How to start an adult day care center in Minnesota

Minnesota requires a Adult day care center license or family adult day services license under the Human Services Licensing Act from Minnesota Department of Human Services, Licensing Division to operate an adult day care center.

License required

Yes

License

Adult day care center license or family adult day services license under the Human Services Licensing Act

Issuing agency

Minnesota Department of Human Services, Licensing Division

Medicaid waiver coverage

HHS (2014) reported adult day services are paid through the Elderly Waiver for people 65+ and other waivers for younger adults.

Regulation

Minn. Stat. ch. 245A (§245A.02 subd. 2a); Minn. R. 9555.9600–9555.9730

1. Note: DHS is not accepting new adult day care applications during the moratorium (February 1, 2026 to January 31, 2028)
2. During the moratorium, a county, managed care organization or Tribal Nation may request an exception and name a potential provider
3. DHS then invites that provider to apply; the standard review still applies
4. Separate MDH licenses (such as food, beverage and lodging) may also be needed

Program

Minnesota Health Care Programs (MHCP) — Medical Assistance and MinnesotaCare (Minnesota DHS)

Enrollment portal

Minnesota Provider Screening and Enrollment (MPSE) portal

Fiscal agent

None named — Minnesota DHS enrolls providers itself (MPSE/MN-ITS)

Application fee

DHS's Minnesota Revalidate 2026 FAQ refers to a revalidation fee that applies to some providers. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

Minnesota runs background studies through NETStudy 2.0; DHS's revalidation FAQ covers when fingerprints are needed for high-risk revalidation. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

As part of Minnesota Revalidate 2026, DHS does unannounced site visits for high-risk services, including at locations where providers had never had one before. Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

Under the federally directed 'Minnesota Revalidate 2026' effort, providers of 13 services designated high risk had to complete an off-cycle revalidation by May 31, 2026; those who did not got disenrollment notices, with appeal rights. Notices arrive in the MN-ITS mailbox and providers revalidate in MPSE. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Minnesota Medicaid enrollment guide →

CON program

No

Agency

Minnesota Department of Health (moratorium exceptions and public interest reviews)

Moratoria

Hospital moratorium (Minn. Stat. §144.551): no new hospitals and no construction that increases hospital bed capacity or relocates beds, except projects specifically listed in statute (many after a Department of Health public interest review). Nursing home moratorium (Minn. Stat. §144A.071): the commissioners of health and human services must deny requests for new licensed or certified nursing home or certified boarding care beds unless an exception or the moratorium exception process in §144A.073 applies.

Minnesota certificate of need details →

State minimum wage

$11.41 an hour

Effective

2026-01-01

Scheduled increases

Rises to $11.87 on 2027-01-01 (inflation adjustment); 90-day training wage for workers under 20 is $9.68.

Direct-care wage floor

Nursing Home Workforce Standards Board minimum wages for nursing home workers, effective 2026-09-10: general worker $19.00, CNA $22.50, trained medication aide $23.50, LPN $27.00; rising 2027-01-01 to $20.50, $24.00, $25.00 and $28.50.

Rate pass-through

Personal care assistance agencies must spend at least 72.5% of Medicaid PCA revenue on PCA wages and benefits.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Adult day care clinics/centers — active organization NPIs (NPPES)

184 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

1,128,624 (as of Jun 1, 2026)

All Minnesota Home care Medicaid rates, ranked →

• Alternative Care program — Reform: Pathways to Independence Section 1115 demonstration (1115)
• Brain Injury (BI) Waiver (1915(c))
• Community Alternative Care (CAC) Waiver (1915(c))
• Community Access for Disability Inclusion (CADI) Waiver (1915(c))
• Community First Services and Supports (CFSS) (1915(k))
• Developmental Disabilities (DD) Waiver (1915(c))
• Elderly Waiver (1915(c))

Minnesota waivers and waiting lists →