Nursing Homes and Assisted Living
With the aging population, more Minnesotans will find themselves seeking nursing home or assisted living residence for themselves or a loved one in the coming years. Minnesota Attorney General Lori Swanson provides the following information on how to research finding the right place for your loved one.
Nursing Homes and Alternatives to Nursing Homes
Minnesota has several residential alternatives for individuals who are no longer able to live on their own, or who need assistance due to health issues on a long-term or temporary basis. Nursing homes provide nursing care in a facility licensed by the Minnesota Department of Health (MDH). Nursing homes must have staff on duty 24 hours a day.
Housing with services (HWS) establishments provide housing and certain supportive services, such as meals, laundry, housekeeping, and arranging for medical services, social services, or transportation. A common example of a HWS facility is assisted living center. An individual is a tenant in a HWS establishment, and may be asked to sign both a lease and a service contract which specifies the type of services the HWS will provide. A tenant in a HWS establishment may also obtain health services from a home care agency that is licensed by MDH. If a HWS establishment has a special program for tenants with dementia, its staff must have additional training.
A HWS establishment that provides assisted living care must register with MDH. An assisted living facility must have a system that allows clients to request assistance with health or safety needs 24 hours per day, 7 days per week, and must have staff on duty who are awake (unless the assisted living facility has less than 12 clients). Some residential facilities offer a variety of options, including independent living, and clients can then move to other alternatives as they need more care.
Review Surveys and Report Cards
Every nursing home in Minnesota must have a state license from MDH in order to operate. MDH conducts “surveys” of nursing homes and assisted living facilities to check whether they are in compliance with state and federal rules. Survey results can be obtained by contacting MDH at (651) 201-4101 or (800) 369-7994, or online at www.health.state.mn.us/divs/fpc/directory/surveyfindings.htm.
MDH and the Minnesota Department of Human Services also jointly created a nursing home “report card.” Nursing home report cards can be obtained on-line at www.health.state.mn.us/nhreportcard or by telephone at (800) 333-2433. The report card allows consumers to compare nursing homes on eight quality measures:
- Resident quality of life;
- Family satisfaction;
- Quality indicators—clinical quality;
- State inspection results;
- Hours of direct care;
- Staff retention;
- Use of temporary nursing staff; and
- Proportion of beds in single bedrooms.
A nursing home can receive one star to five stars on each measure. Consumers can search nursing homes by area of the state and the three measures most important to them. Although helpful, the report card alone should not be the only information used when choosing a nursing home.
Nursing Home Selection
The following is a list of questions you may want to consider before making a nursing home selection:
- Is the nursing home Medicare or Medical Assistance (MA) certified?
- Does the nursing home have the level of care needed and is a bed available? (Check with MDH and/or ask the facility directly).
- Is there a full-time registered nurse in the nursing home at all times?
- Are hospice services available should they be needed?
- What is the nursing home’s staff retention rate?
- Does the same team of nurses and certified nursing assistants work with the same residents most days per week?
- Is there a choice of food items at each meal, and are residents able to get their favorite food items?
- Are staff available to help residents eat and drink during mealtimes?
- Are there daily activities for the residents?
- Does the facility allow pets?
- Is there an active volunteer program?
- What is the nursing home’s safety and care plan in the event of an emergency?
Alternatives to Nursing Homes
Each HWS establishment or assisted living facility is unique. It is important for consumers to ask about the services, amenities, accommodations and care provided. Consumers should ask to review a copy of the residence agreement outlining services, prices, extra charges, admission and discharge criteria, staffing and residence rules. You may want to consider the following questions before making an assisted living selection:
- Are additional services available if a resident’s needs change?
- What are the costs of the services?
- Are residents required to purchase renters’ insurance for personal property in their units?
- Does the residence have a clearly stated procedure for responding to a resident’s medical emergency?
- What are the medical services available and how are they provided?
- Can residents purchase required medications and supplements from a pharmacy or store of their choice, or does the facility provide them? Residents should know that long term care facilities may significantly mark-up the cost of common medications and vitamins, such as Vitamin D or Calcium supplements. It may be much cheaper for a resident or their family to purchase these items on their own rather than acquire them through long term care facilities. Find out how much you are being charged for supplements and whether you can bring your own supplements into the facility.
- Is staff available to meet scheduled and unscheduled needs?
- Are pharmacy, barber/beautician, and physical therapy offered on-site?
- Is transportation available for residents to go to doctor appointments, etc.?
- Are there organized activities for residents?
- Can residents have pets?
- Do volunteers come into the residence to help with or conduct programs?
- Do food menus vary from day to day and meal to meal, and are they nutritionally balanced?
- Are staff welcoming and professional?
- Do the residents socialize with one another?
- Is the residence accommodating to wheelchairs and walkers?
- Is the residence free of odors and is it appropriately heated/cooled?
- Does the residence have a means of security if a resident wanders?
- Does the residence have a process for assessing a resident’s need for services and are those needs addressed periodically?
- Are there government, private, or corporate programs available to help cover the cost of services to the resident?
Visit the Facility
Making an unannounced visit to a nursing home, HWS establishment, or assisted living facility can be a helpful way to scope out its day-to-day function. You may wish to observe:
- Is the facility well-kept?
- Are the residents clean, appropriately dressed, and well-groomed?
- Are the staff polite and respectful?
- Do the staff recognize the residents by name?
- Do the staffing levels appear appropriate for the number of residents?
Reimbursement and Regulation
To find out whether a given nursing home or assisted living facility is Medicare or Medical Assistance (MA) certified, whether regulatory action has been taken against it, what level of care is offered, or what its bed capacity is, contact MDH at (651) 201-4101 or (800) 369-7994 or review its online Provider Database at www.health.state.mn.us/divs/fpc/directory/fpcdir.html.
Every person deserves to receive quality care, respect, and dignified treatment from a nursing home, HWS establishment, or assisted living residence. If you or a loved one are concerned about the quality of care provided by a nursing home, HWS establishment, or assisted living facility, you should report your concerns to the Minnesota Department of Health.
Minnesota Department of Health
Office of Health Facility Complaints
P.O. Box 64970
St. Paul, MN 55164-0970
(651) 201-4200 or (800) 369-7994
Consumers with additional questions may contact the Office of Attorney General Lori Swanson.
Office of Minnesota Attorney General Lori Swanson
445 Minnesota Street, Suite 1400
St. Paul, MN 55101
(651) 296-3353 (Twin Cities Calling Area)
(800) 657-3787 (Outside the Twin Cities)
TTY: (651) 297-7206 or TTY: (800) 366-4812
Seniors Legal Rights
This Handbook is designed to provide Senior Citizens with information regarding legal rights covering topics as consumer protection, consumer rights, charitable giving, investments, healthcare, and more.
Long-Term Care Insurance
If you're thinking about buying a long-term care insurance policy, the Attorney General's Office encourages you to consider the following steps before doing so.
Reporting Abuse of Vulnerable Adults
People with disabilities are victimized at high rates compared to the general population. They are sometimes targeted specifically because of their disabilities. The Minnesota Vulnerable Adults Act is intended to protect adults with physical, mental, or emotional disabilities.