Starting a care business in Michigan

LARA's Bureau of Community and Health Systems sorts adult residences by size and population. Homes for adults who are aged, mentally ill, or developmentally or physically disabled, and who need ongoing supervision but not continuous nursing care, are licensed as adult foster care: a family home for 3 to 6 adults where the licensee lives, a small group home for 3 to 12 or a large group home for 13 to 20. Supervised personal care for 21 or more unrelated residents aged 55 or older makes the building a home for the aged, licensed every year. As published on 2026-10-12, that costs a $2,000 initial application fee plus $500 and $6.27 per bed, under a statutory schedule that runs until October 1, 2027. A building that would otherwise need that license can apply for an exemption under MCL 333.21311a instead, if the housing provider and the care provider are unrelated and residents can choose any care provider.

Size also decides which other offices you deal with before you open. An adult foster care home for 6 or fewer adults is a permitted residential use in every residential zone. Above 6, you may first need local zoning approval or a special use permit, and LARA cannot license the home until the Bureau of Fire Services issues a certificate of approval based on sealed plans and an inspection. A home for the aged needs plan approval from the Health Facilities Engineering Section before construction or conversion starts, plus Bureau of Fire Services approval, a bond covering resident funds and a generator that can run for at least 4 hours. Both rulebooks are recent. The adult foster care rules, R 400.601 to R 400.745, took effect November 3, 2025, and the home for the aged rules were amended effective March 19, 2026.

Michigan has no registration-only option for child care. Caring for even one unrelated child in your own home for pay, for more than four weeks a year, needs a MiLEAP license unless it is babysitting that pays under $600 a year (or below the amount that would require the parent to issue a 1099 form). A family child care home takes 1 to 6 children and a group child care home 7 to 12, under home rules rewritten effective April 27, 2026. Outside a private home, a single child under 13 makes the site a child care center. The center rules effective May 7, 2025 set four center types: early childhood, school-age, outdoor nature-based and small capacity (20 or fewer children). Every new center needs a Bureau of Fire Services plan review and fire inspection, and MiLEAP says licensing takes 3 to 12 months on average. Homes and centers both start on a 6-month original license, followed by a 2-year regular license.

Three business types need no state license. The Michigan Department of Education's adult day services fact sheet says there are no state licensing requirements for adult day services. A center that wants to take part in the federal child and adult care food program must meet the state Minimum State Service Standards for Adult Day Care and hold an agreement with its local Area Agency on Aging or MI Choice waiver agent. The Attorney General's consumer checklist calls private-pay non-medical home care an unregulated industry. Agencies that want to bill Medicaid Home Help must be approved by the Michigan Department of Health and Human Services first. LARA says state licensing is not required for home health agencies. An agency that wants Medicare or Medicaid payment must be certified under federal rules, and LARA's Bureau of Survey and Certification does the certification surveys under contract with CMS.