "definite leave" from the state hospital is an individual on conditional release.
The period of Medicaid suspension under this section begins the day after the day of entry and ends the day before the day of discharge of the individual from an IMD. A Ten-Day Advance Notice is not needed when terminating benefits due to entry into the IMD. See Paragraph (4)(c)(iii) of 510-03-25-25, "Decision and Notice," for further information.