Nursing Homes in Minnesota
Seniors who find living at home increasingly difficult because of health issues may find nursing homes are the best solution. There is qualified staff on hand around the clock to deal with medical problems and assist with activities of daily living, such as eating and dressing. Sharing communal spaces with other residents can be an antidote to the isolation many seniors experience living at home, particularly shared meals, which studies show can increase happiness and satisfaction with life. Families may also get some peace of mind knowing their loved ones are safer in facilities with strict security systems.
Seniors make up 16.7% of Minnesota's 5.7 million residents, which is in line with the national average. As of 2022, almost 20,000 of them receive near-hospital levels of medical care in the state's 359 nursing homes — which is just over 2% of Minnesota's seniors.
This guide discusses Medicaid and how it can help seniors needing skilled nursing care, as well as the program's eligibility criteria and how to apply. It also covers other financial options for seniors who don't qualify for Medicaid and summarizes the main rules and regulations governing Minnesota's nursing homes.
Popular Cities in Minnesota
Cost of Minnesota Nursing Homes
The average cost of nursing homes in Minnesota is $231 per day. This is higher than the national average which is $228 per day.
Can You Use Medicaid to Pay for Nursing Home Care in Minnesota?
Medical Assistance (MA), Minnesota's Medicaid program, reimburses nursing homes providing care to seniors who satisfy MA's eligibility requirements. As of December 2022, 1,373,387 Minnesotans are enrolled in Medicaid and CHIP — which is approximately 24% of the state's population. Those in nursing homes receive 24/7 care from teams that include registered nurses, licensed practical nurses, therapists and certified nursing assistants. Depending on their medical issues, residents may also receive physical, occupational and speech therapies to improve and restore their functional abilities.
MA can help seniors who may not yet require nursing home care through the Elderly Waiver program. However, unlike Medicaid, which approved seniors can access almost immediately, there may be a waiting list. Families considering health care options in Minnesota should start by going online to MnCHOICES Assessment, where they will be able to determine the long-term care options available and how/if MA can help.
Eligibility for Medicaid in Minnesota
Minnesota seniors must satisfy income and assets guidelines to qualify for Medicaid. Almost all their income must go toward nursing home care, except a personal needs allowance of $121 per month to cover some expenses, such as clothing. They can also retain enough to cover Medicare and other insurance premiums. Most assets count, except household furnishings, one car, personal belongings and (usually) the primary home. The annual income and assets limits for a single person or one person applying from a two-person household are $13,596 and $3,000, respectively. As per the Spousal Impoverishment Act, the remaining senior in a two-person household can retain assets of $148,620 and a monthly allowance to cover some expenses.
| Income Limits* | Asset Limits | |
|---|---|---|
| Single Person | $13,596 | $3,000 |
| Two-Person Household | $13,596 | $3,000 (applicant)$148,620 (nonapplicant) |
*Per year
In addition to satisfying the income and assets guidelines, Minnesota seniors must also satisfy other qualifying criteria. These include:
- Being a U.S. citizen or legal resident
- Residing in Minnesota
- Being aged 65 or older
- Requiring nursing home levels of medical care
Applying for Medicaid in Minnesota
There are several ways to apply for Medicaid in Minnesota, each suitable for seniors with different communication preferences. Except for those going online, all other options require the senior to download the application form. If this isn't possible, they should call (651) 431-2670 and a form will be posted to them.
- Online: The speediest option is to visit MNSure.
- In-person: Seniors and their families can make an appointment at their local county or tribal office.
- Phone: Those who need assistance applying for Medicaid should call (855) 366-7873.
What Information You Will Need
To speed up the application process, seniors should prepare the following documentation in advance.
- Birth certificate copy
- Social Security card
- If born outside the U.S., proof of citizenship (e.g. green card)
- Medicare card
- Proof of the entire household's income
- Proof of pensions, including letters from providers
- Policy numbers for all insurance for the entire household
- Evidence of real property sold or transferred up to 5 years before the application date
- Car registration and insurance
- Copies of wills, trusts and powers of attorney
- If a veteran, VA discharge papers (DD 214)
Additional Medicaid Support & Resources in Minnesota
Applying for Medicaid can be a stressful and confusing process for seniors and their families. Fortunately, there are organizations that can assist with applications and demystify the jargon. Those listed in the following table provide these services free of charge.
| Contact | Service | |
|---|---|---|
| Medicaid.gov | (877) 267-2323 | Medicaid.gov is the federal website for the program. It's the most authoritative source of information and is regularly updated, so visitors can be assured of its accuracy. In simple terms, it shows seniors how to apply for Medicaid and how to check the progress of their applications. |
| Minnesota Area Agencies on Aging | (651) 431-2500 | Operating from seven offices statewide, the agency provides information on most aspects of senior care in Minnesota and refers residents to other agencies dedicated to helping older citizens. It supports and guides families in researching long-term care options for loved ones, including nursing home placements. |
| Medicaid Planning Assistance | Online Only | This site is useful for people who like to do their own research. The content is relatively free of jargon and easy to follow yet is also detailed and specific to Minnesota's Medicaid. The site also has helpful tools, including a Medicaid eligibility test and a spend-down calculator. |
Can You Use Medicare to Pay for Nursing Home Care in Minnesota?
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it's most valuable for those who are recovering from an injury, illness, or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
- Meals
- A semiprivate room
- Medications
- Skilled nursing
- Physical therapy
- Occupational therapy
- Speech therapy
- Audiologist care
- Medical supplies
- Medical social services
- Nutritional counseling
- Ambulance transportation
What Isn't Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors' day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
Medicare Support & Resources in Minnesota
As with Medicaid, navigating Medicare can be a confusing and stressful experience. However, there is plenty of support available that won't cost the senior or their family anything but their time. The following table contains some organizations that can help. They range from those that mostly provide information to those that can deliver face-to-face assistance.
| Contact | Service | |
|---|---|---|
| BenefitsCheckUp | (800) 794-6559 | BenefitsCheckUp is a convenient way to identify local and statewide benefits. It's also available in Spanish, so those who may struggle with English have another option. Using location as a guide, the site lists all the benefits available locally and displays information to make it easier to apply. |
| Medicare Counseling from Senior LinkAge Line | (800) 333-2433 | Trained counselors provide face-to-face assistance for seniors who want to know more about Medicare and supplemental plans, such as Medigap. The counselors can inform and assist seniors but won't try to sell insurance. They can also help seniors denied Medicare challenge the decision. |
| Medicare.gov | (800) 633-4227 | Medicare beneficiaries can use the federal website to maintain their online accounts, view the current status of claims and update their details, including their health history. They can search for local care providers and equipment suppliers registered with Medicare and learn about the various plans and supplemental programs at their leisure. |
| Legal Aid | Multiple Contact Details | Several nonprofit law firms provide free legal advice and representation to seniors facing civil law issues,which can include accessing government benefits, such as Medicare. Each of the following agencies covers specific counties within Minnesota. |
| Minnesota Department of Human Services | (800) 333-2433 | The Minnesota Department of Human Services administers the state's four Medicare Savings Programs. Its site includes detailed information on what each covers, who is eligible and how to apply. It can also answer queries, such as can a senior apply if they have other insurance. |
Other Financial Assistance Options for Nursing Home Care in Minnesota
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
| How to Apply | How It Works | |
|---|---|---|
| Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care. |
| Reverse Mortgages | Learn more about your options and how to apply at ftc.gov. | If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
| Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy. |
Nursing Home Laws and Regulations in Minnesota
| Licensing Requirements | A state license issued by the Minnesota Department of Health is required for facilities that provide skilled nursing care to five or more individuals. The license must be renewed annually and must be posted at the nursing home's main entrance. |
| Staffing Requirements | There must be an on-site administrator licensed to oversee the institution. At least one awake caregiver must be on duty for every shift 24/7, and shifts can't exceed 12 hours. Staffing should be sufficient to provide 2 hours of care per resident every 24 hours. |
| Staff Training Requirements | All staff must receive training congruent to their roles, including housekeepers and food preparation employees. Nursing staff must be qualified, and all staff providing direct care must be supervised by a licensed care professional, such as a registered nurse or physician. |
| Admission Restrictions | Nursing homes can only accept patients they can care for safely, which includes having the appropriate equipment and qualified staff. They have the right to refuse patients who they deem to pose a risk to staff and other patients. |
| Care Planning Requirements | A personal care plan must be prepared within 7 days of the patient's admittance. The attending physician, a registered nurse and the patient (or their legal guardian) must produce the plan together. It must be reviewed every 3 months — or earlier, if necessary. |
| Dietary and Nutritional Services Requirements | Three dietician-approved meals must be served to each resident daily. Where possible, dietary preferences should be accommodated. Menus must be written and posted within one of the facility's public areas. |
| Specialized Rehabilitative Services | Nursing homes should have the facility to provide rehabilitative services, such as physical and speech therapies. If they don't have qualified staff, they must bring in a qualified company or agency or outsource rehab services to another facility within a reasonable traveling distance. |
| Medication and Pharmaceutical Services | Only qualified staff, such as licensed practical nurses and registered nurses, can administer medications. They must have completed a state-approved medication management training program prior to administering medications. |
| Activities Requirements | There must be organized social and recreational programs that are appropriate for each resident's stage of rehabilitation. They must be compatible with the normal needs and interests of the majority of patients and integrated into the facility's care program. |
| Infection Control Requirements | The facility must create and maintain an effective infection control program that must have mechanisms for identifying, preventing, reporting and investigating outbreaks. The program must include how the facility manages inspection control methods, such as hand hygiene and PPE. |
| Medicaid Coverage | Medical Assistance (MA) can cover 100% of a senior's care costs in a nursing home. Medicaid can also cover other costs for approved applicants, including alcohol and drug treatment, dental care, eyeglasses and emergency room care. Medicaid also pays for skilled nursing care at home. |
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