Exception to the Nursing Home Moratorium

Request for Proposals for Exception to the Moratorium 

At the authorization by the legislature of additional medical assistance expenditures for exceptions to the moratorium on nursing homes, the commissioner shall publish in the State Register a request for proposals for nursing home and certified boarding care home projects for conversion, relocation, renovation, replacement, upgrading, or addition.  

The commissioner of health is now currently accepting written proposals from nursing homes and certified boarding care homes under moratorium exception process, in accordance with Minnesota Statutes, section 144A.073.  

During each biennium, including any carryover of previous appropriations, and for the period from July 1, 2026, to June 30, 2027, the legislative appropriation available to fund additional costs to the medical assistance program associated with projects approved under Minnesota Statutes, section 144A.073, is $7,654,319.  

Projects that do not meet the criteria for the exceptions to the moratorium process may still qualify as “threshold” projects under Minnesota Statutes, section 256B.434, subdivision 4f. Unlike projects approved through the competitive exceptions to the moratorium process, threshold projects are not required to demonstrate that capitalized expenses are related to improvements to the physical plant beyond the replacement of existing components.  

Note: Effective Oct. 1, 2026, Minnesota Statutes, section 256B.434, subdivision 4f permits threshold projects with costs under $2,474,463 to proceed without applying for an exception to the moratorium process.  

Timeline, Review and Approval of Proposals

Facilities interested in submitting a moratorium exception request are encouraged to submit a Letter of Intent by Oct. 19, 2026. Completed proposals must be uploaded to the Minnesota Department of Health (MDH) CloudDrive by 4:30 p.m. Central Standard Time (CST) on Dec. 17, 2026.  

Proposals will be reviewed by the Advisory Review Panel composed of representatives from organizations serving nursing home consumers and providers, professionals in engineering, building construction, or design services, and relevant state agencies involved in long-term care, housing, and finance.  

Applicants will have the opportunity to present their proposals during a virtual public meeting held prior to the panel’s submission of comments and recommendations to the Commissioner of Health. Meeting details, including the date and time, will be provided to the contact person identified in each moratorium exception proposal.  

The Commissioner of Health will approve or disapprove proposals based on criteria established in state law and rule. A final decision will be issued no later than March 26, 2027.  

Application Materials  

Letter of Intent – Exception to the Moratorium on Nursing Homes (PDF)  

Completed proposals should be uploaded to the MDH CloudDrive in 2 separate files:  

1. Application for Exception to the Moratorium on Nursing Homes (PDF), and Engineering Summary Review Form (PDF) 
2. Schematic Drawings Example (PDF)  

Beds per 1000 65+ and 85+ by individual counties and contiguous county groups, June 2026 (PDF)

Previous Awards

Frequently Asked Questions

Check out Exception to the Moratorium Frequently Asked Questions.

Submit questions to health.nhm@state.mn.us.