Ohio Adm.Code 4761 | Ohio Administrative Code 4761 — Ohio Respiratory Care Board

Chapter 4761-2 Administrative Provisions

Ohio Adm.Code 4761-2-03 Board records.

(A) The board shall maintain an electronic register of applicants for licenses and permits to practice respiratory care. It shall include the name, school of respiratory care from which the applicant graduated, if applicant is such a graduate, method and date the licenses or permits were issued and any other data the board shall require. If the applicant took the examination, the dates of examination shall be shown and scores attained where possible.

(B) The board shall maintain an electronically imaged or paper file containing the original license or limited permit application, verification of national credentialing in the profession of respiratory care, verification of previous or current licensing from other states, proof of successfully completing an accredited program in respiratory care, and any other documentation deemed necessary by the board for the issuance of an initial license or limited permit. The electronically imaged or paper file will also include disciplinary action orders or consent agreements approved by the board. An electronic imaged record shall constitute the official and original record of the board if the original record has been destroyed in accordance with the board's records retention schedule.

(C) A change in the name of the licensee, permit holder or applicant shall not be made on the board's records unless the request is accompanied by one of the following:

(1) A notarized personal affidavit.

(2) A certified copy of a court record.

(3) A certified copy of a marriage certificate.

Last updated November 19, 2025 at 11:45 AM

History

Effective: February 28, 2019
Promulgated Under: 119.03

Chapter 4761-3 Definitions

Ohio Adm.Code 4761-3-01 Definitions of terms.

The following definitions shall apply to the state medical board of Ohio for the practice of respiratory care:

(A) "Board" means the state medical board of Ohio.

(B) "Licensee" means a respiratory care professional issued a license under section 4761.05 of the Revised Code who can practice the full range of respiratory care as defined under division (A) of section 4761.01 of the Revised Code.

(C) "Limited permit holder" or "permit holder" means a person who holds a limited permit issued under Chapter 4761. of the Revised Code.

(D) "Designate" means any person or group authorized by the board as its agent to handle testing or other functions.

(E) "Under the supervision" as it is used under division (B) of section 4761.17 of the Revised Code means that the prescribing physician, physician assistant, or authorized nurse is available to provide direction to the respiratory care practitioner providing the respiratory care service.

(F) "License" as it is used under division (A) of section 4761.05 of the Revised Code, means the license certificate or a notarized copy of the license certificate as issued by the board.

(G) "Conspicuous display" as it concerns the license certificate, means in a place accessible to the public during normal operating hours of the principal place of business.

(H) "National Board for Respiratory Care, Inc. (NBRC)" means the national credentialing board for pulmonary technology and respiratory therapy.

(I) "Licensure by endorsement" means the issuance of a license based upon board approval of an examination recognized by the board as meeting the requirements of division (A)(2) of section 4761.04 of the Revised Code.

(J) "Licensure by Ohio examination" means the issuance of a license based upon successfully passing an examination offered to individuals who qualify for an educational waiver provided for in Section 6 of Sub. House Bill 111 of the 118th General Assembly.

(K) "A prescription or other order" means any verbal or written order or prescription for respiratory care services as defined under section 4761.01 of the Revised Code given in accordance with division (A) of section 4761.17 of the Revised Code.

(L) "Organization" means any agency employing respiratory care providers.

(M) "Official transcript" means an official transcript from a respiratory care educational program approved by the board pursuant to rule 4761-4-01 of the Administrative Code which lists the courses taken to earn a degree or certificate of completion in respiratory care, the number of hours and grade earned for each course, and the date and type of degree or certificate of completion earned. The transcript must be marked "official" by the issuing institution.

(N) "Minimal Sedation," as the term is used in rule 4761-7-05 of the Administrative Code, means a drug-induced state during which patients can respond normally to verbal commands. Although cognitive function and coordination may be impaired, ventilatory and cardiovascular function are unaffected. "Minimal sedation" shall not include sedation achieved through intravenous administration of drugs.

(O) "Moderate sedation/analgesia," as the term is used in rule 4761-7-05 of the Administrative Code, means a drug-induced depression of consciousness during which patients can respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. Reflex withdrawal from a painful stimulus is not a purposeful response. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is maintained.

(P) "Deep sedation/analgesia," means a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patient airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.

(Q) "General anesthesia," a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiopulmonary function may be impaired.

(R) "Off-site supervision," means that the authorized prescriber must be continuously available for direct communication with the respiratory care professional and must be in a location that under normal conditions is not more than sixty minutes travel time from the respiratory care professional's location.

(S) "Direct supervision," means that that the authorized prescriber is actually in sight of the respiratory care professional when the respiratory care professional is administering a medication to induce moderate sedation/analgesia in accordance with paragraph (B)(3)(c) of rule 4761-7-05 of the Administrative Code. Although the prescriber may be performing some other task at the same time, the prescriber is physically present in the same room, so that the prescriber may immediately provide direction or assume the performance of the task if difficulties arise. This does not require that the prescriber is watching "over the shoulder" of the respiratory care professional as would be required during the training period to ensure that the respiratory care professional is competent to perform the task.

(T) "Authorized prescriber" or "prescriber," means an individual authorized to order or prescribe respiratory care pursuant to section 4761.17 of the Revised Code.

(U) "Regular employment" as the term is used in paragraph (A) of rule 4761-5-01 of the Administrative Code means having employment in the practice of respiratory care equaling no less than an average of twenty-five hours per week for a period of fifty-two weeks during the three consecutive years prior to the date of application for an initial license.

(V) "Active duty military service," means currently serving in the branches of the armed forces as defined in section 145.30 of the Revised Code.

(W) "Veteran," means any person who has completed service in the armed forces, including the national guard of any state, or a reserve component of the armed forces, who has been discharged under honorable conditions from the armed forces or who has been transferred to the reserve with evidence of satisfactory service.

Last updated February 2, 2026 at 8:09 AM

History

Effective: January 31, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4761-4-01

The board hereby approves respiratory care educational programs that:

(A) Have been issued provisional accreditation, initial accreditation, continuing accreditation or other accreditation status conferred by the commission on accreditation for respiratory care (CoARC) or their successor organization(s) that permits the respiratory care educational program to continue to enroll and/or graduate students; and

(B) Require a minimum of an associate degree with a major in respiratory care.

Last updated November 19, 2025 at 11:45 AM

History

Effective: February 28, 2019
Promulgated Under: 119.03

Ohio Adm.Code 4761-7-05

(A) Respiratory care professionals and limited permit holders must be able to document appropriate and successful training and proficiency on the route of medication delivery, drug pharmacology, and dosage calculations for any medication for the treatment and testing of cardiopulmonary impairment for which they are authorized to administer pursuant to division (A)(4) of section 4761.01 of the Revised Code. Appropriate training includes, but is not limited to, the following components:

(1) Pharmacology. Subject matter shall include terminology, drug standards, applicable laws and legal aspects, identification of drugs by name and classification, and the principles of pharmacodynamics of medications used in the treatment and testing of cardiopulmonary impairment.

(2) Techniques of drug administration. Subject matter shall include principles of asepsis, safety and accuracy in drug administration, applicable anatomy and physiology, and techniques of administration and any route of administration for any medications for the treatment and testing of cardiopulmonary impairment.

(3) Dosage calculations. Subject matter shall include a review of arithmetic and methods of calculation required in the administration of drug dosages.

(4) The role of the respiratory care professional or limited permit holder in the administration of any medication for the treatment and testing of cardiopulmonary impairment. Subject matter shall include constraints of medication administration under the legal scope of practice for respiratory care, the rationale for specific respiratory care in relation to drug administration; observations and actions associated with desired drug effects, side effects and toxic effects; communication between respiratory care professional or limited permit holder and other members of the health care team; respiratory care provider-client interactions; and the documentation of medication administration for any medication for the treatment and testing of cardiopulmonary impairment.

(5) Clinical experience in the administration of any medication(s) for the treatment and testing of cardiopulmonary impairment, planned under the direction of a qualified respiratory care professional or other qualified health care provider responsible for teaching medication administration for any medication for the treatment and testing of cardiopulmonary impairment.

(B) Respiratory care professionals may administer medications to induce minimal sedation to moderate sedation/analgesia during diagnostic and therapeutic procedures relating to the testing and treatment of cardiopulmonary impairments. It is appropriate for respiratory care professionals to administer these medications if the following criteria are followed:

(1) Only a person authorized to prescribe or write orders pursuant to section 4761.17 of the Revised Code may select and order the drug to be administered to achieve the desired level of sedation/analgesia. The order shall include:

(a) Medication;

(b) Dosage;

(d) Method of administration.

(2) In addition to the general training requiring for medication administration contained in paragraphs (A)(1) to (A)(5) of this rule, a respiratory care professional shall also do the following:

(a) Complete the education and competency requirements of the employing facility on the administration of sedatives and analgesic medications;

(b) Understand the pharmacology, dosage, routes of administration, and adverse reactions of sedatives, analgesics, and antagonists. Identify the appropriate selection of monitoring equipment and be able to understand and interpret vital signs. Record patient's vital signs and medication in the medical record;

(c) Have current advanced cardiac life support (ACLS) or pediatric advanced life support (PALS) certification as appropriate and be able to perform rescue procedures;

(d) Meet competency guidelines, as determined by the facility, for the insertion and maintenance of artificial airways, assessing and maintaining ventilation, administration of oxygen, and

(e) Be able to insert and maintain an intravenous line when medications are administered by this route.

(3) The administration of medications to induce minimal to moderate sedation/analgesia shall be properly supervised by the authorized prescriber. Respiratory care professional must adhere to the following supervisory guidelines:

(a) Oral administration or aerosolized administration of medications to induce minimal to moderate sedation/analgesia may be performed with off-site supervision of the prescriber and do not require the respiratory care professional to be able to insert or maintain an intravenous line.

(b) Intravenous administration of medications to induce minimal sedation/analgesia for emergency intervention procedures, such as intubation may be performed with off-site supervision of the prescriber.

(c) Intravenous administration of medications to induce moderate sedation/analgesia for respiratory care procedures requires direct supervision of the prescriber.

(4) At no time shall a respiratory care professional administer a medication at a dosage and interval that is reasonably expected to induce deep sedation or general anesthesia.

(5) A respiratory care professional who administers a medication to induce minimal sedation to moderate sedation/analgesia shall have no other assignments during the course of administration, monitoring and recovery of the patient that would leave the patient unattended or unmonitored.

(6) Prior to administering a medication to induce minimal sedation to moderate sedation/analgesia, the respiratory care professional shall review the patient's pertinent medical history, including sedation-oriented aspects. The patient history should include a review of the medical history; current medications, herbal products, or vitamins; medication allergies; use of tobacco, alcohol, or substance abuse; last oral intake; and history of adverse reactions to sedatives, analgesics or anesthetics.

(7) Monitoring parameters shall minimally include:

(a) Baseline vital signs prior to and intermittently during the procedure;

(b) Pulmonary ventilation, including respiratory rate, depth of breathing, auscultation and, if appropriate, end tidal CO2 monitoring;

(d) Electrocardiography for patient with history of cardiovascular disease or dysrhythmias, or hypertension;

(e) Response to verbal and tactile stimulation and commands;

(C) For each respiratory care professionals and limited permit holders, the organization shall maintain a record that documents training and proficiency reviews. Documentation of periodic competency reviews shall be maintained by the organization. At the request of the board, records may be audited, reviewed, or copied.

Last updated November 19, 2025 at 11:46 AM

History

Effective: May 23, 2005
Promulgated Under: 119.03

Ohio Adm.Code 4761-5-01

(A) To meet the requirement of division (A)(2) of section 4761.04 of the Revised Code, an applicant for licensure must provide evidence that the applicant has successfully completed:

(1) Both portions of the registered respiratory therapist (R.R.T.) examination administered by the national board for respiratory care, inc. (NBRC) or its successor organization; or

(2) The respiratory therapy examination with a passing score that earns the RRT credential at the time the exam is taken.

(B) All persons currently holding a license in this state to practice respiratory care who obtained an initial license in this state based on showing evidence of successful completion of the certified respiratory therapist (C.R.T.) examination may continue to practice respiratory care in this state if the following conditions are met:

(1) The licensee continues to meet the requirements to renew a license under Chapter 4761. of the Revised Code; and

(2) The licensee continues to timely renew the license through the state medical board.

(C) This rule shall not apply to applicants for reciprocal licensure under division (C) of section 4761.04 of the Revised Code.

Last updated September 30, 2026 at 7:41 AM

History

Effective: September 30, 2026
Promulgated Under: 119.03

Chapter 4761-4 Respiratory Care Educational Programs

Ohio Adm.Code 4761-4-01 Approval of educational programs.

The board hereby approves respiratory care educational programs that:

(B) Require a minimum of an associate degree with a major in respiratory care.

Last updated November 19, 2025 at 11:45 AM

History

Effective: February 28, 2019
Promulgated Under: 119.03

Ohio Adm.Code 4761-4-02 Monitoring of Ohio respiratory care educational programs.

(A) Annually, each respiratory care educational program in Ohio shall submit proof of compliance with the accreditation standards developed by the commission on accreditation for respiratory care (CoARC) or their successor organization(s). At minimum, Ohio respiratory care programs shall provide the following:

(1) A copy of the annual report submitted to CoARC.

(2) A copy of CoARC's response letter.

(3) A copy of any plan of corrective action for program deficiencies issued by CoARC in response to an official site visit or annual report.

(B) Each respiratory care program in Ohio shall also annually submit a current letter of good standing issued by CoARC.

(C) The respiratory care advisory council may be responsible for advising the board on educational policy and issues affecting respiratory care educational programs in Ohio. The respiratory care advisory council may review documentation filed by Ohio respiratory care educational programs in accordance with paragraph (A) of this rule. The respiratory care advisory council may make recommendations to the board regarding the educational programs including a recommendation to survey and investigate a respiratory care educational program. Survey and investigation findings shall be reported to the board. The board may contract independent expert services as needed to assist the respiratory advisory council and the board.

Last updated November 19, 2025 at 11:45 AM

History

Effective: February 28, 2019
Promulgated Under: 119.03

Chapter 4761-5 Examination and Licensing

Ohio Adm.Code 4761-5-01 Examination requirements pursuant to division (A) of section 4761.04 of the Revised Code.

(A) To meet the requirement of division (A)(2) of section 4761.04 of the Revised Code, an applicant for licensure must provide evidence that the applicant has successfully completed:

(1) Both portions of the registered respiratory therapist (R.R.T.) examination administered by the national board for respiratory care, inc. (NBRC) or its successor organization; or

(2) The respiratory therapy examination with a passing score that earns the RRT credential at the time the exam is taken.

(1) The licensee continues to meet the requirements to renew a license under Chapter 4761. of the Revised Code; and

(2) The licensee continues to timely renew the license through the state medical board.

(C) This rule shall not apply to applicants for reciprocal licensure under division (C) of section 4761.04 of the Revised Code.

Last updated September 30, 2026 at 7:41 AM

History

Effective: September 30, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4761-5-04 License application procedure.

(A) An applicant for licensure shall submit to the board an application under oath in the manner determined by the board and provide such other facts and materials as the board requires. No application shall be considered submitted to the board until the appropriate fee has been received by the board.

(B) No application submitted to the board shall be considered complete until the applicant has complied with the requirements of Chapter 4731-4 of the Administrative Code and the board has received the results of the criminal records checks.

(C) If an applicant fails to complete the application process within six months of initial application filing, the board may notify the applicant in writing of its intention to consider the application abandoned. If no response to that notice is received by the board within thirty days, the board shall consider the application as abandoned and no further processing shall be undertaken with respect to that application.

(D) If the application process extends for a period longer than six months, the board may require updated information as it deems necessary.

(E) No application being investigated under section 4761.09 of the Revised Code, may be withdrawn without approval of the board.

(F) Application fees are not refundable.

Last updated February 2, 2026 at 8:05 AM

History

Effective: January 31, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4761-5-06 Respiratory care practice by polysomnographic technologists.

(A) As used in division (B)(3) of section 4761.10 of the Revised Code, "a polysomnographic technologist" shall be defined as a person who holds a credential as a registered polysomnographic technologist (RPSGT) issued by the board of registered polysomnographic technologists (BRPT) or its successor organization.

(B) As used in division (B)(3) of section 4761.10 of the Revised Code, "a trainee" shall be defined as a person who, under the direct supervision of a polysomnographic technologist, performs respiratory care tasks as a part of a defined course of education leading to eligibility to take the comprehensive registry exam for polysomnographic technologists.

(C) As used in division (B)(3) of section 4761.10 of the Revised Code, "being eligible to be credentialled" shall be defined as a person who has completed the training and clinical experience required by the BRPT to take the comprehensive registry exam for polysomnographic technologists. Eligibility status shall not exceed eighteen months.

(D) As used in division (B)(3) of section 4761.10 of the Revised Code, "direct supervision" shall be defined as being immediately available to oversee and direct the care rendered by a trainee.

(E) The following respiratory care tasks performed in the diagnosis and therapeutic intervention of sleep-related breathing disorders may be performed upon the prescription or order under the general supervision of a physician:

(1) Application and titration of bi-level, continuous positive airway pressure, or non-invasive ventilation;

(2) Application and titration of supplemental low flow oxygen;

(3) Application and monitoring of pulse oximetry;

(4) Application and monitoring of capnometry; and

(5) Patient education in the application of bi-level or continuous positive airway pressure, low flow oxygen, or pulse oximetry for the ongoing management of sleep-related disorders.

Last updated November 19, 2025 at 11:45 AM

History

Effective: December 31, 2016
Promulgated Under: 119.03

Chapter 4761-6 Permits

Ohio Adm.Code 4761-6-01 Limited permit application procedure.

(A) An applicant for a limited permit shall submit to the board an application under oath in the manner determined by the board, and provide such other facts and materials as the board requires. No application shall be considered submitted to the board until the appropriate fee has been received by the board. Application fees are not refundable.

(1) An applicant for a limited permit must provide proof of meeting one of the following requirements:

(a) Is enrolled in and is in good standing in a respiratory care educational program that meets the requirements of rule 4761-4-01 of the Administrative Code; or

(b) Is a graduate of a respiratory care educational program that meets the requirements of rule 4761-4-01 of the Administrative Code and is making application within one year of such graduation date; or

(2) An applicant meeting the requirements of paragraph (A)(1)(a) of this rule shall file with the application a verification of education form provided by the board as proof of his/her enrollment and good standing in an approved educational program.

(3) An applicant meeting the requirements of paragraph (A)(1)(b) of this rule shall submit an official transcript.

(4) A person issued a limited permit under paragraph (A)(1)(a) or (A)(1)(b) of this rule shall practice respiratory care only under the supervision of a respiratory care professional until whichever of the following occurs first:

(a) Three years after the date the limited permit is issued;

(b) Until the holder discontinues enrollment in the educational program; or

(c) One year following the date of receipt of a degree or certificate of completion from a board-approved respiratory care education program.

(B) The respiratory care services which may be performed by the holders of a limited permit issued under paragraph (A)(1)(a) of this rule are limited to only those services which have been successfully completed by such persons as part of the curriculum of their respiratory care educational program, as certified by the director of the respiratory care educational program. The board may supply a sample form to document these competencies to be certified by the director of the respiratory care educational program. The limited permit holder must provide documentation of competencies certified by the director of the respiratory care educational program to all employers of respiratory care services. Updated documentation of competencies shall be provided by the limited permit holder to employers of respiratory care services upon successful completion of additional clinical courses as certified by the director of the respiratory care educational program.

(C) A person issued a limited permit under division (B)(1)(b) of section 4761.05 of the Revised Code shall practice respiratory care only under the supervision of a respiratory care professional and may practice for not more than three years, unless the holder has been employed as a provider of respiratory care for an average of not less than twenty-five hours per week for a period of not less than five years by a hospital.

(D) If an applicant fails to complete the application process within six months of initial application filing, the board may notify the applicant in writing of its intention to consider the application abandoned. If no response to that notice is received by the board within thirty days, the board shall consider the application as abandoned and no further processing shall be undertaken with respect to that application.

(E) If the application process extends for a period longer than six months, the board may require updated information as it deems necessary.

(F) No application being investigated under section 4761.09 of the Revised Code, may be withdrawn without approval of the board.

Last updated February 2, 2026 at 8:09 AM

History

Effective: January 31, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4761-4-01

The board hereby approves respiratory care educational programs that:

(B) Require a minimum of an associate degree with a major in respiratory care.

Last updated November 19, 2025 at 11:45 AM

History

Effective: February 28, 2019
Promulgated Under: 119.03

Chapter 4761-7 Issuance of License; Scope of Care; Supervision

Ohio Adm.Code 4761-7-01 Original license or permit, identification card or electronic license verification.

(A) The board shall prepare and provide to each initial license or permit holder a certificate stating the name of the license or limited permit holder, the license or limited permit number assigned and the initial issuance date. The board may permit the electronic verification of the each license or limited permit holder through a web-based verification system. An electronic verification shall contain the person's name, license or permit number, information as to the type of authorization under which they practice, and date of expiration.

(B) Official license or permit certificates shall be signed by the board president and secretary and attested by its seal. Electronic verification of license or limited permit status shall be considered a primary source verification.

(C) Neither the holder nor anyone else shall make any alterations on a certificate or identification card issued by the board.

(D) Licenses to practice respiratory care shall expire two years after the date of issuance unless other limitations pursuant to law, board order, or consent agreement are in effect.

(E) Limited permits shall be renewed annually unless other limitations pursuant to law, board order, or consent agreement are in effect.

(F) Regardless of the date of issuance, the graduate limited permit will expire one year following the date of receipt of a degree or certificate of completion from a board-approved respiratory care education program.

(G) Electronic verification is valid proof of current authorization.

(H) In accordance with division (C) of section 4761.05 of the Revised Code, holders of licenses and permits may display a wall certificate in their office or place where the majority of the holder's practice is conducted.

Last updated February 2, 2026 at 8:09 AM

History

Effective: January 31, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4761-7-03 Scope of respiratory care defined.

(A) "Respiratory care" as employed in Chapter 4761. of the Revised Code, means engaging in respiratory care, as defined in division (A) of section 4761.01 of the Revised Code, as a clinician, an educator, a manager, and/or a consultant, excluding activities related to equipment maintenance, cleaning, and delivery.

(B) "Instructing in the use of medical gases" as it is used in division (A)(2) of section 4761.01 of the Revised Code, means the direct or indirect use of educational material, communicated in writing or otherwise, that explains the clinical indications or contraindications concerning a patient's prescription for a medical gas.

(C) "Administering of medical gases" as it is used in division (A)(2) of section 4761.01 of the Revised Code, means the direct application and quantitative adjustment of a medical gas to a patient, regardless of the device used to administer the gas.

(D) "Monitoring and recording the results of medical gases" as it is used in division (A)(2) of section 4761.01 of the Revised Code, means assessing, evaluating and documenting the use of a medical gas, including measurements of fractional inspired concentrations, flow and volume; and a patient's physiologic or clinical response to a medical gas, including invasive or noninvasive sampling of blood or gas samples.

(E) "Any service" as it is used in division (A) of section 4761.01 of the Revised Code, means any practice performed by a competently trained licensed respiratory care professional or permit holder involving the evaluation of cardiopulmonary function, the treatment of cardiopulmonary impairment, the assessment of treatment effectiveness and the care of patients with deficiencies and abnormalities associated with the cardiopulmonary system.

(F) "Aspiration" as it is used in division (B)(1) of section 4761.10 of the Revised Code, means to remove bodily fluids or mucous from the pulmonary airway by means of a suction device. Included suctioning procedures are naso-pharyngeal, oral-pharyngeal, tracheal, and bronchial. Oral suctioning and suctioning of secretions external to the airway will not be considered aspiration as this term is defined in this rule.

Last updated November 19, 2025 at 11:45 AM

History

Effective: July 11, 2003
Promulgated Under: 119.03

Ohio Adm.Code 4761-7-04 Supervision.

As provided for in division (B) of section 4761.05 of the Revised Code, a limited permit holder must work under the supervision of a respiratory care professional (RCP) and may not be supervised by any other person, including those persons licensed to practice in any other profession.

"To practice under the supervision of a respiratory care professional" as used in division (B) of section 4761.05 of the Revised Code requires that an RCP be readily available in the facility and responsible at all times for the direction and actions of a limited permit holder under their supervision. Three types of limited permits are issued by the board: student-based, employment-based, and graduate-based. The level of supervision and the duties assigned may vary based upon the type of limited permit holder that is being supervised. The RCP shall determine the appropriate level of supervision and assigned respiratory care duties for an employment-based limited permit holder taking into consideration institutional competency reviews and work performance. For student limited permit holders, the appropriate level of supervision and assigned respiratory care duties shall be based, in part, on competencies approved and documented by the student's respiratory care educational program director. At no time shall a supervising RCP assign duties that exceed the approved competencies documented. Graduate-based limited permit holders may practice a full scope of respiratory care duties, but must still be supervised in accordance with this rule. Regardless of the type of limited permit held, an RCP shall not delegate to a less qualified person any service which requires the skill, knowledge and judgment of an RCP.

Last updated November 19, 2025 at 11:45 AM

History

Effective: September 30, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4761-7-05 Administration of medications.

(3) Dosage calculations. Subject matter shall include a review of arithmetic and methods of calculation required in the administration of drug dosages.

(a) Medication;

(b) Dosage;

(d) Method of administration.

(2) In addition to the general training requiring for medication administration contained in paragraphs (A)(1) to (A)(5) of this rule, a respiratory care professional shall also do the following:

(a) Complete the education and competency requirements of the employing facility on the administration of sedatives and analgesic medications;

(c) Have current advanced cardiac life support (ACLS) or pediatric advanced life support (PALS) certification as appropriate and be able to perform rescue procedures;

(d) Meet competency guidelines, as determined by the facility, for the insertion and maintenance of artificial airways, assessing and maintaining ventilation, administration of oxygen, and

(e) Be able to insert and maintain an intravenous line when medications are administered by this route.

(c) Intravenous administration of medications to induce moderate sedation/analgesia for respiratory care procedures requires direct supervision of the prescriber.

(4) At no time shall a respiratory care professional administer a medication at a dosage and interval that is reasonably expected to induce deep sedation or general anesthesia.

(7) Monitoring parameters shall minimally include:

(a) Baseline vital signs prior to and intermittently during the procedure;

(b) Pulmonary ventilation, including respiratory rate, depth of breathing, auscultation and, if appropriate, end tidal CO2 monitoring;

(d) Electrocardiography for patient with history of cardiovascular disease or dysrhythmias, or hypertension;

(e) Response to verbal and tactile stimulation and commands;

Last updated November 19, 2025 at 11:46 AM

History

Effective: May 23, 2005
Promulgated Under: 119.03

Chapter 4761-8 Renewal of License or Permits

Ohio Adm.Code 4761-8-01 Renewal of license or permits.

(A) License renewal.

Persons holding a license to practice respiratory care shall apply for renewal in accordance with section 4761.06 of the Revised Code, complete the prescribed application in the manner determined by the board, submit the renewal fee, and complete the required continuing education in accordance with rule 4761-9-02 of the Administrative Code.

(B) Limited permit renewal.

On or before the expiration date, persons holding a limited permit shall apply for renewal in accordance with section 4761.06 of the Revised Code, complete the prescribed application in the matter determined by the board, and submit the renewal fee.

(C) A license or permit holder who fails to renew in accordance with the schedule established under this rule shall have the license or limited permit placed in expired status.

(D) An expired license may be reinstated or restored, as applicable, in accordance with division (C) of section 4761.06 of the Revised Code. If an applicant fails to complete the reinstatement or restoration application process within six months of application filing, the board may notify the applicant in writing of its intention to consider the application abandoned. If no response to that notice is received by the board within thirty days, the board shall consider the application as abandoned and no further processing shall be undertaken with respect to that application.

(E) A license reinstated or restored in accordance with paragraph (D) of this rule will expire on the next biennial expiration date.

(F) If a licensee has not completed the requisite RCCE contact hours, a license is not eligible for license renewal or reinstatement. The number of RCCE contact hours required for restoration of an expired license shall be equal to the amount required of the applicant had the license not expired and must have been completed within the two years prior to the date of application for restoration.

Last updated February 2, 2026 at 8:05 AM

History

Effective: January 31, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4761-9-02

(A) Licensees and limited permit holders shall verify the successful attainment of RCCE from sources approved by the board as set forth in rule 4761-9-05 of the Administrative Code.

(B) RCCE contact hours shall be obtained during the term of collection as set forth in paragraphs (C)(1) and (C)(2) of this rule. RCCE contact hours shall be earned prior to the license or limited permit expiration date for the renewal period. RCCE contact hours earned during the term of collection in excess of required contact hours cannot be applied towards a subsequent renewal period, unless the RCCE contact hours are earned after the filing date of a completed renewal application that is filed prior to the end of the renewal cycle for the specific authorization type held. A renewal application will be deemed complete when the renewal application form is filled out in its entirety, all continuing education required has been reported and is valid and the full renewal fee has been submitted.

(C) Continuing education earned for license or limited permit renewal must minimally include the following content requirements:

(1) An applicant for license renewal shall complete twenty contact hours of relevant RCCE every two years, beginning with the license renewal date and ending on the license expiration date established under paragraph (D) of rule 4761-7-01 of the Administrative Code, unless a waiver is granted under paragraph (F) of this rule. RCCE earned for license renewal must include the following content requirement:

(a) One contact hour of RCCE on Ohio respiratory care law or professional ethics as set forth in rule 4761-9-04 of the Administrative Code;

(b) At least fifteen of the required contact hours must include content relating to the provision of clinical respiratory care as defined under section 4761.01 of the Revised Code; and

(c) The remaining four contact hours may include indirectly related content, including, but not limited to, activities relevant to specialized aspects of respiratory care, such as education, supervision, management, health care cost containment, cost management, health quality standards, disease prevention, health promotion, or abuse reporting.

(2) An applicant for renewal of a limited permit issued under paragraph (A)(1)(c) of rule 4761-6-01 of the Administrative Code, shall complete ten contact hours of relevant RCCE every year, beginning with the limited permit renewal date and ending on the limited permit expiration date established under paragraph (E) of rule 4761-7-01 of the Administrative Code, unless a waiver is granted under paragraph (F)(2) of this rule. RCCE earned for license renewal must include the following content requirement:

(a) One contact hour of RCCE on Ohio respiratory care law or professional ethics as set forth in rule 4761-9-04 of the Administrative Code;

(b) At least seven of the required contact hours must include content relating to the provision of clinical respiratory care as defined under section 4761.01 of the Revised Code; and

(c) The remaining two contact hours may include indirectly related content, including, but not limited to activities relevant to specialized aspects of respiratory care, such as education, supervision, management, health care cost containment, cost management, health quality standards, disease prevention, health promotion, or abuse reporting.

(D) In lieu of completing RCCE contact hours required under paragraphs (C)(1)(b), (C)(1)(c), (C)(2)(b) and (C)(2)(c) of this rule, applicants may submit proof of successfully passing any written professional examination administered by the national board for respiratory care, inc. (NBRC), including the written registry examination for advanced respiratory therapists, the recredentialing examination for certified respiratory therapists, the written examination for certified pulmonary function technologists, the written examination for registered pulmonary function technologists, the written examination for neonatal/pediatric respiratory care, adult critical care specialist, sleep disorder specialist, or the certified asthma educator specialist. The registered polysomnographic technologist examination administered by the board of registered polysomnographic technologists (BRPT) is also an accepted written examination.

(E) It shall be the responsibility of the licensee to maintain and keep all records to serve as documentation for any audit which may be conducted in accordance with rule 4761-9-07 of the Administrative Code pertaining to the completion of RCCE requirements; including, but not limited to certificates of completion, transcripts, letters of attendance, or attendance registers. Records shall be maintained for a period of two years after the end of a registration. Legible copies shall be sent to the board only in response to an audit.

(F) Waiver of RCCE requirements.

(1) A first time license holder in the state of Ohio who has been licensed for more than six months, but less than one year from the license expiration date must complete at least one half of the RCCE requirements listed in paragraph (C)(1) of this rule, including one contact hour on Ohio respiratory care law or professional ethics. First time license holders who have held a license for less than six months from the biennial license expiration date will not be required to complete the RCCE requirements for the current term of collection, but will have to complete the RCCE requirements for the following biennial renewal period.

(2) For purposes of obtaining a RCCE waiver, the applicant or licensee shall have the burden of establishing that the illness or absence affected the reasonable opportunity to participate in RCCE activities. No more than two hours will be subtracted from the RCCE requirement for each month which is approved for reduction of hours. Application for RCCE waiver shall be completed by the applicant or licensee and submitted to the board at least sixty days prior to the end of the RCCE period. Applicants shall not sign and submit the renewal application prior to receiving approval from the board of the waiver request.

(3) The board shall not waive the total RCCE requirement for any RCCE period.

(4) The board shall not grant a RCCE waiver for consecutive RCCE periods.

(5) Applicants shall be eligible to apply for RCCE waiver only if the applicant's illness or absence from the United States lasted a minimum of six consecutive months and occurred in its entirety within a single RCCE period.

Last updated September 30, 2026 at 7:42 AM

History

Effective: September 30, 2026
Promulgated Under: 119.03

Chapter 4761-9 Continuing Education

Ohio Adm.Code 4761-9-01 Definition of respiratory care continuing education.

(A) "Respiratory care continuing education" (hereafter referred to as RCCE), as required under section 4761.06 of the Revised Code, means post-licensure learning experiences which are approved by the state medical board of Ohio (hereafter referred to as the board) and which enhance or build upon the licensees current knowledge or educational background as it pertains to the practice of respiratory care, as set forth in section 4761.01 of the Revised Code.

(B) For the purposes of this chapter, the following definitions shall apply:

(1) "Post-licensure" means the period following the granting of a license under section 4761.04 of the Revised Code or a limited permit issued under division (B) of section 4761.05 of the Revised Code.

(2) "Learning experiences" means activities or programs which allow respiratory care providers to obtain or enhance skills, knowledge, or behavior needed to provide respiratory care.

(3) "Approved by the state medical board of Ohio" means that the RCCE program or activity qualifies for official recognition by the board in accordance with one of the approval mechanisms set forth in rules 4761-9-04 and 4761-9-05 of the Administrative Code.

(4) "Licensee" means the holder of a license issued under section 4761.04 of the Revised Code or a limited permit issued under division (B)(1)(b) of section 4761.05 of the Revised Code.

(5) "Contact hour" means fifty or sixty minutes of planned classroom, clinical, or provider-directed independent study.

(a) Calculation of contact hours from credit hours earned in an academic institution shall be done using the following formula:

(i) Quarter system: one credit hour = ten contact hours;

(ii) Trimester system: one credit hour = twelve contact hours;

(iii) Semester system: one credit hour = fifteen contact hours.

Last updated November 19, 2025 at 11:46 AM

History

Effective: September 30, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4761-9-04

(A) An acceptable course in Ohio respiratory care law or professional ethics shall meet the following criteria and be taught by an individual with the appropriate qualifications and experience.

(1) The course shall be at least one contact hour in length; and

(2) The course content shall include one of the following:

(a) Standards of respiratory care practice and ethical conduct; or

(b) Acts that constitute violations of the respiratory care practice law under section 4761.09 of the Revised Code; or

(d) Medical ethics.

(B) To be state medical board of Ohio approved RCCE for the one contact hour in respiratory care law or professional ethics required in rule 4761-9-02 of the Administrative Code, a course that meets the requirements of paragraph (A) of this rule shall also be approved by American association for respiratory care (A.A.R.C.), the American medical association (A.M.A.), the American nurses association (A.N.A.), the Ohio association of physician assistants (O.A.P.A.), the Ohio society for respiratory care (O.S.R.C.), the Ohio state medical association (O.S.M.A.), the Ohio nurses association (O.N.A.), the Ohio thoracic society (O.T.S.), the American college of chest physicians (A.C.C.P.), the American heart association (A.H.A.), the American lung association (A.L.A.), the Ohio lung association (O.L.A.), or the American association of critical care nurses (A.A.C.C.N.).

(C) The board may also, in its discretion, offer a respiratory care law or professional ethics course to meet the one contact hour respiratory care or professional ethics requirement in rule 4761-9-02 of the Administrative Code.

Last updated November 19, 2025 at 11:46 AM

History

Effective: November 30, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4761-9-05

(A) Applicants for renewal shall successfully complete the required number of RCCE contact hours according to rule 4761-9-02 of the Administrative Code. RCCE earned from any combination of the following sources may be applicable towards meeting RCCE requirements:

(1) Relevant college credit awarded by an academic institution accredited by its regional accrediting association. This is limited to respiratory care related classes.

(2) RCCE contact hours awarded by respiratory care educational programs approved by the board in accordance with rule 4761-4-01 of the Administrative Code.

(3) The successful completion of advanced life support programs and/or instructors for life support programs will qualify to meet the RCCE requirement. Those meeting this requirement are, but may not be limited to advanced cardiac life support (ACLS), pediatric advanced life support (PALS), neonatal resuscitation program (NRP), and advanced trauma life support (ATLS). The number of contact hours for each program must be assigned by the educational provider. Licensees will be responsible for acquiring documentation supporting completion of the program, the date of completion, and the number of contact hours earned.

(4) Recertification for ACLS, PALS, NRP, or ATLS. The number of contact hours for each program must be assigned by the educational provider. Licensees will be responsible for acquiring documentation supporting completion of the program, the date of completion, and the number of contact hours earned.

(5) All or portions of a continuing education activity relevant to the practice of respiratory care which meet the requirements of paragraph (A) of rule 4761-9-01 of the Administrative Code and which have been approved by a professional organization or association awarding continuing education contact hours, including, but not limited to the American association for respiratory care (A.A.R.C.), the American medical association (A.M.A.), the American nurses association (A.N.A.), the Ohio association of physician assistants (O.A.P.A.), the Ohio society for respiratory care (O.S.R.C.), the Ohio state medical association (O.S.M.A.), the Ohio nurses association (O.N.A.), the Ohio thoracic society (O.T.S.), the American college of chest physicians (A.C.C.P.), the American heart association (A.H.A.), the American lung association (A.L.A.), the Ohio lung association (O.L.A.), and the American association of critical care nurses (A.A.C.C.N.).

(6) Relevant education and training provided by a branch of the U.S. military for active duty military service members.

Last updated November 19, 2025 at 11:46 AM

History

Effective: September 30, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4761-9-02 General RCCE requirements and reporting mechanism.

(A) Licensees and limited permit holders shall verify the successful attainment of RCCE from sources approved by the board as set forth in rule 4761-9-05 of the Administrative Code.

(C) Continuing education earned for license or limited permit renewal must minimally include the following content requirements:

(a) One contact hour of RCCE on Ohio respiratory care law or professional ethics as set forth in rule 4761-9-04 of the Administrative Code;

(b) At least fifteen of the required contact hours must include content relating to the provision of clinical respiratory care as defined under section 4761.01 of the Revised Code; and

(a) One contact hour of RCCE on Ohio respiratory care law or professional ethics as set forth in rule 4761-9-04 of the Administrative Code;

(b) At least seven of the required contact hours must include content relating to the provision of clinical respiratory care as defined under section 4761.01 of the Revised Code; and

(F) Waiver of RCCE requirements.

(3) The board shall not waive the total RCCE requirement for any RCCE period.

(4) The board shall not grant a RCCE waiver for consecutive RCCE periods.

Last updated September 30, 2026 at 7:42 AM

History

Effective: September 30, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4761-7-01

(C) Neither the holder nor anyone else shall make any alterations on a certificate or identification card issued by the board.

(D) Licenses to practice respiratory care shall expire two years after the date of issuance unless other limitations pursuant to law, board order, or consent agreement are in effect.

(E) Limited permits shall be renewed annually unless other limitations pursuant to law, board order, or consent agreement are in effect.

(G) Electronic verification is valid proof of current authorization.

Last updated February 2, 2026 at 8:09 AM

History

Effective: January 31, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4761-6-01