By Minneapolis Senior Advisor Care Team · September 25, 2026
Washington County has the highest share of residents 65 and older in the Twin Cities metro, but its licensed senior care communities cluster tightly around a handful of cities. Here's what that means depending on where in the county your parent lives.
The county with the most gray hair in the metro
Washington County is the oldest-skewing county in the Twin Cities metro, and it isn't close. About 18.8% of its roughly 286,900 residents are 65 or older, according to U.S. Census Bureau population estimates and American Community Survey age data -- call it around 53,900 seniors. Compare that to 17.8% in Dakota County, 17.5% in Ramsey, 17.1% in Hennepin, and 17.0% in Anoka. Washington isn't the biggest county on this list. It's the one where a bigger slice of the population is already at the age where a phone call about mom or dad becomes a regular thing.
There's a reason for that, and it isn't a mystery. Much of Washington County's housing was built out during specific waves -- the historic river towns along the St. Croix developed a century or more ago, and the inner-ring communities closer to St. Paul filled in decades before the county's newer growth areas. People who bought homes during those waves are, on average, older today than people who moved into faster-growing, younger-skewing counties like Scott or Carver. The share of seniors in a county isn't random. It's a fairly direct readout of when the housing got built and who has stayed put since.
None of that changes what a family actually needs to do. It just means that if you're searching for care in Washington County, you're doing it in a county where the search is, statistically, more common than almost anywhere else in the metro -- and where the systems set up to help (the county's own aging services office, the regional Area Agency on Aging, the hospitals) are handling more of this kind of call per capita than their counterparts elsewhere.
A county that doesn't look like the rest of the metro
Washington County runs about 423 square miles, and the St. Croix River forms its entire eastern edge, the state line with Wisconsin. That geography produces a county that doesn't have one senior care market -- it has several, strung out along very different terrain. Oakdale and the communities closest to St. Paul feel like an extension of the Ramsey County suburbs. Woodbury, the county's largest city by a wide margin, is newer, denser development built out mostly in the last three decades. Stillwater, the county seat, is a 19th-century river town with a downtown built long before assisted living existed as a category. And beyond that, the county thins out into townships -- Scandia, Marine on St. Croix, May Township -- that are genuinely rural.
That spread matters for a very practical reason: a 20-minute drive means something different depending on which part of the county you start from. A family in Woodbury is a short trip from a dense, newer suburban corridor. A family in Stillwater or one of the river townships is closer, in practice, to western Wisconsin than to most of the Twin Cities' senior care supply. Don't assume the resources you'd expect from a "Twin Cities suburb" are evenly distributed just because a city is technically inside the metro.
Where the licensed communities actually cluster
Our directory currently lists verified senior care communities in five Washington County cities: Woodbury, Cottage Grove, Forest Lake, Oak Park Heights, and Mahtomedi. Woodbury alone accounts for more than half of that supply, spanning independent living, assisted living, and nursing care. That tracks with Woodbury's size -- at roughly 81,500 residents, it's easily the county's largest city -- but it also means the county's senior housing has grown up around one hub rather than spreading evenly.
Oakdale, the county's second-largest city at around 43,600 residents, has comparatively little licensed senior housing showing up in searches, and neither does Stillwater itself, despite being the county seat. That's not a knock on either city -- it's a reflection of where developers have built in the last twenty years. Families searching from Oakdale or Stillwater shouldn't assume nothing exists nearby; they should assume they'll likely need to widen the search toward Woodbury, toward the Highway 36 corridor, or across the county line into neighboring Ramsey County communities like Maplewood or White Bear Lake. See the full list of verified Washington County communities or browse the complete regional directory before assuming your options are limited to one city.
A hospital system mid-transition in the St. Croix Valley
Stillwater's hospital, Lakeview Hospital, is a HealthPartners facility and a Level III trauma center currently located at 927 Churchill Street West -- and it's in the middle of a roughly $400 million rebuild. HealthPartners is constructing a new Lakeview Hospital campus at Highway 36 and Manning Avenue, with an opening targeted for early 2028. The current hospital keeps operating throughout construction, so there's no gap in care, but it's worth knowing if you're evaluating rehab and discharge options in the St. Croix Valley over the next couple of years: ask any community or transitional care unit near Stillwater whether their referral relationships or transport routines are expected to shift once the new campus opens.
The other anchor hospital serving the county is M Health Fairview Woodwinds Hospital in Woodbury, part of the M Health Fairview system that also runs the University of Minnesota Medical Center. Between Lakeview and Woodwinds, most of Washington County has a hospital within a reasonable drive, but families should still confirm which system a specific senior care community coordinates with most often -- discharge planning goes more smoothly when a transitional care unit already has an established relationship with the hospital your parent is leaving. For more on how that 72-hour discharge window actually works in the Twin Cities, see our general hospital discharge guide, and for what a Medicare-covered rehab stay does and doesn't cover, see our Medicare 100-day guide.
Who to call, and it isn't always the state number
If you suspect abuse, neglect, or financial exploitation of a vulnerable adult anywhere in Minnesota, the number to call is the same everywhere in the state: the Minnesota Adult Abuse Reporting Center (MAARC), 1-844-880-1574, 24 hours a day. Call 911 first if someone is in immediate danger. What happens after that call, though, plays out locally. MAARC routes reports involving licensed facilities or home care providers to the appropriate state agency, while reports about a community setting -- someone's own home, for instance -- get assigned to a Washington County Adult Protection investigator.
Washington County's own Community Services division handles that local response, with regular office hours of 8 a.m. to 4:30 p.m., Monday through Friday, and a separate crisis response line, 651-275-7400, for after-hours and weekend emergencies. The county's Community Services offices sit in Cottage Grove, Forest Lake, Stillwater, and Woodbury -- the same four cities, notably, where most of the county's licensed senior housing has grown up. That's not a coincidence; both reflect where the county's population has actually settled. If a facility-specific complaint is about license compliance rather than suspected abuse of a specific person, the correct line is the state's, not the county's: MDH's Office of Health Facility Complaints at 651-201-4200 (metro) or 1-800-369-7994 (greater Minnesota).
Starting an Elderly Waiver assessment through the county, not the state
A common point of confusion: Minnesota's Elderly Waiver and Alternative Care programs are state programs, but the front door to actually get assessed for them runs through your county of residence, not a single statewide office. In Washington County, that front door is the county's Access, Aging & Disability Division, reachable at 651-430-6422 (option 1), by online referral form, or by email intake. A social worker uses the MnCHOICES assessment to determine what a resident qualifies for -- Elderly Waiver, Alternative Care, Community Access for Disability Inclusion, and several other programs all route through the same assessment.
That number is specific to Washington County. A Hennepin County resident calling 651-430-6422 will not get anywhere useful, and the reverse is equally true -- each metro county runs its own intake line for this process. If you're not sure which county line to call, or you'd rather start with a single statewide number that can point you the right direction, Trellis's Senior LinkAge Line at 1-800-333-2433 covers the entire seven-county metro, including Washington County, and can make the warm handoff for you. For the underlying mechanics of what the Elderly Waiver actually pays for -- and what it doesn't -- see our Elderly Waiver explainer.
Two families, same county, different math
Picture two families starting the same search this fall. One has a parent in Woodbury, a short drive from five licensed communities and from M Health Fairview Woodwinds Hospital. Their search is, relatively speaking, the easy version: multiple options close by, a hospital system with an established local footprint, and a county services office a few minutes away.
The other has a parent in a township outside Stillwater. Their nearest licensed communities are a real drive away, their hospital is mid-construction on a new campus that won't open for roughly two more years, and "nearby help" means driving into Stillwater or Cottage Grove rather than walking distance. Both families live in the same county, call the same 651-430-6422 line, and are covered by the same Trellis Area Agency on Aging -- but the actual logistics of their searches look nothing alike. If you're the adult child making these calls, start by being honest with yourself about which version of Washington County your parent actually lives in.
