Starting a home health care agency has become a popular business. Ohio, along with California, Florida, New York and Texas, is considered to have a large number of home health agencies. The state has more than 700 home health agencies, as reported on the official U.S. government website for Medicare. This figure does not include those agencies that serviced only children, received direct payment or payment through private insurance.

Become licensed/registered as a registered nurse, licensed practical nurse, home health aide, or a skilled therapy provider. A skilled therapy provider is a physical therapist, occupational therapist or a speech therapist. Alternatively, you can hire any of the these professionals on a contract basis.

Obtain Medicare-certification through an approved organization. Ohio allows either the Accreditation Commission for Health Care, the Community Health Accreditation Program or the Joint Commission.

Notify the Ohio Department of Health to participate in Medicare reimbursement. The Bureau of Community Health Care Facilities and Services manages home health agencies.

Execute a provider agreement with the Ohio Department of Job and Family Services, agreeing to provide only required medical services, accept the agreed-upon payment and keep adequate records.

Obtain criminal background checks on any individual considered for hire as required by the Ohio Department of Health and the Ohio Revised Code. Background checks are required for anyone responsible for the care of a child or an adult.

As required by federal guidelines, appoint an administrator to direct the day-to-day functions of the agency and a supervising physician or registered nurse to oversee the professional services being rendered.