How to start a home care agency in Oklahoma (license, RN and administrator, 2026)

Personal care means "assistance with dressing, bathing, ambulation, exercise or other personal needs" (63 O.S. 1-1961(9)), and the rule explains that personal needs means "assistance with activities of daily living such as getting out of bed, ambulation, exercise, toileting, dressing, eating, or bathing. Personal needs do not include domestic or maintenance services provided on a fee basis to maintain the home." (OAC 310:662-1-2) Any organization giving that help for a fee, at clients’ homes, needs the home care agency license. There is no separate personal care license: the same license covers skilled care.

• Advertising counts. "It shall be unlawful for any agency not licensed in accordance with the Home Care Act to advertise or otherwise offer personal care, companion or sitter services, home care services, to use the title "home care agency", "home health agency", or "senior care agency"" (1-1972(E)) Offering personal care or home care without a license is a misdemeanor, with a fine of $500 to $5,000 per offense (1-1972(D)).
• Referrals. Hospitals, nursing homes, assisted living, home care and hospice providers, physicians, APRNs, PAs and state agency employees may not refer clients for personal care or companion services "except to an agency licensed to provide such services" (1-1962(B)). So an unlicensed agency also loses its referral sources.
• Nurse registries. "A nurse registry which provides home care services shall function and be licensed as a home care agency." (OAC 310:662-3-4(h))

The eleven exemptions

Since August 11, 2025 the rule repeats the statute’s list: "The provisions of the Act and promulgated rules shall not apply to" (OAC 310:662-2-1(e)):

1. A person acting alone who provides services in the home of a relative, neighbor or friend.
2. A person who provides maid services only (2-1(e)(1)-(2)).
3. Nurse or aide services run by and for a religious denomination that relies on prayer alone for healing.
4. Hospice providers under the Oklahoma Hospice Licensing Act.
5. A nurse-midwife (2-1(e)(3)-(5)).
6. Developmental disability waiver and DHS developmental disability contractors, only for the services under those contracts.
7. CD-PASS providers, only for those contracts, and still subject to the background check.
8. An individual who only provides Medicaid home- and community-based care under an OHCA contract (2-1(e)(6)-(8)).
9. An RN-trained personal care worker employed by a licensed agency (our reading: the worker is exempt from aide certification, not the agency; see caregivers) (2-1(e)(9)).
10. A VA-approved medical foster home caring for three or fewer veterans (2-1(e)(10)).
11. A certified nurse aide (our reading: this lets a CNA work as an aide without home health aide certification; it does not exempt an agency that employs CNAs) (2-1(e)(11); 63 O.S. 1-1962(D)(11)).

Separately, the statute’s definition of a home care agency leaves out individuals who contract with DHS to provide personal care (they still need home health aide certification), OHCA intermediary services organizations for CD-PASS, CD-PASS employer participants and "PACE organizations as defined by 42 C.F.R., Section 460.6" (1-1961(5)(a)-(d)). Read the full text before relying on any exemption.

Oklahoma licenses companion and sitter services separately, under 63 O.S. 1-1972 and Subchapter 8 of OAC 310:662. "Any agency, employer, employee, or designated agent thereof that provides, offers, or advertises companion or sitter services shall become licensed with the State Department of Health pursuant to the Home Care Act." (63 O.S. 1-1972(C)) Section 1-1972 does not apply to people exempt under 1-1962 or to an individual who is not employed by an agency (1-1972(F)), but Subchapter 8 says no agency or person may run a sitter or companion service without a license (OAC 310:662-8-1). Our reading: if you will work alone, ask OSDH which applies. A companion or sitter gives "assistance with household tasks, shopping, meal preparation or planning, and provision of fellowship and other nonpersonal care for the individual including transportation, letter writing, socialization" (1-1972(A)(1)).

• No hands-on care. OSDH’s guidance letter says: "This license allows no hands-on services to be provided" (Sitter or Companion Service guidance letter). Bathing, dressing, toileting and other personal care need the home care agency license.
• Or under a home care license. "An entity that holds a valid license as a home care agency under the Home Care Act and meets the requirements of this section may provide companion or sitter services in addition to home care services under an existing license." (1-1972(H))
• A supervisor, not a nurse. The application names "the individual responsible for supervision of the companion or sitter services that meets the requirements of the Act and evidence of current licensure and/or training as appropriate" (OAC 310:662-8-2(a)(3)). Subchapter 8 names no nurse and no certified administrator.
• A plan of delivery. "Each initial application shall be accompanied by a plan of delivery that describes the scope and range of companion or sitter service available to clients and their families as well as a description of the system of record keeping that meets the requirements specified in the Act." (8-2(b))
• Insurance and office. Workers’ compensation and liability cover of at least $100,000 per occurrence and $300,000 aggregate (8-2(a)(4)-(5)), and "a a place of business which is accessible to the public and physically located in Oklahoma" (8-4).
• Fees (state fees). $1,000 initial and $500 renewal, both nonrefundable; the license expires one year after issue on the last day of the month of issue. (8-2(c), 8-3(a)) These are OSDH’s fees, not CareRulebook prices.
• Individual Service Plan. "The individual responsible for supervision of the companion or sitter services shall prepare an Individual Service Plan at the time of the initial evaluation." It is shared with the caregiver before or when care starts and reviewed at least every six months (8-7).
• Records. Client names, addresses and services, the "duties performed for each day of service", and background checks meeting the nurse aide criteria (1-1972(B)(7)). "Each companion or sitter service shall maintain a copy of each background check that is conducted on an agency employee to meet the requirements of the Act." (8-5)
• A survey. "Upon receipt of a complete application and review of the documents, a survey will be conducted to verify compliance." (OSDH guidance letter) After a complaint investigation, a service found out of compliance may ask in writing, within ten days, for a certified mediator (8-9).

Our reading: Subchapter 8 sets no written-policy duties, no training hours and no nurse. The documents it asks for are the plan of delivery, the record keeping description and the Individual Service Plan. Whether other parts of Chapter 662 (such as the client rights statement) reach a companion-only licensee is not settled; ask OSDH. OSDH’s July 2026 directory lists 26 companion and sitter licenses, against 370 home care agency licenses (OSDH directory, our count).

OSDH’s guidance says: "Please complete the enclosed ODH Form 757 and return it to this office with the required attachments, accompanied with the appropriate non-refundable fee of $1,000.00 for each home care agency." (Home Care Application Guidance) The guidance letter and ODH Form 757 ask for:

• your certificate of incorporation or LLC, and the trade name report if you use a DBA;
• liability insurance and workers’ compensation (attachment C);
• the administrator’s certification, and the supervising RN’s and alternate RN’s licenses (attachments D to F);
• ownership and affiliation disclosures for the applicant and every affiliated person, including anyone owning or controlling more than 5% of the debt or equity (63 O.S. 1-1965(C); attachments H and I: ODH Form 757 items 12 and 13), and the compliance history of everyone with ownership, operational, management or supervisory authority (OAC 310:662-2-1(c)(6));
• financial solvency: "a bank statement, letter of credit or a line of credit from your financial institution may be submitted as proof of financial ability to operate" (attachment K);
• staff availability: "Staff Availability (estimated number of monthly visits for first six months and list of types and number of staff to perform those visits)" (attachment L);
• a "Plan of Delivery (scope & range of service)" (ODH Form 757, item 2).

The form asks for office hours and an after-hours number, and "the after hour telephone number must be available during non-business hours" (ODH Form 757, instructions item 7). The signer certifies "I am not less than twenty-one (21) years of age; of reputable and responsible character" (signature block). OSDH may deny a license for failing a minimum standard or for a listed conviction of the applicant or an affiliated person (63 O.S. 1-1965(D)).

No services before the license. "It is a violation to provide home care services prior to receiving a license; and carries an administrative penalty of up to $10,000.00" (Home Care Application Guidance) That is a penalty, not a fee.

• The statute allows more. The Act allows an initial fee of up to $3,000, limited to OSDH’s reasonable costs; the rule sets $1,000 (63 O.S. 1-1965(B)(1)).
• The prorated first renewal. An initial license runs 12 months, and one that does not end on July 31 is renewed so the renewal license expires on July 31 (OAC 310:662-2-1(g)(2)). "The fee for each quarter or portion thereof shall be one hundred twenty-five dollars ($125.00) for each parent agency or subunit license" (2-1(d)(4)). So the first renewal costs between $125 and $500, depending on the month you are licensed (our arithmetic).
• The administrator. $140 for the initial certificate (with an OSBI arrest check from the last 60 days); $80 for deeming or a 6-month provisional certificate; $55 to renew each year. (OAC 310:664)
• Background checks. The employer pays OSDH $19 per applicant submitted for fingerprinting or monitoring; the applicant pays a $10 administrative fee when fingerprinted. People already monitored in OK-SCREEN are not fingerprinted again. (63 O.S. 1-1947(J))
• Change of ownership. ODH Form 757 shows $500; OSDH’s change of ownership letter lists $1,000. The rule set $500 until August 11, 2025 and now sets none, so ask OSDH before paying (CHOW guidance).
• Insurance. "Proof of liability insurance coverage of at least one hundred thousand dollars ($100,000.00) per occurrence, three hundred thousand dollars ($300,000.00) aggregate. Each agency shall maintain at least this level of coverage." (OAC 310:662-2-1(c)(5)) Plus workers’ compensation (application guidance). We found no surety bond.
• Penalties (not fees). Up to $100 per violation per day, capped at $10,000 for any related series of violations (63 O.S. 1-1966).

Your other costs are your own: the office, the RN (employed or contracted), insurance, the administrator’s course, and caregiver training.

The supervising RN, even for personal care only

Oklahoma’s rules give a registered nurse a role in every personal care agency. What the rules require:

• A supervising RN or physician. "An agency providing personal care only shall employ or contract with a supervising physician or registered nurse who shall be available to the agency to advise the client care staff whenever personal care is provided." "Services of a supervising physician or registered nurse in an agency only providing personal care may be provided on an on-call basis." (OAC 310:662-3-4(d))
• An alternate, in writing. "A physician or a qualified registered nurse alternate shall be designated in writing to serve in the supervising registered nurse's absence." (3-4(d)) OSDH asks for both nurses’ licenses with the application and license verification at each renewal (renewal letter).
• The initial assessment at home. "An initial assessment shall be performed in the client's residence by a physician, non-physician provider, registered nurse or qualified therapist as indicated by the service to be provided." "The initial assessment shall occur prior to, or at the time that home care services are initially provided. The assessment shall determine whether the agency has the ability to provide the necessary services in the home." (5-1(a)-(b))
• The plan of care. "If only personal care is provided, the physician, non-physician practitioner or registered nurse shall prepare a plan of care at the time of initial assessment." It is developed with the client or representative, and "it shall be reviewed and updated by the registered nurse and all appropriate staff involved in care delivery at least every six (6) months" (5-2(a)). "The plan of care for the client shall be communicated to the caregiver prior to or at the time of the delivery of non-skilled care."
• Supervisory visits. "When only home health aide or personal care services are furnished to a client, a physician or a licensed nurse shall make a supervisory visit to the client's residence at least once every six (6) months." "The frequency of supervisory visits shall be increased if the acuity of the client's illness requires more frequent visits." (5-3(g)(3)) "Appropriate supervision shall be available during all hours services are provided." (5-3(g))
• RN-trained workers. If you use the RN-trained route instead of certified aides, an RN employed by the agency writes the training plan, and an RN trains continuously and visits on site at least every three months (see caregivers).
• No physician order for personal care. The Act says the order rules "shall not prevent an agency from providing personal care to a client without a healthcare provider’s order" (63 O.S. 1-1964(8)). Skilled care is different: "Skilled care shall not be provided by any agency, agency employee, or agency contractor unless and until the agency receives a physician's or non-physician practitioner's order to provide skilled care." (OAC 310:662-5-1(c))

The rule also lets a physician or a "non-physician provider" do the initial assessment, and a "non-physician practitioner" write the plan of care, but the 2025 amendment struck the rule’s definition of that term. Our reading: for a personal-care-only agency the RN does this work in practice; ask OSDH before relying on a nurse practitioner or physician assistant (see where the sources disagree).

The certified administrator

• A certificate is required. "It shall be unlawful and a misdemeanor for any person to act or serve in the capacity as a home care agency administrator unless such individual is the holder of a certification as a home care agency administrator" (63 O.S. 1-1962a(D)) Proof of certification goes with every application and renewal.
• Duties. "The governing body shall be legally responsible for the appointment of a qualified administrator and the delegation of responsibility and authority." The administrator directs the agency’s functions, employs qualified staff, ensures in-service, continuing education and evaluations, and "ensure the accuracy of public information materials and activities, and that agency practices are consistent with written agency policies." (OAC 310:662-3-4(c))
• How to qualify. "Successfully completing a Department-approved preparedness program and the OHCAPA"; OSDH says the preparedness program "is a 160 hour course" (administrator registry page). Or be deemed and take the exam, for example as a "Registered nurse in the State and with at least one (1) year of full time experience in home care within the immediate past two (2) years" (OAC 310:664-3-4(4)). Other deeming routes include a degree plus that experience (310:664-3-1, 3-4).
• Provisional certificate. "An individual may function as an administrator no longer than six (6) months with a provisional certificate" (310:664-3-6(a))
• Limits and upkeep. "A home care administrator shall not function concurrently at more than two (2) agencies or subunits." (310:664-1-3) The administrator completes "at least twelve (12) hours of continuing education each year by July 31", no more than 6 hours by home study (310:664-9-2). The certificate is posted at each licensed agency (310:662-3-4(c)).
• Changing the administrator. ODH Form 757 has a no-charge Change of Information application, and its instructions ask for the certified administrator’s certificate and proof of experience on a new application or a change of administrator. We found no deadline for telling OSDH. (ODH Form 757)

In the Home Care Act, “home health aide” means "an individual who provides personal care to clients in their temporary or permanent place of residence for a fee", whatever the job title (63 O.S. 1-1961(7)). Your personal care staff take one of three routes:

• Certified aides. "No employer or contractor, except as otherwise provided by this subsection, shall employ or contract with any individual as a home health aide for more than four (4) months" unless they are certified and on the registry, or a licensed health professional (1-1962(C)(1)). The course is "At least seventy-five (75) hours of training or the equivalent", with at least 16 hours of classroom training before at least 16 hours of supervised practical training (OAC 310:677-9-3 to 9-5).
• Each year. The agency must "complete an annual performance review of each home care aide and provide at least twelve (12) hours of in-service training each calendar year." In-service is "generally supervised by a registered nurse who has at least two (2) years nursing experience with at least one (1) year of which shall be in the provision of home care" (310:677-9-1(a)). An aide who has not done at least 8 paid hours of nursing or health-related work in 24 months must retrain or retest (9-1(c)).
• Nursing home aides. "An individual who is listed in the nurse aide registry as a long term care aide may be employed by a home care agency upon successful completion of a Department approved home care skills examination" and at least 16 hours of orientation to the agency’s population (310:677-9-2(b)).
• The RN-trained route. Since 2021 a worker who "is employed by a licensed home care agency exclusively to provide personal care services in the home", has no disqualifying convictions, is continuously trained by an RN for the client’s needs, and "is supervised by a registered nurse via an on-site visit at least once every three (3) months or sooner if the client experiences a significant change in health condition", falls outside the Act (1-1962(D)(9)). The worker also "has demonstrated competency in a written training plan developed by a registered nurse employed by the home care agency". The plan covers at least observation, reporting and documentation; a clean, safe, healthy environment; emergencies; bathing, grooming and toileting techniques; meal preparation and food safety; client rights, privacy and property; and hand hygiene and standard precautions. (1-1962(D)(9)(e))
• Supportive home assistants. Subchapter 6 (supportive home assistant competency testing) was revoked effective August 11, 2025, and the rules no longer define or mention supportive home assistants. The statute still defines them (63 O.S. 1-1961(12)); ask OSDH before using the title. (OAC 310:662 Subchapter 6)
• All staff. Orientation to the agency’s policies and objectives, and in-service programs, are part of the personnel policies (OAC 310:662-3-4(e)(2)).

The general duty: "The agency shall implement and follow appropriate written policies." (OAC 310:662-3-4(e)) And "Each agency shall adopt, implement and enforce written client care policies, specific to, and consistent with the scope and range of client care services offered." (3-6(a)) Chapter 662 then names these items:

1. The client rights and responsibilities statement

"Every agency shall have a written statement of clients' rights and responsibilities governing agency services which shall be made available and explained to each client or client's representative." It is given and explained orally and in writing before or at admission, and recorded in the client’s record (3-2(a)). It covers at least eight things (3-2(b)):

1. Available services, unit charges and billing, and changes in fees or billing given orally and in writing as soon as possible, and "no later than thirty (30) calendar days from the date the agency becomes aware of a change" (3-2(b)(1)).
2. The right to take part in planning care, including the disciplines, visit frequency or hours, and the supervisor’s title and contact.
3. "The right of the client or client's representative to be advised in advance of any change in the plan of care."
4. The client’s responsibilities: respect for staff, accurate health information, and saying when instructions cannot be followed.
5. Confidential treatment of client information, and written consent before release unless the law allows otherwise.
6. "The right of the client to have the client's property and person treated with respect."
7. The agency’s grievance procedure, and the right to complain without reprisal or discrimination.
8. "Information to the client or client's representative that a complaint against the agency may be directed to the Department." The rule still prints OSDH’s old address (1000 N.E. Tenth). OSDH’s Home Services page now gives this mailing address: Oklahoma State Department of Health, Medical Facilities Service, Attn: Home Services Division, 123 Robert S. Kerr Ave., Ste 1702, Oklahoma City, OK 73102-6406 (OSDH Home Services page). Our reading: use the current address (3-2(b)(8)).

2. Written standards of practice

"The governing body of each agency shall adopt written standards of practice, which shall be strictly adhered to by all employees, agency contractors and owners of the agency." (3-3(a)) At a minimum: no misleading clients about services, charges or equipment; no misuse of client property; no recruiting another agency’s clients; no payment for referrals; no coercion or harassment to start services; no guardianship of clients unless related; and services that follow accepted standards of practice (3-3(b)(1)-(7)). State law adds that "It shall be unlawful for a caregiver to solicit or accept anything of value greater than One Dollar ($1.00) from any person in the caregiver’s care" (63 O.S. 1-1950.5).

3. Personnel policies (seven items)

Employment procedures; orientation and in-service; job descriptions and qualifications; periodic evaluations; disciplinary action; health screening and TB testing in line with the "Tuberculosis Controllers Association and CDC, 2019" guidelines (3-4(e)(6)); and an annual influenza vaccination program (3-4(e)(1)-(7)). Since August 11, 2025 the vaccine no longer has to be offered onsite; the program still offers it at no charge or accepts proof of current-season vaccination (3-4(e)(7)).

4. Client care policies (four items)

Infection control in the home; safety assessment and teaching on injury prevention; management of emergency medical situations by staff in the home; and "Efforts to maximize client autonomy." (3-6(b)(1)-(4))

5. Other written duties

• Confidentiality: "The agency shall ensure confidentiality of client information in accordance with written policies and procedures. Records shall be stored in a locked area and only authorized personnel shall have access to the records." (3-5(a))
• Quality program: "The program shall be defined by written policies which shall stipulate methods for assessment, agency staff responsible for implementation and the mechanism of reporting assessments and any recommendations for improvement to the administrator and governing body." (5-4(a)) "Program assessments and any recommendations for improvement shall be documented and reported in writing at least each three (3) months to the administrator and the governing body." (5-4(b))
• Infectious waste and sharps: "Infectious wastes that are not sharps shall be disposed appropriately as required by agency policy, and Federal, state and local laws." "At the time of admission, agency staff shall assess the client to determine if infectious wastes or sharps are generated in the home." (5-3.1)
• Records: a complete record for each client, with a signed note for each service (3-5(a), (d)), kept at least five years after the client was last seen (3-5(c)); personnel records (3-4(f)); and an annual operating budget (3-4(b)).
• Contract staff: if you contract out home care services, a written agreement defining the services (3-4(g)).

Plus the documents behind them: the alternate RN designation, the plan of care, supervisory visit notes and the background check consents. "The administrator shall ensure the accuracy of public information materials and activities, and that agency practices are consistent with written agency policies." (3-4(c))

• Before the license. "After receipt of all documents, your application will be put in queue for an initial licensure survey." "Your agency must be ready for business at the time of the initial survey." (Home Care Application Guidance) Its purpose, OSDH says: "To determine if an agency meets the minimum requirements to receive a home care/ hospice or Companion Sitter license." (OSDH Licensure FAQ).
• What it looks at. We found no published OSDH survey checklist for home care. Our reading: the surveyor checks the written policies the rules require and the documents behind them, such as the rights statement, the RN arrangements and personnel files, so have them adopted before you file.
• Deficiencies. "The agency must provide a written plan of correction for review, in response to each cited deficiency." (OSDH Licensure FAQ) We found no deadline for the plan.
• Later inspections. "The Department may inspect any agency at any time in order to determine compliance with the provisions of the Act or this Chapter." (OAC 310:662-7-1) Agencies that are not Medicare-certified or accredited get routine licensure inspections; we found no set interval. An agency certified under Medicare or Medicaid, or accredited by the Joint Commission, CHAP or ACHC, "will not be subject to an inspection or examination by the Department unless necessary to investigate complaints" (63 O.S. 1-1963(A)(3)).
• Who visits. "HSD staff perform on-site surveys, investigate complaints, conduct home visits to clients receiving services, and sanction agencies that fail to comply." (Home Services Division page)
• Complaints. Anyone may complain to OSDH’s Medical Facilities Service by phone at (405) 426-8470, by mail, online, by fax or at MedFacComplaints@health.ok.gov (Complaints FAQ). OSDH says "we are unable give details on when a complaint survey will occur since all surveys are unannounced" (Complaints FAQ), and "Any home care agency with violations found on investigation shall be required to correct non-compliant items." (OAC 310:662-7-2)
• Enforcement. "The Department may deny, modify, deny renewal, suspend, or revoke the license of any agency that has demonstrated a history of non-compliance with the Act or this Chapter." (7-5) Administrative penalties run up to $100 per violation per day (63 O.S. 1-1966).

Under the Long-term Care Security Act, the employers that screen staff with direct patient access include home health and home care agencies (63 O.S. 1-1945(4)(f)). Fingerprint checks have applied to home care agencies since 2014 (OAC 310:2-29-3(b)(6)). Medicaid home and community-based waiver providers may use a name-based OSBI check instead of fingerprints (1-1947(I)(5)). Our reading: ask OSDH whether this covers a licensed agency’s waiver clients.

• Before regular direct access. "an employer shall not employ, independently contract with, or grant privileges to, an individual who regularly has direct patient access to service recipients of the employer until the employer conducts a registry screening and criminal history record check" (1-1947(F)) The check runs through OSDH’s OK-SCREEN: registry screening first, then a fingerprint-based state and national check, and OSDH’s eligibility determination (1-1947(F), (I)).
• Consent and ID. "The employer shall maintain the written consent and information regarding the individual’s identification in their files for audit purposes." (1-1947(H)) "The applicant shall have ten (10) calendar days, after receipt of authorization as provided in this subsection, to submit his or her fingerprints", or the application is treated as withdrawn (1-1947(I)(4)).
• Conditional hires. "The period of provisional employment shall not exceed sixty (60) days pending the completion of the required background check. During this time the employee shall be subject to direct on-site supervision." The check must be requested on hiring and the person signs a statement (1-1947(L)). Our reading: in home care that means a supervisor present, so many agencies will not use it.
• Who cannot work. Abuse, neglect or financial exploitation of a person in one’s care, sex offenses, child abuse, murder, manslaughter, kidnapping, human trafficking, aggravated assault and battery, assault and battery with a dangerous weapon and first-degree arson bar employment; a list of other offenses bars it for five years after the sentence ends. (1-1950.1(C)) A substantiated abuse finding, a federal exclusion, the community services worker or child care restricted registries, or a sex or violent offender registry also disqualify, and OSDH will tell you to end someone’s employment at once (1-1947(D)-(E)). A disqualified person may appeal to OSDH within 30 days and ask for a waiver; OSDH weighs time passed, rehabilitation and relevance to the job (1-1947(T); OAC 310:2-29-5). "An employer shall not employ or continue employing a person addicted to any Schedule I through V drug as specified by the Uniform Controlled Dangerous Substances Act unless the person produces evidence that the person has successfully completed a drug rehabilitation program." (1-1950.1(D))
• Arrest reporting. Each employee and contractor agrees in writing, as a condition of continued employment, to tell you immediately of an arraignment, indictment, conviction or plea for a disqualifying offense, or a substantiated registry finding (1-1947(Q)).
• Keeping status current. OSDH says: "Employers are required to annually update an employee’s status in OK-SCREEN." (OK-SCREEN page)
• Records. Eligibility records are confidential, and "These records shall be destroyed after one (1) year from the end of employment of the person to whom such records relate." (1-1950.1(E))
• Fees. The employer pays OSDH $19 per applicant submitted for fingerprinting or monitoring; the applicant pays a $10 administrative fee when fingerprinted. People already monitored in OK-SCREEN are not fingerprinted again. These are OSDH’s fees (1-1947(J)).

• Vulnerable adults. "Any person having reasonable cause to believe that a vulnerable adult is suffering from abuse, neglect, or exploitation shall make a report as soon as the person is aware of the situation to" Oklahoma Human Services, OSDH’s Office of Client Advocacy, or the local police or sheriff (43A O.S. 10-104(A)). Since 2025 the named reporters include "Job coaches, community service workers, and personal care assistants" (10-104(B)(10)).
• The hotline. "please call the Abuse and Neglect Hotline at 1-800-522-3511, or submit an online report with Adult Protective Services (APS) at OKHotline.org" (Oklahoma Human Services)
• Failing to report. Knowingly and willfully failing to report promptly is a misdemeanor, and employers may not punish staff for reporting (10-104(E), (K)).
• Children. "Every person having reason to believe that a child under the age of eighteen (18) years is a victim of abuse or neglect shall report the matter immediately to the Department of Human Services." (10A O.S. 1-2-101(B)(1))
• Gifts and guardianship. Caregivers may not accept anything worth more than $1 from a person in their care (63 O.S. 1-1950.5), and "No agency, employee of any agency, or home health aide shall serve as the guardian of a client unless such home care provider is related to the client by blood or marriage" (1-1968).

Chapter 662 itself has no abuse policy section. The duty comes from these statutes, and from the rights statement and standards of practice above.

• Renew each year. "The application for renewal of a licensed existing home care agency shall be filed at least thirty (30) days prior to the expiration date of the license." (OAC 310:662-2-1(h)(3)) OSDH’s letter asks for ODH Form 757, attachments and fee "no later than June 30th", with license verification for the supervising and alternate nurses, the administrator’s current certificate, insurance and the trade name report (renewal letter).
• Branches. A branch of an Oklahoma agency may be licensed as part of the parent agency (ODH Form 758, $25 a year, OSDH’s fee). A subunit too far away to share administration and supervision daily must meet the chapter on its own and be licensed separately. (OAC 310:662-1-2)
• Moving the office. The license covers only the premises named in the application (63 O.S. 1-1965(E)). A move is reported on ODH Form 757, item 14. The 30-day notice that the rule used to set is gone since August 11, 2025. Our reading: report the move before you operate from the new office (ODH Form 757).
• Selling or buying. "Not be transferable or assignable except to any affiliated person, parent company or subsidiary of the applicant" (1-1965(E)(1)), so a buyer applies for its own license. "The application for an initial license, for a transfer of ownership or operation, shall be filed at least thirty (30) days prior to the transfer." (OAC 310:662-2-1(h)(2)) OSDH’s letter also asks for the signed sales agreement; the fee is unsettled (see fees).
• Closing. The rule in force sets no closure procedure, but client records are kept at least five years after the client was last seen. Our reading: return the license and tell OSDH in writing where the records are (OAC 310:662-3-5(c)).
• Medicaid ADvantage (a program rule). To serve ADvantage waiver members an agency also needs ADvantage Administration certification and a SoonerCare contract with OHCA; financial certification is re-checked at least yearly. (OAC 317:30-5-761)
• Medicare. "Any agency desiring a survey for Medicare certification must be licensed and have provided skill care to a minimum of ten patients before an initial Medicare Survey is conducted." (Home Care Application Guidance) It does not apply to a personal-care-only agency.

In force since August 11, 2025

OSDH proposed amendments to 310:662-1-2, 2-1, 3-4 and 5-3 and the revocation of Subchapter 6 in November 2024 (comments November 1 to December 2, 2024; hearing December 3, 2024). HJR 1035 (law May 28, 2025) approved OSDH permanent rules filed by February 1, 2025. The official code (Title 310 PDF from rules.ok.gov, generated March 23, 2026) shows the amendment at 42 Ok Reg, Number 22, effective August 11, 2025, as proposed. As adopted, 2-1 runs from (e) to (g): the former transfer of ownership subsection (f) is gone, and the "non-physician practitioner" definition was struck. The supervision subsection of 5-3 moved from (h) to (g). (OSDH notice; official code)

• Flu vaccine offer (OAC 310:662-3-4(e)(7)(A)). The annual flu vaccination program stays, but the vaccine no longer has to be offered onsite: the agency offers it at no charge or accepts proof of current-season vaccination from elsewhere.
• Supportive home assistants (OAC 310:662-1-2; former 310:662-5-3(g); Subchapter 6). References to supportive home assistants and their competency testing (Subchapter 6) were removed, matching HB 3371.
• Exemptions copied from the statute (OAC 310:662-2-1(e)). The rule’s exemption list now repeats the statute’s, including RN-trained personal care workers supervised on site at least every three months.
• PACE exemption (OAC 310:662-1-2). PACE organizations are excluded from the home care agency definition (HB 3238).
• Transfer of ownership subsection dropped (Former OAC 310:662-2-1(f)). Section 2-1 as amended has no subsection (f). Gone with it: the legal assignment rule, the $500 change of ownership fee, the 30-day relocation notice and the duty to return the license and say where records go on closure. The statute still limits transfers (1-1965(E)) and 2-1(h)(2) still requires filing 30 days before a transfer. OSDH’s 2026 revision would reinsert (f).

Under review: no draft published yet

The agenda for the Home Care, Hospice and Palliative Care Advisory Council’s special meeting on September 30, 2026 lists review of and a vote on Chapter 662 section changes and a rule impact statement, inserting 310:662-2-1(f) (transfer of ownership, which the 2025 amendment left out) and updating OSDH’s address. No draft text, notice or comment period is published yet (OSDH’s proposed rules page, checked October 4, 2026). Oklahoma permanent rules also need legislative approval, so, on the 2024 amendment’s timetable, changes are unlikely to take effect before mid to late 2027 (our estimate). (council agenda, September 30, 2026)

• Chapter 662 section changes. The agenda lists changes to Chapter 662 sections; their content is not public.
• Transfer of ownership. Restore the transfer of ownership subsection, which is missing from 2-1 since August 11, 2025.
• OSDH address. Update references to OSDH’s physical address.

We will email rule-change alerts when OSDH publishes the text or opens comments (sign up below), and all states’ open changes are on our rule changes page.

• Change of ownership fee. ODH Form 757 shows $500, OSDH’s letter lists $1,000, and the rule section that set $500 is gone since August 11, 2025 (CHOW guidance). Ask OSDH before paying.
• A provider’s certification of eligibility. A 2021 section says eligibility for home care services is certified by a health care provider (physician, PA or certain APRNs), who oversees care. It does not say whether it reaches personal-care-only clients; we read it with 1-1964(8) and flag it for OSDH. (63 O.S. 1-1962b)
• "Non-physician practitioner". The 2025 amendment struck the definition, but the rules on assessment, the plan of care, client care policies and records still use the term (and 5-1(a) says "non-physician provider"). Our reading: the RN does this work in a personal-care-only agency; ask OSDH whether a nurse practitioner or physician assistant may.
• Who makes the six-month visit. The rule says "a physician or a licensed nurse" (5-3(g)(3)). Our reading: on the text, an LPN could make it; the plan of care review stays with the RN. Ask OSDH.
• Office in a home. The rule asks for a place of business accessible to the public; OSDH’s form says an agency cannot be located in a home (ODH Form 757). Plan on a separate office.
• Supportive home assistants. The statute still defines them, but the rules no longer mention them since August 11, 2025 (Subchapter 6). Ask OSDH before using the title.
• Medication help. We found nothing in the home care rules on aides helping with medication. Our reading: keep to reminders until OSDH or the Board of Nursing says more.
• Companion-only licensees. Covered above: on our reading the home care policy rules do not reach them, not confirmed by OSDH.
• The rule text we quote. Chapter 662 is quoted from the official Oklahoma Administrative Code PDF on rules.ok.gov (generated March 23, 2026), which shows the 2025 amendment. rules.ok.gov has no section links we could confirm, so our Chapter 662 links go to the code’s home page.

• Home care agencies. 370 home care agency licenses (357 listed as home care agency, 13 as deemed home care agency) in OSDH’s directory effective July 8, 2026. The count includes Medicare home health agencies, which hold the same license. (OSDH directory, our count)
• Companion and sitter services. 26 licenses in the same directory (OSDH directory, our count).
• Personal care only. The directory does not say which agencies are Medicare home health agencies, so we cannot say how many give personal care only.