How to start a nursing or PSW agency in Ontario (2026)

What licences does a nursing or PSW agency need in Ontario?

You must follow the same seven steps as any Ontario staffing agency. Register your business, obtain a $1,500 THA licence (plus the $25,000 letter of credit), register with WSIB within 10 days of your first hire, open a CRA payroll account, secure insurance, land your first healthcare client, and build your operational systems. Healthcare staffing agencies are temporary help agencies under the Employment Standards Act, so the regulatory path is identical. See our general guide to starting an Ontario staffing agency for the full seven-step walkthrough.

Healthcare addition 1: Nursing credentials and verification

Before assigning a nurse (RN or LPN) to a client, verify their professional registration. Registered Nurses and Licensed Practical Nurses must be registered with Professional Engineers Ontario (PEO) or the College of Nurses of Ontario (CNO). You can confirm registration status online on the CNO website. Many healthcare clients require you to flag expiry dates (e.g., when a nursing licence comes up for renewal) and some will not allow assignment to a worker whose licence is expired or lapsed.

For nurses, you are verifying professional standing, not just a certificate. A lapsed licence means the nurse cannot legally practice in Ontario, so tracking renewal dates is a compliance obligation.

Healthcare addition 2: PSW credentials and provider verification

Personal Support Workers (PSWs) in Ontario are not regulated by a single college, so there is no central registry. Verify PSW certification against the provider your client recognizes (e.g., Mohawk College, Centennial College, or Red Cross). Ask your client which PSW certifications they accept; there is no legal requirement, but clients have their own standards.

Some clients will accept a PSW certificate from any recognized provider, others accept only specific colleges, and some require additional credentials (e.g., a food handler certificate, a valid driver's license). Ask your client upfront what PSW credentials they require, then verify them before assignment.

Healthcare addition 3: Vulnerable-sector checks

A vulnerable-sector check (VSC) is a police background check specific to working with vulnerable populations. Ontario law does not mandate it for staffing agencies, but virtually all healthcare clients require it. A VSC is not a Kordis capability; you will arrange it through a local police service or a third-party provider.

Frame it honestly: this is a market expectation, not a legal requirement. Most agencies arrange VSCs for their workers (typically CAD$20 to $30 per check) and pass the cost to the client or factor it into rates. Include VSC status in your worker records; clients will ask whether a worker has been cleared.

Healthcare addition 4: Bill 11 (Health Care Staffing Agency Reporting Act, 2025)

Bill 11 received Royal Assent on June 28, 2025, but has not yet come into force as of July 2026. It is awaiting a proclamation order from the Lieutenant Governor in Council. When it does come into force, agencies assigning staff to public hospitals, long-term care homes, and other prescribed health care facilities will be required to submit reports to the Minister at least every six months, including aggregate pay rate information for assigned staff.

What you should do now: even though Bill 11 is not yet in force, start keeping records that Bill 11 will require. Retain copies of all contracts (entered into, amended, or modified after Bill 11 comes into force) for 3 years after the contract expires. Also retain invoices relating to administrative, billing, or pay rate information. Many agencies use this lag time to prepare record-keeping systems so that when the Act is proclaimed, they are already compliant.

Private-pay home care or facility staffing: which are you running?

Two distinct healthcare segments: private-pay home care (assigning nurses and PSWs to clients' private residences, often elderly or palliative care) and facility staffing (assigning staff to hospitals, long-term care homes, retirement homes). Both follow the same THA licensing path, but facility staffing carries Bill 11 obligations (once the Act is proclaimed) and typically involves stricter credential verification.

Private-pay home care is often less regulated but more sensitive to individual client preferences, while facility staffing is more regulated but follows standardized hiring processes. Choose your initial focus based on your local market and your relationships.

Building your healthcare operations spine

Once licensed and registered, set up systems to track credential status for every worker. For nurses, track registration expiry dates and flag when renewal is due (typically every 2 to 3 years). For PSWs, track certification, date of issue, and expiry or renewal timeline. Many clients will not allow assignment if a credential is expired, so dispatch gating (blocking a worker from a shift if their credential has lapsed) is essential.

Also track assignment history and rates. Bill 11 will require you to report rates every 6 months once the Act is proclaimed, so a system that records which worker was assigned to which facility and at what rate will be invaluable when the reporting requirement kicks in.