Which Minnesota assisted living facilities accept the Elderly Waiver

Does every Minnesota assisted living accept the Elderly Waiver?

No — and the state says so itself. In its consumer publication on Elderly Waiver services in assisted living, DHS writes that "not all assisted living facilities accept residents receiving Elderly Waiver services; some limit the number of residents in facilities who are receiving Elderly Waiver services." Source: Minnesota DHS, "Elderly Waiver services in assisted living" (DHS-7935-ENG, 7-2024).

That single sentence is the most consequential thing a Minnesota family can learn early, and almost nobody publishes it. The usual sequence is: a parent is approved for the Elderly Waiver, the family tours four communities they like, and then discovers on the fourth phone call that two of them will not take waiver funding and one has a waiting list for the places it does allocate to it. Weeks are lost.

There is a second gate, and it is separate from whether a building is willing. DHS states that "your assisted living provider must be enrolled with the Department of Human Services in order for the Elderly Waiver to be able to pay them." A facility can be perfectly happy to accept you and still be unable to bill the waiver, because it never enrolled. Source: Minnesota DHS, "Elderly Waiver services in assisted living" (DHS-7935-ENG, 7-2024).

Why would a facility limit how many waiver residents it takes?

DHS confirms that facilities do this. DHS does not publish the reasons facilities give, and we are not going to invent them. What we can do is show you the structure that sits underneath the decision, because it is public, it is specific to Minnesota, and it explains why the question exists at all.

The waiver payment for services is capped by the state

When the Elderly Waiver pays for care in an assisted living, it pays for a package Minnesota calls customized living. DHS publishes an exact monthly ceiling on that payment for every "case mix" — the classification assigned to a person through assessment. These are the limits effective 1 April 2026. Source: Minnesota DHS, Long-Term Services and Supports Service Rate Limits effective April 1, 2026 (DHS-3945-ENG).

That is the mechanism in one line: for a waiver-funded resident, what the facility can be paid for services is bounded by a published state ceiling, while for a private-pay resident the care charge is whatever the facility prices it at. A building deciding how to fill twenty apartments is making that comparison. You do not have to like it to plan around it.

Room and board is a completely separate bill

DHS is unambiguous: "the Elderly Waiver only pays for your services," and "you are responsible for paying the costs of room and board." Qualifying for the waiver does not make assisted living free. It covers the care half of the bill and leaves the rent half with you. Source: Minnesota DHS, "Elderly Waiver services in assisted living" (DHS-7935-ENG, 7-2024).

Some people also qualify for Minnesota's Housing Support programme, which helps with room and board — but DHS cautions that "not everyone who qualifies for the Elderly Waiver will qualify for the Housing Support program." Treat it as a possibility to ask your county or tribal worker about, not as a plan. Source: Minnesota DHS, "Elderly Waiver services in assisted living" (DHS-7935-ENG, 7-2024).

This is why the first DHS-recommended question is about rent rather than care. If the waiver takes over the service bill, what does the facility then charge you for the apartment? That number is set by the facility, it can differ from the private-pay rent, and it is the number your parent's income has to cover every month.

The phone call, word for word

Below is a script. It is written to be read down the phone in order, and it takes about four minutes. The questions in quotation marks are reproduced as DHS words them in its own publication — they are the closest thing Minnesota has to an official script for this conversation, and paraphrasing them tends to produce vaguer answers.

Questions 1, 3, 5, 7 and 9 are DHS's own recommended questions. The rest are the follow-ups that turn a polite answer into a usable one. Source: Minnesota DHS, "Elderly Waiver services in assisted living" (DHS-7935-ENG, 7-2024).

What a good answer actually sounds like

The hard part is not asking. It is knowing, in the two seconds after the answer, whether you have been told something real. Use this table while you are on the call.

The "pay privately first" question, and why it matters most

Of the DHS questions, this is the one families are most surprised by, and the one with the largest financial consequence: "Do I have to pay privately for my services for a certain amount of time before I can use the Elderly Waiver to pay?"

The reason it matters is arithmetic. A private-pay requirement of a year or two converts an apparently affordable community into one that needs a large sum of private money up front — money that, once spent, is gone from the estate and from any other option. A family that discovers this in month eleven of a private-pay stay has very few moves left.

Ask it before you tour, not after. And ask the follow-up: is the requirement written into the contract, or is it an unwritten policy? Those produce different risks. A written term is at least a term you can read and take advice on; an unwritten one can change.

If a private-pay period is required, ask for it to be stated in the assisted living contract, and read it against what the contract must contain under Minnesota law. Our guide to the assisted living contract and the UDALSA disclosure covers what the facility owes you in writing before you sign. This is general information, not legal advice — if a large sum turns on the wording, have someone read it for you.

You found a facility that says yes. What happens next?

Acceptance is one of three things that have to line up. The other two are the assessment that establishes you need this level of care, and the financial approval that establishes you qualify for Medical Assistance. Both have published timelines, and knowing them is the difference between planning and waiting.

Two practical consequences. First, request the needs assessment early — the twenty-day clock does not start until you ask, and the assessment date is what coverage can be backdated to. Second, if the financial side is slow, keep an eye on the sixty-day mark, because an expired assessment has to be redone.

DHS also flags two things worth knowing before money moves: transfers made "within five years before applying for, or while receiving, Elderly Waiver services" may trigger a penalty, and "when you pass away, the Department of Human Services is required to try to recover the cost of your Elderly Waiver services." Neither is a reason to avoid the waiver. Both are reasons to get advice before gifting anything. Source: Minnesota DHS, "Elderly Waiver services in assisted living" (DHS-7935-ENG, 7-2024).

Free help with all of this exists and does not sell anything: Minnesota Aging Pathways, formerly the Senior LinkAge Line, on 1-800-333-2433. DHS Health Care Consumer Support can be reached at 651-297-3862 or 800-657-3672. Source: Minnesota Aging Pathways (formerly the Senior LinkAge Line), 1-800-333-2433 — Minnesota Board on Aging.

How to build the call list

The script only works if you have a list of numbers to work through, and the list should be longer than you think. If some facilities decline waiver residents and some cap them, a shortlist of three is a shortlist of one bad week.

Start with the places you would actually visit. You can search every Minnesota provider we list, browse all assisted living communities, or go city by city — Minneapolis, Saint Paul, Rochester and Duluth — and see the licence number and, where we hold it, the waivers accepted on each listing.

Two things to keep in mind while you build the list. Minnesota has a lot of very small assisted living homes: as of June 2025 MDH had licensed over 2,300 assisted living facilities, more than 1,200 of them with a licensed capacity of five or fewer residents. Those small homes rarely appear on referral sites at all, and they are worth calling. Source: MN Office of the Legislative Auditor, Assisted Living Facility Licensing (2025).

And whatever a listing anywhere says, confirm the licence yourself before you sign anything — MDH publishes a free public lookup. Source: MDH — Verify a Facility License. If you want the wider funding picture first, start with the Elderly Waiver guide and what assisted living actually costs in Minnesota.