Minnesota in top ranking on AARP's long-term care scorecard

By Patti Cullen, CAE  |  October 6, 2023  |  All members

In its 2023 Long-Term Services & Supports (LTSS) Scorecard, AARP put Minnesota in the No. 1 spot for overall long-term care performance, along with four other “Tier 1” states. This annual report evaluates states’ data regarding the safety, quality, affordability, and access to long-term care services, which includes family caregiving. 

Unlike research that focuses on a particular aspect of LTSS system performance, the scorecard compares state LTSS systems across multiple dimensions of performance, reflecting the importance and interconnectedness each has on the overall LTSS system. 

The AARP Public Policy Institute (PPI) published the first State Scorecard on Long-Term Services and Supports in 2011 and that work continues to the present day with support from The AARP Foundation, The Commonwealth Fund, The John A Hartford foundation and The SCAN Foundation. 

Minnesota (1st) and Washington state (2nd) outperformed all other states in the country, particularly due to strong support for family caregivers, and providing many options in terms of healthcare providers and long-term care settings. The lowest scoring states were in the Southeast, with Alabama and West Virginia ranking 50th and 51st, respectively.

In response to media requests about the #1 ranking for Minnesota, Care Providers of Minnesota President/CEO Patti Cullen said, "We continue to be proud of the LTSS system in Minnesota but also note that we continue to have service gaps that we need to address—in particular appropriate services for seniors with mental illness and seniors with complex medical needs." Cullen added, "Some of the service gaps are due to workforce shortages—there simply aren’t enough workers today to meet the needs of seniors wherever they need services. Promoting LTSS as a preferred profession is a challenge we should all embrace to further improve access to LTSS across the state."

 Key recommendations from the report and AARP to strengthen support for long-term care and aging at home:
  • Prioritizing support for the 48 million family caregivers, who are the backbone of the long-term care system, providing over $600 billion in unpaid care, such as with paid leave, tax credits, and other mechanisms to address health and financial needs
  • Investing in all aspects of home and community-based services infrastructure, such as increasing support and training for home health aides and home visits, supporting the ability to access and use medical devices and equipment, and updating key Medicaid regulations and payment models
  • Bolstering the nursing facility and in-home care workforce, with improved recruitment and training, increasing pay, and expanding the ability of trained nurses, aides, community health workers and other paraprofessionals to take on some aspects of care. States can choose to enact and enforce staffing and related care standards
  • Expanding the use of innovative, effective models for nursing facilities can improve both quality of care and quality of life, such as with smaller facilities and private rooms
  • Addressing inequities by making investments that close the staggering gaps in access to quality care and facilities and staffing shortages
  • Building multisector plans for aging, coalitions and age-friendly health systems, and consider the wider needs to allow individuals to live independently in their homes and communities, such as having affordable and accessible housing and transportation, improved community design, and comprehensive emergency preparedness plans
  • Advancing innovation in cities, counties, and states by supporting comprehensive state- and community-wide aging plans and piloting new approaches and programs, like Green House® Nursing Homes and presumptive eligibility, that can then be scaled
  • Ensuring every state in the nation has a sound emergency preparedness plan to support nursing facility residents, in particular, in times of crisis—including natural disaster 


Patti Cullen, CAE
Patti Cullen, CAE  |  President/CEO  |   pcullen@careproviders.org  |  952-851-2487