The Discharge Plan in Five Steps
Ask for the Assessment Before Discharge
If the person is on Medical Assistance or likely to qualify, ask the hospital or TCU social worker to request a MnCHOICES assessment now. It sets waiver eligibility and the care budget, and waiting on it can delay a move.
Choose the Kind of Setting
A small home with 6 or fewer residents, a larger community, or memory care. For dementia with supervision needs, look for an Assisted Living with Dementia Care license.
Send a Request With the Target Date
Describe the care needs, funding, and move date once. Every matching provider in the county that takes email inquiries receives it, and you get a list of the ones who reply.
Have the Care Details Ready
Providers review care needs before accepting. Keep the medication list, mobility and transfer needs, and supervision needs on hand, and share names only with the provider you choose.
Plan the Payment Bridge
Medicare does not pay for assisted living. If waiver approval is still pending, ask providers whether they accept private pay until it starts, and ask the case manager about timing.
Assisted Living Near Minnesota Hospitals
Twin Cities Metro
- MinneapolisAbbott Northwestern · HCMC · U of M Medical Center1,048 assisted living settings in Hennepin County
- RobbinsdaleNorth Memorial1,048 assisted living settings in Hennepin County
- St. Louis ParkMethodist Hospital1,048 assisted living settings in Hennepin County
- Maple GroveMaple Grove Hospital1,048 assisted living settings in Hennepin County
- EdinaFairview Southdale1,048 assisted living settings in Hennepin County
- St. PaulRegions · United Hospital207 assisted living settings in Ramsey County
- Coon RapidsMercy Hospital160 assisted living settings in Anoka County
- FridleyUnity Campus160 assisted living settings in Anoka County
- BurnsvilleFairview Ridges203 assisted living settings in Dakota County
- ShakopeeSt. Francis45 assisted living settings in Scott County
- WoodburyWoodwinds80 assisted living settings in Washington County
- StillwaterLakeview Hospital80 assisted living settings in Washington County
Start the Search Before Discharge
Send one request with the care needs, funding, and target date. Every matching assisted living provider in the county that takes email inquiries receives it, and you get a list of the ones who reply.
Free for discharge planners, social workers, and families.
Minnesota Guides
- Social WorkersCounty, hospital, nursing home, mental health, home health, hospice, and VA. Pick where you work.
- Waiver Case ManagersElderly Waiver, CADI, DD, BI, and CAC. Pick the waiver and the kind of home.
- Leaving a FacilityNursing home, ICF, or IRTS. For relocation and Moving Home Minnesota coordinators.
- Assisted Living PlacementOpen beds by county and one inquiry to providers that take email. For the people placing care in Minnesota.
Common Questions
Frequently Asked Questions
Does Medicare pay for assisted living after a hospital stay?
No. After a qualifying inpatient stay of at least three days, Medicare Part A can cover skilled nursing facility care, often in a transitional care unit, for up to 100 days per benefit period, with a daily coinsurance after day 20. It does not pay for assisted living.
What is a TCU?
A transitional care unit is short-term skilled nursing and rehabilitation after a hospital stay, usually inside a nursing facility. Many families start looking for assisted living during a TCU stay, when it becomes clear going home is not safe.
Can someone move from a nursing home to assisted living?
Yes. People on Medical Assistance leaving a nursing facility can get relocation service coordination (RSC) to plan the move, and the Elderly Waiver or CADI can pay for customized living once a MnCHOICES assessment confirms eligibility. Private-pay residents can move as soon as a provider has an opening.
How fast can someone move into assisted living from a hospital or TCU?
It depends on an opening and on funding. Private-pay moves can happen within days when a provider has an opening. Waiver-funded moves wait on the assessment and authorization. Reaching many providers at once shortens the search for an opening.
Can someone be discharged to a small assisted living home?
Yes, if the home can meet their needs and accepts them. Small homes hold the same Minnesota assisted living license as large communities. For memory care, the home needs a dementia care license.
Who helps with discharge planning?
The hospital or TCU social worker or discharge planner, the county for MnCHOICES and waivers, and the health plan care coordinator for people enrolled in MSHO or MSC+.
Sources: Minnesota Department of Health assisted living licensing records; Medicare skilled nursing facility coverage rules (Medicare.gov). Hospital list covers major Minnesota discharge hospitals and is not exhaustive.