How to start a home care agency in Ohio (2026)

Criminal records check policy

The one document the license rules call a written policy. Agencies file a copy with the application.

"If the applicant for licensure is a home health agency, a copy of the home health agency's written criminal records check policy;"

Services and related policies

A list of your services and any policies and procedures related to them, if applicable.

"A list of the nonmedical home health services which are or will be provided by the home health agency or nonagency provider and any policies and procedures related to those services, if applicable;"

Days and hours of operation

A statement of your days and hours of operation.

"A statement identifying the days and hours of operation for the applicant;"

Service area

A description of the geographic area you serve.

"A description of the geographic area to be served;"

Secretary of State filings

Copies of everything filed with the Ohio Secretary of State.

"Copies of all documents filed and recorded with the Ohio secretary of state;"

Surety bond

A $20,000 surety bond for any agency not providing direct care on or just before September 30, 2021.

"a surety bond issued by a company licensed to do business in this state in the amount of twenty thousand dollars"

Change notices

Written notice to ODH within 10 days of any change to the information in your application.

"A written notice to the director is required within ten days for the following reasons:"

Renewal calendar

Renew at least 90 days before the three-year license expires.

"An application for license renewal is considered timely when it is made at least ninety days prior to the expiration of the license"

Compliance confirmation

Give ODH written confirmation of compliance when asked.

"The home health agency shall, upon request, provide to the director written confirmation of compliance with the provisions of this chapter"

Telling applicants about checks

Tell each applicant about the background checks when they first apply.

"the chief administrator of a home health agency shall inform each applicant of both of the following at the time of the applicant's initial application for employment"

Six-database check

Check six databases, including the Ohio nurse aide registry, before the criminal records check.

"prior to conducting a criminal records check, the chief administrator or their designee of a home health agency shall conduct, with respect to each applicant for a position involving the provision of direct care and each employee who provides direct care, a check of the following databases:"

Disclosing database findings

Tell the applicant or employee about any disqualifying information found.

"the home health agency shall inform the applicant or employee of the disqualifying information."

Criminal records check and rechecks

A BCI check for every direct care applicant, repeated every five years.

"The chief administrator of a home health agency or their designee shall request that the superintendent conduct a criminal records check with respect to each applicant for a direct care position."

FBI check

Add an FBI check for anyone without proof of five years’ Ohio residence.

"the chief administrator of the home health agency shall request that the superintendent obtain information from the United States federal bureau of investigation as part of the criminal records check of the applicant."

Notices to applicants and employees

Give applicants and employees the notices the rule lists.

"The chief administrator of the home health agency or their designee shall notify each applicant and employee of the following:"

Fingerprint forms

Give each applicant and employee the required forms and a fingerprint impression sheet.

"Provide each applicant and employee a copy of the form or forms prescribed by division (C)(1) of section 109.572 of the Revised Code and a standard fingerprint impression sheet"

Charging applicants for checksif applicants pay for their own check

If applicants pay for their own check, tell them the amount when they apply.

"The home health agency notifies the person at the time of the initial application for employment of the amount of the fee and that, unless the fee is paid by the person, the person will not be considered for employment;"

Staffing agency referralsif staff are referred by an employment service

Referrals from an employment service can skip the check only on the rule’s conditions.

"The home health agency is not required to request that the superintendent conduct a criminal records check of an applicant if the applicant has been referred to the home health agency by an employment service"

Conditional employmentif staff start before results are back

Fingerprints before starting, the check requested within 5 business days, and an end to conditional work if results take over 60 days.

"Chief administrator of the home health agency requests the criminal records check required by rule 3701-60-06 of the Administrative Code not later than five business days after the applicant begins conditional employment"

Hiring decisions

Do not employ anyone with a disqualifying offense in a direct care role, under the four-tier rules.

"no employer shall employ or continue to employ a person in a position that involves providing direct care to an individual if the person has been convicted of, pleaded guilty to, or was found eligible for intervention in lieu of conviction:"

Confidential check reports

Check reports are not public records and go only to the people the rule lists.

"is not a public record for the purposes of section 149.43 of the Revised Code and shall not be made available to any person other than the following:"

Personnel records

Keep check results confidential, sealed within or alongside the personnel record.

"The home health agency shall maintain, in a confidential manner either sealed within, or separate from, but a part of the personnel record:"

Background check roster

A roster of applicants and employees with check dates and results, open to ODH.

"The home health agency shall maintain a roster of applicants and employees, accessible by the director,"

Locked records storageif ODA-certified for Medicaid or PASSPORT

A designated, locked space for records at each business site.

"Each business site in which the provider retains records (e.g., headquarters, regional offices) shall have a designated, locked storage space for retaining records"

Theft and damage claimsif ODA-certified for Medicaid or PASSPORT

Written instructions clients can use to claim for theft or property damage.

"Written instructions any individual may use to obtain payment for loss due to theft or property damage caused by the provider, or if applicable, the provider's employee."

Incident documentation policyif ODA-certified for Medicaid or PASSPORT

A written or electronic policy on documenting incidents.

"The provider shall have a written or electronic policy on documenting incidents which complies with paragraph (B)(3)(b) of this rule."

Electronic visit verificationif ODA-certified for Medicaid or PASSPORT

An ODM-approved EVV system where the rules require one.

"establishes the requirements for certain providers to have an ODM-approved EVV system in place."

Abuse, neglect and exploitation reportsif ODA-certified for Medicaid or PASSPORT

Report to adult protective services and notify ODA within one business day.

"The provider shall also notify ODA or its designee within one business day after becoming aware of the reasonable cause."

Significant changesif ODA-certified for Medicaid or PASSPORT

Tell ODA within one business day of a significant change in a client’s needs or safety.

"The provider shall notify ODA or its designee no later than one business day after the provider is aware of any significant change that may affect the individual's service needs or safety"

Ending servicesif ODA-certified for Medicaid or PASSPORT

At least 30 days’ written notice before ending services.

"The provider shall notify the individual and ODA's designee in writing at least thirty days before the last day the provider provides services to the individual"

Confidentialityif ODA-certified for Medicaid or PASSPORT

Follow state and federal confidentiality law, including HIPAA.

"The provider is subject to all state and federal laws and regulations governing individual confidentiality"

Volunteersif ODA-certified for Medicaid or PASSPORT, and uses volunteers

Supervise any volunteers.

"The provider shall supervise the provider's volunteers."

Person-centered planningif ODA-certified for Medicaid or PASSPORT

Follow Ohio Medicaid’s person-centered planning rule.

"The provider is subject to the person-centered planning requirements in rule 5160-44-02 of the Administrative Code."

Code of conductif ODA-certified for Medicaid or PASSPORT

Written policies requiring staff to meet ODA’s conduct standards, from gifts and tips to phone use and visitors.

"The provider shall have written policies, bylaws, or articles of incorporation (or an electronic record of policies, bylaws, or articles of incorporation) that include requirements for its employees to provide services in a manner compliant with paragraph (B)(8) of this rule."

ODA provider trainingif ODA-certified for Medicaid or PASSPORT

Attend ODA’s mandatory free provider training sessions.

"The provider shall participate in ODA's or its designee's mandatory free provider training sessions."

Records retentionif ODA-certified for Medicaid or PASSPORT

Keep service records six years after payment, and qualification records six years after certification or employment ends.

"Six years after the date the provider receives payment for the service."

Access for reviewersif ODA-certified for Medicaid or PASSPORT

Give reviewers access to policies, procedures and records for every unit billed.

"access to policies, procedures, and records for each unit of service billed."

Table of organizationif ODA-certified for Medicaid or PASSPORT

A chart showing lines of administrative, advisory, contractual and supervisory responsibility.

"A table of organization clearly identifying lines of administrative, advisory, contractual, and supervisory responsibilities."

Employment law attestationsif ODA-certified for Medicaid or PASSPORT

Written attestations on civil rights, equal employment, wage and hour, and tax compliance.

"The provider shall provide ODA or its designee with written or electronic attestations on the following:"

Plan of correctionif ODA-certified for Medicaid or PASSPORT

A plan of correction or evidence of compliance within 10 business days of a review summary.

"Within ten business days after the date ODA's designee issues the summary letter to the provider, the provider shall provide a plan of correction or evidence of compliance"

Staffing before referralsif ODA-certified to provide personal care

Accept a referral only with enough aides and supervisors.

"The provider may accept a referral to provide personal care to an individual only if the provider has adequate staffing levels of PCAs and PCA supervisors"

Back-up planif ODA-certified to provide personal care

A back-up plan for when no aide or supervisor is available.

"The provider shall maintain a back-up plan for providing personal care when the provider has no PCA or PCA supervisor available."

Orientationif ODA-certified to provide personal care

Orientation before any in-person contact, covering seven topics including incidents, emergencies and infection control.

"Before allowing a PCA or other employee to have direct, in-person contact with an individual, the provider shall ensure the PCA or other employee successfully completed orientation"

Annual in-serviceif ODA-certified to provide personal care

Six hours of ODA-approved in-service training every 12 months.

"successfully complete six hours of ODA-approved in-service training every twelve months."

Training recordsif ODA-certified to provide personal care

Keep certificates or other proof of each aide’s training.

"The provider shall either retain copies of certificates of completion earned by each PCA"

Nurse supervisorif ODA-certified to provide personal care

Aides are supervised by an RN, or an LPN under an RN.

"Section 173.525 of the Revised Code allows only an RN or LPN under the direction of an RN to qualify as a PCA supervisor."

Activity plan and supervisor visitsif ODA-certified to provide personal care

A written activity plan with the client, and a supervisor visit at least every 60 days.

"The PCA supervisor shall visit the individual at least once every sixty days after the PCA's initial episode of service with the individual"

Required personal care policiesif ODA-certified to provide personal care

Written policies on job descriptions and on keeping records of each aide’s qualifications.

"The provider shall develop, implement, comply with, and maintain written or electronic policies on all the following topics: (a) Job descriptions for each position."

Visit recordsif ODA-certified to provide personal care

Record arrival, departure, activities and identifiers for each visit.

"The following are the mandatory reporting items that a provider retains for each episode of personal care"