25.0241.02000
Sixty-ninth
Legislative Assembly
of North Dakota
Introduced by
Legislative Management
(Health Care Committee)
A BILL for an Act to create and enact chapter 23-17.8 of the North Dakota Century Code,
relating to nursing services agencies; and to provide an effective date.
BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
SECTION 1. Chapter 23-17.8 of the North Dakota Century Code is created and enacted as
follows:
23 - 17.8 - 01. Definitions.
As used in this chapter:
1."Department" means the department of health and human services.
2."Health care facility" means an office or institution at which health care services are
provided. The term includes a hospital; clinic; ambulatory surgery center; outpatient
care facility; nursing home; nursing, basic, long-term, or assisted living facility;
laboratory; and office of any health care provider.
3."Licensed practical nurse" has the meaning provided in section 43 - 12.1 - 02.
4."Nurse" has the meaning provided in section 43 - 12.1 - 02.
5."Nursing services agency" or "agency" means an individual, firm, corporation, limited
liability company, partnership, or association engaged for hire in the business of
providing or procuring temporary services in health care facilities for nurses, licensed
practical nurses, nursing assistants, nurse aids, and orderlies. The term does not
include an individual only engaging in providing the individual's services on a
temporary basis to health care facilities.
23 - 17.8 - 02. License required - Rules.
1.A nursing services agency may not operate without a license issued by the
department.
2.The department shall adopt rules necessary to implement this chapter.
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23 - 17.8 - 03. Application information and fee.
1.The department shall establish forms and procedures for processing an application for
a nursing services agency license. An application must include:
a.The name and address of the owner or owners of the agency;
b.If the owner is a corporation, a copy of its articles of incorporation, current
bylaws, and names and addresses of its officers, directors, and shareholders who
own more than ten percent of the corporation;
c.If the owner is a limited liability company, a copy of its articles of organization,
operating agreement, and names and addresses of its officers and directors;
d.The names and addresses of all supervisors and managers of the agency;
e.Satisfactory proof of compliance with section 23 - 17.8 - 04;
f.A policy or procedure that describes how the agency's records will be made
available to the department upon request;
g.Proof of professional malpractice insurance in the amount of:
(1)At least one million dollars per occurrence; and
(2)At least three million dollars in the aggregate;
h.Proof of general liability insurance covering personal property damage and bodily
injury in the amount of:
(1)At least one million dollars per occurrence; and
(2)At least three million dollars in the aggregate;
i.A list of all other states in which the agency operates; and
j.Any information deemed necessary by the department.
2.An applicant shall submit with the application a nonrefundable application fee of two
thousand dollars to the department. If a license is issued, the application fee shall
satisfy the nursing services agency's first year's annual licensure fee in accordance
with section 23 - 17.8 - 04.
23 - 17.8 - 04. Standards for operation - Annual fee.
A nursing services agency shall:
1.Develop and implement policies and procedures in accordance with this chapter and
comply with all state and federal laws regarding compensation, taxes, overtime, and
workers compensation;
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2.Update contact information with the department as needed;
3.Document that each employee or independent contractor provided to a health care
facility meets the minimum licensing, training, and continuing education standards for
the position in which the individual will be working;
4.Document that each individual provided to a health care facility is an employee or
independent contractor of the agency;
5.Ensure each employee or independent contractor undergoes an annual evaluation by
a licensed and registered nurse who is an employee of the agency, and submit that
evaluation to the department;
6.Develop and provide to each employee or independent contractor a written personnel
policy;
7.Maintain an agency policy that includes provisions for orientation, ongoing training,
and an annual competency evaluation;
8.Maintain a personnel record for each employee or independent contractor, including:
a.Name, address, and social security number;
b.A copy of the individual's license, including a certification or registration number
for each state in which the individual is or was previously licensed;
c.A copy of the individual's cardiopulmonary resuscitation certification;
d.A resume, educational history, prior employment history with verification, training
certificates acquired, references with verification, and proof of attendance at
orientation, training, and seminars;
e.Results of a criminal history record check;
f.Results of all competency testing;
g.A position description;
h.Copies of performance evaluations;
i.Copies of any disciplinary action taken against the individual;
j.Documentation of immunizations; and
k.Results of all drug testing;
9.Develop and implement policies and procedures for complaint, incident, and
disciplinary reporting, including:
a.Receiving, recording, and investigating complaints and incidents;
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b.Informing the health care facility of any complaints filed against the agency; and
c.Reporting information to the department which may be grounds for action under
the nurse practices act or nurse aide registry;
10.Permit officials of the department to enter the premises upon presentation of proper
identification for the purpose of conducting an investigation to determine whether an
applicant or licensee is in compliance with this chapter, to include:
a.Inspection of a nursing services agency, including a review of all records;
b.Interviews with an applicant, licensee, or any employee or independent
contractor of the nursing services agency; and
c.Any other action deemed necessary by the department; and
11.Submit an annual nonrefundable licensure fee of two thousand dollars to the
department.
23 - 17.8 - 05. Enforcement.
The department may refuse to issue, refuse to renew, revoke, or suspend the license of a
nursing services agency for the following reasons:
1.Refusing to allow an official of the department to enter the premises or conduct a full
investigation in accordance with section 23 - 17.8 - 04;
2.Willful submission or use of false or misleading information in connection with an
application for or with the use of a license;
3.Violation of any provision of this chapter, or any state or federal law or rule applicable
to nursing services agencies operating in this state;
4.Failure to meet or maintain the standards of operation as determined by this chapter
or the department;
5.Failure to comply with any lawful order of the department under this chapter;
6.Any act that constitutes a threat to the health or safety of the general public;
7.A felony conviction by the nursing services agency's owner, or one of its employees or
independent contractors; or
8.Insufficient financial or other resources required to operate a nursing services agency
in accordance with this chapter.
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23 - 17.8 - 06. Complaint system.
The department shall establish a system for recording, reporting, and investigating
complaints against a nursing services agency, or its employees or independent contractors.
Complaints may be made by any member of the public.
23 - 17.8 - 07. Restriction of employment.
A nursing services agency may not:
1.Restrict the employment opportunities of its employees or independent contractors; or
2.Require any payment or fee from a health care facility which decides to permanently
hire an employee or independent contractor of a nursing services agency.
23 - 17.8 - 08. Responsibilities of nursing services agencies - Notice and fees.
A nursing services agency shall:
1.Notify the health care facility in advance of the name and qualifications of any
employee or independent contractor assigned to the health care facility; and
2.Provide the health care facility with a written copy of all fees owed within thirty
calendar days of billing.
23 - 17.8 - 09. Responsibilities of health care facility.
A health care facility shall:
1.Orient and supervise each nursing services agency employee or independent
contractor assigned to the facility; and
2.Report any concerns regarding the competency of a nursing services agency
employee or independent contractor to the supervising registered nurse or owner of
the nursing services agency.
23 - 17.8 - 10. Penalty.
A person that violates a provision of this chapter or a rule adopted under this chapter may
be assessed a civil penalty not to exceed one thousand dollars for each violation and for each
day the violation continues, plus interest and any costs incurred by the department to enforce
this penalty. The civil penalty may be imposed by a court in a civil proceeding or by the
department through an administrative hearing under chapter 28 - 32. The assessment of a civil
penalty does not preclude the imposition of other sanctions authorized by rules adopted under
this chapter.
SECTION 2. EFFECTIVE DATE. This Act becomes effective on January 1, 2026.
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