Ohio - Homemaker Service — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The Ohio Department of Aging (ODA) certifies Homemaker service providers for the PASSPORT waiver, while the Ohio Department of Medicaid (ODM) oversees the Home Maintenance/Chore service under the Ohio Home Care Waiver (OHCW). Ohio does not issue a distinct facility license for homemaker agencies through the Department of Health; instead, providers must obtain HCBS Waiver Certification directly through ODA or ODM.

Between May 14, 2026, and November 14, 2026, ODM is enforcing a federal moratorium that halts all new Medicaid enrollment applications for Waiver Organizations and Waiver Individuals. Outside of this moratorium window, prospective agencies must pay a $730 certification fee to ODA and pass an unannounced on-site screening by the Public Consulting Group (PCG) before billing the Provider Network Management (PNM) system.

1. Service Definition and Scope

Homemaker services in Ohio assist individuals with general household activities to maintain a safe and healthy living environment. Under the PASSPORT and Ohio Home Care waivers, this includes meal preparation, laundry, grocery shopping, and light housekeeping when the individual or their primary caregiver cannot perform them.

The service explicitly excludes providing direct personal care, such as bathing or feeding, and cannot be used for respite or pure supervision.

• Waiver Authority: PASSPORT (ODA) and Ohio Home Care Waiver (ODM).
• Covered Tasks: Routine cleaning, laundry, meal preparation, and shopping for basic necessities.
• Exclusions: Respite care, pure supervision, and habilitative care.
• Service Limits: Authorized strictly via the individual's person-centered services plan.

2. Regulatory and Oversight Agencies

Oversight is split between the Ohio Department of Medicaid (ODM) as the single state agency and the Ohio Department of Aging (ODA) for older adult waivers.

Third-party contractors handle specific enrollment and screening functions on behalf of the state.

• Ohio Department of Medicaid (ODM): Administers the Ohio Home Care Waiver and sets overall HCBS policy (https://medicaid.ohio.gov).
• Ohio Department of Aging (ODA): Certifies providers for the PASSPORT and Assisted Living waivers (https://aging.ohio.gov).
• Provider Network Management (PNM): The centralized portal for all Medicaid provider enrollment applications (https://ohpnm.omes.maximus.com).
• Public Consulting Group (PCG): Conducts required pre- and post-enrollment unannounced on-site screening visits for ODM (https://ohiohcbs.pcgus.com).

3. Gatekeeping Prerequisites: Who Can Even Apply

Ohio imposes strict enrollment windows and structural prerequisites for waiver providers.

Applicants must navigate federal moratoria and specific system registrations before submitting an application.

• Enrollment Moratorium: ODM will not accept new Medicaid enrollment applications for Waiver Individuals and Organizations from May 14, 2026, through November 14, 2026.
• NPI Requirement: Providers must obtain a National Provider Identifier (NPI) before applying, as waiver services are paid using federal funds.
• Physical Location: Providers must maintain a physical business location to be subject to PCG on-site screening.
• Age and Relationship Restrictions: Spouses and parents or legal guardians of minors cannot be reimbursed for these services.

4. Licensure and Certification Requirements

Ohio does not issue a distinct Homemaker Agency license through the Department of Health. Instead, providers must obtain HCBS Waiver Certification directly through ODA or ODM.

Certification requires demonstrating administrative capacity and paying required state fees.

• ODA Certification Fee: A $730 non-refundable application fee applies for 2025 ODA certification, plus a 2.5% credit card fee.
• PCG On-Site Screening: Unannounced pre-enrollment site visits are required under OAC 5160-1-17.8.
• Business Registration: Must be registered and in good standing with the Ohio Secretary of State.
• Policy Submission: Applicants must submit written policies for incident management and provider disclosure during the application.

5. Medicaid Provider Enrollment

All enrollment actions are processed through the Provider Network Management (PNM) module.

Providers must select the correct provider type and specialty codes corresponding to ODA or ODM waiver services.

• System of Record: Provider Network Management (PNM) portal (https://ohpnm.omes.maximus.com).
• Application Routing: ODA PASSPORT applications are initiated in PNM and routed to ODA for certification review.
• Provider Disclosure: Federal and state laws require full disclosure of ownership and control interests during enrollment.
• Revalidation: Providers must revalidate their Medicaid enrollment every five years through the PNM.

6. Staffing, Training and Background Checks

Ohio mandates continuous criminal background monitoring for all waiver providers.

Staff must meet basic competency requirements for household management.

• Background Check System: ODM uses the RAPBACK (Retained Applicant Fingerprint Database) system for continuous criminal history monitoring.
• Initial Fingerprinting: Initial BCI&I reports must be sent to the ODM BCII Coordinator (P.O. Box 183017, Columbus, OH).
• Cost: ODM automatically enrolls providers into RAPBACK at no ongoing cost to the provider.
• Supervisor Qualifications: Agencies must designate a supervisor responsible for overseeing homemaker staff and ensuring care plan compliance.

7. Documentation, Policies and Records

Providers must maintain comprehensive records of service delivery to support Medicaid claims.

Documentation must align exactly with the individual's approved care plan.

• Service Delivery Records: Must document the date, start and end times, and specific tasks performed during each visit.
• Care Plan Alignment: Services must be delivered strictly according to the hours and tasks authorized by the waiver case manager.
• Incident Reporting: Providers must maintain and follow a written policy for reporting Major Unusual Incidents (MUIs).
• Record Retention: All Medicaid billing and service records must be retained for a minimum of six years.

8. Billing, Rates and Claims

Homemaker services are billed as fee-for-service or through managed care plans depending on the individual's enrollment.

Prior authorization is required for specific service spans.

• Prior Authorization: Required for service delivery and payment; spans can be authorized up to 365 days for maintenance care.
• Billing Increments: Services are typically billed in 15-minute units or per-visit rates as defined by the specific waiver appendix.
• MyCare Ohio: For dual-eligible individuals, claims must be submitted to the designated Next Generation MyCare managed care plan (https://medicaid.ohio.gov/families-and-individuals/citizen-programs-and-initiatives/mycareohio/mycare-ohio).
• Duplication Prohibition: Cannot bill homemaker services concurrently with home health aide or hospice services for the same scope.

9. Approval Sequence and Timeline

The end-to-end process involves NPI registration, PNM application, and unannounced site visits.

Timelines vary based on ODA review capacity and PCG screening schedules.

• Step 1: Obtain an NPI and register the business with the Ohio Secretary of State.
• Step 2: Submit the initial application and $730 fee through the PNM portal.
• Step 3: Undergo an unannounced pre-enrollment on-site screening by PCG.
• Step 4: Receive final certification from ODA or ODM and execute the Medicaid provider agreement.

10. Common Denials and Survey Findings

Applications are frequently delayed or denied due to incomplete disclosures or failed site visits.

Post-enrollment, PCG and ODA monitor for billing discrepancies and documentation failures.

• Site Visit Failures: Denials occur if PCG representatives are refused access to the facility or if the provider fails to answer questions.
• Background Check Errors: Delays caused by failing to route initial BCI&I reports to the correct ODM P.O. Box.
• Service Duplication: Recoupments for billing homemaker services on the same day or time as waiver personal care or hospice.
• Missing Signatures: Citations for lacking required clinician or case manager signatures on the authorized care plan.

11. Key Contacts and Resources

Providers should utilize official state portals and designated contractors for application support.

Help desks are available for PNM navigation and waiver-specific inquiries.

• Provider Network Management (PNM): https://ohpnm.omes.maximus.com
• Ohio Department of Medicaid (ODM): https://medicaid.ohio.gov
• Ohio Department of Aging (ODA) Certification: https://aging.ohio.gov
• Public Consulting Group (PCG): https://ohiohcbs.pcgus.com

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