This page contains information and forms required to make application to operate as a licensed "Hospice" in the State of Minnesota (Effective 9/26/04). These forms are intended for use as reference. They can be downloaded and completed by individuals and organizations seeking to acquire an initial license.
Please do not use these forms to renew a current license. Currently licensed providers will receive separate notification and instructions for licensure renewal from the Department of Health. If you are unsure this is the correct license for your business or have questions, please contact the Licensing and Certification Program at 651-201-4101 or email firstname.lastname@example.org to obtain additional clarification.
Required Forms and Documents
Please read and understand all applicable documents, statutes and rules list below before making application for this license.
Related Statutes and Rules
|Minnesota Statutes||| 144A.75 | 144A.751 | 144A.752 | 144A.753 | 144A.754 | 144A.755 ||
||Minnesota Rules Chapter 4664 (PDF: 367KB/147pages)|
Hospice Bill of Rights
Federal Centers for Medicare and Medicaid Services
Medicare State Operations Manual (Click on Appendices Table of Contents)