Licensing and Certification
Psychiatric Residential Treatment Facility

This page contains information and forms required to operate as a licensed Psychiatric Residential Treatment Facility (PRTF) in Minnesota. These forms are intended to be downloaded and completed by individuals and organizations seeking to be licensed as a Psychiatric Residential Treatment Facility, or for licensees who need to renew a current license or request a change of ownership.

PRTFs must be in compliance with all applicable state and federal requirements. MDH regulates and oversees PRTFs with surveys and complaint investigations. A PRTF is responsible for submitting notification and construction plans for remodeling projects (see Construction Plan Submittal Process for Healthcare Facilities for more information).

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.HRD-FedLCR@state.mn.us to obtain additional clarification.

• Required Forms and Documents
• Initial State Licensing Process
• License Renewal
• Related Statutes and Rules
• Department of Human Services (DHS) Information on Psychiatric Residential Treatment Facilities
• CMS Resources

Required Forms and Documents

• Application for a License to Operate a Psychiatric Residential Treatment Facility (PDF): Complete and submit this form with payment to apply for an initial license, renew an existing license, or request a change of ownership.
• Example Form: Certificate of Liability Insurance (PDF): Providers are required to submit evidence of workers' compensation coverage with their application; this example shows how the form should be filled out.
• Transfer Agreement:
  • Metro Counties: Community-Wide Transfer Agreement between Hospitals and Related Health Facilities in the Minnesota Seven-County Metropolitan Area (PDF)
  • Non-Metro Counties: Transfer Agreement between a Hospital and a Related Health Facility in Minnesota (PDF)

Initial State Licensing Process

Please read and understand all applicable documents, statutes, and rules listed below before applying for this license. All documentation will be verified before a license is issued.

• Complete and submit the Application for a License to Operate a Psychiatric Residential Treatment Facility (PDF).
• Register with the Office of the Minnesota Secretary of State - How to Register Your Business.
• Once the licensing application and payment is received, MDH will issue a Health Facility Identification (HFID) number and inform the facility.
• Complete the MDH Engineering Construction Plan Submittal Process for Healthcare Facilities.
• Inspections are completed by MDH Engineers and State Fire Marshals.
• The MDH Health Survey Team will coordinate with the facility to schedule the licensing walkthrough. Prior to the walkthrough, the facility must be fully operational.
• After inspections and the licensing walkthrough are cleared, the license for the Psychiatric Residential Treatment Facility is issued.

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License Renewal

Psychiatric Residential Treatment Facility licenses are renewed annually. Licensees will receive a renewal notification approximately 60-90 days prior to the expiration date of the license. If you do not receive a renewal notification within 30 days of the expiration date, please contact Health.HRD-FedLCR@state.mn.us.

• Application for a License to Operate a Psychiatric Residential Treatment Facility (PDF): Complete and submit this form with payment to renew an existing license.
• Example Form: Certificate of Liability Insurance (PDF): Providers are required to submit evidence of workers' compensation coverage with their application; this example shows how the form should be filled out.
• Transfer Agreement:
  • Metro Counties: Community-Wide Transfer Agreement between Hospitals and Related Health Facilities in the Minnesota Seven-County Metropolitan Area (PDF)
  • Non-Metro Counties: Transfer Agreement between a Hospital and a Related Health Facility in Minnesota (PDF)

The completed application, supporting documents, and fee payment can be mailed to:

Minnesota Department of Health
Health Regulation Division
P.O. Box 64900
St. Paul, MN 55164-0900

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Related Statutes and Rules

Read and understand all applicable statutes and rules listed below before submitting the application.

• Minnesota Statutes 144.651 - Health Care Bill of Rights
• Minnesota Statutes 144.652 - Bill of Rights Notice to Patients or Resident; Violation
• Minnesota Statutes 626.557 - Reporting of Maltreatment of Vulnerable Adults
• Minnesota Statutes 144.122 - License, Permit and Survey Fees
• Minnesota Statutes 144.50, Subd. 6. Supervised Living Facility licenses
• Minnesota Rules, Chapter 4665 - Supervised Living Facilities

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Department of Human Services (DHS) Information on Psychiatric Residential Treatment Facilities

The Department of Human Services provides program licensure for Psychiatric Residential Treatment Facility programs in Supervised Living Facilities. Additional information on those programs and requirements can be found on the DHS website: Psychiatric Residential Treatment Facilities (PRTF).

Centers for Medicare and Medicaid Services (CMS) Information on Psychiatric Residential Treatment Facilities

CMS: Psychiatric Residential Treatment Facility Providers

CMS Resources

The Centers for Medicare and Medicaid Services (CMS) provides the following resources:

• CMS Psychiatric Residential Treatment Facility Providers
• CMS Policy & Memos to States and CMS Locations
• CMS Updated Guidance for Emergency Preparedness-Appendix Z of the State Operations Manual (SOM)
• CMS Guidance Related to New State Operating Manual and Appendix N for Psychiatric Residential Treatment Facilities (PRTF)
• CMS Provision of Inpatient Psychiatric Services to Individuals Under the Age of 21(Psych Under 21 Benefit) in Out-of-State Psychiatric Residential Treatment Facilities (PRTFs)
• Quality, Certification & Oversight Reports (QCOR)
• CMS Emergency Preparedness Rule
• CMS Psychiatric Residential Treatment Facilities (PRTF) Frequently Asked Questions (FAQs)