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Bureau of Regulatory Operations

The Bureau of Regulatory Operations is responsible for licensing, certification, and enforcement for health care facilities, services, and programs.

The Health Care Facilities Licensure and Certification Section (HCF Licensure) is responsible for the licensing and certification of health care facilities.  For example:

  • Nursing Homes also know as Long Term Care Facilities
  • Residential Care facilities also known as Assisted Living Facilities
  • Intermediate Care Facilities/Individuals with Intellectually Disabilities
  • Hospices
  • Maternity Units
  • Ambulatory Surgical Facilities
  • Dialysis Centers
  • End Stage Renal Disease Facilities

The Licensure Unit provides licensure consultation, central processing, and support for over 2,500 facilities, programs, and services throughout the state of Ohio.  The Certification Unit provides Medicare/Medicaid certification consultation, central processing, and support for over 3,000 facilities, programs, and services throughout the state of Ohio.  In addition, HCF Licensure has an Information Management Unit which includes functions related to document management, public information, and the Nurse Aide Registry.

The Enforcement Section (Enforcement) is primarily responsible for state and federal health care provider program enforcement. 

The Investigations Section is responsible for certain investigatory activity within BROL and is comprised of two main components.  The Abuse, Neglect and Misappropriation Unit (ANM)  investigates allegations against individuals used by long-term care facility which are required by Ohio and Federal law. 

Policy, Projects and Research Section (PPR) has primary responsibility in BRO for ensuring the timely and appropriate development of, and review and comment on, CMS regulations, legislation and regulations that pertain to the licensure, certification, and registration of health care professionals, facilities, services, products, and laboratories as well as any other matters that are of interest to BRO.  As part of this responsibility, the section coordinates activities with federal, state, and local agencies, health care providers, consumers, professional associations, and other interested parties. 

The Smoke Free Workplace Unit  conducts and coordinates compliance with Ohio’s smoke free workplace law by investigation complaints.  Most investigations are conducted by local health departments pursuant to contracts with ODH.  The unit retains overall supervision of those investigations performed by the local health department and takes appropriate enforcement actions.


The CON and Health Care Services Section (CON) is responsible for the Certificate of Need program and health care services monitoring and hospital registration. The unit reviews and approves applications for the following types of activities: 

  • The development of a new long-term care facility
  • The replacement an existing long-term care facility
  • The renovation of or addition to a long-term facility that involves the expenditure of $2 million or more, excluding equipment, an increase in long-term care bed capacity
  • The relocation of long-term care beds from one site to another. 

Finally the CON unit monitors the long-term care bed inventory and administers the hospital registration process for approximately 250 hospitals in the state of Ohio.