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New State Budget Institutes Licensure Requirement for Ohio’s Hospitals

Client Alert

On July 1, 2021, Governor Mike DeWine signed Ohio’s final budget codified at Ohio Revised Code 3722.01 et seq., which includes a new licensing requirement for Ohio’s hospitals.

For years, Ohio was the only state in the country that did not license its hospitals. This approach will now be replaced with new, detailed requirements that will require careful review and compliance. Here are some of the highlights concerning these new changes:

When will a license be required?

All hospitals operating in the state of Ohio will be required to be licensed with the Ohio Director of Health within three years of the effective date of the new budget.  “Hospital” is defined by the Act as any institution or facility that provides inpatient medical or surgical services for a continuous period longer than 24 hours.

Some facilities will be exempt from the new licensing requirement, including hospitals operated by the federal government, nursing homes, and facilities used exclusively for hospice patients.

How do you receive a license?

License applications will begin to be considered by the Director after the Act has been effective for one year. The following will be required to be eligible for a license:

  • A completed application submitted with the accompanying fee;
  • Title XVIII certification under the “Social Security Act” or accreditation from a national accrediting organization approved by the Centers for Medicare and Medicaid Services; and
  • A detailed breakdown of the number of beds available in the hospital.

An issued license will be valid for three years unless it is revoked or suspended, and a license can be renewed for additional periods of three years upon expiration.

What new policies will necessitate hospital compliance?

Upon issuance of a license, further steps must be taken by the institution to maintain compliance. First, the hospital must have a governing board that is tasked with overseeing the hospital’s management and control. Second, the hospital will be required to comply with rules adopted by the Director establishing health, safety, welfare, and quality standards for licensed hospitals. These rules are required to be provided to hospitals within one year of the effective date of the budget.

The new regulations also carry steep civil penalties for hospitals that fail to comply with their terms. The Director of Health may levy a $250,000 civil penalty against the hospital and fine the institution an additional $1,000 to $10,000 for every day the hospital operates without a license. If a hospital fails to comply with any of the Director’s rules, a civil penalty between $1,000 and $250,000 may be levied. The Director may also petition for injunctive relief in the proper Court of Common Pleas if an imminent threat of harm exists at a licensed hospital; a granted injunction can only be lifted after a showing that the harmful condition identified has been removed.

To learn more about these new, detailed regulations and to discuss any required changes to your current policies and procedures, please contact BMD Government Affairs Member and Lobbyist Victoria L. Ferrise (vlferrise@bmdllc.com – (330) 374-5184).


Cleveland Joins the Pay Transparency Movement: What Employers Need to Know

Beginning October 27, 2025, all Cleveland employers with 15 or more employees will be prohibited from asking applicants about their pay history and will be required to include reasonable pay ranges in all job postings where the position will be performed, solicited, considered, or processed in Cleveland. The ordinance is intended to help close the gender wage gap and promote greater pay equity across the city.

New $100,000 Fee on H-1B Petitions – Legal Immigration

President Trump issued an Executive Order (EO) imposing a $100,000 payment to accompany any new H-1B visa petitions submitted after 12:01 a.m. eastern time on September 21, 2025 and will remain in place for 12 months (unless extended).

Implications of Supreme Court Stay for Business Operations in Noem v. Vasquez Perdomo

On September 8, 2025, the U.S. Supreme Court temporarily reinstated immigration officers’ authority to conduct brief stops based on factors such as location, work type, language, or appearance. This stay in Noem v. Vasquez Perdomo allows enforcement actions to resume in California pending appeal. Employers in industries like construction, agriculture, landscaping, and day labor should prepare for increased worksite disruptions and review compliance protocols.

Ohio House Bill 429: Potential Relief for Providers Facing Same-Day Reimbursement Restrictions

Ohio House Bill 429 aims to prevent third-party payers from reducing provider reimbursement for multiple procedures performed on the same day. The bill could improve payment practices for a range of specialties, including surgery and gastroenterology.

FTC Continues to Target Noncompetes

The FTC is intensifying its focus on noncompete agreements in healthcare, urging employers to review contracts for compliance. While Ohio still generally enforces noncompetes, pending legislation could limit their use.