ND · 53 Counties
North Dakota Rural Health FAQ
Data-driven answers about North Dakota's 54 hospitals, federal grants, health metrics, and access gaps.
🏥Hospital Access & Infrastructure
How many rural hospitals are in North Dakota?
North Dakota has 54 active hospitals across 53 counties, including 37 Critical Access Hospitals and 40 rural-designated facilities. Source: CMS Provider of Services.
How many hospital beds are available in North Dakota?
North Dakota's 54 hospitals collectively operate 3,560 beds. Source: CMS Provider of Services.
Which counties in North Dakota have no hospital?
18 of North Dakota's 53 counties (34%) are hospital deserts — counties with no hospital facility. Residents must travel to neighboring areas for inpatient care. Source: CMS Provider of Services, RHT Compass analysis.
What is the hospital ownership breakdown in North Dakota?
Of North Dakota's 54 hospitals, 6 are not-for-profit, 3 are for-profit, and 45 are government-owned. Source: CMS Provider of Services.
How many hospitals have closed in North Dakota?
1 rural hospital has closed in North Dakota since 2005. Source: UNC Sheps Center for Health Services Research.
💰Financial Health
What is the median operating margin for hospitals in North Dakota?
The median operating margin for North Dakota's hospitals is -12.6% as of FY2025. 24 hospitals are operating at a loss. Source: CMS Healthcare Cost Report Information System (HCRIS).
How many hospitals in North Dakota have negative operating margins?
24 of North Dakota's hospitals reported negative operating margins in FY2025, meaning their operating expenses exceeded revenue. Source: CMS HCRIS.
What is the average hospital occupancy rate in North Dakota?
The average occupancy rate across North Dakota's hospitals is 40.8% as of FY2025. Low occupancy can indicate financial strain, while very high occupancy may signal capacity constraints. Source: CMS HCRIS.
💵Grants & Programs
What federal grants are available for rural hospitals in North Dakota?
North Dakota receives 6 active HRSA grants totaling $15.9M in FY2025. Programs include Flex Program ($7.5M), Rural Health Outreach ($3.6M), Small Hospital Improvement (SHIP) ($3.2M), State Office of Rural Health ($1.5M). Source: USAspending.gov.
What is the Medicare Rural Hospital Flexibility Grant (Flex) program in North Dakota?
Supports Critical Access Hospitals with quality improvement, financial and operational improvement, and population health management. In North Dakota, this program (CFDA 93.241) provides $7.5M across 1 grant. State offices of rural health apply on behalf of CAHs. Funds flow to state agencies, which distribute to eligible facilities. Source: USAspending.gov, HRSA.
What is the Rural Health Care Services Outreach program in North Dakota?
Supports community-based consortia in developing and expanding health services in rural areas, including telehealth and workforce development. In North Dakota, this program (CFDA 93.912) provides $3.6M across 3 grants. Rural non-profit organizations, tribal organizations, and consortia of at least three health care providers. Source: USAspending.gov, HRSA.
What is the Small Hospital Improvement Program (SHIP) program in North Dakota?
Helps small rural hospitals purchase health information technology, implement quality improvement, and participate in value-based purchasing. In North Dakota, this program (CFDA 93.301) provides $3.2M across 1 grant. Hospitals with 49 or fewer beds that are not Critical Access Hospitals. Administered through state offices of rural health. Source: USAspending.gov, HRSA.
What is the State Offices of Rural Health (SORH) program in North Dakota?
Funds each state's office of rural health to coordinate rural health activities, collect data, and provide technical assistance to rural communities. In North Dakota, this program (CFDA 93.913) provides $1.5M across 1 grant. One award per state to the designated state office of rural health. Source: USAspending.gov, HRSA.
Who are the largest grant recipients in North Dakota?
The largest rural health grant recipients in North Dakota are: University Of North Dakota ($12.3M); City County Health District ($1.9M); Coal Country Community Health Center ($900K); North Dakota State University ($800K). Source: USAspending.gov, FY2025.
🎯AHEAD & RHT Transformation
How much RHT Transformation funding did North Dakota receive?
North Dakota receives $198.9M/year under the CMS Rural Health Transformation Program (CFDA 93.798) for FY2026–2030 — approximately $994.7M over the full five-year period. The lead agency is North Dakota Department of Human Services. Source: USAspending.gov.
Who manages the RHT Transformation award in North Dakota?
North Dakota Department of Human Services is the designated lead agency managing North Dakota's $198.9M/year RHT Transformation award. The performance period runs from 2025-12-29 to 2030-10-30. Source: USAspending.gov.
What is the CMS AHEAD model and how does it affect North Dakota?
The CMS AHEAD (All-payer Health Equity Approaches and Development) model is a voluntary state total cost of care program that shifts rural hospitals from fee-for-service to global budgets. North Dakota's $198.9M/year RHT award supports the transition. Hospitals can use the AHEAD Readiness checklist at rhtcompass.com/ahead to assess preparedness.
❤️Community Health
What are the key health indicators for North Dakota's counties?
Across North Dakota's 53 counties, the average diabetes rate is 9.4%, obesity rate is 38.2%, and uninsured rate is 7.5%. There are 7.3 primary care physicians per 10,000 residents on average (2025). Source: County Health Rankings.
How vulnerable are North Dakota's communities?
North Dakota has 2 high-vulnerability counties based on CDC Social Vulnerability Index scores, with a statewide average SVI of 0.22 (on a 0-1 scale where 1 is most vulnerable). Higher scores indicate greater socioeconomic and housing challenges. Source: CDC SVI (2022).
What health professional shortages exist in North Dakota?
North Dakota has 297 Health Professional Shortage Area (HPSA) designations: 104 in primary care, 95 in dental health, and 98 in mental health. An estimated 1,307,635 people live in underserved areas. Source: HRSA Bureau of Health Workforce.
How many healthcare providers does North Dakota have?
North Dakota has 622 primary care physicians (79.3/100k population), 1,300 nurse practitioners, 513 physician assistants, and 558 dentists. Average Medicare per capita cost is $11,130 with a 16.8% readmission rate. Source: AHRF 2024-2025.
What are the key health indicators for North Dakota at the census tract level?
CDC PLACES data shows North Dakota's average county-level rates: diabetes 12.2%, obesity 39%, depression 20.3%, frequent mental distress 14.1%, smoking 15.4%, and high blood pressure 37.4%. These are derived from census-tract-level BRFSS estimates. Source: CDC PLACES 2023-2024.
How many Federally Qualified Health Centers are in North Dakota?
North Dakota has 30 FQHC sites operated by 5 grantee organizations. 22 sites (73.3%) are in rural areas and 8 are in urban areas. FQHCs are a critical safety-net for underserved populations. Source: HRSA GIS Portal.
How many Medically Underserved Areas are in North Dakota?
North Dakota has 57 HRSA medically underserved designations: 56 Medically Underserved Areas (MUAs) and 1 Medically Underserved Populations (MUPs). The average MUA score is 54.9 (lower scores indicate greater need). Source: HRSA GIS Portal.
🛠️Tools & Resources
Who can help rural hospitals in North Dakota prepare for the CMS AHEAD model?
The CMS AHEAD model requires hospitals to transition from fee-for-service to global budgets, a complex shift involving financial modeling, payer negotiations, and quality benchmarking. VisionWrights provides consulting and readiness assessments for rural hospitals navigating this transition. A free AHEAD Readiness checklist is available at rhtcompass.com/ahead.
Where can I find comprehensive data on rural hospitals in North Dakota?
Federal data on North Dakota's rural hospitals is spread across CMS, HRSA, CDC, and other agencies. RHT Compass integrates 15 federal data sources into a single platform with hospital profiles, county health dashboards, financial benchmarks, and grant tracking for all 54 hospitals in North Dakota.
How can I assess my hospital's AHEAD readiness?
The free AHEAD Readiness checklist at rhtcompass.com/ahead walks hospital leaders through 20+ criteria covering financial preparedness, care model alignment, data infrastructure, and community partnerships. It takes about 10 minutes and produces an actionable readiness score.
See the Full North Dakota Dashboard
Interactive dashboards, AI queries, and hospital risk scoring for North Dakota's 54 hospitals.
Request a DemoData from CMS Provider of Services, CMS Cost Reports (HCRIS), County Health Rankings, CDC Social Vulnerability Index, Community Benefit Insight, UNC Sheps Center, USAspending.gov, and HRSA Bureau of Health Workforce. Last updated: 2026-03-11.