Minnesota Health Care Programs

1.4.3 State Residency for People in an Institution

There are specific rules that govern state residency for people who reside in an institution. An institution is an establishment that furnishes food, shelter and some treatment or services to four or more persons unrelated to the proprietor. It also includes medical institutions, such as a skilled nursing facility, intermediate care facility for persons with developmental disabilities or an inpatient hospital.

Residency Rules for Certain Populations

The following people who reside in an institution have special rules for determining state residency:

People who reside in a skilled nursing facility (sometimes referred to as a nursing home) under the North Dakota Agreement
People who reside in a state-operated treatment facility under the Interstate Compact on Mental Health and State Operated Services (SOS)
People placed by a state into an out-of-state institution

Unless placed through the Interstate Compact on Mental Health, people who are placed by a state into an out-of-state institution are residents of the state making the placement.

A person who is placed by Minnesota into an institution in another state is a Minnesota resident. A person who is placed by another state into an institution in Minnesota is not a Minnesota resident.

“Placed by a state” means any state agency or entity under contract with the state, including a county agency, which arranges for a person to be placed in an institution located in another state. Providing information to the person or the person’s family does not constitute arranging a placement.

People Age 21 or Older

The state residency for people age 21 or older who reside in an institution is based on whether the person is capable of indicating intent. A person is incapable of indicating intent if they meet any of the following:

Have an I.Q. of 49 or less
Have a mental age of seven or less
Is determined legally incompetent by a court
Is found incapable of indicating intent by a physician, psychologist, or other person licensed by the state in the field of intellectual disability

People age 21 or older who reside in an institution are Minnesota residents if:

They became incapable of indicating intent before age 21, and any of the following apply:
- Their parents reside in separate states, and the parent who submitted an application on behalf of the person is a Minnesota resident. If a legal guardian has been appointed and parental rights are terminated, the state of residence of the legal guardian is used instead of the parent’s state of residence.
- The parent or legal guardian at the time of placement was a Minnesota resident. If a legal guardian has been appointed and parental rights are terminated, the state of residence of the legal guardian is used instead of the parent’s state of residence.
- The parent or legal guardian who submitted the application on behalf of the person is currently a Minnesota resident and the person resides in an institution in Minnesota. If a legal guardian has been appointed and parental rights are terminated, the state of residence of the legal guardian is used instead of the parent’s state of residence.
- The person resides in an institution in Minnesota, has been abandoned by their parents, there is no legal guardian, and the person who submitted the application on behalf of the person is a Minnesota resident.
They became incapable of indicating intent on or after age 21 and are physically present in Minnesota
They are capable of indicating intent, live in Minnesota and intend to reside in the state

People Younger Than Age 21

People younger than age 21 who reside in an institution are Minnesota residents if any of the following apply:

The parent or legal guardian at the time of placement was a Minnesota resident. If a legal guardian has been appointed and parental rights are terminated, the state of residence of the legal guardian is used instead of the parent’s state of residence.
The parent or legal guardian who submitted the application on behalf of the person is currently a Minnesota resident and the person resides in an institution in Minnesota. If a legal guardian has been appointed and parental rights are terminated, the state of residence of the legal guardian is used instead of the parent’s state of residence.
The person resides in an institution in Minnesota, has been abandoned by their parents, there is no legal guardian, and the person who submitted the application on behalf of the person is a Minnesota resident.

Legal Citations

Code of Federal Regulations, title 42, section 435.403

Minnesota Statutes, section 256B.056, subdivision 1

Minnesota Statutes, section 256L.09