Ohio Home Health Launch & Medicare Certification — Fixed-Price Application Support
$2,495.00
View details
Midwest
Ohio Home Care, Home Health & Hospice Licensing
Ohio requires a state license from ODH for all skilled home health and hospice providers — and right now, a nationwide CMS moratorium on new Medicare enrollment makes timing everything.
RegulatorODH
Typical timelineObtaining the ODH state license alone typically takes 2 to 4 months from application submission to license issuance, factoring in the review period and inspection. Pursuing accreditation through CHAP, ACHC, or The Joint Commission (which is required for Medicare participation) typically adds 3 to 6 months. Medicare enrollment via PECOS, once the moratorium lifts, typically takes 45 to 90 calendar days for institutional providers under standard MAC processing timeframes; budget for the longer end if additional documentation is requested. In total, a new Ohio home health agency or hospice should plan for 6 to 12 months from business formation to active Medicare billing — and should plan around the moratorium timeline, which is not expected to lift before November 2026 and may be extended.
License routes3
Delivery100% Virtual
Licensing in Ohio
Ohio regulates skilled home health agencies and hospice care programs under the Ohio Department of Health (ODH), Bureau of Regulatory Operations, which issues mandatory state licenses under Ohio Revised Code Chapter 3740 (home health) and Chapter 3712 (hospice) — there is no Certificate of Need requirement for either license type. Every new skilled home health applicant that was not providing direct care on or before September 30, 2021 must obtain a $50,000 surety bond as a condition of licensure, a requirement unique to Ohio's 2021 licensing statute. Critically, a nationwide CMS Medicare enrollment moratorium that took effect May 13, 2026 is currently blocking new home health agency and hospice Medicare enrollments; agencies can pursue ODH state licensure during this window but cannot obtain Medicare billing authority until the moratorium lifts — expected no earlier than November 2026, subject to extension.
Your regulator
Ohio Department of Health, Bureau of Regulatory Operations (ODH)
Official licensing page →License routes we cover in Ohio
Skilled Home Health Services License
Any home health agency or nonagency provider employing staff to deliver skilled nursing, physical therapy, occupational therapy, or speech-language pathology services in the home; required under ORC Chapter 3740 and OAC Chapter 3701-60.
Nonmedical Home Health Services License
Agencies providing personal care, companion, or homemaker services through employees — though agencies that already hold a Skilled Home Health Services License are automatically authorized to provide nonmedical services without a separate license.
Hospice Care Program License
Any person or entity proposing to operate a hospice care program in Ohio; required under ORC Chapter 3712 and OAC Chapter 3701-19, and needed as a prerequisite before pursuing Medicare certification as a hospice provider.
How we get you licensed
- 1Form the business entity and establish an Ohio administrative office
Register your LLC or corporation with the Ohio Secretary of State and obtain a federal EIN. Out-of-state entities must establish a physical Ohio administrative office and maintain all Ohio patient clinical records there before submitting a licensure application to ODH.
- 2Prepare and submit the ODH license application with fee and surety bond
Complete the ODH-prescribed application form for a Skilled Home Health Services License (form HEA0621) or Hospice Care Program License. Submit with a non-refundable $250 fee (home health — both skilled and nonmedical) or $600 fee (hospice), payable by cashier's check or postal money order to 'Treasurer, State of Ohio.' New home health applicants not in operation before September 30, 2021 must include a $50,000 surety bond (skilled) or $20,000 surety bond (nonmedical-only). Hospice applicants must file at least 60 days before the requested inspection date.
- 3ODH review and initial inspection
For hospice, ODH conducts an announced initial inspection and must mail written notice granting or proposing to deny a license within 30 days of receiving all information necessary to determine compliance — including the inspection report. For home health, ODH reviews the application and applicants must furnish any additional information ODH requests within 14 calendar days of the mailing date of the director's request. Any violations found trigger a required plan of correction submitted within 10 calendar days.
- 4Obtain accreditation from a CMS-approved accrediting organization (parallel track recommended)
Agencies pursuing Medicare certification may use deemed-status accreditation through CHAP, ACHC, or The Joint Commission in lieu of a separate CMS state survey. Pursuing accreditation concurrently with ODH licensure compresses the overall timeline. ODH accepts evidence of current Medicare certification or recognized accreditation as part of the skilled home health license application.
- 5Monitor and respond to the CMS Medicare enrollment moratorium, then enroll via PECOS
As of May 13, 2026, CMS has imposed a nationwide six-month moratorium (through at least November 13, 2026) blocking new Medicare enrollments for home health agencies and hospices. During this window, agencies should complete ODH state licensure, finalize policies and procedures, and build their compliance infrastructure. When the moratorium lifts, submit the CMS-855A enrollment application through PECOS to the MAC serving Ohio.
- 6Enroll with Ohio Medicaid and begin operations
Once Medicare-certified, enroll with the Ohio Department of Medicaid through its provider enrollment system to access Medicaid reimbursement including the PASSPORT and MyCare Ohio programs (note: as of 2026, PASSPORT waiver participants in most Ohio counties are transitioning into MyCare Ohio). Notify ODH in writing within 10 days of any changes to application information after licensure is issued.
Key Ohio requirements
- Ohio state license from ODH is mandatory for all skilled home health and hospice providers — there is no Certificate of Need, but there is no bypassing the ODH license either.
- $50,000 surety bond for new skilled home health applicants that were not providing direct care on or immediately prior to September 30, 2021 (nonmedical-only applicants: $20,000 bond).
- Evidence of Medicare certification, current accreditation (CHAP, ACHC, Joint Commission, or CMS-approved equivalent), or a notarized attestation of compliance with Medicare Conditions of Participation must accompany the skilled home health license application.
- Out-of-state agencies must establish a physical Ohio administrative office and maintain all Ohio patient records there before applying.
- Hospice applicants must file the ODH application at least 60 days before the requested inspection date and must pay a non-refundable $600 license fee.
- Ohio is subject to heightened CMS scrutiny on multiple fronts: hospice providers newly enrolling or recently enrolled are subject to the Provisional Period of Enhanced Oversight (PPEO) with prepayment review, and home health agencies in Ohio are subject to the Review Choice Demonstration requiring pre- or post-claim review. New entrants must build robust documentation practices from day one.
Traps that catch new owners
- Confusing the ODH state license with Medicare enrollment: the two are separate processes, and ODH licensure alone does not authorize Medicare billing. Agencies that get licensed by ODH but miss the Medicare enrollment moratorium cutoff (May 13, 2026) will still be unable to bill Medicare until the moratorium lifts — potentially in November 2026 or later.
- Missing the surety bond requirement: any skilled home health applicant that was not actively providing care before October 1, 2021 must obtain and attach a $50,000 surety bond to the application; omitting this is a common reason for application rejection for newer entrants.
- Failure to maintain an Ohio administrative office and keep all patient records on-site in Ohio: out-of-state agencies that attempt to operate without a dedicated Ohio office violate OAC 3701-60-03 and will be denied licensure or face enforcement action after licensure.
- Misreading the 14-day deadline: it is the applicant — not ODH — who must furnish any additional information requested by the director within 14 calendar days of ODH's mailing date. Missing this deadline can stall or void the application.
Ohio licensing packages
Fixed price, agreed in writing before any work begins. Each package is prepared and submitted for you, fully online.
Ohio licensing FAQs
Does Ohio have a Certificate of Need (CON) requirement for home health or hospice?
No. Ohio repealed most CON requirements in 2012 and does not require a Certificate of Need for home health agencies or hospice care programs. Any qualified applicant may apply to ODH for a license, subject to meeting all statutory and regulatory requirements including the surety bond for newer entrants.
Can we get our Ohio state license now even though the CMS moratorium blocks Medicare enrollment?
Yes. The CMS moratorium (effective May 13, 2026) freezes new Medicare enrollment applications but does not prevent you from obtaining an Ohio ODH state license or completing accreditation. Pursuing licensure and accreditation now positions you to submit the CMS-855A enrollment application through PECOS as soon as the moratorium lifts — currently expected no earlier than November 2026.
If we already hold a Skilled Home Health Services License in Ohio, do we also need a separate Nonmedical Home Health Services License?
No. Under ORC Chapter 3740, a home health agency or nonagency provider that holds a current Skilled Home Health Services License is authorized to provide nonmedical home health services without obtaining a separate nonmedical license.
Ready to launch in Ohio?
Book a free discovery call and we’ll map exactly what your Ohio licensing will take — and what it will cost.
Book a Free Discovery Call
