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Federal Certification - Health Care Facility and Provider Database
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Related Sites
Supervised Living Facility Licensure
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.
- License Application (PDF)
- Transfer Agreement - 7 County Metro (PDF)
- Transfer Agreement - Non Metro Counties (PDF)
Related Statutes and Rules
- Minnesota Statutes 144.651
- Minnesota Statutes 144.652
- Minnesota Statutes 626.557
- Minnesota Statutes 626.558
- Minnesota Statutes 144.122 - License, Permit and Survey Fees
- Minnesota Statutes 144.50, subd. 6
- Minnesota Rules 4665
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:
- Detoxification Programs
- Chemical Dependency Treatment Program
- Residential Facilities for Adults with Mental Illness
- Intermediate Care Facilities (ICF/DDs)
- DHS Provider Enrollment
Federal Centers for Medicare and Medicaid Services
- CMS: Survey & Certification - General Information
- Medicare State Operations Manual - Click on Appendices Table of Contents