Last updated 2026-07-25
TL;DR
Minnesota licenses group homes through the Department of Human Services (DHS) under the Home and Community-Based Services (HCBS) licensing rules and Adult Foster Care/Community Residential Setting statutes. Expect background studies, a facility health and safety inspection, a program license application, and local zoning review. Most operators start the DHS application and city zoning check in parallel, since both can take months.
What is a group home?
A group home is a licensed residential setting where a small number of people who need support with daily living, whether because of a disability, mental illness, or age-related frailty, live together and receive staff supervision or care on site. In Minnesota, the term overlaps with several licensed categories: Adult Foster Care, Community Residential Setting (CRS), and licensed Adult Day/Residential programs for people with intellectual and developmental disabilities (IDD) or mental illness. Minnesota Statutes chapter 245D governs home and community-based services licensing, and Minnesota Statutes chapter 245A is the umbrella Human Services Licensing Act that DHS uses to license most of these settings [1][2]. If the home also provides housing, the Community Residential Setting license under 245D often sits alongside a housing license issued by the county or DHS Licensing Division. A true group home is not the same as a single unlicensed roommate arrangement. Once a provider accepts payment to deliver a defined set of services (medication management, behavioral support, help with bathing or transfers) to unrelated adults living in the home, Minnesota expects a license. Operating unlicensed when a license is required can trigger a cease-and-desist order and civil penalties under 245A.07 [1]. If you're comparing group homes to other senior housing categories, our assisted living explainer breaks down where the lines blur state to state.
What is assisted living, and how is it different from a group home?
Assisted living is a state-licensed housing-plus-services model, usually built for older adults, that combines an apartment or private room with help for daily activities like bathing, dressing, and medication reminders. A group home is typically smaller, often a single-family house, and more often serves people with disabilities or mental illness rather than exclusively older adults, though senior group homes exist too. Minnesota folded assisted living into a single statewide licensure category in 2021. Minnesota Statutes chapter 144G now requires any provider offering "assisted living services" (a defined list including help with two or more activities of daily living) to hold an assisted living license from the Minnesota Department of Health, not DHS [3]. That's a critical distinction: DHS licenses disability and mental health group homes under 245D/245A, while MDH licenses assisted living facilities for seniors under 144G. Get the wrong agency and you'll lose months. So if your target population is primarily older adults needing housing and personal care, you likely need the MDH assisted living license, covered in our assisted living facility guide. If your population is adults with IDD, mental illness, or substance use disorders living in a small residential setting, you're almost certainly in DHS territory under 245D.
What is an assisted living facility, exactly, under Minnesota law?
Under Minnesota Statutes 144G.08, an assisted living facility is any establishment providing sleeping accommodations to one or more adults and offering, directly or by arrangement, at least one assisted living service, such as help with activities of daily living, health monitoring, or medication management [3]. Minnesota is unusual in that its law applies the same license framework whether the building houses 5 residents or 150. There are two tiers under the law: a standard assisted living license, and an "assisted living facility with dementia care" designation for homes serving residents with Alzheimer's disease or related dementia, which carries added staffing, training, and secured-unit requirements [3]. If you plan to advertise memory care, budget for the dementia care add-on review; MDH inspects those units more closely for elopement risk and staff dementia-care training hours. Applicants file with MDH's Health Regulation Division, not with a county. Application fees and bed-based fee schedules change periodically, so confirm the current fee table on MDH's assisted living licensing page before you budget [4]. For a plain answer to "what is assisted living facility" phrasing variants, see our companion piece on assisted living facilities.
What is assisted living vs nursing home, and does it matter for licensing?
Assisted living is licensed as a residential setting with services layered on top; a nursing home (called a "nursing facility" in most Medicaid rules) is a licensed health care institution that provides 24-hour skilled nursing care and is certified separately for Medicare and Medicaid reimbursement under federal nursing home requirements at 42 CFR Part 483 [5]. Nursing homes have RN coverage requirements, a physician of record, and Medicare/Medicaid certification surveys performed by the state survey agency on behalf of CMS. Assisted living in Minnesota, licensed under chapter 144G, does not require round-the-clock skilled nursing and is not itself a Medicare or Medicaid provider type. Group homes licensed under 245D likewise are not nursing facilities and cannot bill Medicare Part A for room and board. The practical licensing difference: if you want to operate a nursing home, you're filing with MDH for both state licensure and federal Medicare/Medicaid certification, a much heavier process involving Life Safety Code inspections and an OSCAR/CCN provider number from CMS. If you want a group home or assisted living residence, you file only the state license and, if applicable, enroll separately in Minnesota's Medicaid waiver programs for service reimbursement, not facility certification.
What does assisted living provide, day to day?
Under Minnesota's 144G framework, assisted living services can include help with bathing, dressing, grooming, toileting, transferring, eating, medication administration or management, and health monitoring, plus housing, meals, laundry, and activities [3]. Licensees must give each resident a written service plan, referred to in the statute as an "assisted living contract" and coordinated care plan, reassessed at least annually or after a significant change in condition. Minnesota also created a resident bill of rights specific to assisted living settings, spelled out in Minnesota Statutes 144G.91, covering things like the right to receive visitors, the right to voice grievances without retaliation, and required 30-day notice before certain terminations of the housing agreement [6]. If you're writing your policy manual, this statute, more than general elder-rights language, is the one your resident handbook needs to quote directly. Daily staffing has to be enough to meet each resident's assessed needs 24 hours a day, though Minnesota does not set a single fixed staff-to-resident ratio in statute the way some states do; instead it requires staffing sufficient to the acuity mix in the home, verified at inspection through documentation and interviews.
How do I start a group home in Minnesota?
Start by identifying which agency actually licenses your model: DHS for disability/mental health group homes and Community Residential Settings under 245D, or MDH for assisted living under 144G. Confirm this before you sign a lease; the wrong assumption here derails timelines by months. Here's the rough sequence most Minnesota operators follow: 1. Decide your population and service model (245D disability/mental health home vs 144G assisted living for seniors). 2. Confirm the specific program license type with the licensing agency; DHS and MDH both publish provider licensing checklists. 3. Secure a location and check local zoning; many Minnesota cities treat small group homes (6 or fewer residents) as permitted residential uses under state group-home zoning protections in Minnesota Statutes 245A.11, which limits municipalities from treating licensed homes differently from other single-family residences [7]. 4. Complete DHS's Statewide Background Study for every owner, manager, and employee with direct contact, required under Minnesota Statutes 245C [8]. 5. Draft your policies and procedures manual: emergency plans, medication management, staffing plan, resident rights, grievance process. 6. Submit your license application with the required fee (fee schedules vary by license type; confirm the current amount with the DHS Licensing Division or MDH before applying). 7. Pass the pre-licensure health and safety/fire inspection, coordinated with the state fire marshal or local authority having jurisdiction. 8. Receive your license, then enroll as a Medicaid waiver provider if you plan to bill Minnesota's Medicaid HCBS waivers. We built the State Group Home Licensing Kit ($299, one-time) specifically so operators don't have to reverse-engineer this checklist from scratch, it bundles a state-specific application walkthrough, policy manual templates, and a staffing plan template you can adapt to Minnesota's 245D or 144G requirements.
What background checks and staffing rules apply?
Minnesota requires a background study through the DHS NETStudy 2.0 system for anyone with direct contact or access to a licensed program, under Minnesota Statutes 245C.03 [8]. This includes owners, all direct care staff, and often contractors who have unsupervised access. Disqualifying offenses can bar someone permanently or for a set look-back period, and providers can request a variance in limited cases. For 245D disability services, staff must complete required orientation and annual training, including topics like mandated reporting of vulnerable adult maltreatment (Minnesota Statutes 626.557) and person-centered planning [9]. For 144G assisted living, MDH requires dementia care training hours for staff in any facility holding the dementia care designation, plus general orientation on resident rights and service planning documented in the required 144G training log. Staffing levels themselves are outcome-based rather than a single fixed number in most Minnesota licenses: you must staff enough to meet the assessed needs in each resident's individual plan, and inspectors will ask to see your staffing schedule against the acuity of your current residents, more than a headcount rule.
How does Minnesota handle zoning for group homes?
Minnesota Statutes 245A.11 gives licensed residential programs serving six or fewer persons a form of protection against restrictive local zoning: such homes must be treated as a permitted single-family residential use, and cities cannot require a special conditional use permit solely because the home is a licensed group residential setting [7]. This mirrors similar state-level group home zoning protections found across the country and is one of the more operator-friendly features of Minnesota law compared to states that leave zoning entirely to municipal discretion. Homes serving more than six residents, or certain specialized settings, may fall outside this automatic protection and face conditional use review, spacing requirements between group homes, or density caps set by local ordinance. Always confirm current zoning classification and any spacing or density rule with your specific city or county planning department before signing a lease; municipal rules vary widely even though the state floor is consistent. If you're comparing Minnesota's approach to states with weaker zoning protections, it's worth checking our broader state-by-state licensing library for context on how differently this plays out elsewhere.
Does Medicare cover assisted living facilities or group homes?
No. Medicare does not cover room and board in assisted living facilities or group homes, and it generally does not pay for custodial (non-skilled) care of the kind these settings provide. CMS is explicit on this: Medicare covers medically necessary skilled nursing and rehabilitation services, typically in a certified skilled nursing facility for a limited period after a qualifying hospital stay, not long-term custodial care in residential settings [10]. What can help pay for group home or assisted living costs in Minnesota is Medicaid, specifically Minnesota's Medicaid Home and Community-Based Services (HCBS) waivers, such as the Elderly Waiver, Community Access for Disability Inclusion (CADI) waiver, and Brain Injury (BI) waiver, administered by DHS under the state's approved 1915(c) waiver authority [11]. These waivers can pay for services delivered in a licensed group home or assisted living setting, though they typically do not cover the room and board portion, which the resident (or a housing support program) pays separately. Medicaid.gov confirms that HCBS waivers let states "furnish an array of home and community-based services that assist Medicaid beneficiaries to live in the community and avoid institutionalization" [12]. If your business model depends on Medicaid waiver reimbursement, you need a separate DHS provider enrollment process on top of your program license, which our [funding-and-medicaid] resources on the site cover in more depth.
What does the DHS or MDH inspection actually check?
Pre-licensure and ongoing inspections check life safety (smoke detectors, fire extinguishers, exits, sprinkler requirements based on occupancy and resident mobility), sanitation, medication storage, staff files (background study clearance, training records), individual resident files (service plans, health assessments), and required postings like the resident bill of rights. Minnesota conducts licensing reviews on a cycle set by statute and risk level; 245D programs are subject to periodic licensing reviews by DHS, and assisted living facilities under 144G are subject to MDH surveys, with complaint-triggered inspections happening outside the regular cycle whenever DHS or MDH receives a maltreatment report or licensing complaint [1][3]. Common citation areas in practice tend to cluster around incomplete background study documentation, medication administration records missing signatures, staffing schedules that don't match acuity documentation, and expired fire inspection certificates. Building your policy manual around the actual statutory checklist, rather than a generic template, is the single best way to reduce first-inspection findings.
How much does it cost and how long does it take to get licensed?
Minnesota does not publish a single flat statewide fee for every license type; DHS 245D fees and MDH 144G assisted living fees are set on separate schedules and can include an application fee plus an annual or bed-based license fee. Confirm current fee amounts directly on the DHS Licensing Division page or the MDH assisted living licensing page before budgeting, since these schedules are updated periodically by rule and legislative session [4]. Timeline-wise, expect the background study, policy manual review, and pre-licensure inspection scheduling to take a minimum of several months from a complete application, longer if your zoning approval or building code sign-off is still pending. Applicants who submit incomplete paperwork or haven't finished required staff background studies are the most common cause of delay, according to the structure of DHS's own licensing checklist process [8]. Nobody publishes clean average processing-time data across all Minnesota license types, so treat any specific week-count you hear from a consultant or forum post skeptically; ask your regional DHS licensor or MDH reviewer directly for the current queue length when you submit.
Frequently asked questions
What is assisted living?
Assisted living is licensed housing paired with personal care services, like help bathing, dressing, and managing medications, for people who need support but not full-time skilled nursing. In Minnesota it is licensed statewide under Minnesota Statutes chapter 144G by the Department of Health, not the Department of Human Services [3].
What is a group home?
A group home is a small licensed residential setting, often a single-family house, where unrelated adults live together and receive supervision, personal care, or behavioral support from staff. In Minnesota, most group homes serving people with disabilities or mental illness are licensed by DHS under Minnesota Statutes chapter 245D [2].
What is an assisted living facility?
Under Minnesota Statutes 144G.08, an assisted living facility is any establishment offering sleeping accommodations plus at least one assisted living service, such as help with daily living activities, health monitoring, or medication management, to one or more adults [3]. Facilities can also carry a dementia care designation with added training and staffing requirements.
What is assisted living vs nursing home?
Assisted living provides housing plus help with daily activities but not round-the-clock skilled nursing; a nursing home is a certified health care institution providing 24-hour skilled nursing care under federal requirements in 42 CFR Part 483 [5]. Nursing homes can bill Medicare for short-term rehab stays; assisted living generally cannot bill Medicare at all.
What does assisted living provide?
Minnesota's assisted living law lists services including bathing, dressing, toileting, transferring, eating assistance, medication management, health monitoring, meals, housing, and activities [3]. Every resident gets a written service plan reassessed at least annually, and the facility must honor the resident bill of rights in Minnesota Statutes 144G.91 [6].
How do I start a group home in Minnesota?
Confirm whether DHS (245D, for disability/mental health homes) or MDH (144G, for assisted living/senior settings) is your licensing agency, then secure a location, check zoning, complete background studies for all staff, write your policy manual, submit the license application and fee, and pass the pre-licensure inspection before opening.
Does Medicare cover assisted living facilities or group homes in Minnesota?
No. Medicare does not cover room and board or custodial care in assisted living or group homes; it only covers medically necessary skilled care, usually in a certified skilled nursing facility after a qualifying hospital stay [10]. Minnesota Medicaid HCBS waivers can cover services (not room and board) in these settings for eligible residents [11].
What is the difference between a group home and assisted living in Minnesota?
Group homes are usually licensed by DHS under chapter 245D for people with disabilities or mental illness, while assisted living is licensed statewide by MDH under chapter 144G, historically aimed at older adults needing housing plus personal care. The two use different license applications, different inspecting agencies, and different statutory service definitions [2][3].
Does Minnesota require a background check for group home staff?
Yes. Minnesota requires a Statewide Background Study through the DHS NETStudy 2.0 system for owners, employees, and others with direct contact or access in a licensed program, under Minnesota Statutes chapter 245C [8]. Certain disqualifying offenses can bar employment permanently or for a defined look-back period, subject to a variance process.
Can a Minnesota city block a group home through zoning?
Not for homes serving six or fewer residents. Minnesota Statutes 245A.11 requires licensed residential programs of that size to be treated as a permitted single-family use, so a city cannot impose a special conditional use permit purely because the home is licensed [7]. Larger homes may face additional local review, so confirm with your city planning department.
How much does it cost to get a group home license in Minnesota?
There is no single statewide flat fee; DHS 245D fees and MDH 144G assisted living fees run on separate schedules that include application and ongoing license fees. Confirm current amounts directly with the DHS Licensing Division or MDH assisted living licensing office before budgeting, since fee schedules change periodically [4].
How long does Minnesota group home licensing take?
There's no official published average across all license types. Expect at least several months from a complete application, factoring in background study turnaround, policy manual review, and scheduling the pre-licensure health and safety inspection; incomplete paperwork is the most common delay cause according to DHS's own checklist structure [8].
Who inspects group homes and assisted living facilities in Minnesota?
DHS inspects and licenses 245D disability and mental health group homes and community residential settings; MDH inspects and licenses assisted living facilities under chapter 144G. Both agencies also investigate complaints and maltreatment reports outside the regular licensing review cycle [1][3].
Sources
- Minnesota Office of the Revisor of Statutes, Chapter 245A (Human Services Licensing Act): DHS licenses human services programs under chapter 245A, and 245A.07 allows civil penalties/cease-and-desist for unlicensed operation
- Minnesota Office of the Revisor of Statutes, Chapter 245D (Home and Community-Based Services Standards): 245D governs licensing for home and community-based disability and mental health services, including group homes and Community Residential Settings
- Minnesota Office of the Revisor of Statutes, Chapter 144G (Assisted Living): Minnesota's statewide assisted living licensure requirements, definitions, and dementia care designation are set in chapter 144G
- Minnesota Department of Health, Assisted Living Licensure: MDH administers assisted living facility licensing and publishes current fee and application information
- CMS, 42 CFR Part 483 (Requirements for States and Long Term Care Facilities): Federal requirements for nursing facility skilled nursing care and Medicare/Medicaid certification are set in 42 CFR Part 483
- Minnesota Office of the Revisor of Statutes, 144G.91 (Assisted Living Bill of Rights): Minnesota's assisted living resident bill of rights, including notice requirements before termination, is codified at 144G.91
- Minnesota Office of the Revisor of Statutes, 245A.11 (Special Requirements; Residential Programs): Licensed residential programs serving six or fewer persons must be treated as a permitted single-family residential zoning use
- Minnesota Office of the Revisor of Statutes, Chapter 245C (Human Services Background Studies): Minnesota requires a Statewide Background Study for owners, staff, and others with direct contact in licensed programs
- Minnesota Office of the Revisor of Statutes, 626.557 (Reporting of Maltreatment of Vulnerable Adults): Minnesota law requires mandated reporting of vulnerable adult maltreatment, a required training topic for group home staff
- CMS, Medicare.gov: Nursing home care and skilled nursing facility coverage: Medicare covers skilled nursing facility care under specific conditions and does not cover long-term custodial or assisted living/room and board costs
- Minnesota Department of Human Services, Home and Community-Based Services Waivers: Minnesota administers Medicaid HCBS waivers (Elderly Waiver, CADI, Brain Injury) that can pay for services in group home and assisted living settings
- Medicaid.gov, Home & Community-Based Services 1915(c): Federal description of HCBS waivers as a mechanism to furnish home and community-based services and avoid institutionalization