Long-Term Care Fees
In Minnesota, nursing homes follow a policy of “rate equalization.” A nursing home must charge residents paying privately for care the same as Medical Assistance, Minnesota’s Medicaid program, reimburses for the same level of care. However, no such policy exists for assisted living facilities.
Residents paying out of pocket for their care report to the Office of Ombudsman for Long-Term Care (OOLTC) that fees and rent are increasing at an incredibly fast pace. This is approximately 10% of OOLTC’s casework from 2023 – 2025. Residents are paying more and more for the same care they were receiving 3 months ago without an explanation of why fees and rent are increasing. Billing is confusing as well, causing residents to wonder what exactly they are paying for. Often, residents report that the services they are paying more for are routinely not being provided at any price point.
Residents have reported having to pay an additional fee each month when they pay by check instead of ACH. They have also reported being charged every time a resident falls and staff check the resident's vitals and document the fall, which is standard practice. Additionally, residents say they are charged whenever staff hand them one of their personal items.
One resident reported a $9,000 increase in one month without any additional services being provided. Residents in another facility reported a 42% increase in fees.
Residents report that their assisted living facilities are running out of basic food supplies such as coffee and milk. One resident reported a common meal at their assisted living facility is a hot dog and a piece of bread.
Residents report that facilities are not sharing fee schedules, so they don’t know what they are being charged for nor do they know why they are seeing an increase in fees.
In OOLTC’s last Gov Delivery sent on March 4th, 2026, we shared data and examples of residents not receiving the services they and taxpayers are paying for. Residents are sharing with OOLTC that they are experiencing significant frustration when insufficient services are coupled with higher fees. Residents aren’t getting what they are paying for.
As fees increase in both number and amount, residents who thought they had enough assets to pay for their care are running out of money far more quickly than they anticipated. As a result, residents are more likely to rely on taxpayer dollars to pay for care more quickly and in greater numbers.
OOLTC has had some success in supporting residents who are trying to understand their bills and pay only for the services they need. OOLTC can't resolve every situation in which fees increase rapidly, increase without a known reason, or are charged for services not provided. A statutory change that supports financial protections for residents in assisted living facilities paying privately for care is needed.
To work with a regional ombudsman on these or other issues you or a family member may be experiencing, call OOLTC’s main intake line at 651-431-2555 or 1-800-657-3591.
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