Licensing and Certification
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Health Regulation - Facilities and Professions
- Facility Certification, Regulation and Licensing
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- About Health Regulation Division
This page contains information and forms required to operate as a licensed hospice program in the State of Minnesota. These forms are intended to be downloaded and completed by individuals and organizations seeking to be licensed as a hospice program.
Use the forms below to apply for an initial license, or to renew your current license. Please read and understand all applicable documents, statutes, and rules listed below before applying for this license.
If you are unsure this is the correct license for your business or have questions, please contact the Federal Licensing, Certification, and Registration unit at email@example.com or call 651-201-4200 to obtain additional clarification.
Required Forms and Documents
Application for a License to Operate a Hospice Program (PDF): Use this form to apply for an initial license, or to submit a change of ownership of your license.
Renewal Application for a License to Operate a Hospice Provider (PDF): Use this form to renew your current license.
A Guide to Hospice Care Services (PDF)
Background Studies for New Owners (PDF)
Related Statutes and Rules
144A.75 | 144A.751 | 144A.752 | 144A.753 | 144A.754 | 144A.755
Minnesota Administrative Rules: Chapter 4664, Hospice Services
Hospice Bill of Rights
Translated versions of the documents below are available on the Patient, Resident, Home Care Bill of Rights page.
- Hospice Bill of Rights - Regular Print (PDF)
- Hospice Bill of Rights - Large Print (PDF)
- Combined Minnesota & Federal Hospice Bill of Rights - Regular Print (PDF)
- Combined Minnesota & Federal Hospice Bill of Rights - Large Print (PDF)
Federal Centers for Medicare and Medicaid Services
CMS - Survey & Certification - General Information
Medicare State Operations Manual (Click on Appendices Table of Contents)