This page contains information and forms required to make application to operate as a licensed Supervised Living Facility in Minnesota. 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. Providers that are currently licensed 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 651-201-4200 or email health.hrd-fedlcr@state.mn.us to obtain additional clarification.

Required Forms and Documents

Please read and understand all applicable documents, statutes and rules listed below before making application for this license.

Related Statutes and Rules

Department of Human Services (DHS) Information on Supervised Living Facilities

The Minnesota Department of Human Services (DHS) provides licensure for various treatment and rehabilitation programs in Supervised Living Facilities, such as those listed below. Additional information on those programs and requirements for Supervised Living Facility providers can be found on the DHS website at:

Federal Centers for Medicare and Medicaid Services

CMS: Survey & Certification - General Information
Medicare State Operations Manual - Click on Appendices Table of Contents

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