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.