Updated September 6, 2026. Quick answer: In North Dakota, a Medicaid nursing-facility resident’s Personal Needs Allowance (the state uses different terminology; see below) is $115.00/Month; the amount of their own income they keep for personal use each month, with the rest going to the facility as the patient-pay amount toward the cost of care. That is well above the $30/month federal floor set in 1988 and never raised since. North Dakota Dept. of Health & Human Services, Non-ACA Medicaid Policy Manual, “Income Levels 510-05-85-40” (N.D.A.C. Section 75-02-02.1-40 et seq.) states the figure directly.
Why North Dakota’s figure isn’t the federal floor
Federal Medicaid law requires only a $30-a-month personal needs allowance as a floor; a state is free to set its own, higher figure by statute, regulation, or agency policy. North Dakota has done exactly that, setting $115.00/Month, effective April 1, 2026.
What the allowance covers, and what it doesn’t
The personal needs allowance pays for the things a facility’s daily rate doesn’t cover: clothing, haircuts, snacks, a phone or television, small personal purchases. It is deducted before the rest of a resident’s income is applied to the facility bill as the patient-pay (or post-eligibility treatment of income, PETI) amount. It is not extra money on top of what Medicaid already pays the facility; it is the one slice of a resident’s own income that Medicaid rules guarantee the resident, not the facility, keeps.
A note on the name
North Dakota calls this the “nursing care income level,” not “personal needs allowance”; the identical concept (the amount of income a resident may retain; the excess goes to cost of care).
| Citation | North Dakota Dept. of Health & Human Services, Non-ACA Medicaid Policy Manual, “Income Levels 510-05-85-40” (N.D.A.C. Section 75-02-02.1-40 et seq.) |
| What it says | “Nursing care income level. The nursing care income level is $115 per month and must be applied to residents receiving psychiatric or nursing care services in nursing facilities, the state hospital, Prairie Saint John’s, a Psychiatric Residential Treatment Facility (PRTF), or receiving swing bed care in a hospital.” |
Every citation on this page was read directly from the state’s own Medicaid agency, administrative code, or official eligibility manual this session. General information, not legal or financial advice; a figure this specific can change with a budget cycle or a rule amendment, and a facility or state caseworker has the final say on any individual case.