How to Start a Home Care Agency in Ohio: Non-Medical Care, Medicaid Waivers and Dept. of Aging

Starting a home care agency in Ohio means doing two jobs in sequence. The first is forming a business with the Ohio Secretary of State. The second is getting licensed to deliver care through the Ohio Department of Health (ODH). Many owners focus on the first and underestimate the second. Since 2021, Ohio law under Ohio Revised Code (ORC) chapter 3740 requires an ODH license for nonmedical home health services as well as skilled care. The real dividing line is skilled versus nonmedical, not licensed versus unlicensed.

This guide follows the order most new owners should work in: decide which services you will offer, form the entity, set up your tax and workers' compensation accounts, apply for the ODH license, and then decide whether to pursue Ohio Department of Aging (Dept. of Aging) certification and Medicaid waiver work. Waiver clients add a second set of enrollment steps, so plan for them from the start.

Informational content only. This article is not legal or tax advice. Fees, deadlines and forms change, so confirm each one on the official agency page before you pay or file. For a complex setup, including choosing an entity, drafting client contracts or structuring owner pay, work with a qualified attorney and a CPA.

Step 1: Decide Which License Your Agency Needs

The license follows the services, so settle your service list first. ODH licenses fall into two categories:

• Nonmedical home health services license. Covers personal care, including hands-on bathing, dressing, toileting, meal preparation, medication reminders, homemaker help and errands. Most private-pay agencies, and many agencies serving Medicaid waiver clients, start here.
• Skilled home health services license. Covers skilled care. A skilled license also covers nonmedical care, so an agency offering both needs only the skilled license.

Be precise in your written service description, because the application asks for it. Any hands-on help with bathing, dressing or toileting is personal care under the nonmedical category, even if you market the work as companionship. If your service mix sits near that line, ask ODH to confirm in writing how it classifies the work before you sign a lease or buy a bond.

Ohio issues no state general business license, and counties issue no business license either. For a home care agency, the ODH license is the registration that matters most for operating.

Materials and Documents to Gather

Collect these before you file anything. A missing document is the most common reason an application stalls.

• Two or three name options, checked against the Secretary of State's Business Search database
• Articles of Organization for a Domestic Limited Liability Company (Form 610), or Initial Articles of Incorporation for a Domestic For-Profit Corporation (Form 532A)
• A statutory agent with a qualifying Ohio street address, plus the agent's signed acceptance
• Fingerprints for each owner
• A written criminal records check policy for your staff
• Hours of operation and a written description of every service you will provide
• A $20,000 surety bond, required for new agencies, and the $250 license fee
• A federal Employer Identification Number (EIN) from the IRS
• Workers' compensation coverage from the Ohio Bureau of Workers' Compensation (BWC) state fund, in place before your first employee starts work
• A business bank account and a cash reserve that covers the months before billing starts

Step 2: Form the Entity

Most owners choose a limited liability company (LLC). Ohio charges $99 to file Articles of Organization (Form 610). A for-profit corporation files Initial Articles of Incorporation (Form 532A) for the same $99 fee. Entity choice affects personal liability, taxes and how you bring in investors, so have an attorney and a CPA weigh in before you file.

Ohio LLCs file no annual report. No annual or biennial report is required for for-profit corporations either, so you will not have a yearly state filing to track for the entity itself. Your recurring obligations come from the license, the tax accounts and the insurance, covered below.

Name rules

An Ohio LLC name must contain “limited liability company” or one of the abbreviations “L.L.C.,” “LLC,” “limited,” “ltd.” or “ltd.” The name must be distinguishable on the Secretary of State's records from the name of any other domestic or foreign LLC, corporation, limited liability partnership, limited partnership or registered trade name, unless the prior holder gives written consent. You can reserve a name for 180 days for $39.

If you will operate under a name other than your legal name, register a trade name (Form 534A) with the Secretary of State. Registration costs $39, an update or change of registrant name costs $25, and renewal costs $25 every five years. Trade names are registered with the state, not the county, so ignore any county office that offers to handle it. Forms are listed at ohiosos.gov business filing forms.

Appoint your statutory agent

Ohio calls the registered agent a statutory agent, and every LLC must appoint one and keep one in place. The agent must be an Ohio resident individual, or an entity with a business address in Ohio. The listed address must be a street address. A post office box does not qualify, even one with an associated street address. The Secretary of State will not accept your articles without a written appointment and the agent's signed acceptance on the prescribed form. Changing the agent, the agent's address or filing a resignation costs $25. A resignation takes effect 30 days after it is filed.

Step 3: File Through Ohio Business Central

File online through Ohio Business Central, the Secretary of State's online filing portal. Regular service takes 3 to 7 business days from receipt, and online filing is the fastest standard route. If you need faster processing, these options come on top of the $99 filing fee:

Option	Cost	Processing
Expedite Service 1	$100 above the filing fee	Within 2 business days of receipt
Expedite Service 2	$200	Within 1 business day
Expedite Service 3	$300, in-person delivery required	Within 4 hours if received by 1:00 p.m., otherwise by noon the following business day
Preclearance filing review	$50	1 to 2 business days

Expedited filings are sent to P.O. Box 1390, Columbus, OH 43216. A preclearance review checks your filing before you submit it, which can help you catch a rejected name or a defective form early.

Step 4: Set Up Tax and Employer Accounts

Because Ohio has no state general business license, your tax and employer accounts are the registrations that matter most after formation.

• Commercial Activity Tax (CAT). Ohio has no corporate income tax and no LLC franchise or annual tax. Businesses pay the CAT instead, a gross receipts tax of 0.26% (.0026) on Ohio taxable gross receipts. For 2025 and later, only businesses with more than $6 million of Ohio taxable gross receipts owe the CAT or must register, and CAT returns are filed quarterly. A small agency may fall below that exclusion, but confirm your numbers with a CPA. Guidance is at tax.ohio.gov.
• Sales tax vendor's license. If you sell taxable goods or services, you need a vendor's license before your first taxable sale. The county auditor issues it under state statute, and the county application fee is $50 as of April 9, 2025. Whether your home care services are taxable is a question for the Ohio Department of Taxation, so ask before you assume you need one or that you do not. Application details are at Ohio vendor licensing.
• Municipal net profit tax. Cities and villages tax business net profit under their own rates, separate from the state. Ask the city or village where your office is located which rate applies.
• Owner income tax. Taxable business income is taxed at a flat 3%. How that applies to your owners depends on your entity and filing choices, so review it with a CPA.
• Workers' compensation through BWC. Ohio is a state fund state. You buy workers' compensation from the BWC fund, not from a private carrier. Set it up before anyone starts work.

Step 5: Apply for the ODH Nonmedical Home Health Services License

This license is what allows your agency to provide personal care. The application asks for:

• Fingerprints for each owner
• Your Secretary of State filings, meaning the formation documents from Steps 2 and 3
• Your criminal records check policy
• Your hours of operation
• A written description of your services
• A $20,000 surety bond, required for new agencies
• A $250 fee

The license lasts 3 years, and renewal costs $250. The governing sections are ORC 3740.02, 3740.03 and 3740.05. Find the current application on the Ohio Department of Health website, and confirm whether it is filed online or on paper and how long ODH takes to process it. ODH sets its own timeline, so expect the license to take longer than the 3 to 7 business days a Secretary of State filing takes.

The surety bond

The $20,000 surety bond is purchased from a surety company, not paid to the state. Ohio does not set the premium the surety charges you, so request quotes early. Ask ODH when the bond must be filed in your application process.

Aging-certified providers may have items waived

Providers certified by the Ohio Department of Aging under ORC 173.391 get several application items waived. This article does not list which items, so ask ODH to confirm them against your Aging certification before you gather documents you may not need.

Step 6: Decide Whether to Pursue Medicaid Waiver Work

A private-pay agency can operate on the ODH license alone. Serving Medicaid waiver clients is a separate track with its own requirements, and the steps are additional to everything above.

Ohio's PASSPORT program and other Medicaid waiver programs require two things from providers: certification through the Ohio Department of Aging, and enrollment as a provider with the Ohio Department of Medicaid (ODM). A home care license does not by itself make you an Ohio Medicaid provider. The steps, forms, documentation and timing differ by program, and they change, so this article does not list them. Check with the Department of Aging for certification and with ODM for provider enrollment before you plan to bill any waiver client.

Start early. A delay in either certification or enrollment can push back the date you are able to accept and bill waiver clients, and that delay falls on your cash reserve, not on the state's calendar.

Step 7: Put Your Operating Basics in Writing

Before your first client, write down your hours of operation, service description, criminal records check policy, client intake process, care documentation process and employee handling procedures. Keep a complete copy of everything you submitted to ODH, since your actual services should match the description you filed. Talk to an insurance broker about liability coverage that fits a personal care business, and ask an attorney to review your client service agreements.

Common Mistakes to Avoid

• Assuming “non-medical” means no license. Since 2021, nonmedical home health services require an ODH license.
• Using a post office box as the statutory agent address. The address must be a street address in Ohio.
• Choosing a name that is too close to an existing record. The Secretary of State can reject a name that is not distinguishable. Check Business Search first.
• Writing a vague service description. Name hands-on personal care tasks such as bathing, dressing and toileting if you provide them.
• Budgeting for the $250 fee and forgetting the bond. The $20,000 surety bond premium is a separate cost you need to plan for.
• Hiring staff before BWC coverage is in place. Set up the state fund coverage first.
• Treating the Secretary of State filing as the finish line. The filing creates the entity. The ODH license is what lets you provide care.
• Starting Medicaid enrollment after your first private-pay client. Waiver work depends on certification and enrollment that take their own time.
• Filing a trade name with a county office. Trade names are registered with the Secretary of State.

Tips for a Smoother Launch

• Run the entity filing and the ODH application on parallel tracks. Ohio Business Central moves quickly, and ODH timing is usually the longer step.
• Request surety bond quotes in your first week, so the bond cost is not a surprise at application time.
• Use the Ohio Small Business Development Centers for planning help at clients.ohiosbdc.ohio.gov. The U.S. Small Business Administration's Ohio district page at sba.gov/district/ohio lists regional resources.
• Set a renewal calendar: the ODH license every 3 years, a trade name every 5 years, and CAT returns each quarter if your receipts cross the exclusion.

Expected Results and Timing

Your timeline depends on how complete your documents are, which services you offer and how each agency processes its part. Treat the following as a planning guide, not a guarantee. A complete Ohio LLC filing may be processed within 3 to 7 business days under regular service. The ODH license, surety bond and BWC setup may take longer, and Medicaid certification and enrollment may take longer again. A complete, consistent application may help you avoid delays caused by missing or mismatched documents. Owners who plan their cash reserve around the full timeline may be better positioned to hire and serve clients as they become eligible.

Next Steps

Choose your service list, reserve your name if needed, and file the articles through Ohio Business Central. Then contact ODH to confirm your license category and request the current application. The Secretary of State's main site at ohiosos.gov has the filing forms and guidance. Before you sign a lease, a bond or a client contract, have a qualified attorney review your structure and a CPA review your tax setup.

This article is informational and is not legal or tax advice.