Minnesota basic home care license: starting a non-medical home care agency

One license, two levels

Minnesota does not license “companion” or “non-medical” agencies as a separate industry. All paid in-home care falls under one MDH home care license in chapter 144A, issued at either the basic or the comprehensive level. You choose the level on the application ⁠¹. No one may operate, advertise or provide home care services without a temporary or current license. Anyone with authority over the management, operation or control of an unlicensed provider commits a misdemeanor ⁠¹.

The basic level covers “assistive tasks provided by licensed or unlicensed personnel” ⁠¹:

• help with dressing, self-feeding, oral hygiene, hair care, grooming, toileting and bathing;
• standby assistance, defined as being present “to assist a client with an assistive task by providing cues, oversight, and minimal physical assistance” ⁠²;
• verbal or visual reminders to take regularly scheduled medication, including bringing the client medication already set up or in its original container, and the water or food to take with it;
• reminders to do scheduled treatments and exercises;
• preparing modified diets that a licensed health professional has ordered;
• laundry, housekeeping, meal preparation, shopping and other chores, but only if you also provide at least one of the tasks above ⁠¹.

The comprehensive level adds nursing and therapy services, tasks delegated to unlicensed staff by a registered nurse, medication management, “hands-on assistance with transfers and mobility,” treatments and therapies, and help with eating for clients with complicating eating problems ⁠¹. Minnesota law defines hands-on assistance as “physical help by another person without which the client is not able to perform the activity” ⁠². In practice, a client who cannot get from bed to wheelchair without your caregiver taking their weight needs a comprehensive provider. MDH’s sample Statement of Home Care Services for basic providers puts it bluntly: those services “can not be provided with a basic home care license” ⁠⁹. Under a basic license, unlicensed staff may not perform delegated nursing or therapy tasks ⁠¹¹.

Scroll the table sideways to see every column.

If you expect to need nurses or transfer assistance within the first year, note that a temporary licensee can switch from basic to comprehensive before the survey by paying the difference between the two application fees. A switch from comprehensive down to basic earns no refund ⁠⁴. The comprehensive level costs $4,200 for the temporary license and requires additional written policies on nursing assessment, medication and treatment management and delegation ⁠³.

Who needs it, and the exemptions that matter

The license attaches to a “home care provider”: anyone “regularly engaged in the delivery of at least one home care service, directly in a client’s home for a fee” ⁠². Three parts of that definition do most of the work.

Directly. A direct service is one delivered by the provider or its employees, “and not by contract” ⁠¹. MDH looks at seven factors, including who controls when and how services are given, who sets the charges and collects the fees, and whether workers are treated as employees for payroll taxes and workers’ compensation ⁠¹. The application adds that the licensee must provide at least one home care service directly, because “services provided by contract are not direct services” ⁠⁸. A platform that only matches independent caregivers with families should read these factors closely before deciding which side of the line it is on.

Regularly engaged. The factors are whether you promote home care services, whether home care clients are a substantial part of your clientele, and whether the home care is more than “occasional or incidental” to your other work ⁠¹.

In the client’s home. A home care licensee “must not provide sleeping accommodations as a provision of home care services.” Housing combined with assisted living services requires an assisted living facility license under chapter 144G ⁠¹. The basic application asks this question outright. If you answer yes, it sends you to the provisional assisted living application instead ⁠⁸. See the Minnesota assisted living facility license guide.

Section 144A.471 lists exemptions and exclusions. The ones founders most often rely on ⁠¹:

• An individual who performs basic home care services for no more than 14 hours each calendar week to no more than one client is excluded.
• An individual caring only for a relative is excluded.
• A temporary staffing business is excluded if it supplies staff only to licensed or exempt providers and has no direct agreements with clients. So is an independent contractor who works only for licensed providers.
• A business that only assesses needs, refers clients or administers payments is excluded.
• A provider that only does home management and is registered under 144A.482 is exempt. So are providers of Medicaid personal care assistance, and DHS-licensed providers of certain developmental disability services.

Exempt providers must still follow the applicable parts of the home care bill of rights. Excluded ones do not have to ⁠¹⁠⁷. Units of government that provide home care must be licensed like anyone else ⁠¹.

The home management registration, and when you outgrow it

A “home management provider” provides at least two of housekeeping, meal preparation and shopping to someone who cannot do them because of illness, disability or physical condition ⁠¹⁵. If that is all you do, you need an MDH certificate of registration, not a license. It is renewed every year and costs $20 for an individual or $50 for an organization. Each worker must attend an orientation on the bill of rights and on aging within 120 days of starting ⁠¹⁵.

As soon as you add one personal-care task, such as help with bathing or a medication reminder, you are a home care provider and need the basic license ⁠¹⁠¹⁵. A licensed provider does not also need the registration. Employees who only do home management for clients who receive nothing else from you are exempt from most licensing requirements other than the bill of rights ⁠¹⁵.

Before you apply

The application is a statement that your operation is already built. Section 144A.472 requires you to verify that these written policies exist and that you will implement them and keep them current ⁠³:

1. reporting of maltreatment of minors (chapter 260E) and of vulnerable adults (section 626.557);
2. conducting and handling background studies on employees;
3. orientation, training and competency evaluation of staff, and evaluating staff performance;
4. handling complaints from clients, families and representatives;
5. initial evaluation of a client’s needs and of your ability to meet them;
6. initial and ongoing client evaluations, and how changes in a client’s condition are identified and communicated;
7. orientation to and implementation of the home care bill of rights;
8. infection control;
9. reminders for medications, treatments or exercises, if you provide them;
10. tuberculosis screening of staff consistent with CDC standards.

The managerial official in charge of day-to-day operations must initial each item and sign that they have read the home care statutes and the two maltreatment reporting laws ⁠⁸. MDH reviews applications “to determine the applicant’s knowledge of and compliance with Minnesota home care regulations.” It may ask for more documents, a phone call or an in-person meeting, or survey you on site before issuing the temporary license ⁠⁴⁠⁷.

Other items to have ready ⁠³⁠⁸:

• Workers’ compensation. If you have employees, MDH will not issue the license without an active policy naming the applicant as the insured. An application for coverage is not accepted. A sole owner with no employees can check a box promising to get coverage and notify MDH once they hire.
• Liability insurance. It must be documented only “if the provider has it.” The statute does not require it.
• Entity documents. You need the IRS form 147-C showing your federal tax ID. Depending on the entity type, you also need the assumed-name certificate, the certificate of incorporation or articles of organization, a list of owners with their percentage interests, an organization chart and any management agreement.
• Office and service area. The form asks whether your office is in a commercial building, a private residence or another licensed facility, and which counties you will serve. List only counties where you intend to provide services. The statute sets no office or physical-plant standard for basic providers.
• An agent who receives all MDH notices, orders and survey results. An email address is mandatory.

Applying, step by step

1. File in the portal

   Upload the Application for Licensure: Temporary Basic Home Care (revised 09/16/2025) and its attachments to MDH’s Facility and Provider Licensing System ⁠⁸.

2. Acknowledgment

   By statute, MDH acknowledges the application in writing within 14 calendar days and says whether it looks complete ⁠⁴. Incomplete or inaccurate applications may be sent back ⁠⁸.

3. Background studies

   Once MDH confirms receipt, it sends instructions for the studies, which the Department of Human Services runs. All owners and managerial officials must pass before a temporary license issues ⁠⁶⁠⁸. Anyone who has been disqualified under chapter 245C, and not had the disqualification set aside, may not be involved in managing or controlling the agency ⁠⁶. Since August 1, 2022, people holding a health-licensing-board license who passed that board’s check under section 214.075 do not get a separate DHS study ⁠⁷.

4. Pay the fee

   MDH asks for the $2,100 fee through the portal only after it decides the file is complete. If the application is not complete, “MDH will not ask for payment” ⁠⁸. The fee is nonrefundable ⁠³.

5. Decision

   The statute gives MDH 90 days after a complete application to issue or deny the temporary license ⁠⁴. MDH’s own application page says 60 days ⁠⁷. A temporary license is valid for up to one year ⁠⁴.

The temporary year and the initial survey

Minnesota does not inspect before you open. Instead, the temporary license lets you start serving clients while complying with all of sections 144A.43 to 144A.482 ⁠⁴. Expect this sequence:

• Five-day notice. You must notify MDH within five days of starting services ⁠⁴. Failing to notify carries a $1,000 fine ⁠³.
• Unannounced survey. MDH must survey you within 90 calendar days after it learns you are serving clients ⁠⁴. It comes unannounced and on site ⁠¹⁷. Surveyors may phone the day of the visit to make sure someone is there, and may contact or visit your clients with their permission ⁠⁵. By statute, initial full surveys must be completed within 14 months after the temporary license issues ⁠⁵.
• No clients, no license. If you provide no home care services during the temporary year, the license expires and you must reapply ⁠⁴. If you report clients within 45 days before expiry, MDH may extend the temporary license by up to 60 days to finish the survey ⁠⁴.
• Outcome. If you are in substantial compliance, MDH issues the basic license. Otherwise it either terminates the temporary license or extends it for up to 90 days with conditions ⁠⁴. You may ask for reconsideration in writing within 15 calendar days of receiving the correction order ⁠⁴.

What the surveyors check later in routine “core” surveys of basic providers shows what they care about. The list is maltreatment reporting, the bill of rights, the statement of home care services, initial client evaluation, client review and monitoring, service plans, complaints, competency of unlicensed staff, and infection control ⁠⁵. The initial survey is a full survey covering all requirements ⁠⁵.

Client paperwork MDH will ask to see

Before the first visit, give each client the home care bill of rights in writing and get a signed acknowledgment. Also give them a written Statement of Home Care Services, which states that you hold a basic license and lists what you can and cannot do. MDH publishes a sample form ⁠⁹⁠¹⁰. After services start, the clock runs ⁠¹⁰:

• Within 14 days: a written service plan, signed or authenticated by you and by the client or their representative.
• Within 30 days: an individualized initial review of the client’s needs and preferences, held in the client’s residence.
• At least every 90 days after that: monitoring and review. It may be done by phone or video if that meets the client’s needs.

You also need a written complaint policy and a written disaster and emergency plan. You need an individual abuse prevention plan for each vulnerable adult or minor you serve ⁠¹⁰⁠¹⁴. Ending services for a client who still needs care requires at least ten calendar days’ written notice. The notice must state the reason and give contact information for the Ombudsman for Long-Term Care ⁠¹⁰⁠¹⁸.

Section 144A.479 adds business rules that surprise some founders. You may not accept a power of attorney from a client “for any purpose.” You may not serve as a client’s guardian, conservator or representative, or borrow from a client ⁠¹⁴. You may help with paying bills and household purchases, but only with receipts or documentation for every transaction ⁠¹⁴.

Staffing, training and supervision

The basic license does not require a registered nurse. The statute sets these requirements instead:

• Competency before care. Each unlicensed caregiver must either complete training and a competency evaluation, or pass a written or oral test plus a practical skills test. The practical test covers personal hygiene and grooming, standby assistance techniques, and medication, exercise and treatment reminders ⁠¹¹. The 15 required topics also include infection control and blood-borne pathogens, fall prevention, modified diets, boundaries, confidentiality and emergency procedures ⁠¹¹.
• Who trains. For basic services, trainers and evaluators need “work experience and training in providing home care services.” The RN requirement applies only to comprehensive services ⁠¹¹. Contracted individuals and temporary agency staff must meet the same standards as your employees ⁠¹¹.
• Orientation. Everyone who provides or supervises care must complete an orientation to Minnesota home care law, your policies, maltreatment reporting, the bill of rights and complaint channels before serving clients ⁠¹².
• Annual training. Direct care staff need at least eight hours of training every 12 months, including maltreatment reporting, the bill of rights, infection control and your policies ⁠¹². Staff serving clients with Alzheimer’s disease or related disorders need dementia-specific training ⁠¹².
• Supervision. You must have a person available to staff for consultation whenever they are working. Caregivers must be supervised periodically where the services happen, including direct observation ⁠¹³.
• Health screening. You need a tuberculosis infection control program following the most recent CDC guidelines that covers employees, contractors, students and volunteers ⁠¹⁹.
• Background studies are required for every employee, contractor and volunteer, through DHS ⁠⁶⁠⁸.

Keep personnel files with orientation, training, competency, supervision and background study records for at least three years after a worker leaves ⁠¹³⁠¹⁴.

Renewal and the revenue-based fee

A license lasts up to one year ⁠⁴. MDH emails renewal information about 60 to 90 days before expiry, and renewal is filed online ⁠¹⁷. The statute requires the renewal to arrive at least 30 days before expiration ⁠³. You must have provided home care services in the past 12 months. MDH asks for a client service agreement and a billing statement as proof. A provider with no billable home care service in that period “is not eligible to renew” and will be asked to close the license ⁠³⁠¹⁷.

The renewal fee depends on home care revenue from the previous calendar year. Public money counts as revenue ⁠²⁠³:

You may skip revenue reporting by paying the top fee. Knowingly understating revenue costs a civil penalty of double the correct fee ⁠³. A core or full survey with no violations earns a 10% discount on the next renewal fee ⁠⁵. After licensure, MDH surveys at least once every three years, without advance notice ⁠⁵. Violations carry immediate fines: $500 per Level 2 violation, $1,000 per Level 3 incident, $3,000 per Level 4 incident and $5,000 per Level 5 violation ⁠⁵.

Report changes to your application information within ten working days ⁠³. A license cannot be sold or transferred. A new owner, including anyone acquiring 50% or more of the controlling interest, must apply for a new license and pay the same $2,100 fee ⁠³.

Medicaid programs and the integrated license

Two points shape how basic licensees get paid through Minnesota’s public programs.

First, Medicaid personal care is regulated outside chapter 144A. Section 256B.85 says Community First Services and Supports (CFSS) “will replace the personal care assistance program” upon federal approval. It also says CFSS supports “are not considered home care services” under 144A.43 ⁠²⁰. A CFSS agency-provider enrolls with the Department of Human Services under its own rules. These include a $50,000 surety bond at new enrollment and a $20,000 fidelity bond per location. At least 72.5% of CFSS revenue must go to support worker wages and benefits ⁠²⁰. A home care license does not replace that enrollment.

Second, a licensee can add a home and community-based services (HCBS) designation, called an “integrated license.” It lets you provide the basic support services listed in section 245D.03 under your MDH license instead of a separate DHS 245D license. The initial designation fee is $155, and an annual revenue-based fee is added at renewal ⁠¹⁶. MDH warns that the designation does not replace home care. Licensees who do not provide at least one home care service to each client risk having the license denied, not renewed or revoked ⁠⁷. A basic license also cannot be used for Medicare: MDH states that “temporary licensees are not eligible for Medicare certification, nor are basic licensees” ⁠⁷.

For day programs or residential settings instead of in-home care, see the Minnesota adult day services license and adult foster care license guides.

Sources

1. 1
   Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 144A.471: home care provider and home care services (licensure levels, exemptions, exclusions) Checked 12 Oct 2026 · Back to text ↑
2. 2
   Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 144A.43: definitions Checked 12 Oct 2026 · Back to text ↑
3. 3
   Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 144A.472: home care license application and fees Checked 12 Oct 2026 · Back to text ↑
4. 4
   Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 144A.473: issuance of temporary license and license renewal Checked 12 Oct 2026 · Back to text ↑
5. 5
   Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 144A.474: surveys and investigations Checked 12 Oct 2026 · Back to text ↑
6. 6
   Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 144A.476: background studies Checked 12 Oct 2026 · Back to text ↑
7. 7
   Minnesota Department of Health, Home Care Agency Application Materials Checked 12 Oct 2026 · Back to text ↑
8. 8
   Minnesota Department of Health, Application for Licensure: Temporary Basic Home Care (revised 09/16/2025) Checked 12 Oct 2026 · Back to text ↑
9. 9
   Minnesota Department of Health, Statement of Home Care Services: Basic License (MDH sample form) Checked 12 Oct 2026 · Back to text ↑
10. 10
    Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 144A.4791: home care provider responsibilities with respect to clients Checked 12 Oct 2026 · Back to text ↑
11. 11
    Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 144A.4795: home care provider responsibilities; staff Checked 12 Oct 2026 · Back to text ↑
12. 12
    Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 144A.4796: orientation and annual training requirements Checked 12 Oct 2026 · Back to text ↑
13. 13
    Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 144A.4797: provision of services Checked 12 Oct 2026 · Back to text ↑
14. 14
    Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 144A.479: home care provider responsibilities; business operation Checked 12 Oct 2026 · Back to text ↑
15. 15
    Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 144A.482: registration of home management providers Checked 12 Oct 2026 · Back to text ↑
16. 16
    Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 144A.484: integrated licensure; home and community-based services designation Checked 12 Oct 2026 · Back to text ↑
17. 17
    Minnesota Department of Health, Home Care License and Registration Renewal Checked 12 Oct 2026 · Back to text ↑
18. 18
    Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 144A.44: home care bill of rights Checked 12 Oct 2026 · Back to text ↑
19. 19
    Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 144A.4798: employee health status Checked 12 Oct 2026 · Back to text ↑
20. 20
    Minnesota Office of the Revisor of Statutes, Minnesota Statutes, section 256B.85: community first services and supports Checked 12 Oct 2026 · Back to text ↑

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