Institutional Residence (Archive)

This section provides guidance on the federal regulations that apply when MA clients enter institutions.

State Residency for MA Clients Living in an Institution.

Age 18 or Older or Under Age 18 and Emancipated.

Under Age 18.

North Dakota Agreement.

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State Residency for MA Clients Living in an Institution

Age 18 or older or under age 18 and emancipated

The state of residence for a client in an institution is the state where the institution is located, in which the client is living indefinitely or intends to remain permanently, unless an exception applies.

Exceptions:

n  An applicant placed in an institution by another state is not eligible for MHCP; the placing state remains the state of residence so the applicant does not meet Minnesota state residency requirements.

Note:  ”Placed in an institution by another state” means any agency of another state and agencies under contract with the state, including a county agency, that arranges for an individual to be placed in an institution located in another state. Providing information to the individual or the individual’s family does not constitute arranging a placement.  

n  The state of residence for an institutionalized client who became incapable of indicating intent before age 18 is the state of residence of:

m At application:

q The parent applying on the client’s behalf; or

q The guardian.

m At placement:

q The parent; or

q The guardian.

Under Age 18

The state of residence for clients living in an institution who are not emancipated is the state of residence of:

n  At application:

m The parent applying on the client’s behalf; or

m The guardian, if parental rights are terminated.

n  At placement:

m The parent; or

m The guardian, if parental rights are terminated.

If the client has been abandoned by his or her parents and does not have a guardian, the state of residence is the state where the client lives.

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North Dakota Agreement

Minnesota and North Dakota have an interstate agreement that governs state residence for people who reside in one state and enter a nursing facility in the other state. The agreement applies only to skilled nursing facilities (nursing homes). It does not apply to any other type of living arrangement such as assisted living, boarding homes, medical hospitals, or receipt of home and community-based waiver services.

l  North Dakota to Minnesota.

A North Dakota resident who moves to a Minnesota nursing facility from North Dakota remains North Dakota's financial responsibility and is not eligible for MHCP’s because the client does not meet Minnesota state residency requirements:

n  for 24 months following the date of admission if the person has no community spouse living in North Dakota and was not placed in the facility by North Dakota, or until such time as a Minnesota state or county agency assumes responsibility for the person’s care, whichever comes first.

n  for at least 24 months following the date of admission and indefinitely after the 24 months as long as the person has a community spouse living in North Dakota, unless a Minnesota state or county agency assumes responsibility for the person’s care.

n  for at least 24 months following the date of admission if the person was placed in the facility by North Dakota and indefinitely after the 24 months, unless a Minnesota state or county agency assumes responsibility for the person’s care.

l  Minnesota to North Dakota.

A Minnesota resident who moves to a North Dakota nursing facility from Minnesota remains Minnesota's financial responsibility:

n  for 24 months following the date of admission if the person has no community spouse living in Minnesota and was not placed in the facility by Minnesota, or until such time as a North Dakota state or county agency assumes responsibility for the person’s care, whichever comes first.

n  for at least 24 months following the date of admission and indefinitely after the 24 months as long as the person has a community spouse living in Minnesota, unless a North Dakota state or county agency assumes responsibility for the person’s care.

n  for at least 24 months following the date of admission if the person was placed in the facility by Minnesota and indefinitely after the 24 months, unless a North Dakota state or county agency assumes responsibility for the person’s care.

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