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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).


January 2025 Notice of Proposed Rulemaking Brings Notable Changes to HIPAA Security Rule

In January 2025, the U.S. Department of Health and Human Services proposed amendments to the HIPAA Security Rule, aiming to enhance cybersecurity for covered entities (CEs) and business associates (BAs). Key changes include mandatory compliance audits, workforce training, vulnerability scans, and risk assessments. Comments on the proposed rule are due by March 7, 2025.

Corporate Transparency Act Effective Again

The federal judiciary has issued multiple rulings on the enforceability of the Corporate Transparency Act (CTA), which took effect on January 1, 2024. Previously, enforcement was halted nationwide due to litigation in Smith v. U.S. Department of the Treasury. However, on February 18th, the court lifted the stay, reinstating the CTA’s reporting requirements. Non-exempt entities now have until March 21, 2025, to comply. Businesses should act promptly to avoid civil penalties of $591 per day and potential criminal liability.

Status Update: Physician Noncompete Agreements in Ohio

Noncompete agreements remain enforceable in Ohio if they meet specific legal requirements. While the AMA and FTC have challenged these restrictions, courts continue to uphold reasonable noncompete provisions for physicians. Recent cases, like MetroHealth System v. Khandelwal, highlight how courts may modify overly restrictive agreements to balance employer interests with patient care. With ongoing legal challenges to the FTC’s proposed ban, Ohio physicians should consult a healthcare attorney before signing or challenging a noncompete agreement.

Immigration Orders and Their Economic Impact on Small Business: Insights from Attorney and Former Immigration Judge Rob Ratliff

President Trump's recent executive orders, targeting immigration policies, could significantly impact small businesses in Ohio, particularly those owned by undocumented immigrants. With stricter visa vetting, halted refugee admissions, and potential deportations, these businesses face uncertainty, workforce disruption, and closures. Ohio's immigrant-owned businesses, especially in food services and transportation, contribute billions to the state economy, and any disruption could result in economic ripple effects.

Corporate Transparency Act Ruling from the U.S. Supreme Court

The U.S. Supreme Court recently ruled on the enforceability of the Corporate Transparency Act (CTA), lifting an injunction previously imposed by the Fifth Circuit. However, a separate nationwide injunction remains in effect, meaning businesses are still not required to comply with the CTA’s reporting requirements. FinCEN continues to accept voluntary reporting while enforcement remains paused.