How to Open a Nurse-Owned Practice in Ohio

You've done the math in your head more than once. A few injectable appointments on your day off, on your own schedule, in your own space, and suddenly the shifts you pick up out of obligation start to look optional. Ohio has three real metros in Columbus, Cleveland, and Cincinnati, plus a long list of mid-size towns like Dayton and Toledo where a nurse-owned practice can be the only serious injector for 30 miles. Rent is reasonable and patients are loyal. (Already run your own practice? Skip ahead, there's a section below built specifically for you.)

The thing that stops most nurses in Ohio was never the clinical work. You already do harder things on a Tuesday than a first tox or IV appointment will ever ask of you. What stops people is everything around it, the ownership rules, the medical director, the setup, all sitting there as one giant undefined to-do. So let's take it in order, starting with the question every Ohio nurse asks first.

Can a nurse own an aesthetics, wellness, or functional health practice in Ohio?

Yes. The State Medical Board of Ohio's own position statement says "the Ohio legislature has made it clear that the corporate practice of medicine doctrine no longer exists in Ohio," and a physician may practice as an employee of a corporation, LLC, or any other business entity (State Medical Board of Ohio, Corporate Practice of Medicine position statement, approved March 15, 2012, reaffirmed May 15, 2023). An RN can form a standard Ohio LLC, own it outright, and contract with a medical director.

The Ohio rule that catches almost everybody

The medical board wrote a whole chapter on delegation, and the sentence people miss is this: "when a physician delegates the administration of drugs, that physician shall provide on-site supervision" (Ohio Adm. Code 4731-23-02). On-site means the same office suite, not the same room (4731-23-01). That chapter defines delegation as transferring a medical task to an "unlicensed person." An RN giving a medication on a valid order is practicing nursing under Chapter 4723, which requires "a specific current order from an individual who is authorized to practice in this state" (Ohio Adm. Code 4723-4-03), and never touches the delegation chapter. The trap is the moment you hand a syringe to an unlicensed person. That's the day the physician has to be in the building.

Can an NP be the medical director in Ohio?

Yes, with a physician behind them on paper. Ohio hasn't granted full practice authority. A certified nurse practitioner "may practice only in accordance with a standard care arrangement" with a collaborating physician or podiatrist, covering referral criteria, consultation, emergency coverage, and how disagreements get resolved (Ohio Rev. Code 4723.431). So an NP director writes the orders your RN works from, with a collaborating physician one layer back. The Five Square structure for Ohio hasn't been built yet, and this page won't guess at it.

The initial patient evaluation in Ohio

Ohio doesn't call it a good faith exam. Say the initial patient evaluation, which some states call a good faith exam. The Board of Nursing's interpretive guideline on cosmetic injectables requires a valid order from a licensed provider with the right knowledge in cosmetic procedures, that a medical evaluation has occurred, and that the nurse doesn't pick the drug or dose independently. On telehealth, the standard of care is the same as in person, and if video can't meet it the provider sees the patient in a reasonable timeframe (Ohio Adm. Code 4731-37-01).

One that surprises people: Ohio charges $99 to file your LLC and never asks for an annual report after that (Ohio Rev. Code 111.16).

How Five Square actually gets you started

The whole thing lives in one place: the free Five Square Nurses app. Your medical oversight, the step-by-step training, your pharmacy and vendor accounts, and the entire community of nurse business owners are all in there. You can open it between patients, on a lunch break, or on the couch at 9pm, and pick up right where you left off.

When you join, you're not handed a login and wished good luck. There's a Getting Started path that puts the order of operations right in front of you, so the mountain becomes a checklist.

You pick your lane, or combine them. Five Square supports three:

• Aesthetics. Tox and dermal filler, the core of a nurse-injector practice, with room to add more as you train.
• Wellness. IV therapy and vitamin injections. Low startup, very mobile-friendly, and a natural add-on to aesthetics.
• Functional Health. Peptides, lab work, and whole-person care for nurses who want longer-term, relationship-based patients.

You bring the nursing license and the nerve. We bring the medical director, the compliant Ohio setup, the training, member pricing on products, marketing help, and weekly live calls with experts and other nurse owners, so you're never stuck guessing alone.

And every Five Square member, brand new or already established, gets instant on-demand Good Faith Exams for $19.99 each, a price we subsidize because we believe in nurse success. A walk-in can be cleared in about a minute, seven days a week, and the exam paperwork lands right in the patient's chart, which is exactly what a state board wants to see.

You start before you feel ready, and that's the point

Most programs make you wait. Watch every module, sit through every call, and someday you finally see a patient. By then half the people who started have lost momentum. Five Square runs the other way: you start your practice while you're still finishing the training, because the training sticks when there's a real patient on next week's calendar.

Kayla, an ER nurse in North Carolina, had never injected anyone when she joined. She watched the videos, took notes, and set a goal of 30 people in 30 days. Here's the advice she'd give a nurse who's scared to start:

"Believe in yourself, even when you don't know how to do something. Figure it out. The clinical knowledge from your nursing career is more than enough to get started, and there's a community of people around you who want to help. Do it scared."
- Kayla, ER nurse

She launched April 4. Her first month: 46 appointments, 28 good-faith exams, and $10,320 in revenue, run out of a single room inside a salon she'd been a client at for years. That's one real month from one real nurse, not a typical result and not a promise, and your market and hours are your own. The point is she was exactly where you are, never-done-this-before, and she started anyway.

Does it actually work once you launch?

Getting launched is step one. What you really want to know is whether it works after that. Here's the honest picture, numbers included, because income claims in this industry deserve a skeptical read.

Results vary, and they depend on things no membership controls: your market, your hours, how long you've been at it, how consistently you market. As practices mature, some established members report months in the $10,000 to $20,000 range. Individual results vary widely. Some land higher, some lower, and nobody here will promise you a number.

What's more useful is the math underneath, which is public. Neurotoxin appointments bring in $200 to $600. A syringe of filler runs $500 to $800. IV sessions run $150 to $350. Functional health consults run $150 to $300, often with patients coming back monthly. At those prices, two to four appointments a month would cover the $899 membership before product costs, and everything past that is the business growing. Want to see it with your own pricing? Run your numbers in the Five Square membership earnings calculator.

The nurses say it better than a revenue range does:

"Having my own schedule, that flexibility as a mom to say the kids are at school these hours, so I can see patients and make way more than I was making at the hospital."
- Ashley C., RN

"The support is unreal. I did my first lip fillers and felt completely confident thanks to the training and the team."
- Tammi B., RN

Inside the community, the wins show up in real time. A nurse a few weeks into her launch posted she was already up to eight bookings, nearly all of it from one post in a local mom's Facebook group. Another saw a husband and wife for their good-faith exams in under ten minutes using the same-day exam tool when her director wasn't free. Scroll the forum any week and it's full of small wins like these.

The Google rating sits at 4.8 stars, and the reviews keep naming the same things: the setup help, the medical director, the training, and a team that answers when you're stuck.

Already run a practice in Ohio? There's a membership for that too

Not every nurse reading this is starting from scratch. Plenty of you already run your own practice and already pay for a medical director somewhere. If that's you, a lot of what's above is stuff you sorted out a while ago, and Five Square has a leaner membership built for exactly your spot. Ohio is on the Five Square expansion roadmap, and in most new states the Established Nurse Membership opens first, so if you already run a practice, you're likely first in line.

It's called the Established Nurse Membership. It's $799 a month, month to month, no annual lock. You get a medical director who's actually engaged, a compliant structure in Ohio, vendor and product pricing, the Five Square Nurse Community, and those instant on-demand Good Faith Exams at $19.99 each, a price we subsidize for our members because we believe in nurse success. There's no new-injector training folded in, because you don't need it and shouldn't pay for it. If you ever want the full education stack later, you can add it.

Here's the honest pitch. Most established practices are either paying $1,500 to $5,000 a month for a director who's genuinely involved, or a few hundred for one who signs protocols and disappears, which is its own risk when a board comes asking. For most nurses, $799 all in beats both, on price and on what you actually get. Tell us what you're paying now and we'll show you the side by side. No pitch, just the math.

What it costs, and the catch nurses look for

For a nurse starting out, membership is a flat $899 a month for one tier, $1,199 for two, $1,499 for all three, on a 12-month term. Startup beyond that is lighter than people expect: a starter tox order, insurance that runs well under most nurses' guesses, and the products you actually use. No revenue share, ever. (Already have a practice? The Established Nurse Membership above is $799 a month, month to month.)

That's usually the moment the skeptical part of your brain asks where the catch is. Fair. So, plainly: you own your practice and your patients through your own LLC. Five Square does not take a cut of what you make, and if a discovery call turns up that the honest answer for you is 'not yet' or 'start smaller,' the team will tell you that too.

Ohio-specific costs to budget for

Articles of Organization for an Ohio LLC are $99, filed with the Secretary of State (Ohio Rev. Code 111.16), and Ohio doesn't require an annual report for an LLC, so there's no recurring state fee just to stay in good standing. If you retail skincare or supplements, Ohio's state sales tax is 5.75%, with counties adding up to 3% for a combined cap of 8.75%, so check your county's rate before you print price tags. You'll register for a vendor's license with the Department of Taxation to collect it.

So, where do you actually start in Ohio?

You book the call. That's genuinely it. Not a six-month research project, a 15-minute conversation about your license, your goals, and what launching (or leveling up) in Ohio would look like for you. Whether you're brand new or already running a practice, the whole reason Five Square exists is so you're not doing the hard parts alone.

Schedule a discovery call

Common questions about starting a practice in Ohio

Does my medical director have to be on site in Ohio?

Only when a physician delegates drug administration to an unlicensed person. Ohio Adm. Code 4731-23-02 requires on-site supervision in that case, and 4731-23-01 defines delegation as a transfer to someone not licensed or authorized to do the task. An RN giving an injection on a valid prescriber order is practicing nursing under Ohio Adm. Code 4723-4-03, which isn't delegation under the medical board's chapter. Keep your injectors licensed and the rule stays narrow.

Can an NP be my medical director in Ohio without a physician involved?

No. Ohio certified nurse practitioners practice under a written standard care arrangement with a collaborating physician or podiatrist (Ohio Rev. Code 4723.431), and it has to spell out referral criteria, consultation, emergency coverage, and how disagreements get resolved. If the collaboration ends, the NP has 120 days to replace it. An NP can absolutely direct the practice and write your orders; there's just always a collaborating physician one step behind.

Can an LPN give cosmetic injections in Ohio?

Ohio law defines LPN practice as care "at the direction of" an RN, physician, PA, dentist, podiatrist, optometrist, or chiropractor, and LPN medication administration must be authorized by someone licensed to order it (Ohio Rev. Code 4723.01). Before directing an LPN, the RN has to evaluate the patient's stability, the complexity of the task, and the LPN's training (Ohio Adm. Code 4723-4-03). The Board of Nursing's cosmetic injectables guideline is the document to read with your compliance advisor before an LPN injects.

Can a registered nurse own a med spa in Ohio? Yes. The State Medical Board of Ohio's own position statement says "the Ohio legislature has made it clear that the corporate practice of medicine doctrine no longer exists in Ohio," and a physician may practice as an employee of a corporation, LLC, or any other business entity (State Medical Board of Ohio, Corporate Practice of Medicine position statement, approved March 15, 2012, reaffirmed May 15, 2023).

Do I need a medical director for aesthetics in Ohio? Yes. Ohio requires oversight for medical aesthetic services, and every Five Square practice includes a medical director as part of the membership.

Can a nurse do Botox in Ohio? Yes, within a compliant setup and with the oversight Ohio requires. The question is rarely whether a nurse can do the work; it's whether the practice around it is set up right.

I already run a practice in Ohio. Can Five Square still help? Yes. The Established Nurse Membership is built for nurses who already have a practice: $799 a month, month to month, with a medical director, a compliant structure, vendor pricing, and $19.99 on-demand Good Faith Exams. No new-injector training you don't need, and no annual lock.

How much are Good Faith Exams? For Five Square members, simple Good Faith Exams are $19.99 each, on demand, seven days a week, a price we subsidize because we believe in nurse success. One exam can clear a patient for several treatments at once, and the documentation attaches right to the patient's chart.

Is Five Square available in Ohio yet? Ohio is on the Five Square expansion roadmap, and in most new states the Established Nurse Membership opens first. The fastest way to get the timeline and hold your spot is a discovery call.

How much does it cost to start? For a new nurse, membership is $899 a month for one tier, and startup beyond that (a tox order, insurance, products) is lighter than most nurses expect. If you already run a practice, the Established Nurse Membership is $799 a month, month to month. No revenue share either way.