Hospice Licensure - Minnesota Dept. of Health

Hospice Licensure

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 651-201-4200 or email health.fpc-licensing@state.mn.us 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.

License Application (PDF)

A Guide to Hospice Care Services (PDF)

Background Studies for New Owners (PDF)

Related Statutes and Rules

Minnesota Statutes

144A.75 | 144A.751 | 144A.752 | 144A.753 | 144A.754 | 144A.755

Minnesota Rules

Minnesota Administrative Rules: Chapter 4664, Hospice Services

Hospice Bill of Rights

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)

Thursday, January 13, 2022 at 08:45AM