Here you will find useful and informative information that could be relevant to our residents and their families at Keystone Bluffs Assisted Living Facilities Duluth, MN.

Help Sheet for Applying for Medical Assistance at Assisted Living Duluth, MN

January 2017

Please note that I am writing this to you as a guide to assist you. I have had many family members voice frustration with me as to the "how's" of navigating through the medical assistance application process at Assisted Living Duluth, MN. I am not an attorney, and this is not legal advice but rather things I have learned over the past 25 years of helping families through the process.

We accept the GRH, Group Residential Housing rent rate which the State of MN determines every summer, for a shared companion room. This means that you can only remain in a private room while on medical assistance, if someone other than the person applying for medical assistance chooses to pay the private room differential for the resident.

1. When should you apply for Medical Assistance, which is generally titled elderly waiver (EW) in assisted living settings?

  1. A good rule of thumb is to call the county phone numbers in the county which you reside 60 days before your assets reach $3,000 as a total balance.
  2. If you do not have care needs as determined by the state, you may be denied access to assisted living, if your needs could be met in another independent setting. The nurse who determines your level of care needs determines this on the LTCC Consultation or MN Choice Assessment. The State of MN wants to make sure seniors are placed in settings which meets their needs.
  3. You can access the medical assistance application through this link:

2. There are two very important steps to make: (1) is to apply for financial assistance and fill out the medical assistance application and call the county financial worker (2) is to call for a LTCC or MN Choice level of care assessment with the county.

  1. The financial eligibility is one aspect of the process, which determines financial need after the county reviews the application completed by the resident/family member. Once the financial edibility is started with the case has to be opened in 60 days, otherwise if paperwork is not completed, the case will go back to day zero and the process for opening medical assistance may be delayed and the resident may have no payer source to pay their bills for care in a setting such as assisted living.
  2. The level of care assessment is something that is a second aspect of the process, and this is done by a separate agency in the county. This level of care assessment determines medical need and is called a LTCC assessment of MN Choice assessment. Once the nurses from the county do the level of care assessment, this is good for only 60 days. This means that the financial team must have all the paperwork they need timely to assure the case is opened for the senior applying for medical assistance.
  3. Once the financial team opens the case, and the nurse determines level of care need to support assisted living need, then the provider can bill the State of MN for the service portion of the cares. It is important to know that the state does not allow back billing, therefore the resident is considered private pay until the county opens the medical assistance case.
  4. Important phone numbers to call for the county you reside in:
    1. For Diamond Willow Residents who reside in Lester Park, Proctor, Mountain Iron and Keystone Bluffs - Assisted Living Duluth, MN Residents they should call 218-733-2725 to apply for financial assistance. Please call 218-726-2366 for a LTCC/MN Choice level of care assessment.
    2. For Diamond Willow Residents who reside in Little Falls, they should call Morrison County at 320-631-3577 and ask for the long term team to assist them with the financial application. Then they should call 320-632-6664 which is public health for the MN Choice application.
    3. For Diamond Willow residents who reside in Alexandria, they should call Douglas County at 320-762-2302, and this is the number to call to apply for medical assistance at Assisted Living Duluth, MN. Then call 320-763-6018 and this is public health nurse line to request a level of care assessment which is known as a LTCC consultation or MN Choices.
    4. For Diamond Willow residents who reside in Detroit Lakes, they should call Becker County at 218-847-5628, and press zero and ask for: The adult service intake team who processes the LTCC Long Term Care Consultation which is known as the MN Choices and this determines level of care need. Then you will need to call back the same number at 218-847-5628, and press zero and ask for the financial team to apply for medical assistance in assisted living.
    5. For Diamond Willow residents in Baxter, they should call Crow Wing County at 218-824-1250, and when they answer it will say Crow Wing County Economic Assistance line. Then there will be a menu of seven choices. Press, number 0 to speak to a county representative. Then it will say to list to four more choices, then press 4 to speak to a county representative. Please let them know you need to apply for medical assistance and you reside in assisted living. Then call 218-824-1140 to schedule a LTCC screen/MN choice assessment which determines the level of care need.
    6. For Diamond Willow residents in Grand Rapids, they should call Itasca County at 218-327-6706 or 218-327-6146 and let them know you need to apply for financial assistance and you reside in assisted living. You also need to let them know you need a LTCC/MN Choice screen from a nurse to determine the level of care need of the person who is applying.
    7. For Diamond Willow residents in Park Rapids, they should call Hubbard County at 218-732-2453 and let them know you need to apply for financial assistance and you reside in assisted living. You also need to let them know you need a LTCC/MN Choice screen from a nurse to determine the level of care need of the person who is applying.

3. Other things to be aware of:

  1. It is important to know that your monthly income is a completely separate thing from your total assets when applying for medical assistance at Assisted Living Duluth, MN. I Therefore, assets can be a variety of items such as savings, checking, stocks, bonds, commercial or residential property, land etc. as just a list of some common examples.
  2. If you are a married couple, the county will do an assessment to determine your eligibility and sometimes one person remains in their home and one person needs a higher level of care. Sometimes both people need a higher level of care and the county has a formula for this which the state has set forth.
  3. The look back period is 60 months before the date of applying for medical assistance at Assisted Living Duluth, MN (elderly waiver), therefore if assets are transferred outside of this time period there may be a disqualification period to match the amount of money transferred. This is something the county would determine when doing the application for medical assistance.
  4. Have you had a Long term Care Consultation? This is what is also referred to as MN choices which determine that the applicant has care needs which the assisted living provider offers.
  5. If the county determines you have a high monthly income as defined by the State of Minnesota, you may have what is called a "Spenddown or waiver obligation". What this really means is that in addition to the amount you pay for your rent, which is currently $891 per month for a shared room when on medical assistance, then you are personally responsible to pay an additional amount of money from your monthly income to the provider monthly. This is what "spenddown or waiver obligation means". If you have a spenddown or waiver obligation, the state reduces the amount they pay the provider for the services, because the resident has a high monthly income and can afford to pay a higher portion.
  6. During the time you are applying for medical assistance, the resident is responsible to continue paying the provider monthly to avoid an eviction notice. All residents are considered private pay until they are opened on medical assistance.

4. Some items to gather early for records the state will want to review

  1. Recent bank statements of balances
  2. Real estate property tax statements, and documents showing amount owed against property
  3. Burial contracts and the name of the company or funeral home that holds the contract
  4. Other assets such as bonds, trust, stock ownership, annuities, etc. and you must have the current statement with any balance owing against asset.
  5. Other


At Keystone Bluffs Assisted Living, seniors must have self-preservation skills. As a Licensed Nursing Home Administrator, I helped design a NEXT STEP for those who no longer have self-preservation skills. Convalescent Home Duluth, MN caters to seniors who do not have self-preservation skills. Here are some examples of seniors who do not have self-preservation skills:

1. The ability to pull their call light or call pendant for unscheduled services. This means a change of condition where they feel they need further assistance. The aides and nurses come into their room for scheduled events (medication administration, shower assistance etc.) In Between these times, a senior must be able to alert Keystone Staff for any change of condition for additional needs.

2. If a senior is no longer able to independently feed themselves. At Keystone Bluffs Assisted Living we do not feed seniors in their apartment or in the common dining room.

3. If a senior has a change in mental status where they exhibit qualities that become disruptive to their neighbors and or display qualities that may put themselves or others at risk of injury. Some examples may include:

  • Wandering down the hallway knocking on neighbors doors during the night when most are sleeping.
  • Smoking in the building.
  • Communicating to staff they will walk out of facility to find their home, or they impulsively act on leaving facility without notifying staff. There are log out books at both entrances for seniors to communicate if they are leaving property so Keystone Bluffs is not on "alert" for a missing person. However, if Keystone Bluffs has reason to believe a resident's safety is at stake, they will contact family immediately. (For example..... resident is walking outside in winter without proper clothing and could freeze, resident mental status changes and walking off property to Trinity Road could put them in harm's way.)
  • Keystone Bluffs Assisted Living is not a secure setting for those with advancing memory care needs. Keystone Bluffs Assisted Living does not provide 1:1 cares to assure seniors do not leave property and put themselves at risk.
  • A sudden change of condition where the senior is bed bound, or can't come to dining room for meals.

4. If for any reason a senior at Keystone Bluffs Assisted Living requires a NEXT STEP, Diamond Willow Advanced Care Assisted Living homes was designed for them. Diamond Willow Advanced Care Assisted Living was designed as a mini-Keystone Bluffs with the best features of Assisted Living and fewer people under a roof for higher care needs. My own grandma spent several years at Keystone Bluffs Assisted Living, until becoming bed bound with shingles. With a new change in condition her COPD increased, and her mental status declined. Therefore in June of 2004, my own grandma was the first admitted to our Diamond Willow care model. Now all Keystone Bluff seniors have priority admission over the general public to Diamond Willow should they need a higher care level. Diamond Willow is conveniently located in Duluth-Lester Park, Proctor and Cloquet. When higher care needs occur, I am a firm believer that a smaller setting is best. Diamond Willow Assisted Living website