Free senior care guidance for Twin Cities families. No cost to you, ever.
Call (651) 390-4719
Minneapolis Senior Advisor

What Happens When the Money Runs Out

Spend-down, Medicaid waiver transitions, and why you should ask a community about this before you move in.

HomeCosts & PayingWhat Happens When the Money Runs Out
Short answer

If private funds run out, the options generally are a Medicaid HCBS waiver for care inside a licensed community, Medicaid nursing facility coverage, or moving to a community that holds a waiver provider agreement. Confirm your state's specific programs before relying on this.

Ask before you move in, not after

This is the single most consequential question families skip. A community that does not hold a Medicaid waiver provider agreement will ask your parent to leave when private funds are exhausted — often with short notice, at the point when moving is hardest.

Ask directly: do you hold a Medicaid waiver provider agreement, and how many current residents use it? A community can technically hold an agreement and still have no waiver capacity available.

How families pay for care. Minnesota's Elderly Waiver and Alternative Care programs pay for care services -- never room and board -- and VA Aid and Attendance can add tax-free monthly income for eligible veterans. Read the full explanation →
The local long-term care ombudsman. Minnesota's Office of Ombudsman for Long-Term Care (1-800-657-3591) is a single statewide office covering the entire Twin Cities metro. Read the full explanation →

Questions families ask

What license does an assisted living facility need in Minnesota?

Every assisted living community in the Twin Cities must hold an Assisted Living Facility license issued by the Minnesota Department of Health (MDH) under Minnesota Statutes, Chapter 144G. This has been mandatory statewide since August 1, 2021, replacing the older, looser 'Housing with Services' registration model. Facilities must also employ an assisted living director credentialed by the Board of Executives for Long Term Services and Supports.

Does Minnesota require a special license for memory care?

Yes. Any community with a secured dementia care unit must hold the 'assisted living facility with dementia care' license category under Minn. Stat. 144G.10, subd. 2(b) — a base assisted living license is not enough. That license carries two extra legal requirements: dementia-specific staff training under Minn. Stat. 144G.83, and a mandatory written pre-admission disclosure under Minn. Stat. 325F.72.

How do I check if a facility is licensed in Minnesota?

Use the free MDH Health Care Provider Directory to search by provider type ('Assisted Living Facilities' or 'Assisted Living Facilities with Dementia Care'), city, or county — it shows current license status and the administrator of record. For a fuller quality picture, cross-check the Minnesota Assisted Living Report Card (or the Nursing Home Report Card for skilled nursing), which shows resident health, safety, and staffing ratings from MDH surveys.

Is independent living the same as assisted living in Minnesota?

No. Independent living apartments or cooperatives are housing only, with no licensed care services, and are not regulated under Chapter 144G. Assisted living facilities, by contrast, must hold an MDH license because they deliver health-related and supportive services — help with bathing, medication management, mobility — to residents where they live.

What's the difference between an MDH complaint and a MAARC abuse report?

MDH's Office of Health Facility Complaints (651-201-4200 metro, 1-800-369-7994 greater Minnesota) handles concerns about a licensed facility's regulatory compliance — things like understaffing or unsafe conditions — during business hours. The Minnesota Adult Abuse Reporting Center, or MAARC (1-844-880-1574), is the separate 24/7 statewide line for reporting suspected abuse, neglect, or financial exploitation of a specific vulnerable adult.

Not sure where to start?

Answer five questions and a local advisor will come back with senior care options in your area that actually fit your situation and budget. It is free, and there is no obligation.

Find care options
Find senior care — free