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Nursing Home vs. Assisted Living

Two different Minnesota license chapters -- 144A for nursing homes, 144G for assisted living -- and two different levels of medical care.

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Short answer

Minnesota licenses nursing homes under Minnesota Statutes Chapter 144A and assisted living under Chapter 144G -- two entirely separate license chapters with different staffing and medical-care requirements. Nursing homes provide 24-hour licensed nursing care and carry federal CMS star ratings; assisted living does not.

Why nursing homes have CMS star ratings and assisted living does not

Nursing homes are federally certified providers under Medicare/Medicaid, which is why CMS Care Compare publishes a star rating for every one. Assisted living in Minnesota is licensed at the state level only, with no equivalent federal certification or star-rating system.

What pushes a resident out of assisted living

A resident whose medical needs exceed what an assisted living facility's service plan and staffing can safely provide -- ongoing skilled nursing needs, complex wound care, or a level of medical instability the facility is not licensed or staffed for -- typically needs to transition to a nursing home instead.

Questions families ask

Is care different in Bloomington versus other Hennepin County suburbs?

No — Bloomington operates under the identical Minnesota statewide licensing (Chapter 144G), Medicaid waiver (Elderly Waiver/Alternative Care), and abuse-reporting (MAARC) framework as every other city in Hennepin County and the broader metro. What varies city to city is the local supply, style, and pricing of individual communities, not the underlying regulatory or funding structure.

What's the difference between assisted living and memory care in Minnesota?

Assisted living (Minn. Stat. 144G.10, subd. 2(a)) provides housing plus health-related and supportive services for residents who need help with daily activities but not specialized dementia care. Memory care requires the separate 'assisted living facility with dementia care' license (subd. 2(b)), mandatory dementia-specific staff training (Minn. Stat. 144G.83), and a secured unit with a required written pre-admission disclosure (Minn. Stat. 325F.72).

What's the difference between the Elderly Waiver and Alternative Care in Minnesota?

The Elderly Waiver (EW) is a federal-state Medicaid HCBS waiver requiring the applicant to already be Medical Assistance eligible, while Alternative Care (AC) is a state-only-funded program (no federal match) for seniors who need EW-equivalent services but aren't yet financially MA-eligible. Both use a similar service array and cost cap and never pay room and board.

How does a nursing home differ from assisted living in Minnesota?

Nursing homes provide 24-hour skilled nursing care for residents with significant medical needs and are licensed and regulated separately from assisted living, with their own Nursing Home Report Card. Assisted living, licensed under Chapter 144G, serves residents who need help with daily activities and some health-related services but not continuous skilled nursing oversight, and is generally less expensive.

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