HomeCareAtlas Team · Updated November 2026
Researched from primary state regulatory sources.
How to Start a Home Care Agency in Oklahoma
Starting a home care agency in Oklahoma costs roughly $25,000 - $50,000 and takes 45-120 Days. Here's every step, fee, and deadline — sourced directly from Oklahoma State Department of Health (OSDH, Medical Facilities Service).
Oklahoma has TWO license types for non-medical home care. Choose based on what you will do. The Home Care Agency License covers personal care (help with dressing, bathing, walking). Its aides must be certified by OSDH and listed on the Home Health Aide Registry. The Sitter/Companion Service License is for companion or sitter help with no hands-on care (OSDH guidance letter). Both come from the Home Care Act (63 O.S. Section 1-1960 et seq.) and OAC Title 310, Chapter 662. Both cost $1,000 to apply and $500 a year to renew. Home care branch offices cost $25. For a home care agency, you send ODH Form 757 to OSDH. For a sitter/companion service, you send ODH Form 1273. Your agency must be ready for business at the initial on-site survey. Giving home care before you have a license can bring a penalty of up to $10,000 (OSDH guidance letter).
To start a non-medical home care agency in Oklahoma, you need a Home Care Agency License or Sitter/Companion Service Agency License from the Oklahoma State Department of Health (OSDH, Medical Facilities Service). The application fee is $1,000 (initial application fee ($500 renewal)), the process takes approximately 45-120 days, and total startup costs range from $25,000 - $50,000. Two license types exist (Home Care Agency vs. Sitter/Companion). Both cost $1,000 to apply. A home care agency's administrator must be OSDH-certified (160-hour program or deeming, plus the OHCAPA exam), and you must pass an on-site survey before you open.
- License Required
- Yes — Home Care Agency License or Sitter/Companion Service Agency License
- Regulatory Body
- Oklahoma State Department of Health (OSDH, Medical Facilities Service)
- Application Fee
- $1,000 (initial application fee ($500 renewal))
- Timeline
- 45-120 Days (application + initial survey (our estimate))
- Total Startup Cost
- $25,000 - $50,000
- Key Requirement
- Two license types exist (Home Care Agency vs. Sitter/Companion). Both cost $1,000 to apply. A home care agency's administrator must be OSDH-certified (160-hour program or deeming, plus the OHCAPA exam), and you must pass an on-site survey before you open.
- Last Verified
- November 2026 against Oklahoma State Department of Health (OSDH, Medical Facilities Service) regulations
Initial Application Fee ($500 renewal)
Source: OAC 310:662-2-1(d)(1) · Checked Oct 2026
Application + Initial Survey (Our Estimate)
This is our best guess. Check with the Oklahoma State Department of Health (OSDH, Medical Facilities Service).
Residents Age 70+
Moderate Opportunity
How Oklahoma compares to neighboring states
Oklahoma Licensing Overview
The Oklahoma State Department of Health (OSDH, Medical Facilities Service) oversees all non-medical agencies.Oklahoma has TWO license types for non-medical home care. Choose based on what you will do. The Home Care Agency License covers personal care (help with dressing, bathing, walking). Its aides must be certified by OSDH and listed on the Home Health Aide Registry. The Sitter/Companion Service License is for companion or sitter help with no hands-on care (OSDH guidance letter). Both come from the Home Care Act (63 O.S. Section 1-1960 et seq.) and OAC Title 310, Chapter 662. Both cost $1,000 to apply and $500 a year to renew. Home care branch offices cost $25. For a home care agency, you send ODH Form 757 to OSDH. For a sitter/companion service, you send ODH Form 1273. Your agency must be ready for business at the initial on-site survey. Giving home care before you have a license can bring a penalty of up to $10,000 (OSDH guidance letter).
Two License Types — Choose Carefully
Home Care Agency License (hands-on personal care) vs Sitter/Companion Service Agency License (no hands-on care). Pick the one that matches what you will do. A sitter/companion license does not allow home care services.
Certified Administrator Required (OHCAPA)
Your administrator must be certified by OSDH (63 O.S. Section 1-1962a; OAC 310:664). That means a 160-hour OSDH-approved preparedness program, then passing the OHCAPA exam. Or you can use a deeming path. One example is a bachelor's degree plus 1 year of full-time home care work in the past 2 years (OAC 310:664-3-4). The initial certificate costs $140, needs an OSBI background check, and expires every July 31. Renewal is $55 plus 12 hours of continuing education a year. No CE is needed for the first renewal.
Initial Survey Before License Issuance
After OSDH gets all your documents, you go in a queue for an initial on-site survey. Your agency must be ready for business at the time of the survey. Have your policies, staff files, and office ready.
Administrator Certification
Every Home Care Agency License or Sitter/Companion Service Agency License must designate an administrator who has completed the 160-hour certification program.
- Training Hours:160 Hours
- Training Cost:$140 initial certificate ($80 deeming application, if used) + training and exam fees; $55 yearly renewal
- Topics:A 160-hour OSDH-approved preparedness program or a deeming path, then the OHCAPA exam (Oklahoma Home Care Administrator Preparedness Assessment). Take the exam within 3 months of finishing the program or being deemed. Apply for the certificate within 6 months of passing. 12 CE hours each year. Certificate expires July 31.
Source: OAC 310:664-5-4; 63 O.S. §1-1962a · Checked Oct 2026
Estimated Startup Costs (2026)
Budget for $25,000 - $50,000 to ensure 3-6 months of runway.
| Category | Low Est. | High Est. |
|---|---|---|
| OSDH Initial Application Fee | $1,000 | $1,000 |
| Annual Renewal Fee | $500 | $500 |
| Branch Office Fee (if applicable, $25 each) | $0 | $25 |
| Business Formation (LLC with SOS) | $75 | $400 |
| Administrator Training (160 hrs) + OHCAPA Exam + $140 Certificate | $500 | $2,000 |
| General Liability Insurance (state minimum $100K/$300K) | $600 | $2,500 |
| Professional Liability Insurance | $400 | $1,800 |
| Workers' Compensation Insurance | $400 | $1,800 |
| Fingerprint Background Checks via OKSCREEN (initial staff) | $200 | $800 |
| HHA Training Program (75 hours, if Home Care Agency) | $400 | $1,200 |
| Office / Administrative Setup | $400 | $2,500 |
| Initial Marketing & Website | $1,200 | $4,500 |
| Working Capital (3-6 months) | $10,000 | $25,000 |
We map every cost and file your Oklahoma license for you.
How to Get an Oklahoma Home Care Agency License
1-3 Days
Choose Your License Type
Decide between Home Care Agency License (hands-on personal care) and Sitter/Companion Service Agency License (no hands-on care). This sets your training rules, staffing, and services.
1-2 Weeks
Register Your Business
Register your LLC or corporation with the Oklahoma Secretary of State. Obtain an EIN from the IRS. Register for state tax accounts.
4-8 Weeks
Get Your Administrator Certified (OHCAPA)
Finish a 160-hour OSDH-approved preparedness program. Or qualify by deeming, for example with a bachelor's degree plus 1 year of full-time home care work in the past 2 years. Pass the OHCAPA exam. Apply for your certificate within 6 months of passing. Pay $140 and send an OSBI check done in the past 60 days. You need a copy of this certificate for your license application.
1-2 Weeks
Secure Insurance
Get liability insurance of at least $100,000 per occurrence and $300,000 aggregate (OAC 310:662-2-1). Many agencies carry more. Also get workers' compensation. You must send copies with your application.
2-4 Weeks
Develop Policies and Procedures
Write a full manual for care, emergencies, staff, client rights, client agreements, privacy, and quality, per OAC Title 310 Chapter 662. You must not mislead clients about services or charges (OAC 310:662-3-3).
2-4 Weeks
Complete Background Checks and Staff Training
Run background checks on all direct care staff through OKSCREEN, the OSDH fingerprint background check portal (OSBI and FBI). For a Home Care Agency license: aides must be OSDH-certified and listed on the Oklahoma Home Health Aide Registry. Screen client-contact staff for TB. Offer all staff a free flu shot each year (OAC 310:662-3-4).
1-2 Weeks
Submit Application to OSDH
Send ODH Form 757 (Home Care Agency) or ODH Form 1273 (Sitter/Companion) to OSDH with the $1,000 fee. For a home care agency, attach your LLC or corporation papers, proof of liability and workers' comp insurance, your administrator's certificate, and your supervising RN's and alternate RN's licenses. Add proof of money to operate (bank statement, letter of credit, or line of credit) and a six-month staffing and visit estimate. Complete applications are handled in the order received (OSDH guidance letter).
4-8 Weeks
Pass Initial On-Site Survey
Once OSDH has all your documents, you wait in a queue for the initial on-site survey. Your agency must be ready for business when surveyors come. Fix any problems they find. OSDH issues the license after you pass. Home care agency licenses expire July 31 each year. A sitter/companion license expires one year after it is issued (OAC 310:662-8-3).
We can do all of them for you in Oklahoma.
New 2026 Legal Mandates
State License Required (Home Care Act, 63 O.S. Section 1-1960; OAC 310:662)
You need a Home Care Agency License or a Sitter/Companion Service License from OSDH. The fee is $1,000 to apply and $500 to renew each year. Home care agency licenses expire July 31. Giving home care before you have a license can bring a penalty of up to $10,000.
Administrator Certification (63 O.S. Section 1-1962a; OAC 310:664)
Your administrator must be certified by OSDH and listed on the Home Care Administrator Registry. Certification takes a 160-hour approved program (or deeming), the OHCAPA exam, a $140 fee, and an OSBI background check. It expires July 31 each year. Renewal costs $55 and needs 12 CE hours (none for the first renewal). Post the certificate at your office (OAC 310:662-3-4).
Fingerprint Background Checks (63 O.S. Section 1-1950.1)
State law requires criminal history checks on direct care staff. OSDH runs them through OKSCREEN, its fingerprint background check portal (OSBI and FBI). Fingerprints are taken at IdentoGO sites. OSDH says the provider pays $19 and the worker pays $10. Administrators also need an OSBI check for certification.
Certified Home Health Aides (OAC 310:662-5-3; OAC 310:677)
For a Home Care Agency license, aides must be certified by OSDH and listed on the Home Health Aide Registry. Training is at least 75 hours of classroom and supervised practice plus a competency test. You may not keep an uncertified aide more than 4 months. Aides need 12 hours of in-service training each calendar year.
Initial Survey and RN Supervision
OSDH does an on-site survey before it issues your license. Your agency must be ready for business. A personal-care-only agency must employ or contract with a supervising RN or physician, who can be on call (OAC 310:662-3-4). A physician or licensed nurse must visit each aide-only client at least every 6 months (OAC 310:662-5-3).
Honest Business Practices and Client Agreements
Agencies must adopt written standards of practice. You may not mislead a client or family about services or charges (OAC 310:662-3-3). Put services and fees in a written client agreement.
TB Testing, Flu Shots, and Branch Offices
Staff with client contact need TB screening (OAC 310:662-3-4). You must offer a free flu shot each year and keep vaccine or declination records. Each home care branch office costs $25 to license and renew.
Our Oklahoma licensing team tracks the law so you do not have to.
Caregiver Mandates
Important Warning
If you hold a Home Care Agency License, your aides must be OSDH-certified and on the Home Health Aide Registry. You cannot keep an uncertified aide more than 4 months. Certification means at least 75 hours of training plus a competency test. Plan for it in your timeline and budget. Sitter/Companion agencies have lighter training rules but cannot give hands-on personal care.
- Fingerprint Background Check (OKSCREEN): Criminal history check for all direct care staff before they serve clients (63 O.S. Section 1-1950.1). OSDH runs it through OKSCREEN, its fingerprint portal (OSBI and FBI).
- Certified Home Health Aide (Home Care Agency License): Aides must be OSDH-certified and listed on the Oklahoma Home Health Aide Registry. Training is at least 75 hours plus a competency test. Then 12 hours of in-service each calendar year (OAC 310:677-9-1).
- Supervision and Health Screening: A personal-care-only agency must employ or contract with a supervising RN or physician. They can be on call (OAC 310:662-3-4). A physician or licensed nurse visits each aide-only client at least every 6 months (OAC 310:662-5-3). Client-contact staff need TB screening. All staff get a yearly free flu shot offer.
- Initial Orientation: Your personnel policies must include orientation of all staff to agency policies (OAC 310:662-3-4). Cover client rights, safety, and emergencies too.
Regional Billing Snapshots
*Regional rates vary by specialized care needs (Dementia, Parkinson's) and local competition.*
We launch Oklahoma home care agencies start to finish.
Regional Market Opportunities
Oklahoma has about 4.1 million people. About 741,000 are 65 or older (18%, Census 2025 estimate). Oklahoma City and Tulsa have the most people. The billing rates below are our estimates, not official numbers. For aide pay, check BLS wage data for your area.
Oklahoma City Metro
State capital and largest metro. Big health systems include OU Health and INTEGRIS. Likely the most competition, and the most demand.
Key: Build ties with hospital discharge planners. Suburbs like Edmond may have more private-pay clients.
Tulsa Metro
Second-largest market. Saint Francis is a big local health system. Suburbs include Broken Arrow, Bixby, and Jenks.
Key: Build hospital referral ties. Check how many agencies already serve your part of town.
Norman / South-Central OK
University of Oklahoma town, close to Oklahoma City.
Key: A good place to start, close enough to grow into the OKC metro later.
Lawton / Southwest OK
Home to Fort Sill. Military retirees and families live here.
Key: Military retirees can be a client source. Check how many agencies already serve the area.
Rural Oklahoma / Eastern OK
Large rural areas, many tribal nations, and few home care options. Long drives are a challenge.
Key: Don't try to cover too big an area. Medicaid (ADvantage) may be a big payer here. Learn about the tribal health programs in your area.
Cost of care in Oklahoma
What agencies charge clients vs. what caregivers earn in Oklahoma. The difference is the agency's gross margin per billable hour — before overhead like insurance, admin, marketing, and compliance costs.
$31.5
Avg. hourly rate charged to clients
$17.89
Avg. caregiver hourly wage
$13.61
Gross margin per hour
43%
Gross margin %
What this means for agency owners
In Oklahoma, agencies keep roughly $13.61 per billable hour after paying the caregiver. That's a 43% gross margin.
This is a strong margin that gives you room to cover overhead costs (insurance, admin, marketing, compliance) and still run a profitable agency.
Sources: Avg. hourly rate from CareYaya and CareScout 2025 surveys (averaged). Caregiver wage from Care.com. Gross margin is before overhead costs like insurance, admin, marketing, and compliance.
Oklahoma Medicaid Programs
ADvantage Waiver Program (SoonerCare)
A SoonerCare (Medicaid) waiver. The Oklahoma Health Care Authority (OHCA) has details. It serves adults 65 and older and adults with physical disabilities who need nursing home level care. It helps them stay at home with services like personal care. Ask OHCA how to become a provider.
Private-Pay + ADvantage Strategy
Many new agencies start with private-pay clients in OKC or Tulsa. They sign up for ADvantage once things run well.
Becoming a Provider
Essential 2026 Tech Stack for Owners
Tiles outlined in teal are areas HomeCareAtlas covers in our platform.
Oklahoma Licensing FAQ
What license do I need for home care in Oklahoma?
Oklahoma has two license types under OAC 310:662. The Home Care Agency License is for personal care (help with bathing, dressing, walking). Its aides must be OSDH-certified and on the Home Health Aide Registry. The Sitter/Companion Service License is for companion or sitter help with no hands-on care. Choose based on what you will do. Both need an OSDH application, a $1,000 fee, and a survey.
How much does an Oklahoma home care license cost?
The application fee is $1,000 and is not refunded. Renewal is $500 a year. Each home care branch office is $25. Home care agency licenses expire July 31. Our estimate for total startup costs is $25,000 to $50,000.
How long does licensing take in Oklahoma?
OSDH does not publish a set timeframe. Our estimate is 45-120 days. OSDH handles complete applications in the order received, then puts you in a queue for the initial on-site survey. Your administrator must already be certified before your application is complete.
What is the OHCAPA exam?
OHCAPA is the Oklahoma Home Care Administrator Preparedness Assessment, the state exam. To be certified, you finish a 160-hour OSDH-approved program or qualify by deeming. One deeming path is a bachelor's degree plus 1 year of full-time home care work in the past 2 years. Then you pass the OHCAPA exam and apply within 6 months. The certificate costs $140 and needs an OSBI background check. It expires July 31 each year. Renewal is $55 plus 12 hours of continuing education.
What training do caregivers need in Oklahoma?
For Home Care Agency licensees: aides must be OSDH-certified (at least 75 hours of training plus a competency test) and listed on the Oklahoma Home Health Aide Registry, then do 12 hours of in-service a year. For Sitter/Companion agencies: the state sets no training hours, but background checks still apply.
Is Oklahoma a good market for home care?
It can be. About 741,000 Oklahomans are 65 or older (Census 2025 estimate). Startup costs can be lower than in bigger states. The ADvantage waiver adds a Medicaid option.
What's the difference between the two license types?
Home Care Agency License: allows hands-on personal care (bathing, dressing, walking). Aides must be OSDH-certified and on the HHA Registry, and you need a supervising RN or physician. Sitter/Companion Service License: companion or sitter help with no hands-on care. It does not allow home care services. It also needs a place of business in Oklahoma that is open to the public (OAC 310:662-8-4).
Starting in a Nearby State?
Licensing requirements vary a lot between states. Compare your options:
Texas
$2,625 fee · 4-6 Months
Kansas
$250 fee · 60-90 Days
Arkansas
No state license required · 2-4 Months
Missouri
No state license required · 4-8 Weeks
Want us to handle your Oklahoma licensing?
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Home care agencies in Oklahoma
Want to see the competition up close? Look at who is already open, city by city.
- Home care agencies in Oklahoma City
- Home care agencies in Tulsa
- Home care agencies in Norman
- Home care agencies in Durant
- Home care agencies in Broken Arrow
Looking for care for a family member? Find agencies near you
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Where our numbers come from
We check each fact against Oklahoma's own rules. Tap a source to read it yourself.
- License needed?YesOAC 310:662-2-1; 63 O.S. §1-1962(A)· Oct 2026
- Who oversees itOklahoma State Department of Health (OSDH, Medical Facilities Service)OAC 310:662-1-2; 63 O.S. §1-1961(3)· Oct 2026
- License nameHome Care Agency License or Sitter/Companion Service Agency LicenseOAC 310:662 (Subch. 2 and Subch. 8)· Oct 2026
- The rulesOAC 310:662OAC 310:662· Oct 2026
- First license fee$1,000OAC 310:662-2-1(d)(1)· Oct 2026
- License lasts1 yearOAC 310:662-2-1(g)· Oct 2026
- BondNoneOAC 310:662-2-1(c)(5); 63 O.S. §1-1960 et seq.· Oct 2026
- Owner/manager training160 hoursOAC 310:664-5-4; 63 O.S. §1-1962a· Oct 2026
- Caregiver training75 hoursOAC 310:677-9-4; OAC 310:662-5-3(f)· Oct 2026
- Background checksFingerprint-based state and FBI check through OSDH's OK-SCREEN portal, plus registry screening, before hire63 O.S. §1-1950.1(B); Long-Term Care Security Act (63 O.S. §1-1944 et seq.)· Oct 2026
- How long it takes45-120 DaysBest guess — not confirmed yet
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This guide is for informational purposes only and does not constitute legal, regulatory, or business advice. Licensing requirements, fees, and regulations change frequently. Always verify current requirements with your state's licensing agency before making business decisions. HomeCareAtlas is not responsible for the accuracy or completeness of this information.
Researched and reviewed by
John Helmy, Founder of HomeCareAtlasBuilding tools and resources to help home care agency owners navigate licensing, compliance, and growth.