Senior LinkAge Line® Care Transitions

The Senior LinkAge Line® is expanding its service, giving seniors and providers more ways to help older patients live well as they age. Most seniors know about Senior LinkAge Line® Medicare counseling work.

But 2010 was a critical year of partnership for Senior LinkAge Line® when under the direction of the state legislature, specialists started reaching out to nursing home residents who had previously said they wanted to move home.

The initiative, called Return to Community, was so well received that the State of Minnesota funded an expansion to reach more people starting in 2018.  Community Living Specialists have now helped over 5,000 seniors leave nursing homes to their home which for some may be their most recent homestead but for others is an alternative such as assisted living.

Some targeted individuals that the Senior LinkAge Line® is trying to reach with its 2018 expansion include:

1. A person being discharged from a hospital or clinic visit where the practitioner noticed the senior had additional non-medical concerns, such as the following:

    • Caregiver burden
    • Help with finding services
    • Financial
    • Safety
    • Medication assistance
    • Medicare
    • Transportation
    • Memory Concerns
    • Home modifications

2. An individual who has decided not to move to an assisted living facility after discussing all of the options with the Senior LinkAge Line® (referrals are made after a verification code is provided).

3. A person who is on a waiting list to move into an assisted living facility or registered housing with services setting.

4. A patient who has exhausted his or her home care. Someone who you have identified is in need of help but is not a vulnerable adult, those referrals should be made to the Minnesota Adult Abuse Reporting Center.

Alert for people moving in Assisted Living (Registered Housing with Services). 

This new expansion of care transitions does change the required to contact Senior LinkAge Line® for a verification code. For people thinking about moving into a registered housing with services setting, sometimes called assisted living facilities, Senior LinkAge Line® can help you explore your choices and give you information and assistance. This conversation is called long-term care options counseling and is required by Minnesota law. This call can be very helpful, but not everyone needs it. Click here to find out if you or someone you’re helping needs to call.

What services can Senior LinkAge Line® help with?

  • MnCHOICES Assessments

Senior LinkAge Line® can connect you with the free, in-person MnCHOICES assessment available in your county. MnCHOICES can help you see if you qualify for programs that will help you pay for services in the community.


  • Housing resources

Senior LinkAge Line® can help you understand your housing options.

    • Housing with services offers rented housing and purchased health-related services. One company may provide the housing and the services, or several companies may provide some or all of the services. Please note: not all housing with services offer assisted living.
    • Assisted living requirements vary by state. Minnesota’ requirements include those of housing with services plus additional stipulations. Learn more about your rights as a housing tenant and as a client of assistive services.
    • Compare housing services and costs: The Minnesota Department of Health requires each housing facility to complete a Uniform Consumer Information Guide (UCIG) that you can use to compare it to others. They developed UCIG so people can better decide about where and how they live, so they can live independently with dignity, respect and privacy. Visit to search for facilities and look at the UCIG for those you are interested in. 

  • Health insurance counseling

Senior LinkAge Line® can help you find answers to your Medicare and other health care questions, including letting you know what you need to do with Social Security and Medicare if you move from your home. Health Care Choices for Minnesotan on Medicare, guide can help you compare plan options.

  • Community supports

Senior LinkAge Line® can help you connect with community supports like home health care, meal preparation/delivery, transportation, hiring someone to help you bath or dress or help with house and yard work. 

Make a Referral to get help in person:

Phone: 1-800-333-2433
Secure Chat

Fax Forms:
Home Health Care
Registered Housing with Services
Other Providers

More information about Senior LinkAge Line® services, visit