How to Start in Canada

How to Start a Home Care Business in Ontario

How to start a home care business in Ontario: the THA licence and $25,000 security deposit most agencies need, hiring PSWs, insurance, and Ontario Health atHome contracts.

Written October 17, 2026 · 12 min read

Applies in: Ontario

The path in one paragraph

Starting a home care agency in Ontario is a labour-compliance business that happens to sell care. There is no health-ministry licence to chase — the licence that matters is the Temporary Help Agency licence from the Ministry of Labour ($750 to apply, $750 a year to renew, plus a $25,000 security deposit), because you employ caregivers and assign them to clients. Around that, you register the business, get insured, hire credentialled staff (certified PSWs for personal support, CNO-registered nurses if you offer nursing), and either sell directly to private-pay families or bid for Ontario Health atHome contracts as a prequalified Service Provider Organization. Get the compliance layer right first; it is the part that sinks agencies.

First: the licence question everyone gets wrong

Beginners look for a health-care licence and find none, then assume no licence is needed. Both halves are wrong in the same way:

  • There is no health-care licence for home care agencies. The Retirement Homes Regulatory Authority licences retirement homes (buildings where seniors live and receive care services), not agencies that send caregivers into clients' homes. Do not confuse the two — and do not market yourself as "licensed" on the strength of an RHRA-style claim you do not hold.
  • The licence you likely need is a labour one. Since the licensing regime took effect in July 2024, businesses that employ workers and assign them to clients on a temporary basis need a Temporary Help Agency licence under Part XVIII.1 of the Employment Standards Act. Most home care agencies — private-pay managed care, government-contracted care, and caregiver-staffing models alike — land inside that definition.
  • The Ministry decides your specific case. The THA licensing office is explicit: whether a business counts as a THA is determined case-by-case by an employment standards officer during an inspection or claim investigation. You cannot get an advance ruling. The practical move is to apply and comply rather than to argue your way out of it.
  • The price of getting it wrong is steep. $750 application fee (non-refundable), $750 annual renewal, the $25,000 security deposit — and fines of $15,000 / $25,000 / $50,000 for operating unlicensed on the first, second, and third offences.

Treat the THA licence as step zero, not a detail to sort out after your first client.

Step 1: Pick your service model before you register anything

Home care splits into lanes with different staffing, pricing, and risk — and your model decides almost everything downstream:

  • Companionship and homemaking (non-medical). Conversation, meal prep, light housekeeping, laundry, transportation, medication reminders (not administration). Lowest regulatory surface; staffed by caregivers and PSWs.
  • Personal support (non-medical, hands-on). Bathing, dressing, mobility and transfers, continence care — the classic PSW scope. This is where the market-standard hire is a certified PSW (the 700-hour NACC standard) even though no law mandates the credential.
  • Skilled / medical home care. Nursing visits, wound care, medication administration, post-surgical care. Requires CNO-registered RNs or RPNs; verify every registration yourself.
  • Government-contracted care. You bid as a Service Provider Organization to Ontario Health atHome and deliver publicly funded care under their oversight. Different sales motion, steadier volume, heavier compliance.

Most new agencies start in the first two lanes (private-pay families) and add the rest later. Decide now, because your insurance, hiring plan, and marketing all follow from it.

Step 2: Register the business

The paperwork is ordinary small-business registration, in this order:

  1. Choose the structure. See the FAQ above on sole proprietorship vs. corporation — for a care business, the liability argument for incorporation is strong. Get professional advice before you choose.
  2. Register the name. A master business licence through ServiceOntario costs $60 and is valid for five years (sole proprietorships and partnerships); corporations register federally or provincially instead.
  3. Get a Business Number. Free from the CRA; you will need it for payroll, and for GST/HST if your revenue crosses the $30,000 small-supplier threshold. (Our sole-proprietorship and GST/HST guide walks through the BN and GST/HST mechanics.)
  4. Register with the WSIB. Mandatory within 10 days of hiring your first employee — weekends and holidays count. Do not discover this deadline after the fact.
  5. Check the Employer Health Tax. Whether you owe Ontario's EHT depends on your payroll; confirm the exemption rules with the Ministry of Finance before you assume you are exempt.

Step 3: Get the THA licence

Apply through the Ministry of Labour's THA licensing process. You will need:

  • The legal name of the business and all locations; for corporations, the names and addresses of officers and directors.
  • The $750 application fee (non-refundable even if the application is refused), and budget $750 every year for renewal.
  • The $25,000 security — an irrevocable letter of credit or surety bond. Arrange this with your bank or a surety provider before you apply; it is the item that slows applications down.
  • Confirmation of compliance with the ESA, the Employment Protection for Foreign Nationals Act, and the Occupational Health and Safety Act, plus tax compliance verified with the Ministry of Finance.

Keep the licence current and verifiable: families increasingly check the public THA licence status portal before hiring an agency, and "licence pending" reads as a red flag.

Step 4: Build the care team to a hireable standard

Your caregivers are the product. The hiring bar that wins private-pay clients:

  • PSWs: hire to the certificate. Look for the 700-hour NACC-standard PSW certificate and check applicants against the voluntary HSCPOA registry (free, running since December 1, 2024) — employers have been able to require registration as a job qualification for PSWs hired after January 1, 2026, so checking it keeps you ahead of the market. See our guide to becoming a PSW in Ontario for what the credential means.
  • Nurses: verify CNO registration. If you offer skilled care, every RN and RPN must hold current College of Nurses of Ontario registration. Check the public register yourself.
  • Screen like a care business. Vulnerable-sector police checks, reference checks with former care employers (not just character references), and current CPR and First Aid certification as a condition of client-facing work.
  • Onboard to a plan of care. Even in the non-medical lanes, write a care plan for each client and supervise against it. Supervised, plan-driven care is both better service and your best evidence if the THA classification is ever questioned.

PSW wages are the labour market you are buying into: Ontario's provincial median sits around $24 an hour (Job Bank, November 2025), with long-term care and hospitals paying toward the top and some agency roles below it. Price your services against what good caregivers actually cost to retain, not against the cheapest competitor's flyer.

Step 5: Get insured properly

A generic small-business policy will not cover a care agency's exposures. Work with a broker who writes care-business policies and expect to carry:

  • Commercial general liability sized for a business whose employees work inside clients' homes.
  • Professional liability (errors and omissions) for the care services themselves.
  • WSIB coverage for employees (Step 2 — this one is mandatory, not optional).
  • Non-owned auto liability if caregivers drive their own cars between client visits, since personal auto policies often exclude work use.

Get the quotes before you sign your first client, not after your first incident.

Price the service: the Ontario rate card

Families comparison-shop on hourly rate first and everything else second, so your rate card has to sit inside the market bands while leaving you a margin after labour, insurance, the THA overhead, and travel between visits. What Ontario agencies actually publish in 2026:

For PSW-level personal support through an agency, $28–$35 an hour is the band across most of Ontario, rising to $30–$40 in Toronto. Overnight shifts run $200–$350 a night, live-in care $250–$450 a day. Companionship and homemaking starts cheaper, around $19–$26 an hour, though some agencies hold a single from-$28 rate across both lanes. Skilled nursing sits well above: registered nurse visits run roughly $45–$80 an hour, with RPN clinical care starting near $38.

Two pricing conventions matter almost as much as the rates. First, a 3–4 hour minimum per visit is standard: a 90-minute bath visit is usually billed as three hours because the caregiver's travel costs you the same. Second, evenings, weekends, and statutory holidays commonly carry a 10–25% premium. Put both in writing up front rather than surprising families on the first invoice.

The margin math that has to work: Ontario PSWs sit at roughly $24 an hour in wages (Job Bank), and agencies bill $28–$35. That $4–$11 spread pays for your insurance, scheduling, caregiver backup, supervision, and travel time. Price below the band and you are subsidising every visit; price above it and you need a reason, like dementia specialisation or complex care, that families can see. Publish your starting rates ("from $28/hour" beats "call for a quote") and put the full fee schedule, minimums and premiums included, in writing before the first visit.

Step 6: Find clients — private pay first, contracts second

New agencies almost always start with private-pay families: the sales cycle is days, not procurement quarters. What works in Ontario:

  • Discharge planners and hospital social workers are the highest-trust referral source for post-hospital home care — introduce the agency in person, leave a one-page services sheet, follow up.
  • A real local web presence. Families search "[city] home care" at 2 a.m. after a hospital discharge; a clear services page, transparent pricing ranges, and your THA licence number visible on the site beat a franchise directory listing.
  • Google Business Profile and reviews. Home care is a reviews business. Ask every satisfied family.
  • Retirement homes and condos with aging residents — bulletin boards, info sessions, and relationships with building managers.

The second lane is Ontario Health atHome contracts: register on the Ontario Tenders Portal, apply for prequalification through Ontario Health atHome, re-prequalify every year, and bid. It is slower and more demanding, but SPO contracts are the steadiest revenue in Ontario home care — and note that holding one still requires the THA licence.

Step 7: Run it like a compliance business

The agencies that survive treat compliance as operations, not paperwork:

  • Keep the THA licence and renewals on a calendar. An expired licence is an unlicensed agency.
  • Payroll discipline. The $25,000 security deposit exists because agencies have failed to pay caregivers — never be the example. ESA rules on hours, overtime, and public holidays apply to your assignment employees.
  • Document care. Care plans, visit notes, incident reports. Documentation is your quality system and your legal shield in one.
  • Supervise actively. A nurse or experienced supervisor reviewing care documentation weekly is what separates managed care from caregiver-matching — in service quality and in how an inspector sees you.

Related guides

Questions people ask

Do I need a licence to start a home care business in Ontario?

Almost certainly yes — but not a health licence. Most Ontario home care agencies need a Temporary Help Agency (THA) licence under the Employment Standards Act, because they employ caregivers and assign them to clients. The application costs $750 (non-refundable, and $750 each year to renew), and you must post a $25,000 security deposit. The Ministry of Labour decides case-by-case whether a given business counts as a THA, so the safe move is to apply and let them confirm. Operating without a required licence carries fines of $15,000, $25,000, and $50,000 for the first, second, and third offences.

Is there a health-care licence for home care agencies in Ontario?

No. This is the most common confusion. The Retirement Homes Regulatory Authority (RHRA) licences retirement homes — buildings where seniors live and receive care — not home care agencies. Home care agencies answer to no health regulator. The licence you likely need is the labour-law one: the Temporary Help Agency licence from the Ministry of Labour, which has been required for THAs since the licensing regime took effect in July 2024.

What is the $25,000 security deposit for?

It protects your employees' wages. When you apply for (and hold) a THA licence, you post $25,000 — usually as an irrevocable letter of credit or a surety bond — which the government can draw on if the agency fails to pay its workers. It is security rather than a sunk cost — held for the life of the licence, and you need to arrange it before your application is complete.

Do my caregivers have to be certified PSWs?

There is no law forcing a home care agency to hire only certified PSWs — PSW itself is not a licensed occupation in Ontario. But the market standard is a completed PSW certificate (the 700-hour NACC standard), and most competitors hire to that bar. You can also check the voluntary HSCPOA registry (free, began December 1, 2024) when vetting PSW applicants; employers have been able to require it as a job qualification for PSWs hired after January 1, 2026. Hiring below the credential standard saves money on wages and costs you clients — families ask.

Can my agency offer nursing services?

Only with regulated professionals doing the nursing. Registered Nurses and Registered Practical Nurses are regulated under the Regulated Health Professions Act and must hold current registration with the College of Nurses of Ontario — a PSW cannot do nursing work, and an unregulated worker cannot perform controlled acts. If you want to offer skilled (medical) home care, your nurses' CNO registrations must be current, and you should verify them yourself rather than taking a résumé at face value.

How do I get government home-care contracts?

Through Ontario Health atHome, which buys home care services from Service Provider Organizations (SPOs). The path is: register on the Ontario Tenders Portal, apply for prequalification through Ontario Health atHome (you must prequalify annually), and then bid on procurements you are prequalified for. This is a real revenue lane — many agencies live on SPO contracts — but the procurement bar is high: expect due diligence on finances, experience, and compliance, and note that an Ontario Health atHome contract still means you need a THA licence.

Should I register as a sole proprietor or incorporate?

For a care business, incorporation deserves serious consideration. You are sending employees into clients' homes to care for vulnerable people; the liability exposure is real, and a corporation separates the business's liability from your personal assets in a way a sole proprietorship does not. Incorporation costs more and adds annual paperwork (and possibly a higher accounting bill), but most home care operators land on incorporation for exactly this reason. Talk to an Ontario accountant or lawyer before you choose — this guide is not legal advice.

What insurance does a home care agency need?

At minimum, commercial general liability and professional liability (errors and omissions) coverage sized for a care business, plus WSIB coverage for your employees — you must register with the WSIB within 10 days of hiring your first worker. If staff drive between client visits, check whether their personal auto policies cover work use; many agencies carry non-owned auto liability. Get quotes from a broker who writes care-business policies, because a generic small-business package often excludes the exact exposures you have.

How much does it cost to start a home care business in Ontario?

The fixed compliance chunk is knowable: the $750 THA application fee (plus $750 yearly renewal) and the $25,000 security deposit, which is security rather than a sunk cost. On top of that you carry the usual small-business costs — business registration, insurance premiums, a scheduling/payroll system, marketing, and several months of payroll before revenue steadies. The honest answer is that nobody can quote your total without knowing your model; build the number from your own quotes and do not trust round-number estimates from franchise marketing.

Should I buy a home care franchise or start independent?

A franchise buys you a brand, operating playbook, and marketing systems — and charges for them, both upfront and in ongoing royalties. An independent agency keeps every dollar of margin but has to win families' confidence, build operating systems, and develop referral relationships from zero. The deciding question is not which is 'better' but what you lack: if you have care experience and no business systems, the franchise's playbook may be worth the price; if you have business experience and local networks, the royalty stream buys less. Either way, the THA licence, insurance, and registration obligations are identical.

What should a new agency charge per hour?

Sit inside the 2026 market bands: $28–$35 an hour for PSW-level personal support through an agency ($30–$40 in Toronto), starting near $19–$26 for companionship, $45–$80 an hour for RN visits, $200–$350 an overnight shift, and $250–$450 a day for live-in. Standard is a 3–4 hour minimum per visit, with 10–25% premiums on evenings, weekends, and holidays. The margin math that must work: Ontario PSWs earn roughly $24 an hour in wages, so the spread between what you pay and what you bill covers insurance, scheduling, backup staff, supervision, and travel time. Put starting rates on the site and the full fee schedule in writing before the first visit.

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