Medicaid Nursing Home Rates by State

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Minnesota

Medicaid nursing facility payment · Hybrid · researched October 2026

Minnesota’s Medicaid agency and its state plan are the official source for these rules. This page summarizes them as researched in October 2026; check the state’s own documents, listed under Sources, before relying on them.

At a glance

Rate method

Hybrid

Case-mix level

Resident-level

Classification

Transitioning to PDPM

Rate updates

Once a year

Managed care (LTC)

Short stays only

Quality program

VBR quality score, QIIP and PIPP

Paid outside the rate

None

Bed hold

Hospital and leave

Published rates

Not published

Assisted living

Covered

Personal needs allowance

$132 / month

Overview

• Minnesota's 'value-based reimbursement' (VBR, since Jan 2016) pays each facility its own reported direct-care and other care-related costs from its cost report, capped by a facility-specific limit that rises with the facility's quality score.
• Other operating costs (administration, dietary, housekeeping, laundry, plant) are paid at one statewide price: 105% of the 7-county Twin Cities metro median.
• External fixed costs (surcharge, property taxes, employer health insurance, add-ons) are passed through, and property is paid either under a legacy contract rate or, after an approved construction project, a fair rental value rate.
• Only the direct-care piece is multiplied by the resident's case-mix weight; since 2026 each care-related and other-operating piece can grow no more than the lesser of CPI-U or 4% a year.

What matters in Minnesota

• Rate equalization: homes cannot charge private-pay residents more than the Medicaid rate for the same care (Minn. Stat. 256R.06), so the state's rates set private prices too.
• Case mix is per resident: each resident is paid the home's rate for their own class, changing with each assessment.
• Care costs are paid from the home's own cost report, up to 89.375-145.625% of median, depending on quality score.
• Since 1/1/2026, care and operating rates can grow no more than the lesser of CPI-U or 4% a year.
• PDPM phases in slowly: 75% RUG-IV through 2026, 50/50 in 2027, 25/75 in 2028, full PDPM 1/1/2029.
• No recurring payments come outside the per diem; the rate rises 20% for each resident's first 30 days.
• Bed hold pays 30% of the rate, and only when occupancy including held beds is at least 96%.

Frequently asked

Can Minnesota nursing homes charge private-pay residents more than the Medicaid rate?

No. Minn. Stat. 256R.06 subd. 2 bars a Medicaid-certified home from charging a private-pay resident more than the Medicaid rate for similar services, with treble damages for violations. The exceptions are a private-room premium and optional services charged at the same price to Medicaid residents. Subd. 1 also bars the Medicaid rate from exceeding the private rate. Minnesota and North Dakota are the only states in this research with rate equalization.

Does Minnesota pay more for a resident in the first month after admission?

Yes. The rate rises 20% for each resident's first 30 days.

Does a higher quality score raise a Minnesota home's care cost limit?

Yes. The quality score sets the care-related cost limit, from 89.375% of the metro median at a score of 0 to 145.625% at a score of 100.

How could Minnesota reduce nursing home rates in 2029?

Laws 2023 c. 74 requires a rate reduction in 2029 if the one-time $173.1M paid in 2023 raised total Medical Assistance nursing facility spending for FY2024-2027 above projections.

How much is paid outside the posted rate in Minnesota?

None recurring; the only outside money was one-time 2023 payments of $173.1M plus $74.5M in workforce grants.

What does Minnesota Medicaid pay on Medicare coinsurance days?

Medicaid pays only if its case-mix rate exceeds Medicare's net payment, so homes usually receive $0.

Does Minnesota require a minimum share of spending on care?

No floor; spending less simply lowers the cost-based rate about 15 months later.

How is the Minnesota nursing home provider tax charged?

$5,900 per licensed bed per year from 1/1/2026, offset by $19.02 per resident day in the rate.

How the rate is set

How the method got here

Verified October 11, 2026

Cost basis

Uses cost reports

Yes

Cost report

Minnesota Statistical and Cost Report (state-specific; filed with DHS by February 1 for the October 1 - September 30 reporting year). Medicare 2540-10 is not the rate basis.

Base year and rebasing

Rebased every year: rates for the January 1 - December 31 rate year use the cost report for the year ending September 30 fifteen months earlier (e.g., 1/1/2026 rates use the 9/30/2024 report). DHS sends each facility a notice of rates before January 1. No inflation adjustment for the 15-month lag.

Components

Component	Method	Notes
direct care	facility's own cost per standardized day (cost-report basis), limited by a quality-based total care-related limit; since 1/1/2026 also capped at the lesser of prior-year rate x (1 + CPI-U) or 104% of prior-year rate	Confirms the user's context: direct care is funded from the facility's cost report. Covers nursing administration, RNs, LPNs, CNAs, med aides, agency nursing, floor supplies, nursing technology, and (since 10/1/2017) nurse/pharmacy consultants and medical director. Standardized days = resident days weighted by case mix, so the rate is cost at a case-mix index of 1.00; it is then multiplied by each resident's case-mix weight. Minn. Stat. 256R.23 subd. 7; SPA 4.19-D sec. 23.080.
other care-related	facility's own cost per resident day (activities, raw food, therapy, social services, other direct-care staff), subject to the same quality-based limit and the same CPI-U / 104% annual growth caps	Not case-mix adjusted. Minn. Stat. 256R.23 subd. 8.
total care-related limit	limit = metro median total care-related cost per day x (89.375 + 0.5625 x quality score) / 100	Median uses cost reports from Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, Washington counties. Quality score 0 gives 89.375% of median; 100 gives 145.625%. If over the limit, direct care and other care-related are cut proportionally. Former 5%-of-median cap on limit reductions (subd. 6) repealed 2025. Specialized care facilities get a 50% higher limit. Minn. Stat. 256R.23 subds. 2-5.
other operating	statewide price: lesser of 105% of the 7-county metro median other operating cost per day, prior-year price x (1 + CPI-U), or 104% of prior-year price	Same rate for every facility. CPI-U and 104% caps added effective 1/1/2026. Minn. Stat. 256R.24.
external fixed costs	pass-through of actual or statutory amounts	Provider surcharge offset ($19.02/resident day per statute since 1/1/2026; was $8.86), MDH license fee, scholarships, resident/family council $5/365, planned closure and consolidation adjustments, single-bed room incentive, property taxes and special assessments, PERA pension, employer health insurance, special diets, QIIP and PIPP add-ons, border city add-on, critical access add-on, PACE clean energy, nursing home employment standards adjustment (from 1/1/2026). Minn. Stat. 256R.25.
property	legacy contract (alternative payment system) property rate for most facilities; fair rental value rate once a facility completes a moratorium-exception construction project	See capital. Minn. Stat. 256R.26.

Inflation

No inflation from cost year to rate year. Since 1/1/2026, CPI-U (U.S. city average, DHS Reports and Forecasts Division forecast, 12-month midpoint-to-midpoint) acts only as a cap on year-over-year growth of the direct care, other care-related, and other operating rates, together with a hard 4% cap. FRV values move with the RSMeans construction cost per square foot.

Verified October 11, 2026

Case mix

System

Transitioning to PDPM

Applied at

Resident-level

How it works

Each home has a rate for every case-mix class; a resident is paid at the rate for their own classification, which changes with each assessment.

Classification

Transitioning from RUG-IV 48-group (plus penalty AAA and short-stay default DDF classes) to PDPM-based classification using the 25 PDPM nursing groups with Minnesota-assigned indices that match the CMS PDPM nursing CMIs (e.g., ES3 3.84, ES2 2.90, PA1 0.62); classifications set by the Minnesota Department of Health from MDS assessments.

Applies to

Direct care component only; all other components are the same for every resident in the facility.

Acuity measured from

Resident-specific rate by classification. For the PDPM phase-in, the blend uses a 'medical assistance facility average case mix index' built from Medicaid residents only. Standardized days for setting the direct care per diem use all (private-pay and MA) resident days by class from the cost report.

Updated

Per resident: classification changes with each assessment (admission effective day of admission; significant change effective ARD; quarterly/annual effective first of the month after ARD). Facility rates reset each January 1.

Move to PDPM

CMS stopped supporting OBRA RUG-IV on 10/1/2025. Minn. Stat. 256R.531 (Laws 2025, 1st Sp. c. 9) phases PDPM in via a rate adjustment equal to a blended MA case-mix-adjusted direct care rate minus the full PDPM rate: 75% RUG-IV / 25% PDPM through 12/31/2026, 50/50 in 2027, 25/75 in 2028, 100% PDPM from 1/1/2029. Statute dates the blend from 10/1/2025; the approved SPA (TN 26-05) dates the adjustment from 1/1/2026.

Verified October 11, 2026

Low-acuity residents

None found after checking Minn. Stat. ch. 256R (full text), Minn. Stat. 144.0724 (case-mix classification, level of care) and State Plan 4.19-D TN 26-05 (sections 14.000-14.040, 23.000). Low-acuity residents are paid only through their own class's index: the lowest PDPM classes are PA1 (0.62) and PA2 (0.67), multiplied against the direct care component only; the other components are paid in full. There is no reduced or flat rate carved out of the normal rate. Context only: (1) short-stay default class DDF (index 1.00) can be elected for residents staying 14 days or less instead of an admission assessment; (2) penalty class AAA (index 0.62, the facility's lowest rate) applies to late or missing MDS assessments, a compliance penalty rather than a low-acuity rate; (3) a person who does not meet Minnesota's nursing facility level-of-care criteria (144.0724 subd. 11) is not eligible for MA nursing facility payment at all - an eligibility rule, not a rate.

Verified October 11, 2026

Capital

Mixed. Most facilities still receive a property rate carried forward from the old contract-based alternative payment system (prior property rate plus past inflation and project adjustments). Facilities that complete a moratorium-exception project authorized after 3/1/2020 transition to a fair rental value (FRV) rate: limited undepreciated replacement cost (lesser of appraisal or licensed beds x RSMeans cost/sq ft for Minneapolis x 1,000 sq ft/bed), depreciated, plus land at 5% of limited URC, times a rental rate (20-year Treasury average + 3%, floor 7.5%, ceiling 12%), divided by capacity days x 0.88 (88% occupancy floor), plus an equipment allowance per bed x rental rate. FRV replaces all capital payments and ends eligibility for planned closure, consolidation, and single-bed incentives. As of 1/1/2024 only five facilities were on FRV. Minn. Stat. 256R.26, 256R.261.

Verified October 11, 2026

Budget adjustment factor

No across-the-board budget factor. Since 1/1/2026 the CPI-U / 104% annual growth caps on direct care, other care-related, and other operating rates act as a growth limiter. Separate contingent clawback: Laws 2023 c. 74 s. 2 requires DHS to reduce rates in rate year 2029 if the 2023 one-time $173.1M payments are found to have raised total MA nursing facility spending for FY2024-2027 above projections.

Verified October 11, 2026

Add-ons and money outside the rate

Paid outside the posted rate

Level

none

Estimate

None recurring. No MCO directed payments were found; the public-facility UPL election (256R.48) is a higher operating rate, and QIIP, PIPP and critical access add-ons sit in the external fixed rate, so all are inside the per diem. The only money outside the rate was one-time in 2023: $173.1M lump sum plus $74.5M workforce incentive grants (with a possible 2029 clawback).

Components

One-time 2023: $173.1M lump-sum payments and $74.5M workforce incentive grants. No recurring off-rate program found.

Source

https://www.revisor.mn.gov/laws/2023/0/Session+Law/Chapter/74/

Verified October 11, 2026

Payments by owner type

Applies

yes

Detail

Publicly owned facilities (city, county, hospital district) may elect a higher operating rate up to the Medicare upper payment limit (Minn. Stat. 256R.48); private homes cannot. Number of electing homes and the size of the gap were not found.

Funding

The local government pays the full nonfederal share (IGT).

Source

https://www.revisor.mn.gov/statutes/cite/256R/full

Verified October 11, 2026

Quality program

Program

Three pieces: (1) VBR quality score sets each facility's care-related cost limit; (2) Quality Improvement Incentive Payment program (QIIP); (3) Performance-based Incentive Payment Program (PIPP).

Funding

Quality-score limit: no separate pool; it decides how much of a facility's own care-related cost is paid. QIIP: statutory pool equal to 0.8% of all operating payments (DHS manual words it as 0.8% of the statewide average operating rate), paid as added Medicaid rate dollars, not a withhold. PIPP: only within funds the legislature appropriates.

Size

QIIP: up to $3.50 per resident day per facility; total about 0.8% of operating payments (no current dollar total found). PIPP: up to 5% of the facility's operating rate. Quality-score limit ranges from 89.375% (score 0) to 145.625% (score 100) of the metro median care-related cost.

Paid as

Quality score: rate ceiling on direct care + other care-related. QIIP: per-diem add-on inside the external fixed rate for one calendar rate year. PIPP: time-limited per-diem add-on in the external fixed rate under a memorandum of understanding.

Measures

Measure	Source	Weight	How points are earned
Minnesota quality indicators (risk-adjusted clinical QIs from MDS, long- and short-stay)	MDS QM (Minnesota-specific QIs computed by DHS)	up to 50 of 100 quality-score points	Points by performance relative to statewide distribution; exact point scale per DHS methodology (not confirmed)
Resident quality-of-life score (annual in-person resident interviews by an independent contractor)	state survey (Minnesota resident QOL survey, 256B.439 subd. 3)	up to 40 of 100 points	Risk-adjusted domain scores; point scale not confirmed
State inspection results score	survey (MDH health inspections)	up to 10 of 100 points	Based on inspection deficiency results; scale not confirmed
QIIP: one facility-chosen topic: a clinical QI, a quality-of-life domain, 30-day or 31-365-day hospitalization rate, or community discharge rate	MDS QM / state QOL survey / state transitions measures	single measure, 100% of QIIP	Full $3.50 for improving one standard deviation from baseline, or reaching the statewide 75th percentile (25th for higher-is-better) if baseline is among the worst; prorated for partial improvement; topics with fewer than 20 eligible residents not allowed
PIPP: contracted outcomes (community discharge/diversion, new technology, Report Card quality, reduced acute-care costs, facility-proposed)	state contract (MOU)	per contract	Payment levels for performance levels set in each MOU

Scoring period

Quality score uses the most recently available Minnesota Nursing Home Report Card data at rate setting for the January 1 rate year (exact periods not confirmed). QIIP for the 1/1/2026 rate year: topic chosen by 7/1/2024; baseline CY2023 (clinical/hospital QIs), 10/2022-9/2023 (community discharge), Oct 2023-Jan 2024 interviews (QOL); improvement period MDS 7/1/2024-6/30/2025 and fall-2024 interviews; paid 1/1-12/31/2026, i.e. about 6-18 months after the measured period.

Payment formula

Quality score: limit = metro median total care-related cost/day x (89.375 + 0.5625 x score)/100; costs above the limit are cut proportionally across direct care and other care-related. QIIP: $3.50/day x share of goal achieved (0-100%). PIPP: per MOU, up to 5% of operating rate.

Eligibility

Quality score applies to every VBR facility. QIIP: all MA-certified nursing facilities with at least one year of baseline data that submit a topic by July 1; no penalty for not improving. PIPP: competitively selected facilities. No immediate-jeopardy or special-focus disqualifiers found in statute.

Cadence

Annual: quality score and QIIP set with each January 1 rate year; a new QIIP cycle starts every July, overlapping.

Scores published

Partly. The Minnesota Nursing Home Report Card (https://nhreportcard.dhs.mn.gov/) publicly shows facility star ratings on quality indicators, quality of life, inspections and staffing. The numeric VBR quality score, care-related limit and QIIP amounts sit on the login-only Nursing Facility Provider Portal; no public file found.

Notes

A 2019 Purdue/University of Minnesota evaluation found no evidence the VBR quality-based limit improved quality; DHS testimony (2019) said 97.5% of facilities' costs were under their limits. Sources: Minn. Stat. 256R.16 subd. 1, 256R.23 subd. 5, 256R.38, 256R.39; DHS QIIP Instruction Manual for 1/1/2026.

Verified October 11, 2026

Provider tax

Charged

per bed

Standard amount

License surcharge per licensed bed per year, paid monthly: $5,900 effective 1/1/2026 or federal approval (was $2,815 through 2025)

Lower for high-Medicaid homes

no

Returned in the rate

Per-resident-day surcharge offset in the external fixed rate: $19.02/day from 1/1/2026 (was $8.86); approved SPA 26-05 shows $19.02 only for 1/1/2026-9/30/2026, then back to $8.86.

Source

https://www.revisor.mn.gov/statutes/cite/256.9657

Verified October 11, 2026

Provider tax notes

Nursing home license surcharge, per licensed bed per year, paid monthly: $2,815 through 2025; raised to $5,900 effective 1/1/2026 or federal approval (Minn. Stat. 256.9657 subd. 1). Returned through the external fixed rate as a per-resident-day surcharge offset: $8.86 before 2026, $19.02 from 1/1/2026 per 256R.25 subd. 2. Approved SPA 26-05 shows $19.02 only for 1/1/2026 - 9/30/2026, then back to $8.86.

Verified October 11, 2026

Supplemental payments

Publicly owned facilities (city, county, hospital district) may elect a higher operating rate, up to the Medicare upper payment limit, with the local government paying the full nonfederal share (IGT-funded; Minn. Stat. 256R.48). Critical access nursing facility time-limited add-ons for isolated areas (256R.47). No MCO directed payments found. One-time state payments outside the rate in 2023 ($173.1M lump sum; $74.5M workforce incentive grants).

Verified October 11, 2026

Other add-ons

First 30 days after admission: total rate +20% (256R.42). Ventilator-dependent: negotiated rate up to 200%/300% of the highest case-mix rate (256R.45). Private room for medical necessity (256R.44). Specialized care facilities: 50% higher care-related limit (256R.46). Special dietary needs (kosher/halal) raw food add-on (256R.51). Border city add-on for Breckenridge/Moorhead nonprofits (256R.481). Single-bed room incentive, 20% phasing down to 0% by 2031 (256R.41). Nursing home employment standards add-on from 1/1/2026: pays the cost of raising workers below Workforce Standards Board minimums (2026: CNA $22.50, med aide $23.50, LPN $27, other $19; 2027: $24 / $25 / $28.50 / $20.50), in the external fixed rate for two rate years, prorated down if appropriation is short (256R.495). Several statute-named facility exemptions (256R.53).

Verified October 11, 2026

Units paid separately

No separate unit-based payment systems; special populations are handled inside the NF rate: (1) ventilator-dependent residents get a negotiated operating rate based on documented extra cost, capped at 200% (admitted before 7/1/2001) or 300% of the facility's highest case-mix rate (256R.45; SPA 20.020); (2) specialized care facilities serving residents with physical disabilities, and a named Robbinsdale Huntington's disease facility, get a 50% higher care-related limit (256R.46; SPA 23.130); (3) statute-named exemptions, e.g. a Golden Valley 44-bed rehabilitation facility and a Red Wing facility paid actual operating cost without the limit or price (256R.53; SPA 23.131); (4) publicly owned facilities may elect a UPL-limited higher rate (256R.48). ICF/DD facilities are paid under a separate system (not covered here).

Verified October 11, 2026

Payment rules

Managed care for long-term care

Status

short_stay

Detail

MSHO / MSC+ plans pay up to 180 days, then fee-for-service

Verified October 11, 2026

Who pays

mixed: fee-for-service plus managed LTSS for seniors (Minnesota Senior Health Options (MSHO) and Minnesota Senior Care Plus (MSC+)); the health plan is financially responsible for up to 180 days of nursing facility care, after which the stay is paid fee-for-service by DHS.

Verified October 11, 2026

Included in the daily rate

Included: room, board, nursing, floor-stock supplies (dressings, incontinence products, gloves, syringes, etc.), drugs not paid on a separate MA fee schedule, nursing technology, consultants/medical director, activities, social services, raw food, dietary, housekeeping, laundry, administration, property. Paid separately: prescription drugs (pharmacy), hospital and physician services, and therapy (PT, OT, speech, audiology, mental health) billed by the vendor or by the facility under Minn. R. 9505.0170-9505.0475, plus covered transportation as an 'ancillary service' (256R.54). Facility-reported therapy cost still sits in the other care-related cost category. Oxygen, lab/x-ray and DME treatment not confirmed.

Verified October 11, 2026

Bed hold

Hospital stays

Paid at 30% of the resident's total payment rate; up to 18 consecutive days per hospitalization episode.

Leave days

Paid at 30% of the total payment rate; up to 36 leave days per calendar year.

Occupancy rule

Paid only if facility occupancy, including bed-hold days, is at least 96% of licensed and certified beds not in layaway.

Notes

Statute sets the 30% and 96% rules (256R.43); the day limits come from Minn. R. 9505.0415 and DHS provider guidance.

Source

https://www.revisor.mn.gov/statutes/cite/256R.43

Verified October 11, 2026

Personal needs allowance

Per month

132

Effective

2026-01-01

Notes

Clothing and Personal Needs Allowance $132 for 1/1/2026-12/31/2026 ($128 in 2025). Minn. Stat. 256B.35 indexes it to the SS/SSI COLA, rounded to the whole dollar; may be increased for garnished child support (up to $250) or spousal maintenance. Other special allowances in EPM Appendix F.

Confidence

confirmed

Source

https://hcopub.dhs.state.mn.us/epm/appendix_f.htm

Verified October 11, 2026

Medicare coinsurance days

Method

lesser_of

Rule

Lesser-of by statute since 7/1/2003. Minn. Stat. 256B.0625 subd. 57a: MA pays a co-payment during a Medicare-covered SNF stay only if the Medicare rate less the resident's co-payment is below the case-mix-adjusted total payment rate under ch. 256R. The amount paid is the excess of that rate over (Medicare rate - co-payment). Health plans paying NF services under 256B.69 subd. 6a (MSHO/MSC+) may apply the same limit. Medicare Advantage: no separate Part C NF rule found. Most NF duals are in MSHO integrated D-SNPs, which can apply the cap (likely).

Effect

The home is paid only if its 256R case-mix rate exceeds Medicare's net per diem, which is rare, so it usually gets $0.

Confidence

confirmed

Source

https://www.revisor.mn.gov/statutes/cite/256B.0625 (subd. 57a)

Medicare Advantage

lesser-of: Minn. Stat. 256B.0625 subd. 57a applies to any 'Medicare-covered skilled nursing facility stay', with no Part A limit. MA pays only the amount by which the 256R case-mix total rate exceeds the Medicare rate less the co-payment. It adds: 'Health plans paying for nursing home services under section 256B.69, subdivision 6a [MSHO/MSC+, the integrated D-SNP plans for duals], may limit payments as allowed under this subdivision.' The MA limit follows from the statute's wording and is permitted, not required, for plans. There is no explicit 'Medicare Advantage' wording.

Medicare Advantage source

https://www.revisor.mn.gov/statutes/cite/256B.0625

Verified October 11, 2026

Required care spending

Applies

no

Rule

No separate spending floor. Direct care and other care-related costs are paid at the home's own reported cost, within a quality-based limit, so spending less simply lowers the rate about 15 months later rather than triggering a penalty. Related wage rule: the nursing home employment standards add-on (from 1/1/2026) funds raises to Workforce Standards Board minimum wages.

Source

https://www.revisor.mn.gov/statutes/cite/256R.23

Verified October 11, 2026

Occupancy rules

Applies

yes

Rule

(1) The FRV property rate (only homes that completed an approved project; five as of 1/1/2024) is divided by capacity days x 0.88 (88% occupancy floor). (2) Bed-hold days are paid only if occupancy, including bed-hold days, is at least 96% of licensed and certified beds not in layaway.

Source

https://www.revisor.mn.gov/statutes/cite/256R.26

Verified October 11, 2026

MDS accuracy penalties

Late or missing MDS: if an assessment is not completed/submitted within 7 days of the deadline, the resident is put in penalty class AAA (index 0.62) and paid at the facility's lowest rate, from admission or the due date until the first of the month after submission; a facility whose penalty losses over 92 days reach 0.1% of total operating costs can ask DHS to limit the penalty (to 10 days for MA residents) (SPA 14.030 D; Minn. Stat. 144.0724). Accuracy audits: MDH audits each facility's assessments annually (every two years after two audits with 5% or less change), using a 15% stratified sample (min 10); more than 20% of classifications changed triggers a second 15% sample, and 35%+ total change can expand to all assessments and more frequent audits. Misclassified residents are reclassified, which changes payment; no separate dollar fine found (144.0724 subd. 9).

Verified October 11, 2026

Published rates and changes

How often rates change

A home's rate changes

annual

When

Jan 1 calendar rate year; each resident's class (and so pay) changes with every assessment

Verified October 11, 2026

When rates change

Calendar rate year, January 1 - December 31, set from the cost report for the year ending September 30 fifteen months earlier. Resident classifications change with each MDS assessment. FRV rates start the first day of the quarter after project completion. 2026 rate notices were delayed pending CMS approval of 2025 legislative changes (SPA 26-05 approved 8/11/2026) and applied back to 1/1/2026.

Verified October 11, 2026

Posted rates

Home-level rates published

No

Where

No public facility rate list found. Each facility receives its rate notice through the DHS Nursing Facility Provider Portal (https://nfportal.dhs.state.mn.us/), which requires a facility login. DHS nursing facility page: https://www.dhs.state.mn.us/id_008996/

Format

none (public)

Cadence

annual (January 1 rate year), with mid-year notices for property/FRV and add-on changes

Verified October 11, 2026

Rate build-ups

Published

No

Where

Per-facility 'notice of rates' is delivered privately through the Nursing Facility Provider Portal (https://nfportal.dhs.state.mn.us/). Not posted publicly; would require a data request to DHS Nursing Facility Rates and Policy Division (DHS.LTCpolicycenter@state.mn.us, 651-431-2282).

What they show

Per House Research and the SPA, the notice computes direct care per standardized day, other care-related per day, the quality-score limit and cost-to-limit ratio, other operating price, external fixed components, property rate, and the resulting rate for each case-mix class. Exact layout not verified.

Verified October 11, 2026

Recent changes

Verified October 11, 2026

Assisted living

Medicaid assisted living

Covered

yes

Program

Customized living and 24-hour customized living under the Elderly Waiver (EW, 1915(c); Minn. Stat. ch. 256S); also under the BI and CADI waivers

What is paid

Services only; room and board is paid by the resident, often with Housing Support (state program, formerly GRH).

Rate

Individual rates set with the DHS customized living rate tool, capped by monthly/daily service rate limits by case mix (24-hour CL limits +4.53% on 2025-01-01); CY2025 floor of $141/day for disproportionate-share facilities

Limits

No statewide waitlist found; per-person budget caps by case mix

Source

https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMI…

Verified October 11, 2026

Sources

1. Minn. Stat. ch. 256R Nursing Facility Rates (full text) · statute
2. Minn. Stat. 256R.23 Total care-related payment rates · statute
3. Minn. Stat. 256R.24 Other operating payment rate · statute
4. Minn. Stat. 256R.26 Property payment rate · statute
5. Minn. Stat. 256R.531 PDPM phase-in · statute
6. Minn. Stat. 256R.43 Bed holds · statute
7. Minn. Stat. 256R.06 Private pay residents (rate equalization) · statute
8. Minn. Stat. 256.9657 Provider surcharges · statute
9. Minn. Stat. 256R.38 / 256R.39 PIPP and QIIP · statute
10. Minn. Stat. 256R.495 Nursing home employment standards rate adjustment · statute
11. Minn. Stat. 256R.23 (2024 version, pre-2025 amendments) · statute
12. Laws 2025, 1st Spec. Sess. ch. 9 (HF 3) · statute
13. Laws 2023 ch. 74 (temporary $12.35 add-on, one-time payments, clawback) · statute
14. Minn. Stat. 256B.69 subd. 6a (MSHO/MSC+ 180 days NF) · statute
15. MN State Plan Attachment 4.19-D (NF), TN 26-05, effective 1/1/2026, approved 8/11/2026 · state plan
16. DHS MHCP Provider Manual - Nursing Facilities · agency page
17. DHS Nursing Facility Provider Portal (login) · agency page
18. DHS Legislative Report: Nursing Facility Rate Study Recommendation Report (May 2025, Myers and Stauffer) · agency page
19. DHS QIIP Instruction Manual for the rate year beginning 1/1/2026 · agency page
20. Minn. Stat. 144.0724 Resident reimbursement classification (MDS schedule, audits) · statute
21. Minn. Stat. 256R.54 Ancillary services · statute
22. DHS Nursing Facility Rate Payment Overview (House committee presentation, 2019) · agency page
23. Minnesota Nursing Home Report Card · agency page
24. MN DHS AASD/DSD eList: Rate and budget changes on Jan. 1, 2025 · agency page
25. Medicare crossover / coinsurance rule · regulation
26. Medicare crossover rule · regulation
27. Personal needs allowance · regulation
28. MN House Research: Nursing Facility Reimbursement (Oct 2025) · secondary
29. MN House Research: Nursing Facility Reimbursement and Regulation (Dec 2023) · secondary
30. LeadingAge MN: Federal Review Slows 2026 Nursing Facility Rates · secondary

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