Ohio Adm.Code 4723 | Ohio Administrative Code 4723 — Board of Nursing

Chapter 4723-1 Board Organization and Records

Ohio Adm.Code 4723-1-01 Board organization.

(A) The board shall elect a president and vice-president from among the nurse members of the board for one-year terms during the last regularly scheduled board meeting of the calendar year. The new officers shall assume their duties on the first day following the board meeting at which they were elected.

(B) The president shall preside at all meetings of the board. In the absence of the president the vice-president shall preside.

(C) The board shall elect a supervising member for disciplinary matters from among the registered nurse members of the board for a one-year term during the last regularly scheduled board meeting of the calendar year. The new supervising member shall assume his or her duties on the first day following the board meeting at which he or she was elected.

(1) A former supervising board member who remains a member of the board may continue to serve in the supervising member capacity regarding cases initiated under his or her supervision that remain under review at the expiration of his or her one-year term as supervising member.

(2) In the event the supervising member has a conflict of interest in a particular case, the board president shall serve as the supervising member for purposes of reviewing that case.

(D) The board shall hold regular meetings as often as necessary to carry out its duties. Meetings shall be held in locations determined by the board. The board shall provide public notice of meetings in accordance with rule 4723-1-06 of the Administrative Code.

(E) In the event of a vacancy in the elected offices, the board shall fill the vacancy at a regular or special meeting of the board.

(F) Except as otherwise provided in paragraph (G) of this rule, all meetings of the board shall be conducted in accordance with the twelfth edition (2020) of "Robert's Rules of Order, newly revised," which can be accessed at http://www.robertsrules.com/,

(G) The board may develop and approve written guidelines or policies relating to board governance matters. To the extent that such guidelines or policies conflict with provisions of the twelfth edition (2020) of "Robert's Rules of Order, newly revised," which can be accessed at http://www.robertsrules.com/, the board-approved guidelines or policies shall control.

Last updated September 11, 2023 at 11:09 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-1-02 Personnel.

At the last regularly scheduled board meeting of the calendar year, the board shall appoint an executive director who meets the qualifications set forth in section 4723.05 of the Revised Code. The executive director shall serve as the chief administrative officer of the board and be responsible for all administrative functions of the board and board staff. The executive director shall ensure implementation of the provisions of Chapter 119. of the Revised Code as they relate to operations of the board.

Last updated September 11, 2023 at 11:09 AM

History

Effective: February 1, 2008
Promulgated Under: 119.03

Ohio Adm.Code 4723-1-03 Board records and documents.

[Comment: The materials incorporated by reference in agency 4723 of the Administrative Code can be found in paragraph (G) of this rule. The materials may be obtained at https://nursing.ohio.gov/.]

(A) The board shall maintain a record of all applicants for, and holders of, licenses and certificates issued by the board under Chapter 4723. of the Revised Code and any rules adopted under that chapter, in the format determined by the board.

(B) A change in name shall be submitted to the board electronically through the individual's eLicense account by submitting a name change service request within thirty days of the change. The request shall be accompanied by an uploaded certified copy of one of the following documents:

(1) A marriage certificate or abstract;

(2) A dissolution or divorce decree;

(3) A court record indicating a change of name; or

(4) Documentation of a change in name consistent with the laws of the jurisdiction or foreign country where the name change occurred.

(C) A notification of a change in address shall be submitted in writing or electronically, by the licensee or certificate holder to the board within thirty days of the change.

(D) Documents submitted to the board may be returned at the discretion of the board.

(E) Wall certificates or other documents issued by the board as evidence of licensure, certification, or other authorization to practice shall not be falsified or altered.

(F) For purposes of Chapters 4723-1 to 4723-27 of the Administrative Code, when an applicant for licensure or certification, or renewal, reactivation or reinstatement of licensure or certification, submits a criminal records check completed by the bureau of criminal identification and investigation, the board shall consider the records check information to be valid for a period of one year from the date the information was received by the board. This provision shall not apply to criminal records checks required to be obtained according to the terms of board adjudication orders or consent agreements.

(G) Incorporated materials:

(1) "Advanced Practice Registered Nurse Application Certified Nurse Midwife";

(2) "Advanced Practice Registered Nurse Application Certified Nurse Practitioner";

(3) "Advanced Practice Registered Nurse Application Certified Registered Nurse Anesthetist";

(4) "Advanced Practice Registered Nurse Application Clinical Nurse Specialist";

(5) "Advanced Practice Registered Nurse License Reactivation and Reinstatement Application";

(6) "Alternative Program for Substance Use Disorder Admission Application";

(7) "Application for Initial Approval/Reapproval of a Testing Organization that Conducts an Examination of Dialysis Technicians";

(8) "Certified Doula by Endorsement Application";

(9) "Certified Doula Reactivation and Reinstatement Application";

(10) "Certified Doula Renewal Application";

(11) "Certified Registered Nurse Anesthetist Renewal Application";

(12) "Certified Nurse Midwife Renewal Application";

(13) "Certified Nurse Practitioner Renewal Application";

(14) "Clinical Nurse Specialist Renewal Application";

(15) "Community Health Worker Application";

(16) "Community Health Worker Reactivation and Reinstatement Application";

(17) "Community Health Worker Renewal Application";

(18) "Community Health Worker Training Program Application. Approval and Re-Approval";

(19) "Dialysis Technician Application";

(20) "Dialysis Technician Reactivation and Reinstatement Application";

(21) "Dialysis Technician Renewal Application";

(22) "Dialysis Technician Training Program Application.Approval and Re-Approval";

(23) "Doula Application";

(24) "Education Program PN Presurvey Visit Report Form," for licensed practical nursing education programs;

(25) "Education Program RN Presurvey Visit Report Form," for registered nursing education programs;

(26) "LPN Reactivation and Reinstatement Application";

(27) "LPN Renewal Application";

(28) "Medication Aide Application";

(29) "Medication Aide Reactivation and Reinstatement Application";

(30) "Medication Aide Renewal Application";

(31) "Medication Aide Training Program Application. Approval and Re-Approval";

(32) "Nursing Licensure by Endorsement Application";

(33) "NEGP Annual Report Year 1";

(34) "NEGP Annual Report Year 2";

(35) "NEGP Quarterly Progress Report";

(36) "NEGP RFP";

(37) "Nursing Licensure by Endorsement Application, LPN";

(38) "Nursing Licensure by Endorsement Application, RN";

(39) "Nursing Licensure by Examination Application, LPN";

(40) "Nursing Licensure by Examination Application, RN";

(41) "OBN Approver Application";

(42) "Ohio Annual Report Survey," for registered nursing education programs and licensed practical nursing education programs;

(43) "PN New Program Proposal Application";

(44) "RN New Education Program Proposal Application";

(45) "RN Reactivation and Reinstatement Application";

(46) "RN Renewal Application";

(47) "Verification Form Organizations Certifying Advanced Practice Registered Nurses: Certified Nurse Midwives (CNMs), Certified Nurse Practitioners (CNPs), Clinical Nurse Specialists (CNSs), and Certified Registered Nurse Anesthetists (CRNAs)";

(48) "Volunteer's Certificate Application";

(49) "Volunteer's Certificate Reactivation and Reinstatement Application";

(50) "Volunteer's Certificate Renewal Application."

Last updated March 26, 2026 at 8:31 AM

History

Effective: March 26, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4723-1-04 Fees.

(A) All fee payments shall be made in the form specified by the board.

(B) Fees are not refundable once deposited except that payments in excess of the amounts required by Chapter 4723. of the Revised Code and rules adopted under that chapter shall be refunded.

Last updated September 11, 2023 at 11:09 AM

History

Effective: January 1, 2018
Promulgated Under: 119.03

Ohio Adm.Code 4723-1-05 Notice of adoption, amendment, or rescission of rules.

(A) The board shall give public notice of its intention to adopt, amend, or rescind any rule according to Chapter 119. of the Revised Code at least thirty days prior to the date set for the public hearing on the proposal to adopt, amend, or rescind such rule. The public notice shall be published in the register of Ohio and any other publications required by Chapter 119. of the Revised Code. The public notice shall include the following information:

(1) A statement of the board's intention to adopt, amend, or rescind the rule;

(2) A synopsis of the proposed rule, amendment, or rule to be rescinded, or a general statement regarding the subject matter of the rule to be adopted, amended, or rescinded;

(3) A statement of the reason or purpose for the adoption, amendment, or rescission of the rule;

(4) The date, time, and place of the public hearing at which the adoption, amendment, or rescission of the rule will be considered.

(B) The proposed rule, amendment, or rescission shall be made available by the board, according to division (B) of section 119.03 of the Revised Code, to those persons affected by the rule, amendment, or rescission for at least thirty days prior to the date of the public hearing at the board offices in printed or other legible form at no charge. The board may also provide the proposed rule, amendment, or rescission:

(1) By postal or electronic mail to those persons included on a contact list maintained by the board according to paragraph (D) of this rule;

(2) By a link on the board's web site;

(3) In any other manner the board considers appropriate.

(C) Prior to the effective date of a rule, amendment, or rescission the board, according to division (E) of section 119.03 of the Revised Code, shall make a reasonable effort to inform persons affected by the rule, amendment, or rescission, and to have available for distribution to those requesting it, the full text of the rule as adopted or amended. The board may provide the full text by such means as:

(1) Posting the rule as adopted or amended on the board's web site or providing a link to the register of Ohio;

(2) Publishing the rules in the board's quarterly magazine or other board publication;

(3) Sending a notice of the action by postal or electronic mail to those persons included on a mailing list maintained by the board pursuant to paragraph (D) of this rule, or to any person who provided evidence, oral testimony, or a written statement that was made part of the record of the public hearing.

(D) The board may maintain a contact list of all persons who have made a prior written or electronic request to receive a copy of public notices discussed in paragraph (A) of this rule.

(E) The board may assess a reasonable fee not to exceed the cost of copying and mailing, for notices sent by means other than electronic mail according to the provisions of this rule.

Last updated September 11, 2023 at 11:10 AM

History

Effective: January 8, 2018
Promulgated Under: 119.03

Ohio Adm.Code 4723-1-06 Notice of board meetings.

(A) According to division (F) of section 121.22 of the Revised Code, the board shall ensure that any person can determine the time and place of all regularly scheduled meetings and the time, place, and purpose of all special meetings by:

(1) Writing the board to request advance notification of all meetings of the board, board committees or advisory groups;

(2) Writing the board to request advance notification of all meetings at which specific public matters designated by those persons are scheduled to be discussed;

(3) Calling the board office during normal business hours; or

(4) Accessing the information on the board's web site.

(B) Any representative of the news media may obtain notice of all special meetings of the board by requesting in writing that notice be provided and supplying a postal or electronic mail address.

(C) In the event of a special meeting not of an emergency nature, the board shall notify all media representatives who have requested notice of the meeting by doing at least one of the following:

(1) Sending written notice, by postal or electronic mail no later than twenty-four hours prior to the special meeting;

(2) Notifying representatives by telephone no later than twenty-four hours prior to the special meeting. Telephone notice shall be complete if a message has been left for the representative, or if, after reasonable effort, the board has been unable to provide telephone notice;

(3) Informing the representative personally no later than twenty-four hours prior to the special meeting.

(D) In the event of a special meeting of an emergency nature requiring immediate official action, the board shall notify all media representatives who have requested notice of such meeting of the time, place, and purpose of the meeting by providing notice as described in paragraph (C)(1), (C)(2) or (C)(3) of this rule, or by notifying the statehouse press room. In such event, the notice need not be given twenty-four hours prior to the meeting, but shall be given immediately upon completion of the meeting agenda.

(E) For use in complying with the notice requirements of this rule, the board may maintain a contact list of all persons who have made a prior written request to receive notice of regular or special meetings of the board, its committees, and advisory groups.

(F) The board may charge a reasonable fee not to exceed the cost of copying and mailing, for notices sent by means other than electronic mail according to this rule.

(G) For purposes of this rule, "writing" or "written" includes electronic communication.

Last updated September 11, 2023 at 11:10 AM

History

Effective: January 8, 2018
Promulgated Under: 119.03

Ohio Adm.Code 4723-1-07 Personal information system definitions.

For the purposes of administrative rules adopted according to section 1347.15 of the Revised Code, the following definitions apply:

(A) "Access" as a noun means an opportunity to copy, view, or otherwise perceive whereas "access" as a verb means to copy, view, or otherwise perceive.

(B) "Acquisition of a new computer system" means the purchase of a "computer system," as defined in this rule, that is not a computer system currently in place nor one for which the acquisition process has been initiated as of the effective date of the board rule addressing requirements of section 1347.15 of the Revised Code.

(D) "Computer system" means a "system," as defined by section 1347.01 of the Revised Code, that stores, maintains, or retrieves personal information using electronic data processing equipment.

(E) "Confidential personal information" (CPI) has the meaning as defined by division (A)(1) of section 1347.15 of the Revised Code and identified by rules promulgated by the board according to division (B)(3) of section 1347.15 of the Revised Code that reference the federal or state statutes or administrative rules that make personal information maintained by the board confidential.

(F) "Employee of the board" means each employee of the board regardless of whether the employee holds an elected or appointed office or position within the board. "Employee of the board" is limited to the board of nursing.

(G) "Incidental contact" means contact with the information that is secondary or tangential to the primary purpose of the activity that resulted in the contact.

(H) "Individual" means natural person or the natural person's authorized representative, legal counsel, legal custodian, or legal guardian.

(I) "Information owner" means the individual appointed according to division (A) of section 1347.05 of the Revised Code to be directly responsible for a system.

(J) "Person" means natural person.

(K) "Personal information" has the same meaning as defined in division (E) of section 1347.01 of the Revised Code.

(L) "Personal information system" means a "system" that "maintains" "personal information" as those terms are defined in section 1347.01 of the Revised Code. "System" includes manual and computer systems.

(M) "Research" means a methodical investigation into a subject.

(N) "Routine" means common place, regular, habitual, or ordinary.

(O) "Routine information that is maintained for the purpose of internal office administration, the use of which would not adversely affect a person" as that phrase is used in division (F) of section 1347.01 of the Revised Code means personal information relating to the board's employees that is maintained by the board for administrative and human resource purposes.

(P) "System" has the same meaning as defined by division (F) of section 1347.01 of the Revised Code.

(Q) "Upgrade" means a substantial redesign of an existing system for the purpose of providing a substantial amount of new application functionality, or application modifications that would involve substantial administrative or fiscal resources to implement, but would not include maintenance, minor updates and patches, or modifications that entail a limited addition of functionality due to changes in business or legal requirements.

Last updated September 11, 2023 at 11:10 AM

History

Effective: February 1, 2013
Promulgated Under: 119.03

Ohio Adm.Code 4723-1-08 Procedures for accessing confidential personal information.

For personal information systems, whether manual or computer systems, that contain confidential personal information, the following applies:

(A) Criteria for accessing confidential personal information. Personal information systems of the board are managed on a "need-to-know" basis whereby the information owner determines the level of access required for an employee of the board to fulfill the employee's job duties. The determination of access to confidential personal information shall be approved by the employee's supervisor and the information owner prior to providing the employee with access to confidential personal information within a personal information system. The board shall establish procedures for determining a revision to an employee's access to confidential personal information upon a change to that employee's job duties including, but not limited to, transfer or termination. Whenever an employee's job duties no longer require access to confidential personal information in a personal information system, the employee's access to confidential personal information shall be removed.

(B) Individual's request for a list of confidential personal information. Upon the signed written request of any individual for a list of confidential personal information about the individual maintained by the board, the board shall do the following:

(1) Verify the identity of the individual by a method that provides safeguards commensurate with the risk associated with the confidential personal information;

(2) Provide to the individual the list of confidential personal information that does not relate to an investigation about the individual or is otherwise not excluded from the scope of Chapter 1347. of the Revised Code; and

(3) If all information relates to an investigation about that individual, inform the individual that the board has no confidential personal information about the individual that is responsive to the individual's request.

(1) Upon discovery of or notification that confidential personal information of a person has been accessed by an employee for an invalid reason, the board shall notify the person whose information was invalidly accessed as soon as practical and to the extent known at the time. However, the board shall delay notification for a period of time necessary to ensure that the notification would not delay or impede an investigation or jeopardize homeland or national security. Additionally, the board may delay the notification consistent with any measures necessary to determine the scope of the invalid access, including which individuals' confidential personal information was invalidly accessed, and to restore the reasonable integrity of the system.

"Investigation" as used in this paragraph means the investigation of the circumstances and involvement of an employee surrounding the invalid access of the confidential personal information. Once the board determines that notification would not delay or impede an investigation, the board shall disclose the access to confidential personal information made for an invalid reason to the person.

(2) Notification provided by the board shall inform the person of the type of confidential personal information accessed and the date or dates of the invalid access.

(3) Notification may be made by any method reasonably designed to accurately inform the person of the invalid access, including written, electronic, or telephone notice.

(D) Appointment of a data privacy point of contact. The board executive director shall designate an employee of the board to serve as the data privacy point of contact. The data privacy point of contact shall work with the chief privacy officer within the office of information technology to assist the board with both the implementation of privacy protections for the confidential personal information that the board maintains and compliances with section 1347.15 of the Revised Code and the rules adopted pursuant to the authority provided by that chapter.

(E) Completion of a privacy impact assessment. The board executive director shall designate an employee of the board to serve as the data privacy point of contact who shall timely complete the privacy impact assessment form developed by the office of information technology.

Last updated September 11, 2023 at 11:10 AM

History

Effective: February 1, 2013
Promulgated Under: 119.03

Ohio Adm.Code 4723-1-09 Valid reasons for accessing confidential personal information.

Based on the requirements of division (B)(2) of section 1347.15 of the Revised Code, this rule contains a list of valid reasons, directly related to the board's exercise of its powers or duties, for which only authorized employees of the board or board members may access confidential personal information (CPI) regardless of whether the personal information system is a manual system or a computer system.

(A) Performing the following functions constitute valid reasons for authorized employees or members of the board to access confidential personal information:

(1) Responding to a public records request;

(2) Responding to a request from an individual for the list of CPI the board maintains on that individual;

(3) Administering a constitutional provision or duty;

(4) Administering a statutory provision or duty;

(5) Administering an administrative provision or duty;

(6) Complying with any state or federal program requirements;

(7) Processing or payment of claims or otherwise administering a program with individual participants or beneficiaries;

(8) Auditing purposes;

(9) Licensure, certification, or temporary permit processing, including application review, filing or verification processes;

(10) Investigation or law enforcement purposes;

(11) Administrative hearings;

(12) Litigation, complying with an order of the court, or subpoena;

(13) Human resource matters, including hiring, promotion, demotion, discharge, salary or compensation issues, processing leave requests or issues, time card approvals or issues, and payroll processing;

(14) Complying with an executive order or policy;

(15) Complying with a board policy or a state administrative policy issued by the department of administrative services, the office of budget and management or other similar state agency; or

(16) Complying with a collective bargaining agreement provision.

(B) To the extent that the general processes described in paragraph (A) of this rule do not cover the following circumstances, for the purpose of carrying out specific duties of the board, authorized employees and board members would also have valid reasons for accessing CPI in these following circumstances:

(1) Authorized employees and board members may review CPI of individuals who are subject to investigation for alleged violations of Chapter 4723. of the Revised Code or Chapters 4723-1 to 4723-27 of the Administrative Code that may result in licensure or certification discipline. Authorized employees and board members may review CPI of individuals who are not the subject of the investigation, but who otherwise may be witnesses with information related to the investigation. CPI may be reviewed by employees and members of the board in disciplinary matters that become the subject of administrative hearings or board action, including reporting disciplinary actions as required by federal and state law.

(2) Authorized employees and board members may review CPI of individuals who are participants in the alternative program for chemical dependency, the practice intervention and improvement program, or who are being monitored by the board according to a board order or consent agreement, for purposes of monitoring and determining compliance with the terms and conditions of the program, order or agreement.

(3) Authorized employees and board members may review CPI of students enrolled in, or administrative, faculty, or instructional personnel employed by, nursing education or training programs, for the purpose of conducting survey visits and approving or re-approving of those programs.

(4) Authorized employees and board members may review CPI of persons who hold, are applying for, or are renewing a nursing license, dialysis technician certificate, medication aide certificate, community health worker certificate, or any other license, certificate or temporary permit issued by the board, for purposes of verifying licensure or certification, processing licensure or certification applications, determining eligibility for licensure or certification, or performing financial transactions and reporting related to applicant and credential processing.

(5) Authorized employees may review CPI of persons who hold, or are applying for, nurse education grant program funds for purposes of determining grant eligibility or compliance with the terms and conditions of grant awards.

Last updated February 1, 2023 at 8:56 AM

History

Effective: February 1, 2023
Promulgated Under: 119.03

Ohio Adm.Code 4723-1-10 Confidentiality statutes, regulations and rules.

The following federal statutes or regulations or state statutes or administrative rules make personal information maintained by the board confidential and identify the confidential personal information within the scope of rules promulgated by this board in accordance with section 1347.15 of the Revised Code:

(A) Social security numbers: 5 U.S.C. 552a (2012), unless the individual was told that the number would be disclosed.

(B) "Bureau of Criminal Identification and Investigation" criminal records check results: section 4776.04 of the Revised Code and division (D) of section 4723.091 of the Revised Code.

(C) Records or information received by the board pursuant to an investigation of an application for or holder of a license or a dialysis technician certificate; division (I)(1) of section 4723.28 of the Revised Code.

(D) Records or information received by the board pursuant to an investigation of an applicant for or holder of a medication aide certificate: division (C) of section 4723.652 of the Revised Code.

(E) Records or information received by the board pursuant to an investigation of an applicant for or holder of a community health worker certificate: paragraph (J) of rule 4723-26-11 of the Administrative Code.

(F) Patient information or records reviewed in the course of an investigation by the board: division (I)(2) of section 4723.28 of the Revised Code.

(G) Information or records received or maintained as part of continued monitoring of an individual as part of or following any disciplinary action of the board: division (I)(4) of section 4723.28 of the Revised Code.

(H) Information or records received or maintained for purposes of the practice intervention and improvement program: division (D) of section 4723.282 of the Revised Code.

(I) Information or records received or maintained for purposes of an individual's application for or participation in the alternative program for chemical dependency, including medical records, treatment records, and mental health records, unless the exception set forth in division (E)(4) of section 4723.35 of the Revised Code applies: division (E)(3) of section 4723.35 of the Revised Code.

(J) Student education records, unless the individual consents to the release: 20 U.S.C. 1232g (2013).

(K) Security or infrastructure records: division (B) of section 149.433 of the Revised Code.

(L) Information or records that are attorney client privileged: division (A)(1) of section 2317.02 of the Revised Code.

(M) Mediation communications or records: section 2710.03 of the Revised Code.

(N) Trial preparation records: division (A)(1)(g) of section 149.43 of the Revised Code.

(O) Information obtained from the drug database established and maintained by the state board of pharmacy: division (C) of section 4729.80 of the Revised Code.

Last updated February 1, 2023 at 8:56 AM

History

Effective: February 1, 2023
Promulgated Under: 119.03

Ohio Adm.Code 4723-1-11 Restricting and logging access to confidential personal information in computerized personal information systems.

For personal information systems that are computer systems and contain confidential personal information, the following applies:

(A) Access restrictions. Access to confidential personal information that is kept electronically shall require a password or other authentication measure.

(B) Acquisition of a new computer system. When the board acquires a new computer system that stores, manages or contains confidential personal information, the board shall include a mechanism for recording specific access by employees of the board to confidential personal information in the system.

(C) Upgrading existing computer systems. When the board modifies an existing computer system that stores, manages or contains confidential personal information, the board shall make a determination whether the modification constitutes an upgrade. Any upgrades to a computer system shall include a mechanism for recording specific access by employees of the board to confidential personal information in the system.

(D) Logging requirements regarding confidential personal information in existing computer systems.

(1) The board shall require employees of the board who access confidential personal information within computer systems to maintain a log that records that access.

(2) Access to confidential information is not required to be entered into the log under the following circumstances:

(a) The employee of the board is accessing confidential personal information for official board purposes, including research, and the access is not specifically directed toward a specifically named individual or a group of specifically named individuals.

(b) The employee of the board is accessing confidential personal information for routine office procedures and the access is not specifically directed toward a specifically named individual or a group of specifically named individuals.

(c) The employee of the board comes into incidental contact with confidential personal information and the access of the information is not specifically directed toward a specifically named individual or a group of specifically named individuals.

(d) The employee of the board accesses confidential personal information about an individual based upon a request made under either of the following circumstances:

(i) The individual requests confidential personal information about himself or herself.

(ii) The individual makes a request that the board take some action on that individual's behalf and accessing the confidential personal information is required in order to consider or process the request.

(3) For purposes of this paragraph, the board may choose the form or forms of logging, whether in electronic or paper formats.

(E) Log management. The board shall issue a policy that specifies the following:

(1) Who shall maintain the log:

(2) What information shall be captured in the log;

(3) How the log is to be stored; and

(4) How long information kept in this log is to be retained.

Nothing in this rule limits the board from requiring logging in any circumstance that it deems necessary.

Last updated September 11, 2023 at 11:10 AM

History

Effective: February 1, 2013
Promulgated Under: 119.03

Chapter 4723-2 Public Notice

Ohio Adm.Code 4723-2-01 Definitions.

(A) For purposes of Chapters 4723-1 to 4723-27 of the Administrative Code, and except as otherwise provided, the following definitions shall apply:

(1) "Active duty service member" means any member of the armed forces of the United States performing active duty under title 10 of the United States Code.

(2) "Armed forces" means the armed forces of the United States, including the army, navy, air force, marine corps, coast guard, or any reserve components of those forces; the national guard of any state; the commissioned corps of the United States public health service; the merchant marine service during wartime; such other service as may be designated by congress; or the Ohio organized militia when engaged in full-time national guard duty for a period of more than thirty days.

(3) "Applicant" means an individual who applies to the board for a license, temporary permit, or certificate, or renewal, reinstatement or reactivation of a license or certificate, to practice as:

(a) A registered nurse or licensed practical nurse;

(b) A certified dialysis technician;

(d) A community health worker;

(e) An advanced practice registered nurse; or

(f) A doula.

(4) "Service member" means any person who is serving in the armed forces.

(5) "Merchant marine" includes the United States army transport service and the United States naval transport service.

(6) "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 3, 2025 at 8:27 AM

History

Effective: February 1, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-2-02 Processing applications from service members, veterans, or spouses of service members or veterans.

(A) The board shall include questions on all applications for licensure, certification, or biennial renewal of licensure or certification, that inquire as to whether the applicant is:

(1) A service member;

(2) A veteran; or

(3) The spouse or surviving spouse of a service member or veteran.

(B) If the applicant responds affirmatively to any of the questions discussed in paragraph (A) of this rule, the board shall:

(1) Route the application to a board staff member who is responsible for monitoring the application and communicating with the applicant regarding the status of the application, including informing the applicant of any documentation needed for the board to process the application;

(2) Expedite the processing of the application, even if the application was received later in time than other applications that are pending processing;

(3) Provide information to applicants if the applicant or their spouse will be imminently deployed, regarding available fee and continuing education waivers, as discussed in rule 4723-2-03 of the Administrative Code;

(4) Request that the applicant submit documentation to the board demonstrating that the applicant is a service member, veteran, or spouse or surviving spouse of a service member or veteran; and

(5) Track, on an annual basis, the total number of applications submitted by service members, veterans, or spouses or surviving spouses of service members or veterans, and the average number of business days expended by the board to process those applications.

(1) A copy of a document issued by the armed forces showing the applicant is a service member or veteran, or that the applicant's spouse was a service member or veteran; and

(2) If the applicant is a spouse or surviving spouse of a service member or veteran, a copy of a document showing that the applicant and the service member or veteran are spouses according to the law of any state or country.

Last updated December 2, 2024 at 11:48 AM

History

Effective: February 1, 2015
Promulgated Under: 119.03

Ohio Adm.Code 4723-2-03 Fee waivers available to service members, veterans, or spouses of service members or veterans.

(A) A licensed practical nurse or registered nurse, who submits a renewal application after September fifteenth or later, or whose license lapsed, due to the licensee's service in the armed forces, shall be eligible for renewal and reinstatement without payment of the late application fee required by division (A)(9) of section 4723.08 of the Revised Code, and the reinstatement fee required by division (A)(14) of section 4723.08 of the Revised Code, if the following are met:

(1) The licensee presents the board with satisfactory evidence that, not more than six months prior to the date the evidence is submitted to the board, the licensee or certificate holder was honorably discharged or separated under honorable conditions;

(2) The licensee is not suffering a mental or physical impairment that may affect the individual's ability to provide safe care; and

(3) The licensee meets the requirements for license or certificate renewal required by section 4723.24 of the Revised Code.

(B) A licensed practical nurse or registered nurse, who submits a renewal application after September fifteenth or later, or whose license lapsed, due to the licensee's spouse's service in the armed forces, shall be eligible for renewal and reinstatement without payment of the late application fee required by division (A)(10) of section 4723.08 of the Revised Code, and the reinstatement fee required by division (A)(15) of section 4723.08 of the Revised Code, if the following are met:

(1) The licensee presents the board with satisfactory evidence that the licensee did not renew their license because their spouse's military service caused them to be absent from the state of Ohio;

(2) The licensee presents the board satisfactory evidence that, not more than six months prior to the date the evidence is submitted to the board, the licensee's spouse was honorably discharged or separated under honorable conditions; and

(3) The licensee meets the requirements for license renewal required by section 4723.24 of the Revised Code.

(C) An advanced practice registered nurse who submits a renewal application after September fifteenth or later, or whose license lapsed, due to the licensee's service in the armed forces, shall be eligible for renewal and reinstatement without payment of the late application fee required by division (A)(9) of section 4723.08 of the Revised Code, and the reinstatement fee required by division (A)(14) of section 4723.08 of the Revised Code, if the following are met:

(1) The licensee presents the board with satisfactory evidence that, not more than six months prior to the date the evidence is submitted to the board, the licensee was honorably discharged or separated under honorable conditions;

(2) The licensee is not suffering a mental or physical impairment that may affect the individual's ability to provide safe care; and

(3) The licensee meets the requirements for license renewal required by section 4723.42 of the Revised Code.

(D) An advanced practice registered nurse, who submits a renewal application after September fifteenth or later, or whose license lapsed, due to the licensee's spouse's service in the armed forces, shall be eligible for renewal and reinstatement without payment of the late application fee required by division (A)(9) of section 4723.08 of the Revised Code, and the reinstatement fee required by division (A)(14) of section 4723.08 of the Revised Code, if the following are met:

(1) The licensee presents the board with satisfactory evidence that the licensee did not renew their certificate because their spouse's military service caused them to be absent from the state of Ohio;

(3) The licensee meets the requirements for license renewal required by section 4723.42 of the Revised Code.

(E) A dialysis technician certificate holder, who submits a renewal application on March first or later, or whose certificate lapsed, due to the holder's service in the armed forces, shall be eligible for renewal and reinstatement without payment of the late application fee required by division (A)(10) of section 4723.08 of the Revised Code, and the reinstatement fee required by division (A)(15) of section 4723.08 of the Revised Code, if the following are met:

(1) The certificate holder presents the board with satisfactory evidence that, not more than six months prior to the date the evidence is submitted to the board, the certificate holder was honorably discharged or separated under honorable conditions;

(2) The certificate holder is not suffering a mental or physical impairment that may affect the individual's ability to provide safe care; and

(3) The certificate holder meets the requirements for certificate renewal required by section 4723.77 of the Revised Code and rule 4723-23-05 of the Administrative Code.

(F) A dialysis technician certificate holder, who submits a renewal application on March first or later, or whose certificate lapsed, due to the holder's spouse's service in the armed forces, shall be eligible for renewal and reinstatement without payment of the late application fee required by division (A)(9) of section 4723.08 of the Revised Code, and the reinstatement fee required by division (A)(14) of section 4723.08 of the Revised Code, if the following are met:

(1) The certificate holder presents the board with satisfactory evidence that the certificate holder did not renew their certificate because their spouse's military service caused them to be absent from the state of Ohio;

(2) The certificate holder presents the board satisfactory evidence that, not more than six months prior to the date the evidence is submitted to the board, the certificate holder's spouse was honorably discharged or separated under honorable conditions; and

(3) The certificate holder meets the requirements for license renewal required by section 4723.77 of the Revised Code and rule 4723-23-05 of the Administrative Code.

(G) A community health worker certificate holder, who submits a renewal application on April first or later, or whose certificate lapsed due to the holder's service in the armed forces shall be eligible for renewal and reinstatement without payment of the late application fee required by paragraph (C) of rule 4723-26-04 of the Administrative Code and the reinstatement fee required by paragraph (E)(2) of rule 4723-26-04 of the Administrative Code and division (A)(14) of section 4723.08 of the Revised Code if the following conditions are met:

(2) The certificate holder is not suffering a mental or physical impairment that may affect the individual's ability to provide safe care.

(H) A community health worker certificate holder, who submits a renewal application on April first or later, or whose certificate lapsed, due to the holder's spouse's service in the armed forces shall be eligible for renewal and reinstatement without payment of the late application fee required by paragraph (C) of rule 4723-26-04 , and the reinstatement fee required by paragraph (E)(2) of rule 4723-26-04 of the Administrative Code and division (A)(14) of section 4723.08 of the Revised Code, if the following are met:

(1) The certificate holder presents the board with satisfactory evidence that the holder did not renew their certificate because their spouse's military service caused them to be absent from the state of Ohio;

(2) The certificate holder presents the board satisfactory evidence that, not more than six months prior to the date the evidence is submitted to the board, the holder's spouse was honorably discharged or separated under honorable conditions; and

(3) The certificate holder meets the requirements for certificate renewal required by section 4723.85 of the Revised Code.

(I) A medication aide certificate holder who submits a renewal application after March first, or whose certificate lapsed due to the holder's service in the armed forces shall be eligible for renewal and reinstatement by paying the renewal fee set forth in paragraph (A)(2) of rule 4723-27-10 of the Administrative Code without payment of the late application fee set forth in paragraph (A)(3) of rule 4723-27-10 of the Administrative Code or the reinstatement fee specified in paragraph (A)(4) of rule 4723-27-10 of the Administrative Code, if the following conditions are met:

(1) The certificate holder presents the board with satisfactory evidence that not more than six months prior to the date the evidence is submitted to the board, the certificate holder was honorably discharged or separated under honorable conditions; and

(2) The certificate holder is not suffering a mental or physical impairment that may affect the individual's ability to provide safe care.

(J) A medication aide certificate holder who submits a renewal application after March first, or whose certificate lapsed, due to the holder's spouse's service in the armed forces shall be eligible for renewal and reinstatement without payment of the late application fee required by paragraph (C) of rule 4723-27-05 of the Administrative Code , and the reinstatement fee required by paragraph (H)(2) of rule 4723-27-05 of the Administrative Code and division (A)(14) of section 4723.08 of the Revised Code, if the following are met:

(3) The certificate holder meets the requirements for certificate renewal required by rule 4723-27-05 of the Administrative Code and section 4723.651 of the Revised Code.

(K) A doula certificate holder, who submits a renewal application on April first or later, or whose certificate lapsed due to the holder's service in the armed forces shall be eligible for renewal and reinstatement without payment of the late application fee required by paragraph (C) of rule 4723-24-03 of the Administrative Code, and the reinstatement fee required by paragraph (E)(2) of rule 4723-24-03 of the Administrative Code and division (A)(14) of section 4723.08 of the Revised Code if the following conditions are met:

(2) The certificate holder is not suffering a mental or physical impairment that may affect the individual's ability to provide safe care.

(L) A doula certificate holder, who submits a renewal application on April first or later, or whose certificate lapsed, due to the holder's spouse's service in the armed forces shall be eligible for renewal and reinstatement without payment of the late application fee required by rule 4723-24-03 of the Administrative Code, and the reinstatement fee required by paragraph (E)(2) of rule 4723-24-03 of the Administrative Code and division (A)(14) of section 4723.08 of the Revised Code, if the following are met:

(3) The certificate holder meets the requirements for certificate renewal required by section 4723.89 of the Revised Code.

Last updated February 3, 2025 at 8:28 AM

History

Effective: February 1, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-2-04 Military duty time extension and factors to be considered.

(A) Upon receipt of an application from a licensed nurse, dialysis technician, certified community health worker, medication aide, or doula that is accompanied by proper documentation certifying that the individual has been called to active duty during a current or prior reporting period, and certifying the length of that active duty, the individual shall receive an extension of the current continuing education reporting period equal to the total number of months spent in active duty during the current reporting period. For purposes of this rule, any portion of a month served on active duty shall be considered one full month.

(B) In determining whether the requirements of this chapter are met, the board shall consider relevant education, training, or service completed by a licensee or certificate holder as a member of the armed forces.

Last updated February 3, 2025 at 8:28 AM

History

Effective: February 1, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-2-05 Temporary military licenses.

(A) For purposes of this rule, the definitions set forth in section 4743.041 of the Revised Code and rule 4723-2-01 of the Administrative Code apply. In addition, for purposes of this rule:

(1) "In good standing" means an applicant's license in another state or jurisdiction is current, valid and unrestricted;

(2) "License" includes certificates;

(3) "Spouse" means a person to whom the applicant for a temporary license is currently married, or less than six months have expired since the divorce, dissolution, or annulment of the marriage.

(B) The board shall issue temporary licenses to applicants according to section 4743.041 of the Revised Code. For purposes of determining whether an applicant is qualified for a temporary license as set forth in that section, the following apply:

(1) The applicant has indicated in the Ohio elicense system that the applicant is seeking a temporary military license;

(2) The applicant holds a license in good standing in another state or jurisdiction, of the same type sought in this state;

(3) The applicant has submitted to the board a copy of a document issued by the armed forces showing that the applicant or the applicant's spouse is on military duty in this state; and

(4) The board has received the results of a criminal records check conducted in accordance with section 4723.091 of the Revised Code and is not ineligible for temporary licensure due to a disqualifying criminal offense as specified in section 4723.092 of the Revised Code.

(C) The board shall waive all license fees for issuance of a temporary license as required by section 4743.041 of the Revised Code.

(D) The board shall issue a temporary license to a qualified applicant within fourteen days of board's receipt of the results of a criminal records check conducted in accordance with section 4723.091 of the Revised Code.

(1) In order to track, prioritize and expedite the issuance of temporary military licenses, the board shall comply with the requirements of rule 4723-2-02 of the Administrative Code.

(2) The board may postpone issuance of the temporary license until:

(a) Completion of any investigation being conducted by the licensing agency in another state or jurisdiction in which the applicant holds a license; or

(b) Confirmation from the licensing agency in another state or jurisdiction that the applicant holds a license of the same type sought in this state that is in good standing.

(E) For purposes of implementing temporary licenses in accordance with section 4743.041 of the Revised Code, the temporary license shall be valid for a period of six years.

(F) Within thirty days following the board's fiscal year end, the board shall submit a report to the director of veterans services on the number and type of temporary licenses issued according to section 4743.041 of the Revised Code during fiscal year.

Last updated December 2, 2024 at 11:48 AM

History

Effective: April 15, 2021
Promulgated Under: 119.03

Chapter 4723-3 Definitions

Ohio Adm.Code 4723-3-01 Definitions.

For purposes of Chapters 4723-1 to 4723-27 of the Administrative Code, and except as otherwise provided, the following definitions shall apply:

(A) "Board" means the Ohio board of nursing.

(B) "Advanced practice registered nurse" means an individual who holds a current, valid license issued under Chapter 4723. of the Revised Code that authorizes the practice of nursing as an advanced practice registered nurse and is designated as any of the following:

(1) A certified registered nurse anesthetist;

(2) A clinical nurse specialist;

(3) A certified nurse-midwife;

(4) A certified nurse practitioner.

(D) "Current, valid license" and "current, valid certificate" mean an authorization to practice issued under Chapter 4723. of the Revised Code that is not inactive, suspended, revoked, or subject to restrictions, and for which the holder continues to meet all of the requirements for issuance.

(E) "Endorsement" means the process by which a license to practice nursing as a registered nurse or a licensed practical nurse is issued by the board, according to division (B) of section 4723.09 of the Revised Code and Chapter 4723-7 of the Administrative Code.

(F) "Foreign educated nurse graduate" has the meaning set forth in paragraph (E) of rule 4723-7-01 of the Administrative Code.

(G) "Inactive" means that a licensee or certificate holder has submitted a written request that the board place the license or certificate on inactive status. An individual with an inactive license or certificate does not hold a current, valid license or certificate, and is not authorized to engage in the practice for which the license or certificate was issued.

(H) "Jurisdiction" means, in relation to a registered nurse or licensed practical nurse, any state, territory, or political subdivision of the United States in which a board or legal approving authority regulates nurse licensure and nursing practice and maintains membership in the national council of state boards of nursing. In relation to a dialysis technician or community health worker, "jurisdiction" means any state, territory, or political subdivision of the United States in which a board or legal approving authority regulates certification of dialysis technicians or community health workers.

(I) "Lapsed" means that a licensee or certificate holder has failed to fulfill all requirements for renewal, and has failed to comply with the requirements to place the license or certificate on inactive status.

(J) "License" means an authorization to practice issued under Chapter 4723. of the Revised Code.

(K) "Patient" means the recipient of nursing care or dialysis care, which may include an individual, a group, or a community.

(L) "Person" includes, without limitation, a natural person, a corporation, whether nonprofit or for profit, a partnership, a limited liability company, an unincorporated society or association, or two or more persons having a joint or common interest.

(M) "Representative of the board" means an employee of the board or an individual designated by the board to act on its behalf.

(N) "Unauthorized practice" means engaging in activities for which licensure or certification is required under Chapter 4723. of the Revised Code without holding a current, valid license or certificate to engage in such activity.

Unauthorized practice shall not be construed to prevent any person registered, certified, licensed, or otherwise legally authorized in this state under any law from engaging in the practice for which such person is registered, certified, licensed, or authorized. Individuals "legally authorized" includes, but is not limited to, individuals authorized according to section 3313.713 of the Revised Code, DODD personnel authorized according to sections 5123.41 to 5123.47 of the Revised Code, and individuals authorized according to Title 47 of the Revised Code.

Last updated September 11, 2023 at 11:11 AM

History

Effective: January 1, 2018
Promulgated Under: 119.03

Ohio Adm.Code 4723-3-02 Definition of mental or physical impairment or disability.

For purposes of division (G) of section 4723.28 of the Revised Code, division (B)(11) of section 4723.28 of the Revised Code, paragraph (B)(11) of rule 4723-27-09 of the Administrative Code, rule 4723-26-11 of the Administrative Code, and rule 4723-24-07 of the Administrative Code, the following definitions apply:

(A) "Mental impairment" and "mental disability" include, but are not limited to, mental disorder.

(B) "Impaired" and "impairment" includes inability to practice according to acceptable and prevailing standards of safe nursing care, safe dialysis care, or safe care as a certified medication aide, certified community health worker, or certified doula, without appropriate treatment, monitoring, or supervision.

Last updated September 30, 2024 at 8:31 AM

History

Effective: September 30, 2024
Promulgated Under: 119.03

Chapter 4723-4 Standards of Practice Relative to Registered Nurse or Licensed Practical Nurse

Ohio Adm.Code 4723-4-01 General information.

(A) The purpose of this chapter is to establish:

(1) Minimal acceptable standards of safe and effective nursing practice for a registered nurse and a licensed practical nurse in any setting;

(2) Minimal acceptable standards of safe and effective practice for an advanced practice registered nurse designated as a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist in any setting. Additional standards for practice as a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, and clinical nurse specialist are established in Chapters 4723-8 and 4723-9 of the Administrative Code;

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

(1) "Certified nurse-midwife" means a registered nurse who has met the requirements of section 4723.41 of the Revised Code, and who holds a current valid advanced practice registered nurse license issued by the board under section 4723.42 of the Revised Code.

(2) "Certified nurse practitioner" means a registered nurse who has met the requirements of section 4723.41 of the Revised Code, and who holds a current valid advanced practice registered nurse license issued by the board under section 4723.42 of the Revised Code.

(3) "Certified registered nurse anesthetist" means a registered nurse who has met the requirements of section 4723.41 of the Revised Code, and who holds a current valid advanced practice registered nurse license issued by the board under section 4723.42 of the Revised Code.

(4) "Clinical judgment" is the application of the nurse's knowledge and reasoning within the context of the clinical environment in making decisions about patient care.

(5) "Clinical nurse specialist" means a registered nurse who has met the requirements of section 4723.41 of the Revised Code, and who holds a current valid advanced practice registered nurse license issued by the board under section 4723.42 of the Revised Code.

(6) "Direction" means communicating a plan of care to a licensed practical nurse. Direction by a registered nurse is not meant to imply the registered nurse is supervising the licensed practical nurse in the employment context.

(7) "Licensed nurse" means a registered nurse or a licensed practical nurse who holds a current valid license to practice nursing in Ohio.

(8) "Nursing diagnosis" means the identification of a patient's needs or problems which are amenable to nursing intervention.

(9) "Patient" means the recipient of nursing care, which may include an individual, a group, or a community.

(1) "Adult" means anyone who is eighteen years of age or older.

(2) "Antibiotic" means a medication, including an anti-infective or anti-fungal, administered to inhibit the growth of, or destroy, microorganisms in the treatment or prevention of infectious disease.

(3) "Direction" means communication of a plan of care, based upon assessment of the patient by the registered nurse, or licensed physician, physician assistant, dentist, optometrist, or podiatrist, that establishes the parameters for providing care or performing a procedure. Unless otherwise provided by law, the registered nurse, or licensed physician, dentist, optometrist, or podiatrist shall be available on site to assess and evaluate the patient's response to the plan of care.

(4) "Initiate" means to start or to begin.

(5) "Maintain" means to administer or regulate an intravenous infusion according to the prescribed flow rate.

(6) "Piggyback" means an intermittent or secondary intravenous infusion.

Last updated February 1, 2024 at 9:29 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-4-02 Intravenous therapy procedures for licensed practical nurses.

(A) Except as provided in paragraph (B) of this rule, a licensed practical nurse shall not perform any of the following intravenous therapy procedures:

(1) Initiate or maintain any of the following:

(a) Blood or blood components;

(b) Solutions for total parenteral nutrition;

(d) Investigational or experimental medications;

(e) Solutions administered through any central venous line or arterial line or any other line that does not terminate in a peripheral vein, except as provided in paragraph (B)(1) of this rule;

(f) An intravenous piggyback infusion, except as provided in paragraph (B)(3) of this rule.

(2) Discontinue a central venous, arterial, or any other line that does not terminate in a peripheral vein;

(3) Initiate or discontinue a peripherally inserted central catheter, or any catheter that is longer than three inches;

(4) Program or set any function of a patient controlled analgesic;

(5) Mix, prepare or reconstitute any medication for intravenous therapy, except as provided in paragraph (B)(4) of this rule;

(6) Administer medications by an intravenous route, except as provided in paragraph (B)(3) of this rule;

(7) Inject medications by a direct intravenous route, except as provided in paragraph (B)(5) of this rule;

(8) Change tubing on an arterial line, a central venous line, or on any line that does not terminate in a peripheral vein;

(9) Change an intermittent infusion device, unless the tip of the connected intravenous catheter terminates in a peripheral vein.

(B) A licensed practical nurse may perform the following procedures only for individuals aged eighteen or older and only when directed to do so by a licensed physician, physician assistant, dentist, optometrist, podiatrist, or registered nurse in accordance with section 4723.18 of the Revised Code:

(1) Administer the following solutions, or combinations of the solutions, through a venous line:

(a) Five per cent dextrose and water;

(b) Five per cent dextrose and lactated ringers;

(d) Normal saline;

(e) Lactated ringers;

(f) 0.45 per cent sodium chloride and water;

(g) 0.2 per cent sodium chloride and water; or

(h) 0.3 per cent sodium chloride and water.

(2) Administer any of the solutions set forth in paragraph (B)(1) of this rule that contain vitamins or electrolytes after a registered nurse initiates the first infusion of the solution containing vitamins or electrolytes.

(3) Initiate or maintain an intermittent or secondary intravenous infusion containing an antibiotic;

(4) Prepare or reconstitute an antibiotic additive to be administered through an intravenous infusion;

(5) Inject heparin or normal saline to flush an intermittent infusion device or heparin lock, including, but not limited to, bolus or push;

(6) Change tubing on an intermittent infusion device and on an intravenous line if the line terminates in a peripheral vein;

(7) Place a venous access catheter, no longer than three inches in length, in the hand, forearm or antecubital space, followed by the placement of a saline or heparin lock, either for purposes of intermittent infusions, or to initiate infusions of any of the solutions set forth in paragraph (B)(1) of this rule; or

(8) Stop an infusion of blood or blood component, or turn off the function of a patient-controlled analgesic device when a complication arises.

(C) A licensed practical nurse may perform the procedures set forth in paragraph (B) of this rule only if one of the following requirements are met:

(1) The licensed practical nurse is directed to perform intravenous therapy by a licensed physician, physician assistant, dentist, optometrist, or podiatrist who is present and readily available at the facility where the intravenous therapy procedure is performed;

(2) The licensed practical nurse is directed to perform intravenous therapy by a registered nurse who has personally performed an on-site assessment of the individual to receive intravenous therapy, and that registered nurse or another registered nurse is readily available at the site where the intravenous therapy procedure is performed; or

(3) If the intravenous therapy procedures are performed in a home as defined in section 3721.01 of the Revised Code, or in an intermediate care facility for individuals with intellectual disabilities as defined in section 5124.01 of the Revised Code, a registered nurse who directs the authorized licensed practical nurse to perform intravenous therapy is either:

(a) On the premises of the home or facility; or

(b) Accessible by some form of telecommunication.

Last updated February 1, 2024 at 9:29 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-4-03 Standards relating to competent practice as a registered nurse.

(A) A registered nurse shall provide nursing care within the scope of practice of nursing for a registered nurse as set forth in division (B) of section 4723.01 of the Revised Code and the rules of the board.

(B) A registered nurse shall maintain current knowledge of the duties, responsibilities, and accountabilities for safe nursing practice.

(C) A registered nurse shall demonstrate competence and accountability in all areas of practice in which the nurse is engaged including:

(1) Consistent performance of all aspects of nursing care; and

(2) Recognition, referral or consultation, and intervention, when a complication arises.

(D) A registered nurse may provide nursing care that is beyond basic nursing preparation for a registered nurse, provided:

(1) The nurse obtains education that emanates from a recognized body of knowledge relative to the nursing care to be provided;

(2) The nurse demonstrates knowledge, skills, and abilities necessary to provide the nursing care;

(3) The nurse maintains documentation satisfactory to the board of meeting the requirements set forth in paragraphs (D)(1) and (D)(2) of this rule;

(4) When the nursing care is to be provided according to division (B)(5) of section 4723.01 of the Revised Code, the nurse has a specific current order from an individual who is authorized to practice in this state and is acting within the course of the individual's professional practice; and

(5) The nursing care does not involve a function or procedure that is prohibited by any other law or rule.

(E) A registered nurse shall, in a timely manner:

(1) Implement any order for a patient unless the registered nurse believes or should have reason to believe the order is:

(a) Inaccurate;

(b) Not properly authorized;

(d) Harmful, or potentially harmful to a patient; or

(e) Contraindicated by other documented information; and

(2) Clarify any order for a patient when the registered nurse believes or should have reason to believe the order is:

(a) Inaccurate;

(b) Not properly authorized;

(d) Harmful, or potentially harmful to a patient; or

(e) Contraindicated by other documented information.

(F) When clarifying an order, the registered nurse shall, in a timely manner:

(1) Consult with an appropriate licensed practitioner;

(2) Notify the ordering practitioner when the registered nurse makes the decision not to follow the order or administer the medication or treatment as prescribed;

(3) Document that the practitioner was notified of the decision not to follow the order or administer the medication or treatment, including the reason for not doing so; and

(4) Take any other action needed to assure the safety of the patient.

(G) A registered nurse shall, in a timely manner, report to and consult as necessary with other nurses or other members of the health care team and make referrals as necessary.

(H) A registered nurse shall maintain the confidentiality of patient information. The registered nurse shall communicate patient information with other members of the health care team for health care purposes only, shall access patient information only for purposes of patient care, or for otherwise fulfilling the nurse's assigned job responsibilities, and shall not disseminate patient information for purposes other than patient care, or for otherwise fulfilling the nurse's assigned job responsibilities, through social media, texting, emailing or any other form of communication.

(I) To the maximum extent feasible, identifiable patient health care information shall not be disclosed by a registered nurse unless the patient has consented to the disclosure of identifiable patient health care information. A registered nurse shall report individually identifiable patient information without written consent in limited circumstances only and in accordance with an authorized law, rule, or other recognized legal authority.

(J) The registered nurse shall use acceptable standards of safe nursing care as a basis for any observation, advice, instruction, teaching, or evaluation and shall communicate information which is consistent with acceptable standards of safe nursing care.

(K) When a registered nurse provides direction to a licensed practical nurse the registered nurse shall first assess:

(1) The condition of the patient who needs nursing care, including, but not limited to, the stability of the patient;

(2) The type of nursing care the patient requires;

(3) The complexity and frequency of the nursing care needed;

(4) The training, skill, and ability of the licensed practical nurse who will be performing the specific function or procedure, to perform the specific function or procedure; and

(5) The availability and accessibility of resources necessary to safely perform the specific function or procedure.

Last updated January 3, 2024 at 2:02 PM

History

Effective: February 1, 2019
Promulgated Under: 119.03

Ohio Adm.Code 4723-4-04 Standards relating to competent practice as a licensed practical nurse.

(A) A licensed practical nurse shall function within the scope of practice of nursing for a licensed practical nurse as set forth in division (F) of section 4723.01 of the Revised Code and the rules of the board.

(B) A licensed practical nurse shall maintain current knowledge of the duties, responsibilities, and accountabilities for safe nursing practice.

(C) A licensed practical nurse shall demonstrate competence and accountability in all areas of practice in which the nurse is engaged which includes, but is not limited to, the following:

(1) Consistent performance of all aspects of nursing care; and

(2) Recognition, referral or consultation, and intervention, when a complication arises.

(D) A licensed practical nurse may provide nursing care in accordance with division (F) of section 4723.01 of the Revised Code that is beyond basic preparation for a licensed practical nurse provided:

(1) The nurse obtains education that emanates from a recognized body of knowledge relative to the nursing care to be provided;

(2) The nurse demonstrates knowledge, skills, and abilities necessary to perform the nursing care;

(3) The nurse maintains documentation satisfactory to the board of meeting the requirements set forth in paragraphs (D)(1) and (D)(2) of this rule;

(4) When the nursing care is to be provided according to division (F)(3) of section 4723.01 of the Revised Code, the nurse has a specific current valid order or direction from an individual who is authorized to practice in this state and is acting within the course of the individual's professional practice; and

(5) The nursing care does not involve a function or procedure that is prohibited by any other law or rule.

(E) A licensed practical nurse shall, in a timely manner:

(1) Implement any order or direction for a patient unless the licensed practical nurse believes or should have reason to believe the order or direction is:

(a) Inaccurate;

(b) Not properly authorized;

(d) Harmful, or potentially harmful to a patient; or

(e) Contraindicated by other documented information; and

(2) Clarify any order or direction for a patient when the licensed practical nurse believes or should have reason to believe the order or direction is:

(a) Inaccurate;

(b) Not properly authorized;

(d) Harmful, or potentially harmful to a patient; or

(e) Contraindicated by other documented information.

(F) When clarifying an order or direction, the licensed practical nurse shall, in a timely manner:

(1) Consult with an appropriate licensed practitioner or directing registered nurse;

(2) Notify the ordering practitioner or directing registered nurse when the licensed practical nurse makes the decision not to follow the order or direction or administer the medication or treatment as prescribed;

(3) Document that the practitioner or directing registered nurse was notified of the decision not to follow the direction or order, or administer the medication or treatment, including the reason for not doing so; and

(4) Take any other action needed to assure the safety of the patient.

(G) A licensed practical nurse shall, in a timely manner report to and consult as necessary with other nurses or other members of the health care team and make referrals as necessary.

(H) A licensed practical nurse shall maintain the confidentiality of patient information obtained in the course of nursing practice. The licensed practical nurse shall communicate patient information with other members of the health care team for health care purposes only, shall access patient information only for purposes of patient care, or for otherwise fulfilling the nurse's assigned job responsibilities, and shall not disseminate patient information for purposes other than patient care, or for otherwise fulfilling the nurse's assigned job responsibilities, through social media, texting, emailing or any other form of communication.

(I) To the maximum extent feasible, identifiable patient health care information shall not be disclosed by a licensed practical nurse unless the patient has consented to the disclosure of identifiable patient health care information. A licensed practical nurse shall report individually identifiable patient information without written consent in limited circumstances only, and in accordance with an authorized law, rule, or other recognized legal authority.

(J) When a licensed practical nurse is directed to observe, advise, instruct, or evaluate the performance of a nursing task, the licensed practical nurse shall use acceptable standards of safe nursing care as a basis for that observation, advice, instruction, teaching, or evaluation and shall communicate information that is consistent with acceptable standards of safe nursing care.

Last updated January 3, 2024 at 2:02 PM

History

Effective: February 1, 2019
Promulgated Under: 119.03

Ohio Adm.Code 4723-4-05 Standards relating to competent practice as a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist.

(A) A certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist shall do all of the following:

(1) Function within the scope of practice of nursing for a registered nurse as set forth in division (B) of section 4723.01 of the Revised Code and the rules of the board.

(2) Function within the nurse's applicable scope of practice as set forth in section 4723.43 of the Revised Code and the rules of the board.

(3) If authorized by Ohio law to prescribe, practice according to section 4723.481 of the Revised Code and Chapter 4723-9 of the Administrative Code.

(B) When the practice of a certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist is evaluated, the evaluation shall be provided by a collaborating licensed physician or podiatrist, or an advanced practice registered nurse holding a current, valid license with the same designation as the individual being evaluated.

(C) When the practice of a certified registered nurse anesthetist is evaluated, the evaluation shall be provided by a supervising licensed physician, podiatrist, dentist or a certified registered nurse anesthetist whose license is current and valid.

(D) A certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist may provide care within their specialty provided:

(1) The nurse obtains education that emanates from a recognized body of knowledge relative to the nursing care to be provided;

(2) The nurse demonstrates knowledge, skills, and abilities necessary to provide the nursing care; and

(3) The nurse maintains documentation satisfactory to the board of meeting the requirements set forth in paragraphs (D)(1) and (D)(2) of this rule.

Last updated January 3, 2024 at 2:02 PM

History

Effective: February 1, 2019
Promulgated Under: 119.03

Ohio Adm.Code 4723-4-06 Standards of nursing practice promoting patient safety.

(A) At all times when a licensed nurse is providing direct nursing care to a patient the licensed nurse shall display the applicable title or initials set forth in division (E) of section 4723.03 of the Revised Code to identify the nurse's relevant licensure as a registered nurse or as a licensed practical nurse.

(B) At all times when a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist is providing direct nursing care to a patient, the nurse shall display the applicable title or initials set forth in division (E) of section 4723.03 of the Revised Code to identify relevant approval either as a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist.

(C) At all times when a licensed nurse is engaged in nursing practice and interacting with the patient, or health care providers on behalf of the patient, through any form of telecommunication, the licensed nurse shall identify to each patient or health care provider the nurse's title or initials set forth in division (E) of section 4723.03 of the Revised Code to identify applicable licensure as a registered nurse, licensed practical nurse, certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist.

(D) A licensed nurse shall delegate a nursing task, including medication administration, only in accordance with Chapter 4723-13, 4723-23, 4723-26, or 4723-27 of the Administrative Code.

(E) A licensed nurse shall, in a complete, accurate, and timely manner, report and document nursing assessments or observations, the care provided by the nurse for the patient, and the patient's response to that care.

(F) A licensed nurse shall, in an accurate and timely manner, report to the appropriate practitioner errors in or deviations from the current valid order.

(G) A licensed nurse shall not falsify, or conceal by any method, any patient record or any other document prepared or utilized in the course of, or in conjunction with, nursing practice. This includes, but is not limited to, case management documents or reports or time records, reports, and other documents related to billing for nursing services.

(H) A licensed nurse shall implement measures to promote a safe environment for each patient.

(I) A licensed nurse shall delineate, establish, and maintain professional boundaries with each patient.

(J) At all times when a licensed nurse is providing direct nursing care to a patient the licensed nurse shall:

(1) Provide privacy during examination or treatment and in the care of personal or bodily needs; and

(2) Treat each patient with courtesy, respect, and with full recognition of dignity and individuality.

(K) A licensed nurse shall not:

(1) Engage in behavior that causes or may cause physical, verbal, mental, or emotional abuse to a patient;

(2) Engage in behavior toward a patient that may reasonably be interpreted as physical, verbal, mental, or emotional abuse.

(L) A licensed nurse shall not misappropriate a patient's property or:

(1) Engage in behavior to seek or obtain personal gain at the patient's expense;

(2) Engage in behavior that may reasonably be interpreted as behavior to seek or obtain personal gain at the patient's expense;

(3) Engage in behavior that constitutes inappropriate involvement in the patient's personal relationships or financial matters; or

(4) Engage in behavior that may reasonably be interpreted as inappropriate involvement in the patient's personal relationships or financial matters.

For the purpose of this paragraph, the patient is always presumed incapable of giving free, full, or informed consent to the behaviors by the nurse set forth in this paragraph.

(M) A licensed nurse shall not:

(1) Engage in sexual conduct with a patient;

(2) Engage in conduct in the course of practice that may reasonably be interpreted as sexual;

(3) Engage in any verbal behavior that is seductive or sexually demeaning to a patient; or

(4) Engage in verbal behavior that may reasonably be interpreted as seductive, or sexually demeaning to a patient.

For the purpose of this paragraph, the patient is always presumed incapable of giving free, full, or informed consent to sexual activity with the nurse.

(N) A licensed nurse, when functioning in an administrative role, shall verify that each nurse, dialysis technician, or medication aide under the nurse administrator has:

(1) A current valid license to practice nursing in Ohio or a current valid certificate to practice as a dialysis technician or medication aide in Ohio; and

(2) If applicable, other documents of approval or certification as required by the board.

(O) When nursing practice, as set forth in section 4723.01 of the Revised Code, is supervised or evaluated:

(1) Only a registered nurse shall supervise or evaluate the practice of nursing, as set forth in Chapter 4723. of the Revised Code and the rules of the board, performed by other registered nurses and licensed practical nurses; or

(2) In matters other than the practice of nursing, a non-nursing supervisor may evaluate a nurse employee.

(3) Supervision or evaluation by a registered nurse does not require that the registered nurse be present on-site on a routine basis, but at minimum:

(a) Supervision requires that the registered nurse be continuously available through some form of telecommunication with the supervised nurse, and take all action necessary, including but not limited to conducting periodic on-site visits, to insure that the supervised nurse is practicing in accordance with acceptable and prevailing standards of safe nursing care as set forth in Chapter 4723. of the Revised Code and the rules of the board; and

(b) Evaluation requires that the registered nurse conduct periodic on-site visits sufficient to enable the evaluating nurse to evaluate the evaluated nurse's performance.

Nothing in this paragraph shall be construed to authorize a licensed practical nurse to practice without direction, as required by division (F) of section 4723.01 of the Revised Code.

Nothing in this paragraph shall be construed to prohibit a licensed practical nurse from participating in activities that contribute to the delivery of patient care services. Such participation may include, but is not limited to, scheduling of coverage for nursing services and observation and documentation by a licensed practical nurse regarding care provided by assistive personnel.

(P) A licensed nurse shall not make any false, misleading, or deceptive statements, or submit or cause to be submitted any false, misleading or deceptive information, or documentation to:

(1) The board or any representative of the board;

(2) Current employers;

(3) Prospective employers when applying for positions requiring a nursing license;

(4) Facilities in which, or organizations for whom, the nurse is working a temporary, agency, or locus tenens assignment;

(5) Other members of the patient's health care team; or

(6) Law enforcement personnel.

(Q) For purposes of paragraphs (I), (J), (K), (L), and (M) of this rule, a nurse shall not use social media, texting, emailing, or other forms of communication with, or about a patient, for non-health care purposes or for purposes other than fulfilling the nurse's assigned job responsibilities.

Last updated January 3, 2024 at 2:02 PM

History

Effective: February 1, 2021
Promulgated Under: 119.03

Ohio Adm.Code 4723-4-07 Standards for applying the nursing process as a registered nurse.

(A) A registered nurse shall apply the nursing process in the practice of nursing as set forth in division (B) of section 4723.01 of the Revised Code and in the rules of the board. The nursing process is cyclical in nature and requires that the nurse's actions respond to the patient's changing status throughout the process. The following standards shall be used by a registered nurse, using clinical judgment, in applying the nursing process for each patient under the registered nurse's care:

(1) Assessment of health status:

The registered nurse shall, in an accurate and timely manner:

(a) Collect data. This includes:

(i) Collection of subjective and objective data from the patient, family, significant others, or other members of the heath care team. The registered nurse may direct or delegate the performance of data collection; and

(ii) Documentation of the collected data.

(2) Analysis and reporting:

The registered nurse shall, in an accurate and timely manner:

(a) Identify, organize, assimilate and interpret data;

(b) Establish, accept, or modify a nursing diagnosis that is to be addressed with applicable nursing interventions; and

(3) Planning:

The registered nurse shall, in an accurate and timely manner:

(a) Develop, establish, maintain, or modify the nursing plan of care consistent with current nursing science, including the nursing diagnosis, desired patient outcomes or goals, and nursing interventions; and

(b) Communicate the nursing plan of care and all modifications of the plan to members of the health care team;

(4) Implementation:

The registered nurse shall, in an accurate and timely manner implement the current nursing plan of care which may include:

(a) Executing the nursing regimen;

(b) Implementing the current valid order authorized by an individual who is authorized to practice in this state and is acting within the course of the individual's professional practice;

(c) Providing nursing care commensurate with the documented education, knowledge, skills, and abilities of the registered nurse;

(d) Assisting and collaborating with other health care providers in the care of the patient;

(e) Delegating nursing tasks, including medication administration, only in accordance with Chapter 4723-13, 4723-23, 4723-26, or 4723-27 of the Administrative Code;

(5) Evaluation:

The registered nurse shall, in an accurate and timely manner:

(a) Evaluate, document, and report the patient's:

(i) Response to nursing interventions; and

(ii) Progress towards expected outcomes; and

(b) Reassess the patient's health status, and establish or modify any aspect of the nursing plan as set forth in this rule.

(B) For purposes of this rule, standards for implementing the nursing process also apply to a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist.

Last updated January 3, 2024 at 2:02 PM

History

Effective: February 1, 2014
Promulgated Under: 119.03

Ohio Adm.Code 4723-4-08 Standards for applying the nursing process as a licensed practical nurse.

(A) The licensed practical nurse shall contribute to the nursing process in the practice of nursing as set forth in division (F) of section 4723.01 of the Revised Code and in the rules of the board. The nursing process is cyclical in nature so that the nurse's actions respond to the patient's changing status throughout the process. The licensed practical nurse is directed in providing nursing care by the established nursing plan. The following standards shall be used by a licensed practical nurse in utilization of the nursing process:

(1) Contribution to assessment of patient health status:

The licensed practical nurse shall contribute to the nursing assessment of the patient. The licensed practical nurse shall, in an accurate and timely manner:

(a) Collect and document objective and subjective data related to the patient's health status; and

(b) Report objective and subjective data to the directing registered nurse or health care provider, and other members of the health care team;

(2) Planning:

The licensed practical nurse shall, in an accurate and timely manner:

(a) Contribute to the development, maintenance, or modification of the nursing component of the care plan;

(b) Communicate the nursing plan of care and all authorized modifications of the plan to members of the health care team;

(3) Implementation:

The licensed practical nurse shall, in an accurate and timely manner, implement the nursing plan of care, which may include:

(a) Providing nursing interventions;

(b) Collecting and reporting patient data as directed;

(c) Administering medications and treatments prescribed by an individual who is authorized to practice in this state and is acting within the course of the individual's professional practice;

(d) Providing basic nursing care as directed by a registered nurse, advanced practice registered nurse, or licensed physician, dentist, optometrist, chiropractor or podiatrist;

(e) Collaborating with other nurses and other members of the health care team;

(f) Delegating nursing tasks as directed, including medication administration, only in accordance with Chapter 4723-13, 4723-23, 4723-26, or 4723-27 of the Administrative Code; and

(4) Contributing to evaluation:

The licensed practical nurse shall, in an accurate and timely manner:

(a) Contribute to the evaluation of the patient's response to nursing interventions;

(b) Document the patient's responses to nursing interventions;

(c) Communicate the patient's responses to nursing interventions to the directing registered nurse or health care provider, and members of the health care team; and

(d) Contribute to the reassessment of the patient's health status and to the modifications of any aspect of the nursing plan of care as set forth in this rule.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2014
Promulgated Under: 119.03

Ohio Adm.Code 4723-4-09 Specialty certification.

(A) Nothing in this rule shall apply to an advanced practice registered nurse licensed to practice pursuant to section 4723.41 of the Revised Code.

(B) A registered nurse with a current, valid license to practice nursing in Ohio may use a title or initials denoting specialty certification in a particular area of specialty in nursing granted by a national certifying organization that has established standards for:

(1) Practice qualifications, formal education, continuing education, or other demonstration of knowledge in specialty practice; and

(2) The construction and administration of a psychometrically sound examination for a registered nurse applying for certification in a particular area of specialty in nursing.

(C) The title to be used by the registered nurse who focuses in a particular area of specialty in nursing shall be the title granted by the national certifying organization to those nurses who meet the requirements for specialty certification established by the national certifying organization. The registered nurse may use such title or initials following the title "Registered Nurse" or the initials "RN".

(D) No person shall use any title or initials implying or representing specialty certification unless that person has been granted a specialty certification title in nursing by a national certifying organization as set forth in paragraph (B) of this rule.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2019
Promulgated Under: 119.03

Chapter 4723-5 Nursing Education Program

Ohio Adm.Code 4723-5-01 Definitions.

For the purpose of this chapter, the following definitions shall apply:

(A) "Administrator of the program" or "program administrator" means the registered nurse who is administratively responsible for a program.

(B) "Advanced standing" means credit granted for prior nursing courses or transfer credit, according to the policy required by paragraph (A)(3) of rule 4723-5-12 of the Administrative Code.

(C) "Accelerated program" means a program or program track that accepts applicants with a non-nursing baccalaureate or higher degree, and that provides a pre-license nursing education program curriculum that meets the requirements of rule 4723-5-13 of the Administrative Code, except that the program spans a minimum of fifty-two weeks of clinical courses.

(D) "Associate program administrator" means a registered nurse who meets the requirements set forth in rule 4723-5-10 of the Administrative Code for a registered nursing education program or rule 4723-5-11 of the Adminstrative Code for a practical nursing education program.

(E) "Change of control" means transfer of the authority to manage, direct, or supervise a program from a controlling agency to another entity, including, but not limited to, the power, directly or indirectly, to direct the management or policies of a program or to vote fifty per cent or more of any class of voting interest in an entity that is the controlling agency.

(F) "Clinical course" means a nursing course that includes clinical experience.

(G) "Clinical experience" means an activity planned to meet course objectives or outcomes and to provide a nursing student with the opportunity to practice cognitive, psychomotor, and affective skills in the supervised delivery of nursing care to an individual or group of individuals who require nursing care.

(H) "Compliance" means a program meets and maintains the requirements set forth in this chapter.

(I) "Conceptual framework" means the key concepts and basic themes drawn from the program's philosophy that form the basis for the curriculum.

(J) "Conditional approval" means the initial approval status granted to a proposed program that meets and maintains the requirements of this chapter. Conditional approval authorizes implementation of the program and is required prior to the final acceptance of a student into the program.

(K) "Controlling agency" means the entity that grants credentials upon completion of a program and under which a program is organized and administered.

(L) "Course objectives or outcomes" means the cognitive, psychomotor, or affective knowledge and skills to be learned by the nursing student upon completion of a course.

(M) "Current, valid license" and "current, valid licensure" mean, for the period from February 1, 2008 to February 1, 2016, an individual holds a license issued under Chapter 4723. of the Revised Code that is not inactive, suspended, revoked, or currently subject to any restrictions, and for which the individual continues to meet all of the requirements for issuance.

(N) "Current, valid license" and "current, valid licensure" mean an individual holds a license to practice nursing issued under Chapter 4723. of the Revised Code that is not inactive, suspended, revoked, subject to restrictions, or subject to a consent agreement or board order with remaining terms or conditions that the individual has not satisfied, and for which the individual continues to meet all of the requirements for issuance.

(O) "Curriculum" means all theory components, clinical components, and laboratory experiences that must be successfully completed for admission to licensure examinations.

(P) "Faculty" means a registered nurse who meets the faculty requirements set forth in rule 4723-5-10 of the Administrative Code for a registered nursing education program or rule 4723-5-11 of the Administrative Code for a practical nursing education program. Faculty:

(1) Plan and teach all courses containing nursing objectives, or direct the teaching of those courses provided by teaching assistants;

(2) Report to the program administrator or associate administrator; and

(3) Contribute to the evaluation and implementation of, or changes in program curriculum.

(Q) "Full approval" means the approval status granted to a program that meets and maintains the requirements of this chapter. Full approval may be granted for a five-year period to:

(1) A program with conditional approval after completion of the program by the first class who entered the program immediately after conditional approval was granted, provided the program meets and maintains the requirements of this chapter;

(2) A program with full approval demonstrating that the requirements of this chapter continue to be met and maintained; or

(3) A program with provisional approval if the board determines that the program is meeting and maintaining the requirements of this chapter and if the established time period for provisional approval has expired.

(R) "High fidelity" means experiences using full scale computerized patient simulators, virtual reality or standardized patients that are extremely realistic and provide a high level of interactivity and realism for the learner.

(S) "Jurisdiction" means any state, territory, or political subdivision of the United States of America in which a board or legal approving authority regulates nurse licensure and nursing practice and maintains membership in the national council of state boards of nursing.

(T) "Laboratory experience" means an activity planned to meet course objectives or outcomes and to provide a nursing student with the opportunity to practice cognitive, psychomotor, and affective skills in the performance of nursing activities or tasks in a simulated clinical environment, which may include the opportunity to practice nursing skills through the reproduction of life-like health care experiences using computerized models and simulator programs.

(U) "Life span" means conception to death.

(V) "Low fidelity" means experiences such as case studies, role-playing, using partial task trainers or static mannequins to immerse students in a clinical situation or practice of a specific skill.

(W) "Mid or moderate fidelity" means experiences that are more technologically sophisticated, such as computer-based self-directed learning systems simulations in which the participant relies on a two-dimensional focused experience to problem solve, perform a skill, and make decisions, or which use mannequins that are more realistic than static low- fidelity ones and have breath sounds, heart sounds and/or pulses.

(X) "Observational experience" means faculty assigned learning experiences during which a student observes the delivery of care to patients, but does not participate in providing nursing care.

(Y) "Organizing theme" means the concepts drawn from one or more theorists that provide a description as to how the concepts serve as a basis for curriculum development.

(Z) "Patient simulation" means the replication of a real world patient in situ through accurate representations of patient cues and stimuli that a student is to observe, analyze, interact, and respond to with right nursing judgments and actions. The replication may be provided through the use or combination of low fidelity, mid or moderate fidelity, or high fidelity experiences.

(AA) "Pharmacotherapeutics" means knowledge and intervention related to the administration of medications and includes, but is not limited to, drug actions and interactions, indications for and usage of the drug, contraindications, dosage, route of administration, side effects of the drug, and nursing implications.

(BB) "Philosophy" means beliefs about the nature of the individual, society or community, nursing, health, teaching, and learning.

(CC) "Practical nursing education program" means a nursing education program that leads to initial licensure as a licensed practical nurse.

(DD) "Preceptor" means a registered nurse or licensed practical nurse who meets the requirements of this chapter, who provides supervision of a nursing student's clinical experience at the clinical agency in which the preceptor is employed, to no more than two students at any one time, and who implements the clinical education plan at the direction of a faculty member responsible for the course in which the student is enrolled.

(EE) "Program" means an approved nursing education program leading to initial licensure to practice as a nurse that issues a program completion letter to the board.

(FF) "Program objectives or outcomes" means the cognitive, psychomotor, or affective knowledge and skills to be learned by a nursing student upon completion of a program.

(GG) "Provisional approval" means the approval status granted in accordance with this chapter to a program that was previously granted full approval, but fails to meet and maintain the requirements of this chapter. Provisional approval is granted for a specific time period.

(HH) "Registered nursing education program" means a professional nursing education program that leads to initial licensure as a registered nurse.

(II) "Representative of the board" means an employee of the board or an individual designated by the board to act on the board's behalf.

(JJ) "Resume" means a resume, curriculum vitae, or any other record that summarizes an individual's education and nursing related employment history, including the locations of educational institutions and employers, dates of graduation, months and years of employment, and description of job functions performed.

(KK) "Structured setting" means a setting in which direction and supervision are readily available; written policies and procedures are in place; and information, material, and human resources are easily accessed.

(LL) "Supervision of a nursing student in a clinical setting" means that a faculty member, teaching assistant, or preceptor is immediately available to the nursing student at all times to provide guidance and review of the student's performance.

(MM) "Survey report" means any report, or any summary of such a report, prepared by a representative of the board that contains information from an on-site review of a program or proposed program.

(NN) "Survey visit" means an on-site review of a program or proposed program by a representative of the board to determine whether the program meets and maintains the requirements of this chapter for nursing education programs.

(OO) "Teaching assistant" means a person employed to assist and work at the direction of a faculty member providing instruction in the classroom, laboratory, or in a clinical setting in which nursing care is delivered to an individual or group of individuals, and who meets the qualifications set forth in this chapter.

(PP) "Teaching strategy" means a system of instructional processes designed to meet course objectives or outcomes.

Last updated February 1, 2022 at 8:49 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-02 General information.

(A) A program must meet and maintain the requirements set forth in this chapter in order to maintain approval by the board.

(B) The board shall evaluate whether a program is meeting and maintaining the requirements of this chapter, and shall determine a program's approval status in accordance with this chapter. The board shall have the authority to review all documents retained by the program that are required by this chapter.

(C) Failure to meet and maintain a requirement of this chapter shall be considered noncompliance and may affect a program's approval status, upon action by the board in accordance with rule 4723-5-04 of the Administrative Code.

(D) If a representative of the board fails to conduct a survey visit of a program with full approval, as set forth in rule 4723-5-06 of the Administrative Code, before the approval period expires, the board shall issue a notice to the administrator of the program extending full approval status until a representative of the board conducts a survey visit and the board takes action on the program's approval status.

Last updated June 10, 2022 at 8:31 AM

History

Effective: February 1, 2012
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-03 Change of control of a program.

(A) When a controlling agency of a program plans to implement a change of control, the chief officer or designee of the controlling agency shall provide the board, at least thirty days prior to the effective date of change of control, the following written information:

(1) The name and address of the program;

(2) The name and address of the new controlling agency;

(3) The effective date for the change of control;

(4) Name of the program administrator;

(5) A letter verifying that the program will continue to meet and maintain the requirements established in Chapter 4723-5 of the Administrative Code;

(6) Whether any curriculum changes will be proposed as a result of the change in control; and

(7) The anticipated graduation date for the first class of students admitted following the change in control.

(B) Following the effective date of the change of control a representative of the board may conduct a survey visit, as outlined in rule 4723-5-06 of the Administrative Code, or may request a progress report to determine compliance with this chapter.

Last updated June 10, 2022 at 8:31 AM

History

Effective: February 1, 2012
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-04 Procedure for board determination of a program's status.

(A) The board shall grant full approval status to programs holding:

(1) Full approval, if a program demonstrates to the board that it continues to meet and maintain the requirements of this chapter;

(2) Conditional approval, at the first board meeting following completion of the survey process required by division (A)(5) of section 4723.06 of the Revised Code, provided the program demonstrates to the board that it meets and maintains the requirements of this chapter;

(3) Provisional approval, if the program demonstrates to the board that it meets and maintains the requirements of this chapter.

(B) The following procedures shall be followed by the board when a program does not meet and maintain the requirements of this chapter:

(1) For a program with conditional approval, the board shall propose to withdraw conditional approval pursuant to an adjudication under Chapter 119. of the Revised Code. The adjudication may result in the continuance of conditional approval, continuance of conditional approval based on compliance with the terms and conditions of a board order or consent agreement, or withdrawal of conditional approval;

(2) For a program with full approval, the board shall place the program on provisional approval in accordance with this chapter. When a program is placed on provisional approval, the board shall specify the requirements the program has not met and maintained and shall establish the time period during which the program will be on provisional approval. The board shall reconsider the program's approval status when the program demonstrates to the board that it meets and maintains the requirements of this chapter;

(3) If a program on provisional approval continues to fail to meet and maintain the requirements of this chapter at the end of the time period established for provisional approval, the board may propose to continue provisional approval for a period of time specified by the board or may propose to withdraw approval pursuant to an adjudication under Chapter 119. of the Revised Code. The adjudication may result in the continuance of provisional approval, withdrawal of approval, or granting of full approval;

(4) The board may enter into a consent agreement in lieu of conducting an adjudication under this rule that addresses the requirements of this chapter not met and maintained.

(D) If a program with full approval status loses its approval, accreditation or certificate of registration from the Ohio board of regents, the Ohio department of education, the state board of career colleges and schools, or any national or regional post-secondary education accreditation entity, a representative of the board may conduct a survey visit and the board may place the program on provisional approval.

(E) If a program with full approval status fails to meet any of the following requirements, the board shall place the program on provisional approval status for a period of time:

(1) Failure to provide clinical or laboratory experience to students, as required by paragraph (G) or (I)(8) of rule 4723-5-13 of the Administrative Code for a registered nursing program, or paragraph (G) or (H)(12) of rule 4723-5-14 of the Administrative Code or paragraph (I) of rule 4723-5-14 of the Administrative Code for a practical nursing program;

(2) Failure to timely designate a qualified administrator or interim administrator according to paragraph (D) of rule 4723-5-09 of the Administrative Code;

(3) Providing or submitting false, misleading or deceptive information, documentation or statements to the board, in violation of rule 4723-5-25 of the Administrative Code; or

(4) Having pass rates on the licensure examination of less than ninety-five per cent of the national average for first-time candidates for the fourth consecutive year, as specified in paragraph (B) of rule 4723-5-23 of the Administrative Code.

Last updated February 1, 2024 at 9:30 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-05 Program reports to the board.

[Comment: Information regarding the availability and effective date of the materials incorporated by reference in this rule can be found in paragraph (G) of rule 4723-1-03 of the Administrative Code.]

(A) An "Education Program PN Annual Report Form" or "Education Program RN Annual Report Form" for each program with full approval, provisional approval, or continued conditional approval during a reporting period shall:

(1) Be completed by the administrator of the program;

(2) Be submitted in a format prescribed by the board;

(3) Be in accordance with a schedule determined by the board; and

(4) Include documentation of meeting and maintaining the requirements of this chapter, and a list of all locations where all or part of the theory components of the curriculum are taught.

(B) When requested by the board, the administrator of the program shall submit progress reports or periodic supplemental reports, completed questionnaires and surveys, and other documents that shall include the information requested by the board. The administrator of the program shall complete all surveys or questionnaires requested by the board to verify compliance with this chapter.

(C) Failure to submit a report as required by the board may result in a change of the program's approval status in accordance with rule 4723-5-04 of the Administrative Code.

Last updated June 10, 2022 at 8:31 AM

History

Effective: April 1, 2017
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-06 Survey visits, reports, and response by the administrator of a program to a survey visit report.

(A) A representative of the board shall conduct a survey visit for the purpose of determining if a program is meeting and maintaining the requirements of this chapter. Survey visits may be made to the program and any or all of its locations. Survey visits include the following:

(1) An announced survey visit for each program at least once during the program's approval period as part of the reapproval process. If a representative of the board fails to conduct a survey visit before a program's full approval period expires, the board shall issue a notice to the administrator of the program extending the full approval status until a representative of the board conducts a survey visit and the board takes action on the program's approval status;

(2) Additional announced or unannounced survey visits as deemed necessary and appropriate by the board or representative of the board;

(3) An announced survey visit for a proposed program seeking conditional approval as provided in paragraph (D) of rule 4723-5-08 of the Administrative Code.

(a) The board may conduct a survey visit for a proposed program prior to granting conditional approval.

(b) If a survey visit is not conducted prior to the board granting conditional approval, a survey visit shall be conducted no later than eight months after the date on which formal instruction begins for the first class of students admitted to the program.

(c) A survey visit conducted within eight months after the date on which formal instruction begins for the first class of students admitted to a program, may be conducted in conjunction with the survey visit required by paragraph (A)(4) of this rule;

(4) An announced survey visit for a program with conditional approval, prior to completion of the program by the first class that entered the program immediately after conditional approval was granted;

(5) An announced survey visit in accordance with paragraph (B) of rule 4723-5-23 of the Administrative Code when a program has a pass rate on the licensure examination that is less than ninety-five per cent of the national average for first-time candidates in a calendar year for three consecutive years; and

(6) An announced survey visit in accordance with paragraph (B) of rule 4723-5-23 of the Administrative Code when a program has a pass rate on the licensure examination that is less than ninety-five per cent of the national average for first-time candidates in a calendar year for four or more consecutive years.

(B) Prior to an announced survey visit as set forth in paragraph (A) of this rule, the board shall contact the administrator of the program to arrange the dates for the survey visit. The contact shall be followed by a notice to the administrator of the program that shall include information pertinent to the survey visit.

(1) If the program to be surveyed has two or more locations, the program administrator shall notify the faculty, teaching assistants and students at each program location of the anticipated date of the survey, and provide contact information for the board so that faculty, teaching assistants and students at each location may directly forward any comments to the board concerning the program.

(2) When finalizing the survey schedule, a representative of the board may consider faculty, teaching assistant and student comments when determining if survey visits will be made for program locations.

(C) Prior to an announced survey visit as set forth in paragraph (A)(1) of this rule, the administrator of the program shall complete an "Education Program PN Presurvey Visit Report Form " or "Education Program RN Presurvey Visit Report Form" and shall submit the form to the board at least three weeks prior to the scheduled date of the survey visit.

(D) After a survey visit is completed by a representative of the board, a survey report of the visit shall be completed and submitted to the administrator of the program. The report shall indicate the requirements that were not met and maintained by the program, when applicable, and the date that the survey report will be considered by the board. The report may include recommendations for enhancement of the program.

(E) If the survey report indicates that a requirement is not being met and maintained, the administrator of the program may submit to the board, not later than forty-five days prior to the date the board is to consider the report, documentation that the program is meeting and maintaining each requirement identified in the report as not being met and maintained.

(F) When making a determination about a program's approval status, the board shall consider the survey report and any documentation submitted by the administrator of the program, provided the documentation was submitted by the administrator of the program within the time frame specified in paragraph (E) of this rule.

Last updated June 10, 2022 at 8:31 AM

History

Effective: April 1, 2017
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-08 Requirements for seeking conditional approval.

[Comment: Information regarding the availability and effective date of materials incorporated by reference in this rule can be found in paragraph (G) of rule 4723-1-03 of the Administrative Code.]

(A) In order to obtain conditional approval, a program applicant shall first submit a letter of intent to the board:

(1) The letter of intent must include the following information and records:

(a) The type of program the applicant intends to establish;

(b) The location of the program and a detailed assessment of the need for a new nursing education program in the area;

(c) The name and credentials of the registered nurse who will serve as the program administrator, if known at the time the letter is submitted, as well as the program administrator's:

(i) Resume; and

(ii) Official transcripts verifying academic preparation that satisfies the requirements set forth in rule 4723-5-10 of the Administrative Code if the proposed program is a registered nursing education program or rule 4723-5-11 of the Administrative Code if the proposed program is a practical nursing education program;

(d) A list of potential sites for students to obtain clinical experience as required by rule 4723-5-13 of the Administrative Code for a registered nursing education program, and rule 4723-5-14 of the Administrative Code for a practical nursing education program.

(e) A certified copy of a document indicating that the applicant is approved, authorized, or has a certificate of registration issued by:

(i) The Ohio department of higher education;

(ii) The Ohio department of education; or

(iii) The state board of career colleges and schools.

(2) If information about the program administrator is not available at the time of submission of the letter of intent, the applicant shall submit a subsequent letter at the time of appointment of an individual to serve as program administrator that includes the information required by paragraph (A)(1)(c) of this rule.

(3) In order to meet the requirements of paragraph (A)(1)(e) of this rule, an applicant may submit a copy of its application for a certificate of registration, filed with the state board of career colleges and schools if:

(a) The state board of career colleges and schools has not made a decision regarding the certificate of registration at the time the applicant submits a letter of intent to the board; and

(b) At least thirty days before the board considers the program for full approval status, as set forth in paragraph (A) of rule 4723-5-04 of the Administrative Code, the program submits a certified copy of certificate of registration from the state board of career colleges and schools demonstrating that the program has been approved by the state board of career colleges and schools.

(B) When the board receives the information set forth in paragraph (A) of this rule and has verified that the program administrator satisfies the requirements of this chapter, the board shall notify the program that the program administrator meets the requirements of paragraph (A)(1)(c) of this rule.

(C) In order to obtain conditional approval, the applicant program administrator shall submit a complete "PN New Program Proposal Application" or "RN New Program Proposal Application" that includes the following:

(1) The defined target region from which the student population will be drawn;

(2) The planned strategy for establishing the proposed program within the defined target region that includes, but is not limited to, documentation with referenced data addressing the following:

(a) The shortage or surplus of existing registered nurses if the proposal is for a registered nursing education program;

(b) The shortage or surplus of existing licensed practical nurses if the proposal is for a practical nursing education program;

(c) Copies of letters of intent from proposed clinical education sites to the applicant, indicating that the site should be able to accommodate the applicant's students. The letters of intent submitted by the applicant to the board must demonstrate that the proposed program would be able to provide students clinical experiences that meet course objectives or outcomes, provide students the opportunity to practice skills with individuals or groups across the life span, and provide students clinical experience at sites concurrent with related theory instruction;

(3) The official name and address of the proposed program and the proposed program's controlling agency;

(4) The planned date for admission of the first class and a projected date of completion for the first graduate of the proposed program;

(5) The following information and documents:

(a) Organization and administration of the program as set forth in rule 4723-5-09 of the Administrative Code;

(b) Qualifications of administrators, faculty, teaching assistants and preceptors for a registered nursing education program as set forth in rule 4723-5-10 of the Administrative Code, or for a practical nursing education program as set forth in rule 4723-5-11 of the Administrative Code;

(d) Proposed curriculum for a registered nursing education program as set forth in rule 4723-5-13 of the Administrative Code, or for a practical nursing education program as set forth in rule 4723-5-14 of the Administrative Code;

(e) Proposed evaluation plan of the program as set forth in rule 4723-5-15 of the Administrative Code;

(f) The program contractual relationships as set forth in rule 4723-5-17 of the Administrative Code;

(g) Responsibilities of faculty teaching a nursing course as set forth in rule 4723-5-19 of the Administrative Code;

(h) Responsibilities of faculty, teaching assistants and preceptors in a clinical setting involving the delivery of care to an individual or group of individuals as set forth in rule 4723-5-20 of the Administrative Code;

(i) Program records maintenance plan as set forth in rule 4723-5-21 of the Administrative Code; and

(6) Other information requested by the board.

(D) After a representative of the board determines that a proposal is complete, the proposed program shall be subject to a survey visit in accordance with paragraph (A)(3) of rule 4723-5-06 of the Administrative Code. The board has discretion to conduct the initial survey either before the program is granted conditional approval, or after approval and within the first eight months of the program's operations as provided in paragraph (A)(3) of rule 4723-5-06 of the Administrative Code. A report of the survey visit shall be provided to the administrator of the program.

(E) If an applicant for a proposed program fails to communicate with the board for a period of one year following receipt of the letter of intent required by paragraph (A) of this rule, or following submission of the program proposal required by paragraph (C) of this rule, the board shall consider that the letter of intent or the program proposal has been withdrawn.

(F) At a regularly scheduled board meeting, the board shall review a summary of the proposal and review the survey visit report to consider the approval status of the program. At the board's request, the administrator of the program, who prepared the proposal, shall present the proposal to the board and may provide any additional information.

(G) If the board determines that the requirements of this chapter are met, and the proposal outlines a plan for maintaining the requirements, the program shall be granted conditional approval.

(H) If the board determines that the requirements of this chapter have not been met or maintained where applicable, the board shall propose to deny conditional approval in accordance with Chapter 119. of the Revised Code. The adjudication may result in the granting of conditional approval, granting of conditional approval based on compliance with the terms and conditions of a board order or consent agreement, or denial of conditional approval.

(I) A proposed program shall not accept students into the program until the board grants conditional approval to the program.

(J) When conditional approval is granted to a program, the program shall be implemented with the first class entering on the date originally identified by the proposed program. If circumstances alter the plan to admit students on the originally identified date, the program shall submit to the board, not more than seven business days following the originally identified implementation date, a written request for an extension of the implementation date.

(K) During the period of conditional approval, the administrator of the program shall submit progress reports to the board as directed. The progress reports shall include at least the following information:

(1) A summary of the evaluations of each course implemented by the program faculty;

(2) A summary of the evaluations of each clinical experience in relation to the established clinical objectives;

(3) Verification of meeting and maintaining the requirements of this chapter;

(4) Any problem related to this chapter encountered during the implementation of the program, and measures used to resolve each problem;

(5) Any variation from the proposal occurring in the implementation process and the rationale for the variation;

(6) The number of students who have been admitted and are continuing in the program;

(7) Copies of executed contracts with cooperating entities for student clinical experience. The program shall include with each contract information indicating the name of the nursing education course to which the contract corresponds; and

(8) Other information requested by the board.

(L) A survey visit of a program with conditional approval may be conducted by a representative of the board when deemed necessary.

(M) Prior to completion of the program by the first class who entered the program after conditional approval was granted, a survey visit shall be conducted by a representative of the board in accordance with rule 4723-5-06 of the Administrative Code to determine whether the program is meeting and maintaining the requirements of this chapter.

(N) In accordance with rule 4723-5-04 of the Administrative Code, the approval status of a program with conditional approval shall be reconsidered by the board after completion of the program by the first class that entered the program immediately after conditional approval was granted.

(O) The provisions of this rule do not apply to a program that intends to expand to another location provided that the program in the new location is governed by the same controlling agency and has the same philosophy, conceptual framework or organizing theme, program objectives or outcomes, curriculum and admission, progression and completion policies as the program currently approved, and the program satisfies the following prior to accepting students in another location:

(1) Provides written notice to the board no later than ninety days prior to expanding to another location;

(2) Submits to the board the information and documentation required by paragraphs (C)(1), (C)(2), (C)(3), (C)(4) and (C)(6) of this rule to explain the need for the nursing program in the location for which an expansion is planned.

(P) The board may deny approval to a person who submits or causes to be submitted false, misleading or deceptive statements, information, or documentation to the board in the process of applying for approval of a new education program, pursuant to an adjudication conducted under Chapter 119. of the Revised Code.

Last updated February 1, 2022 at 8:49 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-09 Organization and administration of the program.

(A) The program shall have and implement a plan of organization and administration that clearly shows:

(1) The relationship between the program and the controlling agency;

(2) How faculty and students are involved in determining academic and program policies and procedures, planning curriculum, and program evaluation;

(3) How faculty are involved in implementing academic and program policies and procedures.

(B) The program shall be administered by a registered nurse administrator who meets the qualifications set forth in rule 4723-5-10 of the Administrative Code for a registered nursing education program, or rule 4723-5-11 of the Administrative Code for a practical nursing education program. The program administrator shall have the authority, accountability, and responsibility for all aspects of the program including but not limited to:

(1) Providing input into the budget process;

(2) Maintaining communication with central administration and other units of the controlling agency, faculty, teaching assistants, students, clinical agencies, and the board;

(3) Ensuring regular meetings of the faculty and teaching assistants to facilitate communication and faculty participation in planning, implementing, and evaluating the curriculum;

(4) Implementing an orientation process for new faculty and teaching assistants;

(5) Recommending faculty and teaching assistants for appointment, promotion, tenure or retention, and termination as applicable;

(6) Facilitating faculty and teaching assistant development, including enhancing educational competencies;

(7) Establishing the faculty or teaching assistant to student ratio for direct patient care experiences at no greater a ratio than ten students to one faculty or teaching assistant, or a smaller ratio in clinical settings where necessary to ensure the safe delivery of nursing care by students, faculty, and teaching assistants;

(8) Ensuring a written policy related to the evaluation of faculty, teaching assistants and preceptors is implemented;

(9) Certifying to the board, in a format prescribed by the board, for each student who is an applicant for licensure in Ohio that each applicant successfully completed the requirements of a program and the date the applicant completed the program requirements;

(10) Submitting to the board a corrective action plan any time the program administrator submits one or more erroneous certifications of program completion to the board;

(11) Verifying that each nurse teaching a course in the program holds a current, valid license; and

(12) Maintaining resources, including but not limited to classroom and skills laboratory equipment and supplies necessary for students to successfully complete the program.

(C) If a program has more than one location and all locations share the same philosophy, conceptual framework or organizing theme, program objectives or outcomes, curriculum and admission, progression and completion policies, the program shall be administered by a registered nurse administrator who meets the qualifications set forth in rule 4723-5-10 of the Administrative Code for a registered nursing education program, or rule 4723-5-11 of the Administrative Code for a practical nursing education program. The program administrator shall have the authority, accountability, and responsibility for all aspects of the entire program at all locations.

(1) If the program has more than one location, each location that is more than sixty miles from the program shall be administered by a registered nurse associate administrator who meets the qualifications set forth in rule 4723-5-10 of the Administrative Code for a registered nursing education program, or rule 4723-5-11 of the Administrative Code for a practical nursing education program. The associate administrator, acting at the direction of the program administrator, shall have the authority, accountability, and responsibility for the program at the given location.

(2) The board may require a program that is not otherwise subject to paragraph (C)(1) of this rule to designate an associate administrator for a program location based upon consideration of the following:

(a) Average student census at program locations;

(b) Total number of program locations;

(d) Approval status of the program.

(3) The program shall develop and implement a plan of organization and administration that clearly delineates the lines of authority, accountability, and responsibility among all program locations and associate administrators.

(4) If a program or any of its locations fail to meet or maintain the requirements of this chapter, the approved program and all of its locations shall be subject to board review and possible board action.

(5) The program and all of its location must use the program's name on all signage, advertising and written materials.

(D) The controlling agency shall ensure continuity of the administrative responsibilities for the program as follows:

(1) If the program administrator vacates the position the controlling agency shall:

(a) Notify the board, in writing, no later than forty-five days following the date of the vacancy; and

(b) Within forty-five days of the date of vacancy, ensure that a qualified registered nurse assumes the position of program administrator or interim program administrator.

(2) If the program administrator is absent for more than thirty consecutive business days, the controlling agency shall:

(a) Notify the board, in writing, of the absence, no later than forty-five days after the thirtieth consecutive business date of absence; and

(b) Within forty-five days, following the thirtieth consecutive business date of absence, appoint a registered nurse to replace the program administrator or designate a registered nurse to serve as an interim program administrator.

(3) For purposes of this rule an interim program administrator must be a registered nurse, who assumes the administrative responsibilities of the program administrator on a temporary basis, and meets all of the following requirements:

(a) Meets the requirements of an associate administrator as set forth in rule 4723-5-10 of the Administrative Code for a registered nursing education program, except that an individual with a master's degree in nursing may serve as an interim program administrator for a baccalaureate program for a period not to exceed one year;

(b) Meets the requirements of an associate administrator as set forth in rule 4723-5-11 of the Administrative Code for a practical nursing education program, except that, an individual with a bachelor of science in nursing degree may serve as an interim program administrator for a period not to exceed one year;

(c) Provide official transcripts to the board verifying academic preparation that satisfies the requirements of rule 4723-5-10 of the Administrative Code for a registered nursing education program or rule 4723-5-11 of the Administrative Code for a practical nursing education program; and

(d) Have been a faculty member with the program for a minimum of one year.

(4) When the controlling agency appoints a new program administrator or designates an interim program administrator, the controlling agency shall notify the board, in writing, within forty-five days of the effective date of the appointment or designation and provide the name and resume of the new program administrator or interim program administrator. The controlling agency shall attest in its written notification to the board that the new program administrator or interim program administrator:

(a) Meets the requirements for a program administrator set forth in rule 4723-5-10 of the Administrative Code for a registered nursing education program or rule 4723-5-11 of the Administrative Code for a practical nursing education program, or that the interim program administrator meets the requirements of an associate administrator of a program set forth in rule 4723-5-10 of the Administrative Code for a registered nursing education program or rule 4723-5-11 of the Administrative Code for a practical nursing education program.;

(b) Has provided the controlling agency official transcripts verifying academic preparation that satisfies the requirements of rule 4723-5-10 of the Administrative Code for a registered nursing education program, or rule 4723-5-11 of the Administrative Code for a practical nursing education program.

Last updated February 1, 2022 at 8:49 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-10 Qualifications of administrators, faculty, teaching assistants and preceptors for a registered nursing education program.

(A) The minimum qualifications and academic preparation for administrator, faculty, teaching assistant and preceptor appointments for a registered nursing education program are as follows:

(1) For administrator of a program:

(a) Completion of an approved registered nursing education program in a jurisdiction as defined in paragraph (S) of rule 4723-5-01 of the Administrative Code;

(b) Experience for at least five years in the practice of nursing as a registered nurse, two of which have been as a faculty member in a registered nursing education program;

(d) Current, valid licensure as a registered nurse in Ohio; and

(e) If the program is a baccalaureate or graduate program, an earned doctoral degree;

(2) For an associate administrator or interim program administrator of a program:

(a) Completion of an approved registered nursing education program in a jurisdiction as defined in paragraph (S) of rule 4723-5-01 of the Administrative Code;

(b) Experience for at least five years in the practice of nursing as a registered nurse, two of which have been as a faculty member in a registered nursing education program;

(d) Current, valid licensure as a registered nurse in Ohio;

(3) For faculty teaching a nursing course:

(a) Completion of an approved registered nursing education program in a jurisdiction as defined in paragraph (S) of rule 4723-5-01 of the Administrative Code;

(b) Experience for at least two years in the practice of nursing as a registered nurse;

(i) If the individual does not possess a bachelor of science in nursing degree, the master's or other academic degree, including, but not limited to a Ph.D., shall be in nursing;

(ii) If the individual possesses a bachelor of science in nursing degree, the master's degree may be, but is not required to be, in nursing; and

(d) Current, valid licensure as a registered nurse in Ohio;

(4) For a teaching assistant as defined in paragraph (OO) of rule 4723-5-01 of the Administrative Code:

(a) Completion of an approved registered nursing education program in a jurisdiction as defined in paragraph (S) of rule 4723-5-01 of the Administrative Code;

(b) Experience for at least two years in the practice of nursing as a registered nurse;

(c) A baccalaureate degree in nursing or enrollment in a graduate level course in a program for registered nurses to obtain a master's or doctoral degree with a major in nursing; and

(d) Current, valid licensure as a registered nurse in Ohio;

(5) For a preceptor as defined in paragraph (DD) of rule 4723-5-01 of the Administrative Code:

(a) Completion of an approved registered nursing education program in a jurisdiction as defined in paragraph (S) of rule 4723-5-01 of the Administrative Code;

(b) Experience in the practice of nursing as a registered nurse with demonstrated competence in the area of clinical practice in which the preceptor provides supervision to a nursing student;

(d) Current, valid licensure as a registered nurse in the jurisdiction or foreign country where the supervision of a nursing student's clinical experience occurs.

(B) The requirements of this rule do not prohibit an individual appointed to a position prior to February 1, 2008 from continuing to serve in the position if the individual met the rule requirements for the position at the time of appointment.

(C) An individual who is a foreign educated nurse graduate, as defined in paragraph (D) of rule 4723-7-01 of the Administrative Code, shall be deemed to have met the academic preparation for an administrator, faculty, teaching assistant or preceptor for a registered nursing education program specified in paragraphs (A)(1)(a), (A)(2)(a), (A)(3)(a), (A)(4)(a), and (A)(5)(a) of this rule, if the individual has practiced nursing as a registered nurse in the state of Ohio, or in another jurisdiction of the national council of state boards of nursing, for at least two years.

Last updated February 1, 2022 at 8:50 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-11 Qualifications of administrators, faculty, teaching assistants and preceptors for a practical nursing education program.

(A) The minimum qualifications and academic preparation for administrator, faculty, teaching assistant and preceptor appointments for a practical nursing education program are as follows:

(1) For an administrator of a program:

(a) Completion of an approved registered nursing education program in a jurisdiction as defined in paragraph (S) of rule 4723-5-01 of the Administrative Code;

(b) At least five years of experience in the practice of nursing as a registered nurse, two of which have been as a faculty member of a registered or practical nursing education program;

(i) If the individual does not possess a bachelor of science in nursing degree, the master's or other academic degree, including, but not limited to a Ph.D., shall be in nursing.

(ii) If the individual possesses a bachelor of science in nursing degree, the master's degree may be, but is not required to be, in nursing; and

(d) Current, valid licensure as a registered nurse in Ohio;

(2) For an associate administrator or interim program administrator of a program:

(a) Completion of an approved registered nursing education program in a jurisdiction as defined in paragraph (S) of rule 4723-5-01 of the Administrative Code;

(b) At least five years of experience in the practice of nursing as a registered nurse, including two years as a faculty member in a registered or practical nursing education program;

(i) If the individual does not possess a bachelor of science in nursing degree, the master's or other academic degree, including, but not limited to a Ph.D., shall be in nursing;

(ii) If the individual possesses a bachelor of science in nursing degree, the master's degree may be, but is not required to be, in nursing; and

(d) Current, valid licensure as a registered nurse in Ohio;

(3) For faculty teaching a nursing course:

(a) Completion of an approved registered nursing education program in a jurisdiction as defined in paragraph (S) of rule 4723-5-01 of the Administrative Code;

(b) Experience for at least two years in the practice of nursing as a registered nurse;

(d) Current, valid licensure as a registered nurse in Ohio;

(4) For a teaching assistant as defined in paragraph (OO) of rule 4723-5-01 of the Administrative Code:

(a) Completion of an approved registered nursing education program in a jurisdiction as defined in paragraph (S) of rule 4723-5-01 of the Administrative Code;

(b) Experience for at least two years in the practice of nursing as a registered nurse; and

(5) For a preceptor as defined in paragraph (DD) of rule 4723-5-01 of the Administrative Code:

(a) Completion of an approved registered or practical nursing education program in a jurisdiction as defined in paragraph (S) of rule 4723-5-01 of the Administrative Code;

(b) Experience in the practice of nursing as a registered nurse or as a licensed practical nurse with demonstrated competence in the area of clinical practice in which the preceptor provides supervision to a nursing student;

(c) Current, valid licensure as a registered nurse or as a licensed practical nurse in the jurisdiction or foreign country where the supervision of a nursing student's clinical experience occurs.

(C) An individual who is a foreign educated nurse graduate, as defined in paragraph (D) of rule 4723-7-01 of the Administrative Code, shall be deemed to have met the academic preparation for an administrator, faculty, teaching assistant or preceptor for a practical nursing education program specified in paragraphs (A)(1)(a), (A)(2)(a), (A)(3)(a), (A)(4)(a), and (A)(5)(a) of this rule, if the individual has practiced nursing as a registered nurse in the state of Ohio, or in another jurisdiction of the national council of state boards of nursing, for at least two years.

Last updated February 1, 2022 at 8:50 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-12 Program policies.

(A) The administrator of the program and the faculty shall establish and implement written policies for the following:

(1) Student admission;

(2) Student readmission, including a requirement that the readmitted student meet the curriculum requirements effective at the time of readmission;

(3) The process for determining the amount of credit to be granted to an applicant for advanced standing in a program;

For individuals with experience in the armed forces of the United States, or in the national guard or in a reserve component, the program shall have a process in place to:

(a) Review the individual's military education and skills training;

(b) Determine whether any of the military education or skills training is substantially equivalent to the curriculum established in Chapter 4723-5 of the Administrative Code;

(4) Student progression, which shall include the following:

(a) The level of achievement a student must maintain in order to remain in the program or to progress from one level to another; and

(b) The requirements for satisfactory completion of each course required in the nursing curriculum;

(5) Requirements for completion of the program;

(6) Payment of fees, expenses, and refunds associated with the program;

(7) Procedures for student illness in the classroom and clinical settings;

(8) Availability of student guidance and counseling services;

(9) Process for students filing grievances and appeals;

(10) A description of faculty responsibilities related to the supervision of students in accordance with section 4723.32 of the Revised Code and rule 4723-5-20 of the Administrative Code;

(11) Periodic evaluation by the faculty of each nursing student's progress in each course and in the program; and

(12) Procedures for notifying students of changes in program policies.

(B) The program shall not implement changes to policies or requirements for student progression, or requirements for completion of the program, regarding students enrolled in the program at the time the changes are adopted.

(C) In addition to the policies required in paragraph (A) of this rule, the program administrator and faculty shall implement policies related to student conduct that incorporate the standards for safe nursing care set forth in Chapter 4723. of the Revised Code and the rules adopted under that chapter, including, but not limited to the following:

(1) A student shall, in a complete, accurate, and timely manner, report and document nursing assessments or observations, the care provided by the student for the patient, and the patient's response to that care.

(2) A student shall, in an accurate and timely manner, report to the appropriate practitioner errors in or deviations from the current valid order.

(3) A student shall not falsify any patient record or any other document prepared or utilized in the course of, or in conjunction with, nursing practice. This includes, but is not limited to, case management documents or reports, time records or reports, and other documents related to billing for nursing services.

(4) A student shall implement measures to promote a safe environment for each patient.

(5) A student shall delineate, establish, and maintain professional boundaries with each patient.

(6) At all times when a student is providing direct nursing care to a patient the student shall:

(a) Provide privacy during examination or treatment and in the care of personal or bodily needs; and

(b) Treat each patient with courtesy, respect, and with full recognition of dignity and individuality.

(7) A student shall practice within the appropriate scope of practice as set forth in division (B) of section 4723.01 and division (B)(20) of section 4723.28 of the Revised Code for a registered nurse, and division (F) of section 4723.01 and division (B)(21) of section 4723.28 of the Revised Code for a practical nurse;

(8) A student shall use universal and standard precautions established by Chapter 4723-20 of the Administrative Code;

(9) A student shall not:

(a) Engage in behavior that causes or may cause physical, verbal, mental, or emotional abuse to a patient;

(b) Engage in behavior toward a patient that may reasonably be interpreted as physical, verbal, mental, or emotional abuse.

(10) A student shall not misappropriate a patient's property or:

(a) Engage in behavior to seek or obtain personal gain at the patient's expense;

(b) Engage in behavior that may reasonably be interpreted as behavior to seek or obtain personal gain at the patient's expense;

(d) Engage in behavior that may reasonably be interpreted as inappropriate involvement in the patient's personal relationships.

For the purpose of this paragraph, the patient is always presumed incapable of giving free, full, or informed consent to the behaviors by the student set forth in this paragraph.

(11) A student shall not:

(a) Engage in sexual conduct with a patient;

(b) Engage in conduct in the course of practice that may reasonably be interpreted as sexual;

(d) Engage in verbal behavior that may reasonably be interpreted as seductive, or sexually demeaning to a patient.

For the purpose of this paragraph, the patient is always presumed incapable of giving free, full, or informed consent to sexual activity with the student.

(12) A student shall not, regardless of whether the contact or verbal behavior is consensual, engage with a patient other than the spouse of the student in any of the following:

(a) Sexual contact, as defined in section 2907.01 of the Revised Code;

(b) Verbal behavior that is sexually demeaning to the patient or may be reasonably interpreted by the patient as sexually demeaning.

(13) A student shall not self-administer or otherwise take into the body any dangerous drug, as defined in section 4729.01 of the Revised Code, in any way not in accordance with a legal, valid prescription issued for the student, or self-administer or otherwise take into the body any drug that is a schedule I controlled substance.

(14) A student shall not habitually or excessively use controlled substances, other habit-forming drugs, or alcohol or other chemical substances to an extent that impairs ability to practice.

(15) A student shall not have impairment of the ability to practice according to acceptable and prevailing standards of safe nursing care because of the use of drugs, alcohol, or other chemical substances.

(16) A student shall not have impairment of the ability to practice according to acceptable and prevailing standards of safe nursing care because of a physical or mental disability.

(17) A student shall not assault or cause harm to a patient or deprive a patient of the means to summon assistance.

(18) A student shall not misappropriate or attempt to misappropriate money or anything of value by intentional misrepresentation or material deception in the course of practice.

(19) A student shall not have been adjudicated by a probate court of being mentally ill or mentally incompetent, unless restored to competency by the court.

(20) A student shall not aid and abet a person in that person's practice of nursing without a license, practice as a dialysis technician without a certificate issued by the board, or administration of medications as a medication aide without a certificate issued by the board.

(21) A student shall not prescribe any drug or device to perform or induce an abortion, or otherwise perform or induce an abortion.

(22) A student shall not assist suicide as defined in section 3795.01 of the Revised Code.

(23) A student shall not submit or cause to be submitted any false, misleading or deceptive statements, information, or document to the nursing program, its administrators, faculty, teaching assistants, preceptors, or to the board.

(24) A student shall maintain the confidentiality of patient information. The student shall communicate patient information with other members of the health care team for health care purposes only, shall access patient information only for purposes of patient care or for otherwise fulfilling the student's assigned clinical responsibilities, and shall not disseminate patient information for purposes other than patient care or for otherwise fulfilling the student's assigned clinical responsibilities through social media, texting, emailing or any other form of communication.

(25) To the maximum extent feasible, identifiable patient health care information shall not be disclosed by a student unless the patient has consented to the disclosure of identifiable patient health care information. A student shall report individually identifiable patient information without written consent in limited circumstances only and in accordance with an authorized law, rule, or other recognized legal authority.

(26) For purposes of paragraphs (C)(5), (C)(6), (C)(9), (C)(10), (C)(11) and (C)(12) of this rule, a student shall not use social media, texting, emailing, or other forms of communication with, or about a patient, for non-health care purposes or for purposes other than fulfilling the student's assigned clinical responsibilities.

Last updated February 1, 2022 at 8:50 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-13 Curriculum for a registered nursing education program.

(A) The registered nursing education program curriculum shall include content that validates the student's acquired knowledge, skills and behaviors that are necessary to safely and effectively engage in the practice of registered nursing, as defined in division (B) of section 4723.01 of the Revised Code.

(B) The curriculum shall be derived from a philosophy, conceptual framework, or organizing theme that is consistently evident throughout the curriculum.

(C) The curriculum objectives or outcomes, course objectives or outcomes, teaching strategies, and evaluation methods shall be:

(1) Developed and written by program faculty;

(2) Consistent with the law regulating the practice of nursing as a registered nurse;

(3) Implemented as written;

(4) Distributed to each nursing student.

(D) The program shall establish a curriculum plan that sets forth the sequence of courses, the laboratory and clinical experiences that are included in each course, and the total number of clock hours per term allotted to theory, laboratory, and clinical experiences within each course. The curriculum plan shall be:

(1) Implemented as written;

(2) Distributed to each nursing student.

(E) The curriculum shall span a minimum length of two years of full-time study, with each year containing at least thirty weeks including examination time, unless it is an accelerated program that must provide a minimum of fifty-two weeks of clinical course work, or a program offering advanced standing as discussed in paragraph (H) of this rule.

(F) The program may move hours between laboratory and clinical experiences within a course offering provided the laboratory and clinical experiences are sufficient for student opportunity to achieve the behavioral objectives and requirements established in the course.

(G) The curriculum shall include clinical experiences in providing care to patients across the lifespan. The only periods of life span excepted are those related to the obstetrical patient, the immediate newborn, and pediatrics. Programs utilizing high fidelity simulation or mid or moderate fidelity simulation obstetrical, immediate newborn, or pediatric simulation laboratory experiences may use those experiences instead of providing clinical experience in those periods of life span.

(H) A program may offer an advanced standing option, as defined in paragraph (B) of rule 4723-5-01 of the Administrative Code, provided that it complies with all of the following:

(1) The program curriculum requires not less than forty-five weeks of clinical nursing coursework;

(2) The philosophy, conceptual framework, outcome objectives, and overall curriculum in the nursing major are substantively equivalent to that required for program completion for typical students graduating from the same program;

(3) The advanced standing option meets all other requirements set forth in this rule.

(I) The curriculum shall consist of course content in nursing art and science, the physical biological and technological sciences, and social and behavioral sciences. This content may be integrated, combined, or presented as separate courses as follows:

(1) Nursing art and science applied in a variety of settings to individuals or groups across the life span, that include but are not limited to:

(a) The nursing process;

(b) The application of nursing care concepts in addressing the physiological, psychological, cultural and spiritual needs of patients;

(d) Documentation of nursing care within various health information systems;

(e) Information management as it pertains to health records, nursing science and evidence-based practice;

(f) Concepts of teaching and learning;

(g) The exercise of clinical judgment, using evidence-based practice, to integrate increasingly complex knowledge, skills, and technologies as they relate to the patient;

(2) Safe and effective care environment:

(a) Manager of care role that includes:

(i) Delegation of nursing tasks in accordance with Chapter 4723-13 of the Administrative Code;

(ii) Legal, ethical, historical, and emerging issues in nursing that include but are not limited to the laws and rules regulating nursing practice in Ohio;

(iii) Collaboration with patients, families, other members of the health care team, and other individuals significant to the patient;

(iv) Professionalism and acting as a mentor for other nurses;

(v) Prioritization and resource allocation;

(b) Safety and infection control;

(3) Health counseling and health teaching;

(4) Psychological integrity;

(5) Physiological integrity, including:

(a) Care and comfort;

(b) Pharmacological and parenteral therapies, including but not limited to safe medication administration that incorporates application of pharmacotherapeutics;

(d) Physiological adaptation;

(6) Physical, biological, and technological sciences, including:

(a) Pharmacology;

(b) Human anatomy and physiology;

(d) Biology;

(e) Microbiology;

(f) Physics;

(g) Nutrition;

(h) Mathematics;

(i) Computer operations;

(j) Nursing informatics;

(7) Humanities, and social and behavioral sciences that are necessary to understand the effect of a patient's religious, spiritual, cultural, gender identity, sexuality, and growth and developmental experiences on the patient's health, the patient's attitude toward health maintenance, and to effectively communicate with the patient;

(8) The program will provide a combination of clinical and laboratory experiences concurrently with the related theory instruction that:

(a) Are directly relevant to the applied theoretical and behavioral objectives of each clinical course, are sufficient for students to practice their cognitive, psychomotor and affective skills, and are sufficient for students to effectively demonstrate their ability to meet the course's nursing behavioral outcomes;

(b) Provide the student with the opportunity to achieve technical skills including skills related to intravenous therapy;

(c) Provide faculty, with input from the teaching assistant if applicable, the opportunity to effectively evaluate and document the student's achievement of each course's specified behavioral outcomes;

(d) With respect to obstetrics, immediate newborn care, and pediatrics, the program may provide high fidelity simulation or mid or moderate fidelity patient simulation instead of clinical experience if:

(i) A faculty member or teaching assistant is responsible for conducting the patient simulation, and in doing so, may utilize computer technology specialists to assist in operating computer equipment. The faculty member or teaching assistant must:

(a) Have demonstrated knowledge, skills and abilities necessary to conduct the patient simulation obtained from a recognized body of knowledge relative to the simulation;

(b) Maintain through continuing education current knowledge, skills and abilities relative to the patient simulation;

(c) Maintain documentation satisfactory to the board of having met and maintained the knowledge, skill and abilities necessary to conduct the patient simulation; and

(ii) All of the requirements of paragraph (I)(8) of this rule are met.

Last updated February 1, 2022 at 8:50 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-14 Curriculum for a practical nursing education program.

(A) The practical nursing education program curriculum shall include content that validates the student's acquired knowledge, skills and behaviors that are necessary to safely and effectively engage in the practice of licensed practical nursing, as defined in division (F) of section 4723.01 of the Revised Code.

(B) The curriculum shall be derived from a philosophy, conceptual framework, or organizing theme that is consistently evident throughout the curriculum.

(C) The curriculum objectives or outcomes, course objectives or outcomes, teaching strategies, and evaluation methods shall be:

(1) Developed and written by program faculty;

(2) Consistent with the law regulating the practice of nursing as a licensed practical nurse;

(3) Implemented as written;

(4) Distributed to each nursing student.

(1) Implemented as written;

(2) Distributed to each nursing student.

(E) The curriculum shall consist of content that spans a minimum length of thirty weeks of full-time study, including examination time;.

(F) The program may move hours between laboratory and clinical experiences within a course provided the laboratory and clinical experiences are sufficient for student opportunity to achieve the behavioral objectives and requirements established in the course,

(H) The curriculum shall include but not be limited to the following areas of study that may be integrated, combined, or presented as separate courses:

(1) Basic biological, physical, and technological sciences, human anatomy and physiology, chemistry, microbiology, nutrition, pharmacology, mathematics, and computer operations;

(2) Social and behavioral sciences that are necessary for a basic understanding of the effect of a patient's religious, spiritual, cultural, gender identity, sexuality, and growth and developmental experiences on the patient's health, the patient's attitude toward health maintenance, and to effectively communicate with the patient;

(3) Basic nursing art and science practiced in a variety of structured settings, with courses and clinical experiences sufficient to prepare the graduate to safely deliver nursing care to individuals and groups across the life span, that include but are not limited to:

(a) The nursing process:

(i) Collection and organization of relevant health care data;

(ii) Assisting in the identification of health needs and problems;

(iii) Contributing to the interdisciplinary health care team in addressing patient physiological, psychological, cultural, and spiritual needs;

(b) The application of nursing care concepts in addressing the physiological, psychological, cultural and spiritual needs of patients;

(d) Documentation of nursing care within various health information systems;

(e) Information management as it pertains to health records, nursing science, and evidence-based practice;

(f) Concepts of teaching and learning;

(4) Safe and effective care environment and coordinated care:

(a) Collaboration with patients, families, other members of the health care team, and other individuals significant to the patient;

(b) Delegation of nursing tasks in accordance with Chapter 4723-13 of the Administrative Code;

(c) Demonstration of knowledge of legal, ethical, historical, and emerging issues in nursing that include but are not limited to the law and rules regulating nursing practice in Ohio;

(5) Safety and infection control;

(6) Health promotion and maintenance;

(7) Psychosocial integrity;

(8) Physiological integrity, including:

(a) Basic care and comfort;

(b) Pharmacological therapies, including but not limited to safe pharmacotherapeutics, and safe medication administration;

(9) Reduction of risk potential, including but not limited to patient safety strategies;

(10) Physiological adaptation;

(11) Application of principles of clinical judgment in the delivery of nursing care;

(12) A combination of clinical and laboratory experiences concurrently with the related theory instruction that:

(b) Provide the student with the opportunity to achieve technical skills including skills related to intravenous therapy;

(a) Have demonstrated knowledge, skills and abilities necessary to conduct the patient simulation obtained from a recognized body of knowledge relative to the simulation;

(b) Maintain through continuing education current knowledge, skills and abilities relative to the patient simulation;

(c) Maintain documentation satisfactory to the board of having met and maintained the knowledge, skill and abilities necessary to conduct the patient simulation;

(ii) All of the requirements of paragraph (H)(12) of this rule are met; and

(13) Professionalism and acting as a mentor for other nurses.

(I) In addition to the content set forth in paragraph (H) of this rule, all practical nursing education programs shall include a course or content in intravenous therapy. A course or content in intravenous therapy to be included in a practical nursing education program shall have, at a minimum, didactic, laboratory, and supervised clinical practice that covers the following:

(1) The law and rules related to the role, accountability, and responsibility of the licensed practical nurse in intravenous therapy;

(2) Policies and procedures related to intravenous therapy and affiliating clinical agencies;

(3) Sciences related to intravenous therapy, including, but not limited to anatomy, physiology, microbiology and standard precautions, principles of physics, pharmacology, and pharmacology mathematics;

(4) Nursing care of individuals receiving intravenous therapy, including the clinical experience required in paragraph (H)(12)(b) of this rule;

(5) Documentation related to intravenous care;

(6) Any other training or instruction the board considers appropriate;

(7) A testing component through which a student is able to demonstrate competency related to intravenous therapy;

(8) A means to verify that a student has successfully completed the course in intravenous therapy as set forth in this rule.

(J) A practical nursing education program that is offered to students at the secondary or high school level may be commenced no earlier than the beginning of a student's junior year.

Last updated February 1, 2022 at 8:51 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-15 Evaluation plan of the program.

A written systematic plan of evaluation shall be established and implemented by the administrator of a program and shall include data collected from faculty, teaching assistants, preceptors, nursing students, graduates, and employers of graduates and shall:

(A) Specify the responsibility, time frame, and procedure for evaluating each aspect of the program, including:

(1) Program organization and administration as set forth in rule 4723-5-09 of the Administrative Code;

(2) Qualifications of administrators, faculty, teaching assistants and preceptors as set forth in rule 4723-5-10 of the Administrative Code for a registered nursing education program, or rule 4723-5-11 of the Administrative Code for a practical nursing education program;

(3) Program policies as set forth in rule 4723-5-12 of the Administrative Code;

(4) Curriculum as set forth in rule 4723-5-13 of the Administrative Code for a registered nursing education program, or rule 4723-5-14 of the Administrative Code for a practical nursing education program;

(5) Evaluation plan of the program as set forth in this rule;

(6) Program contractual relationships as set forth in rule 4723-5-17 of the Administrative Code;

(7) Responsibilities of faculty teaching a nursing course as set forth in rule 4723-5-19 of the Administrative Code;

(8) Responsibilities of faculty and instructional personnel in a clinical setting involving the delivery of nursing care to an individual or group of individuals as set forth in rule 4723-5-20 of the Administrative Code;

(9) Maintenance of program records as set forth in rule 4723-5-21 of the Administrative Code;

(10) Licensure examination results as set forth in rule 4723-5-23 of the Administrative Code; and

(11) Follow-up of graduates, which shall include but not be limited to:

(a) Statistics on the number of first-time candidates passing the licensure examination during each calendar year; and

(b) Employment patterns of graduates;

(B) The results of the evaluation of each aspect of the program as set forth in paragraph (A) of this rule shall be summarized and documented; and

(C) Documentation shall demonstrate that the results of the evaluation of each aspect of the program as set forth in paragraph (A) of this rule have been used to plan and implement changes in the program.

Last updated February 1, 2022 at 8:51 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-16 Board approval of a curriculum revision.

(A) Board approval shall be required prior to implementation of a curriculum revision that results from a change in a program's philosophy, conceptual framework, organizing theme, program objectives or program outcomes.

(B) The administrator of a program shall submit to the board a written plan for a proposed curriculum revision as set forth in paragraph (A) of this rule at least ten weeks preceding the scheduled board meeting at which the proposed revision is expected to be reviewed by the board. The plan for a curriculum revision based on a proposed change in a program's philosophy, conceptual framework, or organizing theme shall include at least the following:

(1) The rationale for the proposed curriculum revision;

(2) The revised philosophy, conceptual framework, or organizing theme, or program objectives or outcomes that result in a curriculum change;

(3) The proposed total curriculum plan;

(4) The course syllabus or outline for each nursing course that includes at least: the title of the course, the number of theory hours, the number of clinical and laboratory hours, the course description, the course objectives or outcomes, the teaching strategies, the methods of evaluation, and a topical course outline; and

(5) The plan for implementation of the proposed curriculum revision, including the impact of the curriculum revision on currently enrolled nursing students.

(C) If the plan for the proposed curriculum revision meets the requirements set forth in rule 4723-5-13 of the Administrative Code for a registered nursing education program, or rule 4723-5-14 of the Administrative Code for a practical nursing education program, and satisfactorily provides all information listed in paragraph (B) of this rule, the board shall approve the proposed curriculum revision. If the plan for the proposed curriculum revision does not meet the requirements set forth in rule 4723-5-13 of the Administrative Code for a registered nursing education program, or rule 4723-5-14 of the Administrative Code for a practical nursing education program, or does not satisfactorily provide the information listed in paragraph (B) of this rule, the board shall provide written notice to the administrator of the program regarding the requirement not met or the information not satisfactorily provided.

(D) Additions, deletions, or revisions to a curriculum other than those set forth in paragraph (A) of this rule shall be reported to the board in the annual report required by rule 4723-5-05 of the Administrative Code.

Last updated February 1, 2022 at 8:51 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-17 Program contractual relationships.

(A) When a program has any type of cooperative relationship with another entity or a separate division within the same entity including, but not limited to, clinical agencies, a written agreement with the cooperating entity shall:

(1) Exist and be current;

(2) Be entered into and signed by representatives of both the program and the entity or division with which is has entered into a cooperative relationship; and

(3) Be on file at the program office.

(B) When a program is using preceptors, the contract shall expressly set forth the expectations the preceptors are to fulfill.

(1) Contact the board of nursing or other entity regulating nursing in that jurisdiction or foreign country and document compliance with any and all requirements of that board or entity; and

(2) Indicate on the annual report to the board, required by rule 4723-5-05 of the Administrative Code, that the faculty member, teaching assistant or preceptor who is supervising the student clinical experience in that jurisdiction or foreign country is in compliance with licensure requirements in the jurisdiction or foreign country where the clinical experience is occurring.

Last updated June 10, 2022 at 8:31 AM

History

Effective: April 1, 2017
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-19 Responsibilities of faculty teaching a nursing course.

Faculty teaching a nursing course shall:

(A) Provide a syllabus or outline to each nursing student that includes at least:

(1) The title of the course;

(2) The total number of theory clock hours for the course, if applicable;

(3) The total number of clinical and laboratory clock hours combined for the course, if applicable, and of this combined number:

(a) The total number of planned clinical clock hours for the course;

(b) The total number of planned laboratory clock hours for the course;

(4) The course description;

(5) The course objectives or outcomes;

(6) The teaching strategies;

(7) The methods of evaluation;

(8) The name of the faculty who will be teaching the course;

(9) The name of teaching assistants that will teach the course, or provide instruction in laboratory or clinical settings, as directed by faculty;

(10) For any individual providing course content under the direction of the faculty, the job title, credentials or other information describing the background of the individual that demonstrates qualifications directly related to the course content; and

(11) The required textbooks and other bibliography of learning resources.

(B) Design and implement teaching strategies that will assist a nursing student to meet the course objectives or outcomes;

(D) Evaluate each nursing student's achievement and progress with input from the teaching assistant or preceptor, if utilized;

(E) At the conclusion of each course, the faculty responsible for teaching the course shall:

(1) Compare the number of planned clinical hours as established in the syllabus with the number of clinical hours actually provided to students and report the course data to the administrator; and

(2) Compare the number of planned laboratory hours as established in the syllabus with the number of laboratory hours actually provided to students and report the data to the administrator;

(F) The data reported under paragraph (E) of this rule shall be prepared in a chart form that contains the name of the course, the dates through which the course was taught, the faculty's name and the number of clinical and laboratory hours planned, and the actual number of clinical and laboratory hours provided to students. The data in chart form shall be maintained by the administrator and shall be submitted with the annual report to the board required by rule 4723-5-05 of the Administrative Code.

Last updated February 1, 2022 at 8:52 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-20 Responsibilities of faculty, teaching assistants and preceptors in a clinical setting.

(A) A faculty member of a nursing education program is responsible for planning the student's clinical experience and for evaluating the student's performance. Clinical nursing experiences are assigned by faculty based on course objectives and student learning needs. Faculty, teaching assistants or preceptors shall supervise student practice by providing guidance, direction, and support appropriate to the clinical situation.

(B) Supervision of a nursing student shall be provided for each clinical experience involving the delivery of nursing care to an individual or group of individuals. This supervision shall be provided only by a faculty member, teaching assistant, or preceptor who meets the qualifications set forth in rule 4723-5-10 of the Administrative Code for a registered nursing education program, or rule 4723-5-11 of the Administrative Code for a practical nursing education program. When supervising a nursing student, the faculty member or teaching assistant shall function only as faculty or as a teaching assistant during the student's clinical experience.

(C) All experiences for a nursing student in a clinical setting involving the delivery of nursing care to an individual or group of individuals shall be performed under the direction of a faculty member who functions only as a faculty member during the nursing student's clinical experience. The faculty member providing direction shall:

(1) Establish clinical objectives or outcomes within the framework of the course in which the student is enrolled;

(2) Communicate clinical objectives or outcomes to:

(a) The student;

(b) The teaching assistant and preceptor, if utilized; and

(3) Provide for orientation of each student to the clinical site, including introduction to staff;

(4) Make assignments, in conjunction with the teaching assistant or preceptor, if utilized, for the student's experience, consistent with the specific objectives or outcomes of the course in which the student is enrolled;

(5) Provide for supervision of each student in accordance with this chapter; and

(6) Evaluate the student's experience, achievement, and progress in relation to the clinical objectives or outcomes, with input from the teaching assistant or preceptor, if utilized.

(D) The faculty or teaching assistant to student ratio for direct patient care experiences shall be no greater a ratio than ten students to one faculty or teaching assistant, or a smaller ratio in clinical settings where necessary to ensure the safe delivery of nursing care.

(E) The teaching assistant or preceptor providing supervision of a nursing student shall at least:

(1) Have competence in the area of clinical practice in which the teaching assistant or preceptor is providing supervision to a student;

(2) Design, at the direction of a faculty member, the student's clinical experience to achieve the stated objectives or outcomes of the nursing course in which the student is enrolled;

(3) Clarify with the faculty member:

(a) The role of the teaching assistant or preceptor;

(b) The responsibilities of the faculty member;

(d) The clinical experience evaluation tool; and

(4) Contribute to the evaluation of the student's performance by providing information to the faculty member and the student regarding the student's achievement of established objectives or outcomes.

(F) A preceptor shall provide supervision to no more than two nursing students at any one time, provided the circumstances are such that the preceptor can adequately supervise the practice of both students.

Last updated February 1, 2024 at 9:30 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-21 Program records.

The administrator of the program shall maintain records including the following::

(A) Records for currently enrolled nursing students that include:

(1) Admission or transfer records;

(2) Transcripts; and

(3) Clinical experience evaluation records for each clinical course that reflect the student's achievement of the specific behavioral and cognitive skills and outcomes to successfully complete the course and to engage in safe and effective nursing practice;

(4) Laboratory evaluation records for each course regarding nursing care of obstetrical patients, immediate newborns and pediatric patients, where high fidelity or mid or moderate fidelity simulation is used, that reflect the student's achievement of the specific behavioral and cognitive skills and outcomes to successfully complete the course, and to engage in safe and effective nursing practice;

(5) Laboratory experience evaluation records for each course containing laboratory hours, not referenced in paragraph (A)(4) of this rule, that reflect the student's achievement of the specific behavioral and cognitive skills and outcomes to successfully complete the course, and to engage in safe and effective nursing practice;

(B) Records for all graduates of the program that shall include complete transcripts indicating the credential granted and the date of completion of the program;

(D) Records for each faculty and teaching assistant currently being utilized in the program that include:

(1) Documentation of academic credentials, including copies of official academic transcripts;

(2) A record that includes the time periods, by month and year of employment in clinical practice, and in teaching, and the names and locations of all employers in the field of nursing and nursing education; and

(3) Verification of current, valid licensure as a registered nurse in Ohio at the time of appointment, if the record has not been reviewed during a previous survey visit by the board, and at each licensure renewal.

(E) Records for preceptors that include:

(1) Verification of current, valid licensure as a registered nurse, or, for a practical nursing education program, as a licensed practical nurse, in the jurisdiction or foreign country where the supervision of a nursing student's clinical experience occurs; and

(2) A record demonstrating competency in the area of clinical practice in which the preceptor provides supervision to a nursing student, including the names and locations of employers in the field of nursing, with time periods of employment.

Last updated June 10, 2022 at 8:32 AM

History

Effective: February 1, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-23 Program NCLEX rates.

(A) Only a program with full, conditional, or provisional approval shall issue program completion letters to the board for its students.

(B) If a program has a pass rate on the licensure examination that is less than ninety-five per cent of the national average for first-time candidates, who took the examination within six months of completion of the program, in a calendar year the following shall apply:

(1) After the first year, the program shall establish a plan indicating action steps to improve the NCLEX scores of its graduates, and submit the plan with the annual report;

(2) After two consecutive years, the program shall prepare a report that evaluates the plan of action established after the first year of low NCLEX scores, identify additional steps, and submit the plan with the annual report; and

(3) After three consecutive years, a representative of the board shall conduct a survey visit and the board may take action on the approval status of the program.

(4) After four consecutive years, a representative of the board may conduct a survey visit and the board shall place the program on provisional approval, or, if the program is on conditional approval status, propose to withdraw conditional approval and deny full approval status according to the procedures contained in Chapter 119. of the Revised Code.

(5) During, or during a relevant time period following, an emergency declared by the state or federal government, or state or local disaster, the board may abstain from changing a program's approval status.

(C) For the board to consider restoring a program to full approval status after a program is placed on provisional status due to low NCLEX scores, a program shall attain a pass rate for at least two consecutive years that meets or exceeds ninety-five per cent of the national average for first-time candidates who took the examination within six months of completion of the program.

Last updated December 28, 2022 at 8:41 AM

History

Effective: December 22, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-24 Closure of a program.

(A) The administrator of the program shall complete the closure process set forth in this rule when the program will:

(1) No longer be admitting nursing students; or

(2) Be changing to a different type of program whose graduates will continue to take the same licensure examination.

(B) When the decision to close a program has been made, the administrator of the program shall inform the board in writing of the decision, the tentative date of closing, and the plan for the closure of the program, which shall be accomplished either by:

(1) The transfer of nursing students to another approved program; or

(2) The discontinuation of further student admissions into the program with the official closing on the date the last student completes the program.

(C) Each of the minimum requirements set forth in this chapter shall be met and maintained until the last nursing student is transferred or completes the program.

(D) The administrator of the program shall:

(1) Submit in writing to the board the final date of closure after the last nursing student has completed the program requirements and is eligible to receive a diploma, certificate or degree, or has been transferred to another program, or the student's enrollment has otherwise been terminated;

(2) Submit in writing to the board the location of the program's records and the name and address of the custodian of the records; and

(3) Affix a label to the records indicating that if the records are relocated, or the custodian of the records changes, the board shall be notified in writing.

(E) When the program closes, the controlling agency shall be responsible for providing for the safekeeping of the program records. If any change from the original location of program records is necessitated, the controlling agency shall notify the board in writing of any change of location.

Last updated June 10, 2022 at 8:33 AM

History

Effective: February 1, 2007
Promulgated Under: 119.03

Ohio Adm.Code 4723-5-25 Submission of false, misleading or deceptive information or documents.

A program, or an applicant seeking approval to operate a program under this chapter shall not make any false, misleading, or deceptive statements, or submit or cause to be submitted any false, misleading or deceptive information or documentation to the board or any representative of the board. Violation of this requirement shall be considered a failure to meet the requirements of this chapter in considering approval status.

Last updated June 10, 2022 at 8:33 AM

History

Effective: February 1, 2010
Promulgated Under: 119.03

Chapter 4723-6 Alternative Program for Substance Use Disorder Monitoring

Ohio Adm.Code 4723-6-01 Definitions.

As used in this chapter:

(A) "Agreement" means a voluntary, written contract between an individual and the board's alternative program for substance use disorder in which the board abstains from taking disciplinary action against the individual for violation of Chapter 4723. of the Revised Code and the individual agrees to be monitored by the board according to the terms and conditions of the program specified in section 4723.35 of the Revised Code, this chapter, and any other terms and conditions determined necessary by the program to ensure that the individual is able to practice in accordance with acceptable standards of safe care.

(B) "Approved treatment program" means an alcohol or substance use disorder treatment program which is either certified by a state agency or is accredited by a joint commission, council on Accreditation (COA), or commission on accreditation of rehabilitation facilities (CARF).

(C) "Drug of abuse" has the same meaning as in section 3719.011 of the Revised Code, and includes any controlled substance as defined in section 3719.01 of the Revised Code, any harmful intoxicant as defined in section 2925.01 of the Revised Code, or any dangerous drug as defined in section 4729.01 of the Revised Code.

(D) "Medication-assisted treatment" has the same meaning as in section 340.01 of the Revised Code.

(E) "Person" includes, without limitation, a natural person, a corporation, whether nonprofit or for profit, a partnership, a limited liability company, an unincorporated society or association, or two or more persons having a joint or common interest.

(F) "Practitioner" means a healthcare professional who is authorized by law to prescribe drugs, dangerous drugs, or drug therapy related devices in the course of the professional's practice and is licensed under Chapter 4715., 4723., 4725., 4731., or 4730., of the Revised Code and authorized by law to write prescription's for drugs or dangerous drugs.

(G) "Program" means the unit of the board responsible for administering the alternative program for substance use disorder established by section 4723.35 of the Revised Code.

(H) "Random alcohol and drug screen" means a laboratory or breathalyzer test administered at an irregular interval not known in advance by the individual to be tested to detect the presence of alcohol, drugs of abuse, or other mood altering substances in the individual's body fluids, breath, hair, or nails.

(I) "Substance use disorder" for purposes of section 4723.35 of the Revised Code and Chapter 4723-6 of the Administrative Code means either of the following:

(1) The chronic and habitual use of alcohol to the extent that the user no longer can control the use of alcohol; or the user's health, safety, or welfare or that of others is endangered; or

(2) The use of a drug of abuse, to the extent that the user becomes physically or psychologically dependent on the drug; or the user's health, safety, or welfare or that of others is endangered.

To the extent that under prior law, the term "chemical dependency" was used, the term is to be construed to hold the same meaning as "substance use disorder" for purposes of the board's monitoring program established according to section 4723.35 of the Revised Code and Chapter 4723-6 of the Administrative Code.

(J) "Support group" means individuals who hold licenses or certificates issued under Chapter 4723. of the Revised Code who meet regularly to discuss practice issues related to recovery and to provide substance use disorder support for its members.

(K) "Treatment provider" means a licensed healthcare provider, with demonstrated expertise in substance use disorder, who provides alcohol or substance use treatment in an approved treatment program to an individual participating in the alternative program for dependency.

(L) "Twelve-step meeting" means a meeting sponsored by a group such as alcoholics anonymous, narcotics anonymous, or a related organization which addresses substance use disorders and promotes sobriety and recovery through peer group support, self-help, and anonymity, and which is based on an abstinence model of recovery.

Last updated February 1, 2024 at 9:31 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-6-02 Eligibility requirements for participation in the alternative programfor substance use disorder.

(A) An individual may participate in the program if the board supervising member for disciplinary matters determines that all of the following conditions are met:

(1) The individual has been issued a license to practice nursing as either a registered nurse or a licensed practical nurse in Ohio, or a certificate to practice as a dialysis technician or community health worker in Ohio;

(2) The individual requests and the board provides the individual an "Alternative Program for Substance Use Disorder Admission Application," that includes an "Initial Voluntary Temporary License/Certificate Surrender" form. Within ten business days of the date the application was provided by the board to the individual, the board must receive the individual's completed "Initial Voluntary Temporary License/Certificate Surrender" form;

(3) The individual submits a completed "Alternative Program for Substance Use Disorder Admission Application" to the board within sixty days of the date the application was provided by the board to the individual. The completed application shall be accompanied by all of the following:

(a) A substance use disorder assessment performed by a licensed healthcare provider with demonstrated expertise in the treatment of substance use disorders that documents a diagnosis of substance use disorder and sets forth an organized plan for treatment.

(b) Signed waivers giving the program consent to receive and release information necessary for purposes of determining program eligibility. This includes, but is not limited to, information to and from employers, probation officers, law enforcement agencies, peer assistance programs, and any treatment providers or health care practitioners. No person with knowledge of any information disclosed by the program pursuant to this paragraph shall divulge the information to any other person. The information contained in the completed application shall indicate to the board supervising member for disciplinary matters all of the following:

(i) The individual may be effectively treated for the substance use disorder;

(ii) The individual may be effectively monitored for compliance with program requirements; and

(iii) The individual is not subject to the prohibitions in paragraph (B) of this rule.

(B) An individual may not participate in the program if the board receives information indicating that the individual's compliance with the program may not be effectively monitored while participating in the program. This information includes, but is not limited to, the following:

(1) The individual has a medical and/or psychiatric condition, diagnosis, or disorder, other than a substance use disorder, in which the manifest symptoms are not adequately controlled;

(2) The individual has attempted or completed two or more substance use disorder treatment programs as of the date of the application, not including the individual's current substance use disorder treatment plan and related treatment currently submitted for purposes of program eligibility;

(3) The individual has substituted or tampered with a substance or drug of abuse;

(4) The board has taken action against the individual's license to practice nursing as either a registered nurse or a licensed practical nurse or certificate or intern certificate to practice as a dialysis technician or community health worker;

(5) A board regulating nurses, dialysis technicians or community health workers in another jurisdiction has taken action against the individual's license to practice nursing as either a registered nurse or a licensed practical nurse in that jurisdiction or certificate or intern certificate to practice as a dialysis technician or community health worker in that jurisdiction;

(6) The individual has completed the program or a similar program in another jurisdiction;

(7) The individual has been terminated from the program or from a similar program in another jurisdiction;

(8) The individual was admitted to, but did not complete or is no longer in good standing, a similar program in another jurisdiction;

(9) The individual has been convicted of, pled guilty to (other than a plea resulting in a finding of eligibility for intervention in lieu of conviction), had a judicial finding of eligibility for diversion for, or had a judicial finding of guilt resulting from a plea of no contest to any felony or an act in another jurisdiction that would constitute a felony in Ohio;

(10) The board determines that the public may not be adequately protected from unsafe practice if the individual enters the program; or

(11) The individual has failed or refused to cooperate with a board investigation.

Last updated February 1, 2024 at 9:31 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-6-03 Terms and conditions a participant must meet to successfully complete the substance use disorder monitoring program.

(A) The participant shall enter into an agreement with the program and shall comply with all of the terms and conditions of the participant's agreement for the time period specified in the agreement.

(B) The agreement may include the following requirements:

(1) The participant:

(a) Enter substance use disorder treatment in an approved treatment program or provide documentation of current participation in treatment or completion of treatment no later than thirty days from the execution of the agreement; and

(b) Comply with all requirements of the participant's substance use disorder treatment plan;

(2) The participant cause the treatment provider to submit documentation acceptable to the program of the participant's compliance with the participant's substance use disorder treatment plan;

(3) The participant abstain from the use of alcohol, drugs of abuse, and controlled substances, except for the participant's use of drugs of abuse and controlled substances prescribed for purposes of medication-assisted treatment in accordance with state law, or prescribed for other health purposes by a treating practitioner who has knowledge of the participant's substance use disorder and treatment plan;

(4) The participant cause all treating healthcare providers who authorize, prescribe or administer medication with respect to the participant, including but not limited to drugs of abuse, to submit documentation regarding the medication to the program, in the manner specified in the agreement;

(5) The participant inform any and all treating healthcare practitioners of the participant's substance use disorder and recovery status prior to receiving treatment and prescriptions;

(6) The participant cause any and all healthcare practitioners, substance use disorder treatment providers, and counselors to provide progress reports to the program at the intervals specified in the participant's agreement;

(7) The participant submit to random alcohol and drug screens when requested by the program, and that the participant comply with all requirements of random alcohol and drug screening as specified in the agreement;

(8) The participant attend support, peer group, or twelve-step group meetings as specified in the participant's agreement, and that the participant verify attendance at these meetings by using the meeting form provided by the program;

(9) The participant comply with the employment restrictions, for positions that require a nursing license, or dialysis technician certificate , or community health worker certificate, specified in the agreement, which may include, but are not limited to:

(a) Program approval of the employment;

(b) Work schedule restrictions;

(c) Restrictions against administering and having access to alcohol or products containing alcohol, excluding topically applied alcohol-based products used for disinfection purposes, controlled substances, and drugs of abuse; and

(d) Practice setting or patient population restrictions;

(10) The participant sign waivers required by division (E) of section 4723.35 of the Revised Code, and that the participant also sign waivers permitting the program to receive or release information necessary to properly facilitate the monitoring of the participant's progress in their recovery from substance use disorder and compliance with their program requirements. The information may be released to or received from persons, including, but not limited to, employers, probation officers, law enforcement agencies, peer assistance programs, substance use disorder treatment providers, healthcare practitioners, government agencies, or court officials. No person with knowledge of any information disclosed by the program pursuant to this paragraph shall divulge the information to any other person.

(11) The participant return to employment in a position that requires a nursing license or dialysis technician certificate , or as a community health worker, while under the terms of the agreement, and continue in that employment, or other employment requiring licensure or certification, for an aggregate period of at least one year of full-time employment, prior to being considered for release from the terms and conditions of the agreement;

(12) The participant be responsible for all costs to the participant resulting from the participant's program requirements. All costs incurred by the participant resulting from the participant's participation in the program are wholly between the participant and any person providing the services according to the program requirements. None of the costs incurred by the participant shall be charged to the program and the program assumes no liability for any costs incurred by the participant in paying all costs;

(13) The participant meet with a program representative at the intervals specified by the agreement; and

(14) The participant obey all federal, state, and local laws and rules including, but not limited to, all laws and rules regulating the practice of nursing or dialysis care in Ohio.

Last updated February 1, 2024 at 9:31 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-6-04 Successful completion of the alternative programfor substance use disorder.

(A) A participant successfully completes the program when the participant complies with the terms and conditions of the program specified in section 4723.35 of the Revised Code, this chapter, and the participant's agreement for the time period specified in the agreement.

(B) When a participant successfully completes the program as indicated in paragraph (A) of this rule, the program shall notify the participant of such successful completion in writing. Once the participant receives this written notification of successful completion from the program, the participant shall no longer be required to comply with the terms and conditions of the program specified in section 4723.35 of the Revised Code, this chapter, and the participant's agreement.

(C) When making a decision regarding disciplinary action for violations of Chapter 4723. of the Revised Code or the rules of the board, the board will be notified by a written communication from board staff, marked as confidential according to division (F) of section 4723.35 of the Revised Code, if the individual who is the subject of proposed board action previously successfully completed the program.

(D) A participant who successfully completes the program shall not be reported to the national council of state boards of nursing's disciplinary data bank or the federally mandated national database unless the board imposes disciplinary action against the participant.

Last updated February 1, 2024 at 9:31 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-6-05 Causes for termination from the alternative programfor substance use disorder.

Participation in the program may be terminated for any of the following reasons:

(A) The participant fails to comply with any of the terms and conditions of the program specified in section 4723.35 of the Revised Code and this chapter;

(B) The participant fails to comply with any provision of the participant's agreement;

(D) The program receives information which, after investigation, indicates that the participant may have committed an additional violation of a provision of Chapter 4723. of the Revised Code or any rules of the board.

Last updated February 1, 2024 at 9:32 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-6-06 Confidentiality regarding the alternative programfor substance use disorder.

(A) Admission and ongoing monitoring shall be conducted in a manner that maintains the confidentiality of the individual.

(B) According to division (F)(3) of section 4723.35 of the Revised Code, all records regarding an individual's application to or participation in the program are confidential and are not public records. The records include, but are not limited to:

(1) Medical records;

(2) Substance use disorder records;

(3) Mental health records;

(4) Treatment records;

(5) Reports required by the participant's agreement;

(6) Waivers and releases required by the participant's agreement;

(7) Alcohol and drug screen results;

(8) Verification of attendance at support, peer group or twelve-step meetings; and

(9) Internal program documentation concerning participants in the program, including program assessments and recommendations;

(10) Applications submitted to the program, records related to review of program eligibility, and participant agreements.

(C) According to division (E)(4) of section 4723.35 of the Revised Code, a participant may authorize in writing the release of information regarding his or her progress in the program.

(D) All program records shall be maintained in a secure storage area for a period of two years following the participant's date of successful completion of the program, or for a period of two years following a determination that an applicant is not eligible for participation.

Last updated February 1, 2024 at 9:32 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Chapter 4723-7 Examination and Licensure

Ohio Adm.Code 4723-7-01 Definitions.

As used in this chapter,

(A) "Authorization to test" means the authorization to take the examination for licensure issued by the testing service to an eligible applicant.

(B) "Current" or "active" license means a license that is not inactive, suspended, lapsed, or revoked.

(C) "Eligible applicant" means an individual who applies for licensure by examination whom the board has determined, based on the requirements contained in section 4723.09 of the Revised Code and this chapter, is eligible to take the examination.

(D) "Examination" or "examination for licensure" means the NCLEX-RN or the NCLEX-PN.

(E) "Foreign educated nurse graduate" means an individual who has completed a nursing education program leading to initial licensure as a nurse that is not located within a jurisdiction of the national council of state boards of nursing.

(F) "Inactive" means the status of a license or certificate of an individual who has entered an electronic or written request for the board to place the license or certificate on inactive status. An individual with an inactive license or certificate does not hold a current, valid license or certificate.

(G) "Jurisdiction of the national council of state boards of nursing" means any state, territory, or political subdivision of the United States in which a board or legal approving authority regulates nurse licensure and nursing practice and maintains membership in the national council of state boards of nursing.

(H) "Lapsed" means the status of a license or certificate of an individual who did not meet all the requirements of license or certificate renewal, who did not request that the board place the license or certificate on inactive status prior to the license expiration date, and whose license or certificate has expired.

(I) "NCLEX-PN" means the national council licensing examination for practical nurses developed and administered by the national council of state boards of nursing.

(J) "NCLEX-RN" means the national council licensing examination for registered nurses developed and administered by the national council of state boards of nursing.

(K) "Practical nursing education program" means a nursing education program that leads to initial licensure as a licensed practical nurse.

(L) "Reactivate" means to change the status of a license or certificate from inactive to active.

(M) "Registered nursing education program" means a professional nursing education program that leads to initial licensure as a registered nurse.

(N) "Reinstate" means to change the status of a license or certificate from lapsed or suspended to reinstated.

(O) "Testing service" means the entity that the national council of state boards of nursing contracts with for the development and administration of the examination.

Last updated June 10, 2022 at 8:37 AM

History

Effective: April 1, 2017
Promulgated Under: 119.03

Ohio Adm.Code 4723-7-02 Requirements and application for licensure by examination as a nurse.

(A) The NCLEX-RN shall be the approved examination for licensure as a registered nurse in Ohio.

(B) The NCLEX-PN shall be the approved examination for licensure as a licensed practical nurse in Ohio.

(C) To apply for licensure by examination to practice nursing as a registered nurse in Ohio, an applicant shall have successfully completed a registered nursing education program that satisfies one of the following:

(1) Is approved by the board according to section 4723.06 of the Revised Code and Chapter 4723-5 of the Administrative Code;

(2) Is approved by a jurisdiction of the national council of state boards of nursing; or

(3) Has been determined to be acceptable by the board for a foreign educated nurse graduate according to rule 4723-7-04 of the Administrative Code.

(D) To apply for licensure by examination to practice nursing as a licensed practical nurse in Ohio, an applicant must have successfully completed a practical nursing education program that satisfies one of the following:

(1) Is approved by the board according to section 4723.06 of the Revised Code and Chapter 4723-5 of the Administrative Code;

(2) Is approved by a jurisdiction of the national council of state boards of nursing; or

(3) Has been determined to be acceptable by the board for a foreign educated nurse graduate according to rule 4723-7-04 of the Administrative Code.

(E) In addition to the requirements set forth in paragraphs (C) and (D) of this rule, an applicant for licensure by examination shall:

(1) Submit to the board a completed "Nursing Licensure by Examination Application";

(2) As required by section 4723.09 of the Revised Code, submit to a criminal records check completed by the bureau of criminal identification;

(3) Submit to the board the applicable licensure application fee required by section 4723.08 of the Revised Code; and

(4) Complete the registration process for examination required by the testing service.

(F) Prior to the board determining an applicant is eligible to take an examination, the board shall have received the following:

(1) For an applicant who has successfully completed an Ohio nursing education program approved by the board, written notification of the applicant's completion of the program, submitted directly by the education program administrator or designee to the board, according to paragraph (B)(9) of rule 4723-5-09 of the Administrative Code. If the program has closed, the board may accept a copy of the applicant's official transcript certified to be a true copy by the custodian of the original transcript, instead of a program completion letter.

(2) For an applicant who has successfully completed a nursing education program approved by a jurisdiction of the national council of state boards of nursing, other than Ohio, an official transcript from the nursing education program submitted directly by the education program administrator or designee to the board that sets forth the completed program requirements and the date on which it was completed. If the program has closed, the board may accept other documentation evidencing that the applicant's educational preparation is substantially similar to that required for programs approved by the board.

(3) For an applicant who is a foreign educated nurse graduate, the information set forth in paragraph (A) of rule 4723-7-04 of the Administrative Code.

(G) The board may propose to deny admission to the licensure examination pursuant to an adjudication under Chapter 119. of the Revised Code. Based on the results of the adjudication, the board may grant admission to the licensure examination, deny admission to the licensure examination, or condition admission to the licensure examination on the applicant's successful correction of the area of deficiency identified by the board.

(H) If an applicant for licensure by examination fails to meet the requirements for licensure within one year from the date the application is received, or the application remains incomplete for one year, the application shall be considered void and the fee submitted with the application shall be forfeited. The application shall state the circumstances under which forfeiture may occur.

Last updated February 1, 2022 at 8:53 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-7-03 Authorization to test, accommodations, retesting, and notification.

(A) If the board determines an applicant is eligible to take the examination it shall request that the testing service issue the applicant an authorization to test.

(1) The testing service shall issue an authorization to test to each eligible applicant.

(2) An eligible applicant who has received an authorization to test must contact the testing service to schedule a time to take the examination.

(B) If an eligible applicant fails to take the examination within one year from the date the authorization to test was issued, the authorization is void, and the applicant must submit a new application for licensure by examination to the board and complete the registration process for the examination required by the testing service.

(C) The national council of state boards of nursing may grant accommodations for the examination related to the applicant's disability. In order to be considered for accommodations, the board must receive the following:

(1) A letter from the applicant that includes information regarding the specific type of disability involved, the specific type of accommodations requested and the applicant's contact information;

(2) A letter from the applicant's nursing education program administrator indicating what accommodations, if any, were provided to the applicant during the nursing education program, unless the disability occurred after the completion of the program; and

(3) A letter submitted to the board directly from a qualified professional with expertise in the area of diagnosed disability, on the professional's letterhead stating:

(a) The applicant's current disability diagnosis;;

(b) Recommendations for testing accommodations that are appropriate for the diagnosed disability; and

(c) The professional may include documentation such as recent reports, test results, evaluations and assessments of the applicant's need for accommodations, and may include information regarding the history of the disability and past accommodations granted to the applicant.

(D) The board shall notify the applicant of the results of the examination as reported by the testing service.

(E) If an applicant fails the examination, the board shall inform the applicant of the right to repeat the examination. To repeat the examination, the individual shall:

(1) Apply for licensure by examination to the board and meet all requirements as set forth in this chapter, including submitting a completed "Nursing Licensure by Examination Application" and the application fee required by section 4723.08 of the Revised Code; and

(2) Complete the registration process for examination required by the testing service.

(F) If the applicant passes the examination, the board shall issue a license if the applicant has:

(1) Completed all requirements for licensure required by this chapter and section 4723.09 of the Revised Code;

(2) Has not committed any act that may be grounds for disciplinary action under section 4723.28 of the Revised Code.

(G) The board may send reports of the testing results to nursing education programs for their graduates on a schedule established by the board.

Last updated February 1, 2022 at 8:53 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-7-04 Requirements for licensure for foreign educated nurse graduates.

(A) A foreign educated nurse graduate applying for licensure by examination shall satisfy all of the following:

(1) Provide to the board a full education course-by-course report from the credentialing evaluation service (CES) of the commission of graduates of foreign nursing schools (CGFNS) that includes information sufficient for the board to determine whether the foreign educated nurse graduate's education program has educational content and requirements that are substantially similar to a registered nursing education program set forth in rule 4723-5-13 of the Administrative Code if the applicant is applying for licensure by examination as a registered nurse, or a practical nursing education program set forth in rule 4723-5-14 of the Administrative Code if the applicant is applying for licensure by examination as a practical nurse;

(2) Provide to the board evidence of obtaining the minimum passing score on the "Test of English as a Foreign Language" (TOEFL iBt). This requirement does not apply to a foreign educated nurse who graduated from a college, university, or professional education program located in Australia, Ireland, New Zealand, the United Kingdom, South Africa, Trinidad and Tobago, Jamaica, Barbados, or Canada, except that, with respect to Canada, the exception from the requirement does not apply to Quebec, unless the individual graduated from McGill university, Dawson college in Montreal, Vanier college in St. Laurent, John Abbot college in Sainte-Anne-de-Bellevue, or Heritage college in Gatineau;

(3) As required by section 4723.09 of the Revised Code, submit to a criminal records check completed by the bureau of criminal identification and investigation, the results of which indicate that the individual has not been convicted of, pleaded guilty to, or had a judicial finding of guilt for any violation set forth in section 4723.092 of the Revised Code;

(4) As required by section 4723.09 of the Revised Code, not be required to register under Chapter 2950. of the Revised Code or a substantially similar law of another state, the United States, or another country;

(5) According to rule 4723-7-02 of the Administrative Code, submit to the board a completed "Nursing Licensure by Examination Application," and the applicable license application fee required by section 4723.08 of the Revised Code;

(6) According to with rule 4723-7-02 of the Administrative Code, complete the registration process for examination required by the testing service; and

(7) In addition to the requirements of this paragraph, a foreign educated nurse graduate applying for licensure by examination is subject to the provisions of rule 4723-7-03 of the Administrative Code.

(B) A foreign educated nurse graduate applying for licensure by endorsement shall satisfy all of the following:

(1) If seeking licensure by endorsement as a registered nurse, have been originally licensed by examination to practice as a registered nurse in a jurisdiction of the national council of state boards of nursing, and meet one of the following requirements:

(a) If originally licensed by examination prior to January 1, 1953, evidence of having passed an examination;

(b) If originally licensed by examination on or after January 1, 1953, but prior to July 1, 1982, achievement of a score of at least three hundred fifty on each subject tested in the "State Board Test Pool Examination";

(c) If originally licensed by examination on or after July 1, 1982, but prior to October 1, 1988, achievement of a score of at least one thousand six hundred on the NCLEX-RN; or

(d) If originally licensed by examination on or after October 1, 1988, achievement of a "pass" score on the NCLEX-RN;

(2) If seeking licensure by endorsement as a licensed practical nurse, have been originally licensed by examination to practice as a practical nurse in a jurisdiction of the national council of state boards of nursing, and meet one of the following requirements:

(a) If originally licensed by examination on or after July 1, 1956, but prior to July 1, 1982, achievement of a score of at least three hundred fifty on the "State Board Test Pool Examination";

(b) If originally licensed by examination on or after July 1, 1982, but prior to October 1, 1988, achievement of a score of at least three hundred fifty on the NCLEX-PN; or

(3) Provide evidence to the board of possessing a working knowledge of the English language by submitting one of the following:

(a) Evidence of obtaining a minimum passing score on the "Test of English as a Foreign Language" (TOEFL iBt) or another English language proficiency test accepted by a jurisdiction of the national council of state boards of nursing;

(b) A letter on academic letterhead from the foreign education program the applicant graduated from stating that the nursing education program the applicant completed was conducted in the English language with English textbooks;

(c) A letter on facility or institutional letterhead from a licensed nurse who supervised the applicant's nursing practice in another jurisdiction stating that the applicant demonstrated a working knowledge of the English language;

(d) A letter from a jurisdiction of the national council of state boards of nursing in which the applicant practiced as a nurse stating that the applicant demonstrated a working knowledge of the English language; or

(e) Evidence of completion of a nursing education program located in Australia, Ireland, New Zealand, the United Kingdom, South Africa, Trinidad and Tobago, Jamaica, Barbados, or Canada, except that, with respect to Canada, this does does not apply to Quebec, unless the individual graduated from McGill university, Dawson college in Montreal, Vanier college in St. Laurent, John Abbot college in Sainte-Anne-de-Bellevue, or Heritage college in Gatineau,

(4) Have submitted to the board either directly by the jurisdiction in which the foreign educated nurse graduate was originally licensed by examination, or electronically by the national council of state boards of nursing, one of the following:

(a) Verification of licensure by examination as a registered nurse, if seeking licensure by endorsement as a registered nurse; or

(b) Verification of licensure by examination as a practical nurse if seeking licensure by endorsement as a licensed practical nurse;

(5) Have submitted to the board directly from any jurisdiction of the national council of state boards of nursing, or electronically by the national council of state boards of nursing:

(a) Verification of current, valid licensure as a registered nurse, if seeking licensure by endorsement as a registered nurse; or

(b) Verification of current, valid licensure as a practical nurse if seeking licensure by endorsement as a licensed practical nurse;

(6) Have submitted to the board the results of a criminal records check conducted by the bureau of criminal identification and investigation according to section 4723.09 of the Revised Code;

(7) Have completed two contact hours of continuing education that is directly related to Chapter 4723. of the Revised Code or rules adopted by the board, and that meets the requirements set forth in paragraph (C) of rule 4723-14-01 of the Administrative Code for category A education; and

(8) Submit to the board a completed "Nursing Licensure by Endorsement Application" and the applicable license application fee required by section 4723.08 of the Revised Code.

(C) If the board determines that the educational content and requirements of a foreign graduate's nursing education program are not substantially similar to those for nursing education programs set forth in Chapter 4723-5 of the Administrative Code, the board may condition the foreign educated nurse graduate's eligibility for licensure by endorsement on successful completion of a program or course of study identified by the board as necessary to address any deficiency.

(D) The board may propose to deny licensure by examination or endorsement to a foreign educated nurse graduate pursuant to an adjudication conducted in accordance with Chapter 119. of the Revised Code. Based on the outcome of the adjudication, the board may grant licensure, deny licensure, or condition licensure on the applicant's successful completion of education in the area of deficiency identified by the board.

(E) According to section 4723.09 of the Revised Code, the board may issue a nonrenewable temporary permit to practice nursing as a registered nurse or a licensed practical nurse to a foreign educated nurse graduate seeking licensure by endorsement. A temporary permit expires at the earlier of one hundred eighty days after the permit is issued or upon licensure by endorsement.

(F) A foreign educated nurse graduate seeking licensure by endorsement as a registered nurse or licensed practical nurse, who requests a temporary permit to practice nursing in Ohio shall:

(1) Have submitted directly by the jurisdiction in which the applicant was originally licensed by examination, or electronically by the national council of state boards of nursing, verification of licensure by examination, as provided in paragraph (B)(5) of this rule;

(2) Have submitted verification of current, valid licensure directly from any jurisdiction of the national council of state boards of nursing, or electronically by the national council of state boards of nursing.

(G) If a foreign educated nurse graduate seeking licensure by examination or endorsement fails to meet the requirements for licensure within one year from the date the application for licensure is received, or the application remains incomplete for one year, the application shall be considered void and the fee forfeited. The application shall state the circumstances under which forfeiture may occur.

Last updated February 1, 2022 at 8:53 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-7-05 Registered nurse licensure by endorsement.

(A) A registered nurse applicant for licensure by endorsement shall satisfy the following:

(1) Have completed a registered nursing education program approved by a jurisdiction of the national council of state boards of nursing at the time the applicant completed the program;

(2) Submit a completed "Nursing Licensure by Endorsement Application," and the license application fee required by section 4723.08 of the Revised Code;

(3) As required by section 4723.09 of the Revised Code, submit to a criminal records check completed by the bureau of criminal identification and investigation;

(4) Have been originally licensed by examination to practice as a registered nurse and meet one of the following requirements:

(a) If originally licensed by examination prior to January 1, 1953, evidence of having passed an examination;

(c) If originally licensed by examination on or after July 1, 1982, but prior to October 1, 1988, achievement of a score of at least one thousand six hundred on the NCLEX-RN; or

(d) If originally licensed by examination on or after October 1, 1988, achievement of a "pass" score on the NCLEX-RN;

(B) In addition to meeting the requirements in paragraph (A) of this rule, prior to licensure by endorsement as a registered nurse an applicant shall:

(1) Submit evidence of successful completion of a registered nursing education program according to paragraph (A)(1) of this rule;

(2) Have submitted directly from the jurisdiction of the applicant's original licensure by examination, or electronically from the national council of state boards of nursing, verification of licensure by examination as a registered nurse, as required by paragraph (A)(4) of this rule;

(3) Have submitted verification of current, valid licensure as a registered nurse directly from any jurisdiction of the national council of state boards of nursing, or electronically by the national council of state board of nursing;

(4) Complete two contact hours of continuing education that is directly related to Chapter 4723. of the Revised Code or rules adopted by the board, and that meets the requirements set forth in paragraph (C) of rule 4723-14-01 of the Administrative Code for category A education; and

(5) Submit any other documentation required by the board.

(C) The board may propose to deny licensure by endorsement pursuant to an adjudication conducted in accordance with Chapter 119. of the Revised Code.

(D) According to section 4723.09 of the Revised Code, the board may issue a nonrenewable temporary permit to practice nursing as a registered nurse to a registered nurse applicant for licensure by endorsement. A temporary permit expires at the earlier of one hundred eighty days after the permit is issued, or upon licensure by endorsement.

(E) An applicant for endorsement as a registered nurse who requests a temporary permit to practice nursing as a registered nurse in Ohio shall:

(1) Have submitted directly from the jurisdiction of the applicant's original licensure by examination, or electronically from the national council of state boards of nursing, verification of licensure by examination as a registered nurse according to paragraph (A)(5) of this rule;

(2) Have submitted verification of current, valid licensure as a registered nurse directly from any jurisdiction of the national council of state boards of nursing, or electronically from the national council of state boards of nursing; and

(3) Submit any other documentation required by the board.

(F) If an applicant for licensure by endorsement as a registered nurse fails to meet the requirements for licensure within one year from the date the application is received, or the application remains incomplete for one year, the application shall be considered void and the fee forfeited. The application shall state the circumstances under which forfeiture may occur.

Last updated February 1, 2022 at 8:53 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-7-06 Practical nurse licensure by endorsement.

(A) A practical nurse applicant for licensure by endorsement shall satisfy the following:

(1) Have completed:

(a) A practical nursing education program approved by a jurisdiction of the national council of state boards of nursing at the time the applicant completed the program;

(b) If the applicant has practiced and maintained current, valid licensure as a licensed practical nurse in another jurisdiction for a minimum continuous period of five years prior to the date of application, either:

(i) A registered nursing education program approved by a jurisdiction of the national council of state boards of nursing, at the time the applicant completed the program; or

(ii) A registered nursing education program not approved by a jurisdiction of the national council of state boards of nursing, for which the board has received from the program administrator or designee, or from the jurisdiction in which the applicant was originally licensed by examination as a licensed practical nurse, a copy of an official transcript or other documentation demonstrating that the applicant's educational preparation is substantially similar to that required for programs approved by the board;

(2) Submit a completed "Nursing Licensure by Endorsement Application," and the applicable license application fee required by section 4723.08 of the Revised Code;

(3) As required by section 4723.09 of the Revised Code, submit to a criminal records check completed by the bureau of criminal identification and investigation;

(4) Have been originally licensed to practice as a licensed practical nurse based upon passing a practical nurse examination and meet one of the following requirements:

(a) If originally licensed by examination on or after July 1, 1956, but prior to July 1, 1982, achievement of a score of at least three hundred fifty on the "State Board Test Pool Examination";

(b) If originally licensed by examination on or after July 1, 1982, but prior to October 1, 1988, achievement of a score of at least three hundred fifty on the NCLEX-PN; or

(B) In addition to meeting the requirements in paragraph (A) of this rule, prior to licensure by endorsement as a practical nurse an applicant shall:

(1) Submit evidence of successful completion of a practical nursing program according to paragraph (A)(1) of this rule;

(2) Have submitted directly from the jurisdiction of the applicant's original licensure by examination, or electronically from the national council of state boards of nursing, verification of licensure by examination as a practical nurse, as required by paragraph (A)(4) of this rule;

(3) Have submitted verification of current, valid licensure as a licensed practical nurse directly from any jurisdiction of the national council of state boards of nursing or electronically by the national council of state boards of nursing;

(4) Have completed two contact hours of continuing education that is directly related to Chapter 4723. of the Revised Code or rules adopted by the board and that meets the requirements set forth in paragraph (C) of rule 4723-14-01 of the Administrative Code for category A education; and

(5) Submit any other documentation required by the board.

(C) The board may propose to deny licensure by endorsement pursuant to an adjudication conducted in accordance with Chapter 119. of the Revised Code.

(D) According to section 4723.09 of the Revised Code, the board may issue a nonrenewable temporary permit to practice nursing as a licensed practical nurse to a practical nurse applicant for licensure by endorsement. A temporary permit expires at the earlier of one hundred eighty days after the permit is issued, or upon licensure by endorsement.

(E) An applicant for licensure by endorsement as a practical nurse who requests a temporary permit to practice nursing as a licensed practical nurse in Ohio shall:

(1) Have submitted directly from the jurisdiction of the applicant's original licensure by examination, or electronically from the national council of state boards of nursing, verification of licensure by examination as a licensed practical nurse, according to paragraph (A)(4) of this rule;

(2) Have submitted verification of current, valid licensure as a licensed practical nurse directly from any jurisdiction of the national council of state boards of nursing, or electronically from the national council of state boards of nursing, and if the applicant qualifies for licensure by endorsement as a practical nurse by satisfying the requirements of paragraph (A)(1)(c) of this rule, documentation that the applicant has practiced and maintained current, valid licensure as a licensed practical nurse in another jurisdiction for a continuous period of five years prior to the date of application; and

(3) Submit any other documentation required by the board.

(F) If an applicant for licensure by endorsement as a licensed practical nurse fails to meet the requirements for licensure within one year from the date the application is received, or the application remains incomplete for one year, the application shall be considered void and the fee forfeited. The application shall state the circumstances under which forfeiture may occur.

Last updated February 1, 2024 at 9:32 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-7-07 Original certificate and license.

(A) A certificate shall be made available to each licensed nurse stating the licensee's name, license number, and date of issuance.

(B) The numbering of licenses shall be sequential.

(C) License certificates or other documents issued by the board as evidence of licensure, certification, or other authorization shall not be falsified or altered.

Last updated February 1, 2024 at 9:32 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-7-08 Reporting a misdemeanor or felony.

(A) An individual licensed or issued a certificate under Chapter 4723. of the Revised Code shall report any of the following to the board within 30 days of a conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction for:

(1) Any felony;

(2) Any misdemeanor with a direct and substantial relationship to practice under Chapter 4723. of the Revised Code;

(3) Violating of any municipal, state, county, or federal drug law; and

(4) Any DUI/OVI or physical control while under the influence.

(B) This requirement is in addition to any other reporting requirement including reporting all information required during the licensure or certificate application or renewal process.

Last updated February 1, 2024 at 9:32 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-7-09 License renewal for licensed practical nurses and registered nurses.

(A) Licenses shall be renewed as required by section 4723.24 of the Revised Code. The board may request that licensees provide nursing practice, education, and demographic information relevant to the public interest as part of the renewal process. Data provided by licensees shall be used only in aggregate form for the purposes of research and public information. The entire licensure renewal application, including requested data, shall be completed to satisfy the requirements of the renewal procedure.

(B) The board shall provide access to an on-line "LPN Renewal Application," and "RN Renewal Application," for renewal to every holder of a current, valid license, except when the board is aware that the individual may be ineligible for license renewal for any reason, including those reasons set forth in section 4723.24 of the Revised Code or section 4723.092 of the Revised Code.

(C) If a completed renewal application is not submitted on-line by September fifteenth of odd numbered years for registered nurses, or September fifteenth of even numbered years for licensed practical nurses, in order to renew the applicant shall pay a late processing fee of fifty dollars according to division (A)(10) of section 4723.08 of the Revised Code. The late processing fee is in addition to the renewal fee required by division (A)(7) of section 4723.08 of the Revised Code. Failure to pay the late processing fee and license renewal fee prior to November first of the applicable renewal year will cause the license to lapse, according to division (A) of section 4723.24 of the Revised Code.

(D) A licensee, with a current, valid license, who does not intend to practice nursing in Ohio may request the license be placed on inactive status at any time by submitting to the board a written statement or electronic request asking that the license be placed on inactive status.

(E) A registered nurse who does not renew a license to practice nursing on or before October thirty-first of odd numbered years and who has not requested inactive status according to paragraph (D) of this rule, shall have a lapsed license.

(F) A licensed practical nurse who does not renew a license to practice nursing on or before October thirty-first of even numbered years and who has not requested inactive status according to paragraph (D) of this rule, shall have a lapsed license.

(G) A licensee who continues to practice nursing in Ohio with an inactive or lapsed license shall be subject to disciplinary action under section 4723.28 of the Revised Code.

(H) To reactivate an inactive license or reinstate a lapsed license, the licensee must submit:

(1) A completed "LPN Reactivation and Reinstatement Application", for licensed practical nurses, or "RN Reactivation and Reinstatement Application," for registered nurses, including all required documentation;

(2) Verification of completion of continuing education in accordance with Chapter 4723-14 of the Administrative Code;

(3) Payment of the applicable fees required by section 4723.08 of the Revised Code; and

(4) If the license has been inactive for at least five years from the date of the application for reactivation or has been lapsed for at least five years from the date of the application for reinstatement, submit a request to the bureau of criminal identification and investigation for a criminal records check and check of federal bureau of investigation records according to section 4723.091 of the Revised Code.

(I) A licensee who placed a license on inactive status according to paragraph (D) of this rule after September fifteenth of the year in which the license is to be renewed, and who then notifies the board on or before October thirty-first of the same renewal year of the intent to reactivate the license, must still pay the late processing fee required by division (A)(10) of section 4723.08 of the Revised Code and paragraph (C) of this rule.

(J) When a license to practice nursing as a registered nurse is first issued by the board on or after July first of an odd numbered year, that license shall be current through October thirty-first of the next odd numbered year.

(K) When a license to practice nursing as a practical nurse is first issued by the board on or after July first of an even numbered year, that license shall be current through October thirty-first of the next even numbered year.

(L) A licensee who is a service member or veteran, as defined in rule 4723-2-01 of the Administrative Code, or who is the spouse or surviving spouse of a service member or veteran, may be eligible for a waiver of the late application fee and the reinstatement fee according to rule 4723-2-03 of the Administrative Code.

(M) A licensee who is engaged in active military duty may be eligible for an extension of time to complete continuing education as provided in rule 4723-2-04 of the Administrative Code.

(N) A licensee holding a current, valid volunteer's certificate issued by the board according to section 4723.26 of the Revised Code may renew the certificate by completing and submitting to the board a "Volunteer's Certificate Renewal Application," which includes verification of completion of continuing education in accordance with Chapter 4723-14 of the Administrative Code and rule 4723-7-10 of the Administrative Code. No fee is required to renew a volunteer's certificate.

Last updated June 10, 2022 at 8:37 AM

History

Effective: January 1, 2018
Promulgated Under: 119.03

Ohio Adm.Code 4723-7-10 Volunteer's certificate.

(A) For purposes of division (A)(2) of section 4723.26 of the Revised Code, "expired" means "lapsed" as defined in paragraph (H) of rule 4723-7-01 of the Administrative Code.

(B) An individual who holds a lapsed license to practice, as a licensed practical nurse, registered nurse, or advanced practice registered nurse, issued by the board or by a jurisdiction of the national council of state boards of nursing, may be issued a volunteer's certificate if:

(1) The requirements set forth in section 4723.26 of the Revised Code are met;

(2) The applicant has completed and submitted a "Volunteer's Certificate Application"; and

(3) The applicant has provided documentation satisfactory to the board of twenty-four contact hours of continuing education, completed in the twenty-four month period immediately before the application date, that meets the requirements of Chapter 4723-14 of the Administrative Code, and includes:

(a) Two contact hours of category A with learning outcomes that address standards of safe practice and nursing delegation;

(b) One contact hour that includes content in patient abuse, patient rights, and professional boundaries;

(c) Two contact hours that include content in the scope of practice of the licensed practical nurse, if the applicant is a retired licensed practical nurse, or two contact hours that include content in the scope of practice of the registered nurse, if the applicant is a retired registered nurse or advanced practice registered nurse;

(d) Two contact hours in nursing documentation;

(e) Three contact hours in principles of pain management;

(f) One contact hour that addresses the application of the nursing process and critical thinking related to patient care;

(g) One contact hour that includes content in maintaining patient confidentiality;

(h) Four contact hours in patient assessment and wound care;

(i) Four contact hours in medication administration and preventing medication errors; and

(j) Four contact hours relevant to the nurse's anticipated practice setting.

(D) A volunteer's certificate is valid, unless suspended or revoked by the board, for a period of two years from the date the board issues the certificate, and may be renewed according to paragraph (O) of rule 4723-7-09 of the Administrative Code.

(E) An individual holding a current, valid volunteer's certificate issued by the board:

(1) Shall only provide nursing services to indigent and uninsured persons, as defined in section 2305.234 of the Revised Code;

(2) Shall not accept any form of remuneration for providing nursing services; and

(3) Shall at all times while engaging in nursing practice display identification that clearly identifies the person as holding a volunteer's certificate, and shall not represent them self as, sign documents as, or use titles indicating that the person is licensed as a licensed practical nurse, registered nurse or advanced practice registered nurse, without also referencing the volunteer's certificate status. Volunteer's certificate status may be abbreviated in nursing documentation as "V.C."

(F) A certificate holder may place a volunteer's certificate on inactive status by submitting a written request to the board. To reactivate an inactive certificate or reinstate a lapsed certificate, the holder must submit a completed "Volunteer's Reactivation and Reinstatement Application," with all required records, and provide documentation of continuing education as set forth in paragraph (K) of rule 4723-14-03 of the Administrative Code. If the applicant has been lapsed or inactive for at least five years from the date of the application, the requirements set forth in division (D) of section 4723.24 of the Revised Code must be met in order to be eligible to reactivate or reinstate the certificate.

(G) A certificate holder engaged in active military duty may be eligible for an extension of time to complete continuing education as provided in rule 4723-2-04 of the Administrative Code.

(H) The provisions of section 4723.28 of the Revised Code apply to a volunteer's certificate issued by the board.

(1) A volunteer's certificate holder shall be subject to disciplinary action for any of the grounds set forth in section 4723.28 of the Revised Code;

(2) A certificate holder who continues to practice nursing in Ohio with a lapsed or inactive certificate, who fails to comply with the scope of practice and other provisions set forth in section 4723.26 of the Revised Code, or who violates the provisions of this rule, shall be subject to disciplinary action according to section 4723.28 of the Revised Code.

Last updated February 1, 2022 at 8:54 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Chapter 4723-8 Advanced Practice Nurse Certification and Practice

Ohio Adm.Code 4723-8-01 Definitions.

As used in this chapter:

(A) "Advanced practice registered nurse" means an individual who holds a current, valid license issued under Chapter 4723. of the Revised Code that authorizes the practice of nursing as an advanced practice registered nurse and is designated as any of the following:

(1) A certified registered nurse anesthetist;

(2) A clinical nurse specialist;

(3) A certified nurse-midwife;

(4) A certified nurse practitioner.

(B) "Collaboration" or "collaborating" means:

(1) In the case of a certified nurse practitioner or a clinical nurse specialist, that a podiatrist or physician has entered into a standard care arrangement with the nurse and is continuously available to communicate with the clinical nurse specialist or certified nurse practitioner either in person, or by electronic communication;

(2) In the case of a certified nurse-midwife, that a physician has entered into a standard care arrangement with the nurse and is continuously available to communicate with the nurse either in person, or by electronic communication.

(C) "Dentist" means an individual holding a license issued under Chapter 4715. of the Revised Code to practice dentistry, and who is practicing in Ohio.

(D) "Physician" means an individual holding a certificate issued under Chapter 4731. of the Revised Code authorizing the practice of medicine and surgery or osteopathic medicine and surgery, and who is practicing in Ohio.

(E) "Podiatrist" means an individual holding a certificate issued under Chapter 4731. of the Revised Code authorizing the practice of podiatric medicine, and who is practicing in Ohio.

(F) "Practice of nursing as an advanced practice registered nurse" means providing to individuals and groups nursing care that requires knowledge and skill obtained from advanced formal education, training and clinical experience. Such nursing care includes the care described in section 4723.43 of the Revised Code, and additionally, with respect to certified registered nurse anesthetists, sections 4723.433, 4723.434, and 4723.435 of the Revised Code.

(G) "Nursing specialty" means a specialty in practice as a certified registered nurse anesthetist, clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner.

(H) "Standard care arrangement" means a written, formal guide for planning and evaluating a patient's health care that is developed by a collaborating physician or podiatrist and a certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist, and that meets the requirements of section 4723.431 of the Revised Code and this chapter.

(I) "Supervision" means that a certified registered nurse anesthetist is under the direction of a podiatrist, a dentist, or a physician.

Last updated February 18, 2026 at 8:11 AM

History

Effective: February 1, 2021
Promulgated Under: 119.03

Ohio Adm.Code 4723-8-02 Standards of practice.

(A) An advanced practice registered nurse shall provide to patients nursing care that requires knowledge and skill obtained from advanced formal education, which includes a clinical practicum, and clinical experience as specified in sections 4723.41, 4723.43, 4723.433, 4723.434, 4723.435 and 4723.482 of the Revised Code and this chapter.

(B) Except as otherwise precluded by law or rule, each advanced practice registered nurse shall practice in accordance with the following:

(1) The advanced practice registered nurse's education and clinical experience;

(2) The advanced practice registered nurse's national certification as provided in section 4723.41 of the Revised Code; and

(3) Chapter 4723. of the Revised Code and rules adopted under that chapter.

(C) Only a certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist holding a current valid license as an advanced practice registered nurse may prescribe drugs. A certified registered nurse anesthetist may order drugs for use in the health care facility where the nurse practices in accordance with sections 4723.434 and 4723.435 of the Revised Code.

(D) Each certified nurse-midwife, certified nurse practitioner, and clinical nurse specialist shall utilize and incorporate into the nurse's practice, knowledge of Chapter 4731. of the Revised Code and rules adopted under that chapter that govern the practice of the nurse's collaborating physician or podiatrist. Each certified registered nurse anesthetist shall utilize and incorporate into the nurse's practice, knowledge of Chapters 4715. and 4731. of the Revised Code and rules adopted under these chapters that govern the practice of the nurse's supervising podiatrist, dentist, or physician.

(E) Nothing in this rule precludes an advanced practice registered nurse from practicing as a registered nurse in accordance with section 4723.01 of the Revised Code and the rules of the board.

Last updated February 18, 2026 at 8:12 AM

History

Effective: February 1, 2021
Promulgated Under: 119.03

Ohio Adm.Code 4723-8-03 Title protection.

(A) Only a person who holds a current valid license to practice as an advanced practice registered nurse issued in accordance with sections 4723.41, 4723.42 and 4723.482 of the Revised Code and this chapter may use the following titles or initials if designated to do so:

(1) Certified nurse-midwife, or A.P.R.N.-C.N.M., if the individual is authorized to practice in accordance with division (A) of section 4723.43 of the Revised Code;

(2) Clinical nurse specialist, or A.P.R.N.-C.N.S., if the individual is authorized to practice in accordance with division (D) of section 4723.43 of the Revised Code;

(3) Certified nurse practitioner, or A.P.R.N.-C.N.P., if the individual is authorized to practice under division (C) of section 4723.43 of the Revised Code;

(4) Certified registered nurse anesthetist or A.P.R.N.-C.R.N.A., if the individual is authorized to practice in accordance with division (B) of sections 4723.43, 4723.433, 4723.434, and 4723.435 of the Revised Code; or

(5) Advanced practice registered nurse or A.P.R.N. if the individual is authorized to practice under division (A) to division (D) of section 4723.43 of the Revised Code.

(B) Only a person who holds a current valid advanced practice registered nurse license issued in accordance with sections 4723.41, 4723.42 and 4723.482 of the Revised Code and this chapter to practice as a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist shall:

(1) Practice in accordance with section 4723.43, 4723.433, 4723.434, or 4723.435 of the Revised Code, as applicable, and this chapter as a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist;

(2) Hold themselves out as being a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, clinical nurse specialist, or advanced practice registered nurse;

(3) Use any title or initials implying that the person is a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, clinical nurse specialist, or advanced practice registered nurse authorized to practice in accordance with section 4723.03 of the Revised Code and paragraph (A) of this rule.

(C) At all times when an advanced practice registered nurse is providing direct care to a patient within the nurse's respective scope of practice, each certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist shall display and identify the applicable title and designation as set forth in this rule.

(D) No person who is not authorized to do so shall knowingly prescribe or personally furnish drugs or therapeutic devices without holding a current valid license to practice nursing as an advanced practice registered nurse issued under Chapter 4723. of the Revised Code and being designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner according to section 4723.42 of the Revised Code.

Last updated February 18, 2026 at 8:12 AM

History

Effective: February 1, 2021
Promulgated Under: 119.03

Ohio Adm.Code 4723-8-04 Standard care arrangement for a certified nurse-midwife, certified nurse practitioner, and clinical nurse specialist.

(A) Prior to engaging in practice, a standard care arrangement shall be entered into with each physician or podiatrist with whom the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist collaborates.

(1) The standard care arrangement shall be revised to reflect the addition or deletion of a physician or podiatrist with whom the nurse collaborates within that employment setting. Under these circumstances, a new standard care arrangement is not necessary.

(2) A new standard care arrangement shall be executed when the nurse is:

(a) Employed at a different or additional organization or practice; and

(b) Engages in practice with a collaborating physician or podiatrist outside of the primary employing organization.

(B) Except as provided in paragraph (C) of this rule, a certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist engaged in the practice of the nurse's specialty, shall enter into a written standard care arrangement with one or more collaborating physicians or podiatrists whose practice is the same or similar to the nurse's practice.

(C) In accordance with division (A)(2)(c) of section 4723.431 of the Revised Code, a clinical nurse specialist certified as a psychiatric-mental health CNS by the American nurses credentialing center or a certified nurse practitioner who is certified as a psychiatric-mental health NP by either the American nurses credentialing center or by the American association of nurse practitioners certification board, may enter into a standard care arrangement with a physician, but not a podiatrist, if the collaborating physician is practicing in one of the following specialties:

(1) Psychiatry;

(2) Pediatrics;

(3) Primary care of family practice.

(D) The standard care arrangement shall include at least:

(1) The signatures of each nurse, and each collaborating physician, or the physician's designated representative, or each podiatrist with whom the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist primarily collaborates indicating review of and agreement to abide by the terms of the standard care arrangement. For purposes of this rule, a physician's designated representative means a physician who serves as the department or unit director or chair, within the same institution, organization or facility department or unit, and within the same practice specialty, that the nurse practices, and with respect to whom the physician has executed a legal authorization to enter collaborating agreements on the physician's behalf;

(2) The date when the arrangement is initially executed;

(3) The date of the most recent review of the arrangement;

(4) The complete name, specialty and practice area, business address, and business phone number or number at which the individual can be reached at any time for:

(a) Each collaborating physician or podiatrist with whom the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist primarily collaborates and who is a party to the standard care arrangement, unless a physician's designated representative has entered the standard care arrangement on the physician's behalf; and

(b) Each certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist who is a party to the standard care arrangement;

(5) A statement of services offered by the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist consistent with section 4723.43 of the Revised Code and this chapter, including a description of the scope of prescriptive practice and authorization to enter consult agreements for patients, if applicable;

(6) A plan for incorporation of new technology or procedures consistent with the applicable scope of practice as set forth in section 4723.43 of the Revised Code and this chapter;

(7) Quality assurance provisions, including at least:

(a) When modification is made to the body of the standard care arrangement, reapproval of the standard care arrangement is required;

(b) Criteria for referral of a patient by the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist to a collaborating physician or podiatrist, including, for the certified nurse-midwife, a plan for referral of breech or face presentation or any other abnormal condition identified as such in the standard care arrangement;

(c) A process for the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist to obtain consultation from a physician or podiatrist; and

(d) A process for chart review in accordance with rule 4723-8-05 of the Administrative Code if the nurse's practice includes any direct patient care;

(8) A plan for coverage of patients in instances of emergency or planned absences of either the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist, or the collaborating physician or podiatrist;

(9) A process for resolution of disagreements regarding matters of patient management; and

(10) Regarding the prescribing component of the clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner's practice, the following quality assurance provisions shall include at least:

(a) Provisions to ensure timely direct, personal evaluation of the patient with a collaborating physician or the physician's designee when indicated;

(b) Prescribing parameters for drugs or therapeutic devices when indicated;

(d) If the nurse is prescribing to minors, as defined in division (A) of section 3719.061 of the Revised Code, provisions for complying with section 3719.061 of the Revised Code when prescribing an opioid analgesic to a minor; and

(e) Provisions for obtaining and reviewing OARRS reports, and engaging in physician consultation and patient care consistent with section 4723.487 of the Revised Code and rule 4723-9-12 of the Administrative Code.

(11) Quality assurance standards consistent with rule 4723-8-05 of the Administrative Code.

(E) The most current copy of the standard care arrangement, and any legal authorization signed by a physician according to paragraph (D)(1) of this rule, shall be retained on file by the nurse's employer. Upon request of the board, the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist shall immediately provide a copy of the standard care arrangement to the board.

(F) Copies of previously effective standard care arrangements shall be retained by the nurse for three years and provided to the board upon request.

(G) When a hospital negotiates a standard care arrangement in accordance with division (E) of section 4723.431 of the Revised Code and this chapter, the standard care arrangement shall be developed in accordance with paragraph (D) of this rule. Review and approval of the standard care arrangement shall be in accordance with the policies and procedures of the hospital governing body and the bylaws, policies, and procedures of the hospital medical staff.

(H) A certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist shall notify the board of the identity of a collaborating physician or podiatrist not later than thirty days after engaging in practice.

(I) A certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist shall notify the board of any change in the name and business address of a collaborating physician or podiatrist not later than thirty days after the change takes effect, except as provided in division (D) of section 4723.431 of the Revised Code.

Last updated March 26, 2026 at 8:28 AM

History

Effective: March 26, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4723-8-05 Quality assurance standards.

(A) An advanced practice registered nurse shall comply with all continuing education requirements for registered nurse license renewal and advanced practice registered nurse license renewal set forth in division (C) of section 4723.24 of the Revised Code and national certification requirements set forth in sections 4723.41 and 4723.42 of the Revised Code and this chapter.

(B) Each certified nurse-midwife, certified nurse practitioner, and clinical nurse specialist who is a party to a standard care arrangement shall comply with all quality assurance provisions of the standard care arrangement in accordance with this chapter. Failure to provide, enter into, or to practice in accordance with a standard care arrangement may result in disciplinary action in accordance with section 4723.28 of the Revised Code.

(C) Each practicing certified nurse-midwife, certified nurse practitioner, and clinical nurse specialist who is a party to a standard care arrangement shall participate in a quality assurance process and shall immediately provide documentation satisfactory to the board of such participation upon request of the board. The quality assurance process shall include at a minimum:

(1) Periodic random chart review which includes prescribing patterns and schedule II prescribing, if indicated, at least annually by a collaborating physician, podiatrist, or a designated member of a quality assurance committee, composed of at least one physician, of the institution, organization, or agency where the nurse has practiced;

(2) An opportunity for the advanced practice registered nurse and the collaborating physician to discuss feedback or issues subsequent to the chart review; and

(3) A process for patient evaluation of care.

(D) Documentation of participation in an ongoing, systematic quality assurance process at an institution, organization, or agency shall satisfy the requirements of paragraph (C) of this rule, provided there is a plan to utilize the results of the quality assurance process to maintain or improve care delivery.

(E) The board may audit, review or investigate, at any time, whether an advanced practice registered nurse has complied with the quality assurance standards set forth in this rule.

Last updated March 26, 2026 at 8:28 AM

History

Effective: March 26, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4723-8-06 National certifying organizations.

(A) To be approved by the board, a national certifying organization shall meet all of the requirements set forth in division (A) of section 4723.46 of the Revised Code.

(B) Annually at a time specified by the board, each national nursing certifying organization approved by the board for the prior year shall submit a "Verification Form Organizations Certifying Advanced Practice Registered Nurses: Certified Nurse Midwives (CNMs), Certified Nurse Practitioners (CNPs), Clinical Nurse Specialists (CNSs), and Certified Registered Nurse Anesthetists (CRNAs)," attesting that the organization has met and continues to meet all the requirements contained in section 4723.46 of the Revised Code. The board shall verify compliance of each national nursing certifying organization with the criteria contained in section 4723.46 of the Revised Code. No later than January thirtieth of each year, the board shall publish a list of approved national certifying organizations that meet these requirements. The board may approve additional national nursing certifying organizations or discontinue approval of a national nursing certifying organization based on criteria in section 4723.46 of the Revised Code. At the discretion of the board, it may discontinue approval of a national certifying organization for failure of the organization to return to the board the form indicating compliance with the requirements of section 4723.46 of the Revised Code.

Last updated February 18, 2026 at 8:12 AM

History

Effective: February 1, 2021
Promulgated Under: 119.03

Ohio Adm.Code 4723-8-08 Advanced practice registered nurse license renewal; notification of national recertification.

(A) To renew a current valid license to practice as an advanced practice registered nurse, a licensee shall:

(1) Submit a "Certified Registered Nurse Anesthetist Renewal Application," "Certified Nurse Midwife Renewal Application," "Certified Nurse Practitioner Renewal Application," and/or "Clinical Nurse Specialist Renewal Application," that includes:

(a) Except as provided in paragraph (A)(2) of this rule, documentation satisfactory to the board that the licensee has maintained certification in the nursing specialty with a national certifying organization as required by division (B) of section 4723.42 of the Revised Code;

(b) Documentation satisfactory to the board of completion of continuing education required by division (C)(2) of section 4723.24 of the Revised Code and rule 4723-8-10 of the Administrative Code;

(c) A list of the names and business addresses of the holder's current collaborating physicians and podiatrists, if the nurse is a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner; and

(d) The renewal fee set forth in division (A)(8) of section 4723.08 of the Revised Code. If a completed renewal application is not renewed on-line by September fifteenth of odd numbered years, in order to renew the applicant shall pay a late processing fee of fifty dollars in accordance with division (A)(10) of section 4723.08 of the Revised Code. The late processing fee is in addition to the renewal fee specified in division (A)(8) of section 4723.08 of the Revised Code, and is in addition to any late processing fee imposed with respect to renewal of the applicant's registered nurse license; and

(2) A clinical nurse specialist, originally issued a certificate of authority on or before December 31, 2000 in accordance with division (C) of section 4723.41 of the Revised Code, as that division existed prior to March 20, 2013, is not required to provide documentation of having maintained certification in the holder's specialty, but shall submit documentation satisfactory to the board of completion of continuing education in compliance with paragraph (E) of rule 4723-8-10 of the Administrative Code.

(B) A renewed advanced practice registered nurse license is subject to renewal in odd-numbered years. When an advanced practice registered nurse license is first issued by the board on or after July first of an odd numbered year, that license shall be current through the thirty-first of October of the next odd-numbered year.

(C) The board shall provide access to an on-line application to each holder of a current valid advanced practice registered nurse license for renewal of the license, except when the board is aware that an individual is ineligible for renewal for any reason, including those reasons specified in section 4723.24 of the Revised Code.

(D) Within thirty days of recertification by the applicable national certifying organization, an advanced practice registered nurse shall request that the national certifying organization provide, directly to the board, satisfactory documentation of recertification to the board. This requirement does not apply to a clinical nurse specialist, originally issued a certificate of authority on or before December 31, 2000 in accordance with division (C) of section 4723.41 of the Revised Code, as that division existed prior to March 20, 2013.

(E) An advanced practice registered nurse who fails to maintain certification or recertification by the applicable national certifying organization approved by the Board according to section 4723.46 of the Revised Code, may be subject to disciplinary action in accordance with section 4723.28 of the Revised Code. This requirement does not apply to a clinical nurse specialist, originally issued a certificate of authority on or before December 31, 2000 in accordance with division (C) of section 4723.41 of the Revised Code, as that division existed prior to March 20, 2013.

(F) A clinical nurse specialist, originally issued a certificate of authority on or before December 31, 2000 in accordance with division (C) of section 4723.41 of the Revised Code, as that division existed prior to March 20, 2013, who fails to complete the continuing nursing education required by division (B) of section 4723.42 of the Revised Code and rule 4723-8-10 of the Administrative Code, may be subject to disciplinary action in accordance with section 4723.28 of the Revised Code.

(G) A holder of a current valid advanced practice registered nurse license who does not intend to practice as a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist in Ohio may request that the license be placed on inactive status at any time, by submitting a written statement to the board or electronic request asking that the certificate be placed on inactive status.

(H) While on inactive status a nurse shall not represent or imply to the public that the nurse is authorized to practice as a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist or use the titles or designations established by section 4723.03 of the Revised Code and rule 4723-8-03 of the Administrative Code.

(I) An inactive or lapsed advanced practice registered nurse license may be reactivated or reinstated by:

(1) Submitting an "Advanced Practice Registered Nurse Reactivation and Reinstatement Application"; and

(2) Payment of the applicable fees set forth in section 4723.08 of the Revised Code.

(J) An advanced practice registered nurse who is a service member or veteran, as defined in rule 4723-2-01 of the Administrative Code, or who is the spouse or surviving spouse of a service member or veteran, may be eligible for a waiver of the late application fee and the reinstatement fee according to rule 4723-2-03 of the Administrative Code.

Last updated February 18, 2026 at 8:12 AM

History

Effective: February 1, 2021
Promulgated Under: 119.03

Ohio Adm.Code 4723-8-09 Advanced practice registered nurse license for a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist practicing in another jurisdiction.

A certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist who is practicing in another jurisdiction may apply for an advanced practice registered nurse license to practice in Ohio if the nurse meets the requirements for licensure set forth in section 4723.41 of the Revised Code and this chapter. An applicant from another jurisdiction shall:

(A) Submit a completed "Advanced Practice Registered Nurse License Application,"; and

(B) Submit the applicable fee.

Last updated February 18, 2026 at 8:13 AM

History

Effective: January 1, 2018
Promulgated Under: 119.03

Ohio Adm.Code 4723-8-10 Continuing education requirements.

(A) Each advanced practice registered nurse who obtains continuing nursing education in the nurse's area of practice for the purpose of obtaining or maintaining a national certification may use those continuing education hours to satisfy the continuing education requirements for renewal of a license to practice as a registered nurse and advanced practice registered nurse set forth in this rule, section 4723.24 of the Revised Code and Chapter 4723-14 of the Administrative Code, if the continuing education meets the requirements of Chapter 4723-14 of the Administrative Code.

(B) An advanced practice registered nurse who holds an active license shall complete continuing nursing education as follows in order to renew the license:

(1) Twenty-four contact hours of continuing nursing education;

(2) For advanced practice registered nurses designated as a clinical nurse specialist, certified nurse-midwife or certified nurse practitioner, at least twelve hours of the education must be in advanced pharmacology and must have been provided by an accredited institution recognized by the board, including any provider referenced in paragraph (E) of rule 4723-9-01 of the Administrative Code;

(3) For the first period of renewal immediately following the initial issuance of the advanced practice registered nurse license by the board, a licensee is not required to complete any contact hours of continuing education;

(4) For purposes of fulfilling the twenty-four hours of continuing education required for renewal, an advanced practice registered nurse may satisfy up to eight hours by providing health care services as a volunteer if the following requirements are met:

(a) The licensee provides the health care services to an indigent and uninsured person as defined in section 2305.234 of the Revised Code;

(b) The health care provided is advanced practice registered nursing, as defined in division (P) of section 4723.01 of the Revised Code and is within the designated specialty scope of practice of the advanced practice registered nurse providing the services as set forth in section 4723.43 of the Revised Code;

(c) The health care services provided are provided as a volunteer, as that term is defined in section 2305.234 of the Revised Code;

(d) The licensee satisfies the requirements of section 2305.234 of the Revised Code to qualify for the immunity from liability granted under that section;

(e) One hour of continuing education may be awarded for each sixty minutes documented as spent providing health care services as a volunteer;

(f) The advanced practice registered nurse obtains, and maintains for a period of six years following the date the health care services are provided, a signed statement from a person at the health care facility or location where the health care services were performed indicating:

(i) The date and time period the licensee performed the health care services;

(ii) That the recipient of the health care services was indigent and uninsured as defined in section 2305.234 of the Revised Code; and

(iii) That the licensee provided the health care services as a volunteer as defined in section 2305.234 of the Revised Code.

(C) An advanced practice registered nurse who earns more than the number of hours required by this rule during a single renewal period cannot apply the extra hours to meet future renewal period continuing education requirements.

(D) The waiver option discussed in rule 4723-14-03 of the Administrative Code, for purposes of registered nurse or licensed practical nurse continuing nursing education, does not apply to the advanced practice registered nurse continuing education requirements set forth in this rule.

(E) A clinical nurse specialist, originally issued a certificate of authority on or before December 31, 2000 in accordance with division (C) of section 4723.41 of the Revised Code, as that division existed prior to March 20, 2013, who is not certified by a national nursing certifying organization approved by the board shall obtain twelve contact hours of continuing nursing education in addition to the twenty-four hours required every two years for renewal of a license to practice nursing as a registered nurse and the twenty-four hours required for renewal of a license to practice as an advanced practice registered nurse. For the purposes of complying with this rule:

(1) The additional hours shall be in programs that are targeted to advanced practice registered nurses in the nurse's area of practice or in relevant programs from other health care disciplines;

(2) The continuing education activity must meet the requirements of Chapter 4723-14 of the Administrative Code; and

(3) The clinical nurse specialist cannot use the waiver option contained in rule 4723-14-03 of the Administrative Code for the additional twelve contact hours of continuing nursing education required by this paragraph.

Last updated February 18, 2026 at 8:15 AM

History

Effective: January 1, 2018
Promulgated Under: 119.03

Ohio Adm.Code 4723-8-11 Youth concussion assessment and clearance.

(A) For purposes of this rule:

(1) "Interscholastic athletics" means an athletic activity, that is an interscholastic extracurricular activity as defined in section 3313.535 of the Revised Code, that a school or school district sponsors or participates in and that includes participants from more than one school or school district.

(2) "Youth" means an individual between the ages of four and nineteen who participated in youth sports organization or interscholastic athletics and was removed from practice or competition under division (D) of section 3707.511 of the Revised Code or division (D) of section 3313.539 of the Revised Code, based on exhibiting signs, symptoms or behaviors consistent with having sustained a concussion or head injury while participating in practice or competition.

(3) "Youth sports organization" has the same meaning as in section 3707.51 of the Revised Code and means a public or nonpublic entity that organizes an athletic activity in which the athletes are not more than nineteen years of age and are required to pay a fee to participate in the athletic activity or whose cost to participate is sponsored by a business or nonprofit organization.

(4) "Consensus Statement" means the "Consensus Statement on Concussion in Sport - the 6th International Conference on Concussion in Sport held in Amsterdam, October 2022."

(B) An advanced practice registered nurse clinical nurse specialist or certified nurse practitioner may assess and clear a youth to return to practice or competition if all of the following requirements are met:

(1) The advanced practice registered nurse's practice must include care and treatment of patients aged four through nineteen years of age and the nurse must collaborate with a physician whose practice includes this age group;

(2) The advanced practice registered nurse has completed education and training in the detection of concussion, its clinical features, assessment techniques, and the principles of safe return to play protocols consistent with the "Consensus Statement";

(3) The advanced practice registered nurse has maintained competency and completed continuing education in the detection of concussion, its clinical features, assessment techniques, and the principles of safe return to play protocols consistent with the "Consensus Statement"; and

(4) The nurse uses the medical clearance return to play after suspected concussion form located at: https://nursing.ohio.gov/.

Last updated March 26, 2026 at 8:28 AM

History

Effective: March 26, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4723-8-12 Consult agreements for a certified nurse-midwife, certified nurse practitioner, and clinical nurse specialist.

(A) For purposes of this rule and rule 4723-8-13 of the Administrative Code, practitioner means an advanced practice registered nurse licensed under Chapter 4723. of the Revised Code and practicing in Ohio as a certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist.

(B) Requirements of a consult agreement

(1) A consult agreement shall include all of the following:

(a) Identification of the practitioner(s) and pharmacist(s) authorized to enter the agreement. They may include:

(i) Individual names of the practitioner(s) and pharmacists;

(ii) Practitioner or pharmacist practice groups;

(iii) Identification based on institutional credentialing or privileging; or

(iv) If multiple practitioners are entering the consult agreement, identification of the primary practitioner for the patient.

(b) A description of the patient's consent to drug therapy management pursuant to the consult agreement in compliance with paragraph (E) of rule 4729:1-06-01 of the Administrative Code.

(c) The specific diagnoses and diseases being managed under the agreement, including whether each disease is primary or comorbid.

(d) A description of the drugs or drug categories managed as part of the agreement.

(e) A description of the procedures, decision criteria, and plan the managing pharmacist is to follow in acting under a consult agreement. Such a description should provide a reasonable set of parameters for the activities a managing pharmacist is allowed to perform under a consult agreement.

(f) A description of the types of tests permitted pursuant to section 4729.39 of the Revised Code that may be ordered and evaluated by the managing pharmacist as long as the tests relate directly to the management of drug therapy. This may include specific tests or categories of testing that may be ordered and evaluated.

(g) A description of how the managing pharmacist shall maintain a record of each action taken for each patient whose drug therapy is managed under the agreement. All prescribing, administering, and dispensing of drugs shall be documented using positive identification pursuant to paragraph (N) of rule 4729-5-01 of the Administrative Code.

(h) A description of how communication between a managing pharmacist and practitioner acting under a consult agreement shall take place at regular intervals specified by the practitioner who authorized the agreement. The agreement may include a requirement that the managing pharmacist send a consult report to each consulting practitioner.

(i) A provision that allows a practitioner to override a decision made by the managing pharmacist when appropriate.

(j) An appropriate quality assurance mechanism to ensure that managing pharmacists only act within the scope authorized by the consult agreement.

(k) A description of a continuous quality improvement (CQI) program used to evaluate effectiveness of patient care and ensure positive patient outcomes. The CQI program shall be implemented pursuant to the agreement.

(l) The training and experience criteria for managing pharmacists. The criteria may include privileging or credentialing, board certification, continuing education or any other training requirements. The agreement shall include a process to verify that the managing pharmacists meet the specified criteria.

(m) A statement that the practitioner(s) and pharmacists shall meet minimal standards of care at all times.

(n) An effective date and expiration date.

(o) Any other requirements contained in rules 4729:1-6-01, 4729:1-6-02 and 4729:1-6-03 of the Administrative Code.

(2) Institutional or ambulatory outpatient facilities may implement a consult agreement and meet the requirements of paragraphs (A)(1)(c) to (A)(1)(f) of this rule through institutional credentialing standards or policies. Such standards or policies shall be referenced as part of the consult agreement and available to an agent of the board upon request.

(3) The consult agreement shall be signed by the primary practitioner and one of the following:

(a) The terminal distributor's responsible person, which may include the responsible person's designee if the designee meets the qualifications of the responsible person pursuant to Chapter 4729. of the Revised Code; or

(b) A managing pharmacist licensed pursuant to Chapter 4729. of the Revised Code.

(4) All amendments to a consult agreement shall be signed and dated by the primary practitioner and one of the following:

(b) A managing pharmacist licensed pursuant to Chapter 4729. of the Revised Code.

(c) Amendments to the consult agreement are required when the scope of the managing pharmacist's permitted procedures expands past what was contemplated in the original agreement.

(5) A consult agreement shall be valid for a period not to exceed two years.

(6) A practitioner may enter a consult agreement with an Ohio licensed pharmacist if the physician or podiatrist with whom the practitioner collaborates, with respect to patient(s) that are the proposed subjects of consult agreements, has authorized in the standard care agreement that the practitioner may enter consult agreements for those patient(s).

(C) Recordkeeping. The primary practitioner, practitioner group or institution as defined in agency 4729 of the Administrative Code shall maintain a copy of the original consult agreement, all amendments made to the agreement, and a record of actions made in consultation with the managing pharmacist regarding each patient's drug therapy. The records shall be maintained in such a manner that they are readily retrievable for at least three years from the date of the last action taken under the agreement. Consult agreements shall be considered confidential patient records.

(D) Managing drug therapy.

(1) For purposes of implementing the management of a patient's drug therapy by an authorized managing pharmacist acting pursuant to a consult agreement, the primary practitioner must:

(a) Provide the managing pharmacist with access to the patient's medical record;

(b) Establish the managing pharmacist's prescriptive authority as one or both of the following:

(i) A prescriber authorized to issue a drug order in writing, orally, by a manually signed drug order sent via facsimile or by an electronic prescribing system for drugs or combinations or mixtures of drugs to be used by a particular patient as authorized by the consult agreement. For all prescriptions issued by a pharmacist pursuant to this paragraph, the pharmacist shall comply with rules 4729-5-30 and 4729-5-13 of the Administrative Code; and or

(ii) With respect to non-controlled dangerous drugs only, an agent of the consulting practitioner(s). As an agent of the consulting practitioner(s), a pharmacist is authorized to issue a drug order, on behalf of the consulting practitioner(s), in writing, orally, by a manually signed drug order sent via facsimile or by an electronic prescribing system for drugs or combinations or mixtures of drugs to be used by a particular patient as authorized by the consult agreement;

(i) Change the duration of treatment for the current drug therapy; adjust a drug's strength, dose, dosage form, frequency of administration, route of administration, discontinue a drug, or to prescribe new drugs; and or

(ii) Order tests related to the drug therapy being managed and to evaluate those results; and

(d) Identify the extent to which, and to whom, the managing pharmacist may delegate drug therapy management to other authorized pharmacists under the agreement.

(E) Review of consult agreements. Upon the request of the board, the practitioner shall immediately provide a copy of the consult agreement, amendments, and any related policies or documentation pursuant to this rule and section 4729.39 of the Revised Code. The board may prohibit the execution of a consult agreement, or subsequently void a consult agreement, if the board finds any of the following:

(1) The agreement does not meet the requirements set forth in section 4729.39 of the Revised Code or Chapter 4723. of the Administrative Code; or

(2) The consult agreement, if executed, would present a danger to patient safety.

Last updated February 18, 2026 at 8:16 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-8-13 Standards for managing drug therapy according to a consult agreement.

(A) A practitioner may elect to manage the drug therapy of an established patient by entering into a consult agreement with a pharmacist. The agreement is subject to but not limited by the following standards:

(1) The primary practitioner must ensure that the managing pharmacist has access to the patient's medical record, the medical record is accurate, and that while transferring the medical record, the primary practitioner ensures the confidentiality of the medical record.

(2) The practitioner must have an ongoing practitioner-patient relationship with the patient whose drug therapy is being managed, including an initial assessment and diagnosis by the practitioner prior to the commencement of the consult agreement.

(3) With the exception of inpatient management of patient care at an institutional facility as defined in agency 4729 of the Administrative Code, the practitioner, prior to a pharmacist managing the patient's drug therapy, shall communicate the content of the proposed consult agreement to each patient whose drug therapy is managed under the agreement, in such a manner that the patient or the patient's representative understands the scope and role of the managing pharmacist, which includes the following:

(a) That a pharmacist may be utilized in the management of the patient's care;

(b) That the patient or an individual authorized to act on behalf of a patient has the right to elect to participate in and to withdraw from the consult agreement; and

(4) The diagnosis by the practitioner must be within the practitioner's scope of practice.

(5) The practitioner shall meet the minimal and prevailing standards of care.

(6) The practitioner must ensure that the pharmacist managing the patient's drug therapy has the requisite training and experience related to the particular diagnosis for which the drug therapy is prescribed. Practitioners practicing at institutional or ambulatory outpatient facilities may meet this requirement through institutional credentialing standards or policies.

(7) The practitioner shall review the records of all services provided to the patient under the consult agreement.

(B) Quality assurance mechanisms. The following quality assurance mechanisms shall be implemented to verify information contained within the consult agreement, and ensure the managing pharmacist's actions are authorized and meet the standards listed in paragraphs (A) and (B) of this rule:

(1) Verification of ongoing practitioner-patient relationship. A practitioner-patient relationship can be established by detailing criteria set forth in paragraph (A)(2) of this rule within the consult agreement.

(2) Verification that practitioner diagnosis is within the practitioner's scope of practice. Establishing that a diagnosis is within the practitioner scope of practice may be established by detailing the criteria set forth in paragraph (A)(4) of this rule within the consult agreement.

(3) Verification that the pharmacist's training and experience is related to the drug therapy. Establishing that a pharmacist's requisite training and experience with a particular drug therapy is related to the diagnosis for which the drug therapy is prescribed may be established by detailing the criteria set forth in paragraph (A)(6) of this rule within the consult agreement.

(C) Continuous quality improvement program. The following should be included in the development of a continuous quality improvement program in order to evaluate the effectiveness of patient care and ensure positive patient outcome:

(1) Notifications to the primary practitioner. The managing pharmacist must notify the primary practitioner of the following situations regarding any pharmacist authorized to manage drug therapy under the agreement:

(a) A pharmacist has had their pharmacist license revoked, suspended, or denied by the state board of pharmacy;

(b) If prescribing controlled substances, a pharmacist has failed to renew their controlled substance prescriber registration;

(D) Overriding decisions of managing pharmacist. Any authorized practitioner identified under the consult agreement may override any decision, change, modification, evaluation or other action by any pharmacist acting pursuant to the consult agreement or under the direction of the managing pharmacist, that was made with respect to the management of the patient's drug therapy under the consult agreement.

Last updated March 26, 2026 at 8:28 AM

History

Effective: March 26, 2026
Promulgated Under: 119.03

Chapter 4723-9 Prescriptive Authority

Ohio Adm.Code 4723-9-01 Definitions.

For purposes of this chapter the following definitions shall apply:

(A) "Collaboration or collaborating" means in the case of an advanced practice registered nurse designated as a certified nurse practitioner, a clinical nurse specialist or a certified nurse-midwife, that a physician has entered into a standard care arrangement with the nurse and is continuously available to communicate with the nurse either in person, or by electronic communication.

(B) "Controlled substance" means a drug, compound, mixture, preparation, or substance included in schedule I, II, III, IV, or V pursuant to the provisions of Chapter 3719. of the Revised Code.

(C) "Contact hour" means a minimum of sixty minutes of continuing education. For credit hours earned on an academic quarter system, one credit hour is equivalent to ten contact hours. For credit hours earned on an academic trimester system, one credit hour is equivalent to twelve contact hours. For credit hours earned on an academic semester system, one credit hour is equivalent to fifteen contact hours.

(D) "Course of study" means an advanced level instructional program in pharmacology required by section 4723.482 of the Revised Code for advanced practice registered nursing licensure, that is either:

(1) Offered by an accredited educational institution acceptable to the board. Accredited educational institutions acceptable to the board include programs that are required to obtain approval, authorization, or accreditation from one of the following:

(a) The chancellor of higher education under section 3333.07 of the Revised Code;

(b) The Ohio department of education under section 3313.90 of the Revised Code;

(d) The higher learning commission of the north central association of colleges and schools;

(e) The accrediting council for independent colleges and schools; or

(f) Any other national or regional post-secondary education accreditation entity recognized by the board; or

(2) A continuing education course that meets the requirements of Chapter 4723-14 of the Administrative Code.

(E) "Dangerous drug" has the same meaning as in section 4729.01 of the Revised Code.

(F) "Jurisdiction" means any state, territory, or political subdivision of the United States in which a board or legal approving authority regulates nurse licensure and nursing practice and maintains membership in the national council of state boards of nursing.

(G) "Physician" means an individual who holds a current valid license to practice medicine and surgery, osteopathic medicine and surgery, or podiatric medicine and surgery issued by the Ohio state medical board, or, in the case of applicants who hold a current valid certificate of authority to prescribe drugs and therapeutic devices from another jurisdiction, or who have been employed by the United States government and authorized to prescribe in conjunction with that employment, the physician's license may be issued by another jurisdiction as defined in this chapter.

(H) "Sample drug" has the same meaning as in section 2925.01 of the Revised Code.

(I) "Types of drugs" means therapeutic drug class.

Last updated February 18, 2026 at 8:16 AM

History

Effective: February 1, 2021
Promulgated Under: 119.03

Ohio Adm.Code 4723-9-02 Requirements for a course of study in advanced pharmacology.

(A) To be acceptable to the board, a course of study shall meet the following requirements:

(1) Be a minimum of forty-five contact hours in length and include content which ensures sufficient preparation for the safe and effective prescribing of drugs and therapeutic devices;

(2) Include content which is specific to the participant's nursing specialty and which includes all of the following:

(a) A minimum of thirty-six hours of training, obtained from a single provider, in:

(i) Pharmacokinetic principles and clinical application; and

(ii) Principles of the use of drugs and therapeutic devices in the prevention of illness and maintenance of health;

(b) The fiscal and ethical implications of prescribing drugs and therapeutic devices;

(d) Instruction that is specific to schedule II controlled substances, including instruction in all of the following:

(i) Indications and contraindications for the use of schedule II controlled substances in drug therapies, including risk, evaluation and mitigation strategies for the use of opiates in the management of acute, sub-acute and chronic pain, as those terms are defined in rule 4723-9-10 of the Administrative Code, for non-terminal conditions, and the need for periodic assessment and documentation of the patient's functional status;

(ii) The most recent guidelines and recommendations for pain management therapies and education, as established by state and national organizations such as the Ohio pain initiative, the American pain society, the governor's recoveryOhio initiative, and the United States food and drug administration (FDA), and the centers for disease control (CDC);

(iii) The most recent guidelines and recommendations for stimulant therapies utilized in the management of attention-deficit or hyperactivity disorder, as adopted by state and national organizations;

(iv) Fiscal and ethical implications of prescribing schedule II controlled substances;

(v) State and federal laws that apply to the authority to prescribe schedule II controlled substances, including state medical board of Ohio rules governing controlled substances and the treatment of chronic pain, and Ohio state board of pharmacy rules governing the manner of issuance of a prescription, and rules set forth in Chapters 4723-1 to 4723-27 of the Administrative Code;

(vi) Prevention of abuse and diversion of schedule II controlled substances, including identification of the risk of abuse, addiction and diversion, recognition of abuse, addiction and diversion, types of assistance available for prevention of abuse, addiction and diversion, the use of the Ohio automated rx reporting system (OARRS), including standards and procedures for OARRS access and review established in section 4729.75 of the Revised Code and rule 4723-9-12 of the Administrative Code, and other methods of establishing safeguards against abuse and diversion; and

(e) Instruction specific to schedule II controlled substances as set forth in paragraph (A)(2)(d) of this rule may be integrated with areas of instruction required by paragraphs (A)(2)(a), (A)(2)(b) and (A)(2)(c) of this rule.

(3) Include a process for interaction of the participants with instructional personnel;

(4) Include a process for evaluating the participants' learning of the content required by this rule; and

(5) May be provided online, but must be faculty-directed or independent study and, as defined in rule 4723-14-01 of the Administrative Code, is offered by either an accredited educational institution acceptable to the board or a continuing education course that meets the requirements of Chapter 4723-14 of the Administrative Code.

Last updated March 26, 2026 at 8:29 AM

History

Effective: March 26, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4723-9-03 Completing a course of study in advanced pharmacology.

Applicants seeking an advanced practice registered nurse license, with designation as a clinical nurse specialist, certified nurse practitioner, or certified nurse-midwife, who do not meet the requirements set forth in division (C) of section 4723.482 of the Revised Code, shall complete, within the five years immediately preceding the application, a course of study, as defined in rule 4723-9-01 of the Administrative Code, that meets the requirements of rule 4723-9-02 of the Administrative Code.

Last updated February 18, 2026 at 8:16 AM

History

Effective: January 1, 2018
Promulgated Under: 119.03

Ohio Adm.Code 4723-9-08 Safety standards for personally furnishing drugs and therapeutic devices.

(A) An advanced practice registered nurse with a current valid license issued by the board and designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner may personally furnish to a patient a drug or therapeutic device, whether as a sample drug or a complete or partial supply, only if the following requirements are met:

(1) The drug or therapeutic device is not excluded by the formulary set forth in rule 4723-9-10 of the Administrative Code;

(2) If the drug furnished is a controlled substance, the requirements of section 4729.291 of the Revised Code are met, including limiting the amount of the controlled substance to a seventy-two hour supply, and, in any thirty-day period, not personally furnishing to or for patients, taken as a whole, an amount that exceeds two thousand five hundred dosage units;

(3) If the drug furnished is a dangerous drug, other than a sample drug, the nurse affixes labeling to the container as specified in rule 4729:5-19-02 of the Administrative Code;

(4) The nurse complies with rule 4723-9-12 of the Administrative Code regarding standards and procedures for review of OARRS reports;

(5) The nurse maintains a written record of all drugs and therapeutic devices personally furnished by the nurse as required by rule 4729:5-19-04 of the Administrative Code; and

(6) The nurse maintains current knowledge of and complies with all applicable state and federal laws or rules related to personally furnishing drugs and therapeutic devices.

(B) An advanced practice registered nurse with a current valid license issued by the board and designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner may personally furnish to a patient a sample drug only if, in addition to the requirements set forth in paragraph (A) of this rule, the following requirements are met:

(1) The sample drug is furnished in compliance with section 3719.81 of the Revised Code, including but not but limited to the requirement that the sample be provided free of charge; and

(2) If the sample is a dangerous drug, the requirements of rule 4729:5-19-02 of the Administrative Code are met.

(C) Notwithstanding the requirements of this rule, an advanced practice registered nurse with a current valid license issued by the board and designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner may personally furnish a supply of an overdose reversal drug according to section 3715.501 of the Revised Code.

(D) Notwithstanding the requirements of this rule, an advanced practice registered nurse with a current valid license issued by the board and designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner may personally furnish a complete or partial supply of a drug to treat chlamydia, gonorrhea, or trichomoniasis as specified in section 4723.4810 of the Revised Code.

Last updated September 15, 2025 at 7:36 AM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-9-10 Formulary; standards of prescribing for advanced practice registered nurses designated as clinical nurse specialists, certified nurse-midwives, or certified nurse practitioners.

(A) Definitions; for purposes of this rule and interpretation of the formulary set forth in paragraph (B) of this rule, except as otherwise provided:

(1) "Acute pain" means pain that normally fades with healing, is related to tissue damage, significantly alters a patient's typical function, and is expected to be time-limited and not more than six weeks in duration.

(2) "Chronic pain" means pain that has persisted after reasonable medical efforts have been made to relieve it and continues either episodically or continuously for twelve or more weeks following initial onset of pain. It may be the result of an underlying medical disease or condition, injury, medical treatment, inflammation, or unknown cause. "Chronic pain" does not include pain associated with a terminal condition or with a progressive disease that, in the normal course of progression, may reasonably be expected to result in a terminal condition.

(3) "Extended-release or long-acting opioid analgesic" means an opioid analgesic that:

(a) Has United States food and drug administration approved labeling indicating that it is an extended-release or controlled release formulation;

(b) Is administered via a transdermal route; or

(4) "Family member" means a spouse, parent, child, sibling or other individual with respect to whom an advanced practice registered nurse's personal or emotional involvement may render the advanced practice registered nurse unable to exercise detached professional judgment in reaching diagnostic or therapeutic decisions.

(5) "Hospice care program" has the same meaning as in section 3712.01 of the Revised Code.

(6) "ICD-10-CM medical diagnosis code" means the disease code in the most current international classification of diseases, clinical modifications published by the United States department of health and human services.

(7) "Opioid analgesic" has the same meaning as in section 3719.01 of the Revised Code, and means a controlled substance that has analgesic pharmacological activity at the opioid receptors of the central nervous system, including but not limited to the following drugs and their varying salt forms or chemical congeners: buprenorphine, butorphanol, codeine (including acetaminophen and other combination products), dihydrocodeine, fentanyl, hydrocodone (including acetaminophen combination products), hydromorphone, meperidine, methadone, morphine sulfate, oxycodone (including acetaminophen, aspirin, and other combination products), oxymorphone, tapentadol, and tramadol.

(8) "Medication therapy management" has the same meaning as in rules adopted by agency 4729 of the Administrative Code.

(9) "Minor" has the same meaning as in section 3719.061 of the Revised Code.

(10) "Morphine equivalent daily dose (MED)" means a conversion of various opioid analgesics to a morphine equivalent dose by the use of accepted conversion tables provided by the state board of pharmacy at: https://www.ohiopmp.gov/MED_Calculator.aspx (effective 2017).

(11) "Palliative care" has the same meaning as in section 3712.01 of the Revised Code.

(12) "Sub-acute pain" means pain that has persisted after reasonable medical efforts have been made to relieve it and continues either episodically or continuously for more than six weeks but less than twelve weeks following initial onset of pain. It may be the result of an underlying medical disease or condition, injury, medical or surgical treatment, inflammation, or unknown cause.

(13) "Terminal condition" has the same meaning as in section 2133.01 of the Revised Code.

(B) Exclusionary formulary. An advanced practice registered nurse with a current valid license issued by the board and designated as a certified nurse practitioner, clinical nurse specialist or certified nurse midwife shall not prescribe or furnish any drug or device in violation of federal or Ohio law, or rules adopted by the board, including this rule. The prescriptive authority of an advanced practice registered nurse designated as a certified nurse practitioner, clinical nurse specialist and certified nurse midwife shall not exceed the prescriptive authority of the collaborating physician or podiatrist.

(C) An advanced practice registered nurse with a current valid license issued by the board and designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner may prescribe any drug or therapeutic device in any form or route of administration if:

(1) The ability to prescribe the drug or therapeutic device is within the scope of practice in the advanced practice registered nurse's license designation;

(2) The prescription is consistent with the terms of a standard care arrangement entered into with a collaborating physician;

(3) The prescription would not exceed the prescriptive authority of the collaborating physician, including restrictions imposed on the physician's practice by action of the United States drug enforcement administration or the state medical board, or by the state medical board rules, including but not limited to rule 4731-11-09 of the Administrative Code;

(4) The individual drug or subtype or therapeutic device is not one excluded by the exclusionary formulary set forth in paragraph (B ) of this rule;

(5) The prescription meets the requirements of state and federal law, including but not limited to this rule, and all prescription issuance rules adopted by agency 4729 of the Administrative Code;

(6) A valid prescriber-patient relationship exists. This relationship may include, but is not limited to:

(a) Obtaining a relevant history of the patient;

(b) Conducting a physical or mental examination of the patient;

(d) Prescribing medication;

(e) Consulting with the collaborating physician when necessary; and

(f) Documenting these steps in the patient's medical records;

(7) Notwithstanding paragraph (C)(6) of this rule, a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner may prescribe or personally furnish a drug according to section 4723.4810 of the Revised Code to not more than a total of two individuals who are sexual partners of the advanced practice registered nurse's patient.

(8) If the patient is a family member, acceptable and prevailing standards of safe nursing care require that the advanced practice registered nurse maintain detached professional judgment. The advanced practice registered nurse shall not prescribe to a family member unless:

(a) The advanced practice registered nurse is able to exercise detached professional judgment in reaching diagnostic or therapeutic decisions;

(b) The prescription is documented in the patient's record.

(9) Controlled substances. For drugs that are a controlled substance:

(a) The advanced practice registered nurse has obtained a United States drug enforcement administration registration, except if not required to do so as provided in rules adopted by agency 4729 of the Administrative Code, and indicates the number on the prescription;

(b) The prescription indicates the ICD-10-CM medical diagnosis code of the primary disease or condition that the controlled substance is being used to treat. The code shall, at minimum, include the first four alphanumeric characters of the ICD-10 CM medical diagnosis code, sometimes referred to as the category and etiology (ex. M165);

(d) The patient is not a family member; and

(e) The advanced practice registered nurse shall not self-prescribe a controlled substance.

(D) Schedule II controlled substances. An advanced practice registered nurse with a current valid license issued by the board and designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner may prescribe a schedule II controlled substance only in accordance with section 4723.481 of the Revised Code.

(E) Acute pain. For the treatment of acute pain, an advanced practice registered nurse with a current valid license issued by the board and designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner shall comply with the following:

(1) Extended-release or long-acting opioid analgesics shall not be prescribed for the treatment of acute pain;

(2) Before prescribing an opioid analgesic, the advanced practice registered nurse shall first consider non-opioid treatment options. If opioid analgesic medications are required as determined by history and physical examination, the prescription should be for the minimum quantity and potency needed to treat the expected duration of pain, with a presumption that a three-day supply or less is frequently sufficient;

(3) In all circumstances where opioid analgesics are prescribed for acute pain:

(a) Except as provided in paragraph (E)(3)(a)(iii) of this rule, the duration of the first opioid analgesic prescription for the treatment of an episode of acute pain shall be:

(i) For adults, not more than a seven-day supply with no refills;

(ii) For minors, not more than a five-day supply with no refills. As set forth in section 4723.481 of the Revised Code, the advanced practice registered nurse shall comply with section 3719.061 of the Revised Code, including but not limited to obtaining the parent or guardian's written consent prior to prescribing an opioid analgesic to a minor;

(iii) The seven-day limit for adults and five-day limit for minors may be exceeded for pain that is expected to persist for longer than seven days based on the pathology causing the pain. In this circumstance, the reason that the limits are being exceeded and the reason that a non-opioid analgesic medication was not appropriate to treat the patient's condition shall be documented in the patient's medical record; and

(iv) If a patient is intolerant of or allergic to an opioid medication initially prescribed, a prescription for a different opioid medication may be issued at any time during the initial seven-day or five-day dosing period, and the new prescription shall be subject to the requirements of this rule. The patient's intolerance or allergy shall be documented in the patient's medical record, and the patient advised to safely dispose of the unused medication;

(b) The patient, or a minor's parent or guardian, shall be advised of the benefits and risks of the opioid analgesic, including the potential for addiction, and the advice shall be documented in the patient's medical record; and

(c) The total morphine equivalent dose (MED) of a prescription for opioid analgesics for treatment of acute pain shall not exceed an average of thirty MED per day, except when:

(i) The circumstances set forth in paragraph (A)(3)(c) of rule 4731-11-13 of the Administrative Code exist; and

(ii) The patient's treating physician has entered a standard care arrangement with the advanced practice registered nurse that states the understanding of the physician as to when the advanced practice registered nurse may exceed the thirty MED average, and when the advanced practice registered nurse must consult with the physician prior to exceeding the thirty MED average. The standard care arrangement in this circumstance must comply with rule 4731-11-13 of the Administrative Code, and the advanced practice registered nurse must document in the patient's record the reason for exceeding the thirty MED average and the reason it is the lowest dose consistent with the patient's medical condition.

(F) The requirements of paragraph (E) of this rule apply to treatment of acute pain, and do not apply when an opioid analgesic is prescribed:

(1) To a patient in a hospice care;

(2) To a patient who is receiving palliative care;

(3) To a patient who has been diagnosed with a terminal condition, as defined as follows:

(a) An irreversible, incurable, and untreatable condition caused by disease, illness, or injury from which, to a reasonable degree of medical certainty as determined in accordance with reasonable medical standards by a physician who has examined the patient, both of the following apply:

(i) There can be no recovery; and

(ii) Death is likely to occur within a relatively short time if life-sustaining treatment is not administered; or

(4) To a patient who has cancer or a condition associated with the individual's cancer or history of cancer.

(G) The requirements of paragraph (E) of this rule do not apply to:

(1) Prescriptions for opioid analgesics for the treatment of opioid addiction utilizing a controlled substance that is approved by the FDA for opioid detoxification or maintenance treatment; or

(2) Inpatient prescriptions as defined in rules adopted by agency 4729 of the Administrative Code.

(H) Sub-acute and chronic pain. As specified in section 4723.481 of the Revised Code, for treatment of sub-acute and chronic pain, an advanced practice registered nurse with a current valid license issued by the board and designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner shall prescribe in a manner not exceeding the prescriptive authority of the collaborating physician or podiatrist. Prescribing parameters specifically include, but are not limited to, the following requirements set forth in rule 4731-11-14 of the Administrative Code:

(1) Prior to treating, or continuing to treat sub-acute or chronic pain with an opioid analgesic, the advanced practice registered nurse shall first consider and document non-medication options. If opioid analgesic medications are required as determined by a history and physical examination, the advanced practice registered nurse shall prescribe the minimum quantity and potency needed to treat the expected duration of pain and improve the patient's ability to function;

(2) Before prescribing an opioid analgesic for sub-acute or chronic pain, the advanced practice registered nurse shall complete or update and document in the patient record assessment activities to assure the appropriateness and safety of the medication, as required by rule 4731-11-14 of the Administrative Code, including but not limited to:

(a) Completing an OARRS check in compliance with rule 4723-9-12 of the Administrative Code;

(b) Offering the patient a prescription for an overdose reversal drug if the following circumstances exist:

(i) The patient has a prior history of opioid overdose;

(ii) The patient is co-prescribed a benzodiazepine, sedative hypnotic drug, carisprodal, tramadol, or gabapentin;

(iii) The patient has a concurrent substance use disorder; or

(iv) The dosage exceeds eighty MED as discussed in paragraph (H)(5) of this rule;

(c) The advanced practice registered nurse shall consider offering the patient a prescription for an overdose reversal drug if the dosage exceeds fifty MED as discussed in paragraph (H)(4) of this rule.

(3) During the course of treatment with an opioid analgesic at doses below the average of fifty MED per day, the advanced practice registered nurse shall provide periodic follow-up assessment and documentation of the patient's functional status, the patient's progress toward treatment objectives, indicators of possible addiction, drug abuse or diversion, and any adverse drug effects.

(4) Fifty MED. Prior to increasing the opioid dosage to a daily average of fifty MED or greater, the advanced practice registered nurse shall complete and document in the patient record the activities and information set forth in rule 4731-11-14 of the Administrative Code, including but not limited to the following:

(a) Review and update the assessment completed in paragraph (H)(2) of this rule if needed. The advanced practice registered nurse may rely on an appropriate assessment completed within a reasonable time if the advanced practice registered nurse is satisfied that he or she may rely on that information for purposes of meeting the requirements of Chapter 4723-8 and Chapter 4723-9 of the Administrative Code;

(b) Except when the patient was prescribed an average daily dosage that exceeded fifty MED before the effective date of this rule, document consideration of:

(i) Consultation with a specialist in the area of the body affected by the pain;

(ii) Consultation with a pain management specialist;

(iii) Obtaining a medication therapy management review by a pharmacist;

(iv) Consultation with a specialist in addiction medicine or addiction psychiatry, if aberrant behaviors indicating medication misuse or substance use disorder are noted;

(d) During the course of treatment with an opioid analgesic at doses at or above the average of fifty MED per day, the advanced practice registered nurse shall complete and document in the patient record all of the information and activities required by rule 4731-11-14 of the Administrative Code not less than every three months.

(5) Eighty MED. Prior to increasing the opioid dosage to a daily average of eighty MED or greater, the advanced practice registered nurse shall complete and document in the patient record the activities and information set forth in rule 4731-11-14 of the Administrative Code, including but not limited to the following:

(a) A written pain management agreement shall be entered with the patient that outlines the advanced practice registered nurse's and patient's responsibilities during treatment, which requires the patient or patient guardian's agreement to all of the provisions set forth in rule 4731-11-14 of the Administrative Code;

(b) The advanced practice registered nurse shall offer the patient a prescription for an overdose reversal drug;

(c) Except when the patient was prescribed an average daily dosage that exceeded eighty MED before the effective date of this rule, the advanced practice registered nurse shall obtain at least one of the following based upon the patient's clinical presentation:

(i) Consultation with a specialist in the area of the body affected by the pain;

(ii) Consultation with a pain management specialist;

(iii) A medication therapy management review by a pharmacist; or

(iv) Consultation with a specialist in addiction medicine or addiction psychiatry, if aberrant behaviors indicating medication misuse or substance use disorder are noted.

(6) One hundred twenty MED. The advanced practice registered nurse shall not prescribe a dosage that exceeds an average of one hundred twenty MED per day. This prohibition shall not apply under the following circumstances:

(a) The advanced practice registered nurse holds national certification by a national certifying organization approved according to section 4723.46 of the Revised Code in:

(i) Pain management;

(ii) Hospice and palliative care;

(iii) Oncology; or

(iv) Hematology, or coursework in hematology leading to certification in oncology;

(b) The advanced practice registered nurse of has received a written recommendation for a dosage exceeding an average of one hundred twenty MED per day from a board certified pain medicine physician, a board certified hospice and palliative care physician, or a board certified oncology or hematology physician, who based the recommendation on a face-to-face visit and examination of the patient. The advanced practice registered nurse shall maintain the written recommendation in the patient's record; or

(c) The patient was receiving an average daily dose of one hundred twenty MED or more prior to the effective date of this rule. However, prior to escalating the patient's dose, the advanced practice registered nurse shall receive a written recommendation as set forth in paragraph (H)(6)(b) of this rule.

(7) The requirements of paragraph (H) of this rule do not apply when an opioid analgesic is prescribed:

(a) To a patient in hospice care;

(b) To an patient who has terminal cancer or another terminal condition, as defined as follows:

An irreversible, incurable, and untreatable condition caused by disease, illness, or injury from which, to a reasonable degree of medical certainty as determined in accordance with reasonable medical standards by a physician who has examined the patient, both of the following apply:

(i) There can be no recovery; and

(ii) Death is likely to occur within a relatively short time if life-sustaining treatment is not administered; or

(I) As specified in section 4723.44 of the Revised Code, an advanced practice registered nurse designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner shall not prescribe any drug or device to perform or induce an abortion, as that term is defined in section 2919.11 of the Revised Code.

(J) As specified in section 3715.501 of the Revised Code, notwithstanding the requirements of this rule, an advanced practice registered nurse with a current valid license issued by the board and designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner may prescribe or personally furnish an overdose reversal drug.

(K) The requirements of paragraph (C)(9)(c) of this rule apply to prescriptions for products that contain gabapentin.

(L) The advanced practice registered nurse may enter consult agreements with pharmacists in accordance with section 4729.39 of the Revised Code and rules 4723-8-12 and 4723-8-13 of the Administrative Code.

Last updated September 15, 2025 at 7:36 AM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-9-11 Course in Ohio law governing drugs and prescriptive authority.

(A) All applicants seeking an advanced practice registered nurse license who practiced or are practicing as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner in another jurisdiction or as an employee of the United States government, in accordance with division (C) of section 4723.482 of the Revised Code, are required to complete a course of instruction in the laws of this state that govern drugs and prescriptive authority. To meet this requirement, the course of instruction must:

(1) Include content and instruction on rules 4723-9-08, 4723-9-10, and 4723-9-12 of the Administrative Code, and other state, or federal laws that apply to the authority to prescribe schedule II controlled substances;

(2) Include content and instruction concerning the indications and contraindications for the use of opioids and benzodiazepines in drug therapies, and alternatives to opioid therapies in the management of acute and chronic pain, including the guidelines issued by the governor's RecoveryOhio initiative;

(3) Be approved by the board, or by an OBN approver as defined in rule 4723-14-01 of the Administrative Code, or offered by an OBN approved provider unit, as defined in rule 4723-14-01 of the Administrative Code that is headquartered in the state of Ohio; and

(4) Be at minimum two hours in length.

(B) Applicants must attest to completion of a course of instruction as described in paragraph (A) of this rule.

(C) Upon request, applicants must submit documentation of successful completion to the board in the form of an original certificate, issued by the provider of the course of instruction that includes:

(1) Name of the attendee;

(2) Title of the program;

(3) Date of the program;

(4) Name and address of the provider and OBN approver number, if applicable; and

(5) Verification of completion of at least two hours of instruction, each of sixty minutes in duration.

Last updated September 15, 2025 at 7:36 AM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-9-12 Standards and procedures for review of OARRS.

(A) Definitions; for purposes of this rule:

(1) "APRN" means a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner who holds a current, valid license as an advanced practice registered nurse issued by the board.

(2) "Delegate" means an authorized representative who is registered to obtain an OARRS report on behalf of an APRN.

(3) "OARRS" means the Ohio automated RX reporting system established and maintained according to section 4729.75 of the Revised Code.

(4) "OARRS report" means a report of information related to a specified patient generated by the drug database established and maintained by the state board of pharmacy pursuant to section 4729.75 of the Revised Code.

(5) "Reported drugs" means all drugs listed in rule 4729:8-2-01 of the Administrative Code that are required to be reported to the drug database established and maintained according to section 4729.75 of the Revised Code, including controlled substance schedules II, III, IV and V.

(B) Standards of care: in addition to the requirements set forth in rule 4723-9-08 and rule 4723-9-10 of the Administrative Code, accepted and prevailing standards of care require that when prescribing or personally furnishing a reported drug, an APRN shall take into account the potential for abuse of the reported drug, the possibility that the reported drug may lead to dependence, the possibility the patient will obtain the reported drug for a nontherapeutic use or distribute it to other persons, and the potential existence of an illicit market for the reported drug. When considering these circumstances in the course of determining whether to prescribe or personally furnish a reported drug to a patient, the APRN shall use sound clinical judgment and consider obtaining and reviewing an OARRS report, consistent with the requirements of this rule.

(C) Red flags: an APRN shall obtain and review an OARRS report when any of the following red flags pertain to the patient:

(1) Selling prescription drugs;

(2) Forging or altering a prescription;

(3) Stealing or borrowing reported drugs;

(4) Increasing the dosage of reported drugs in amounts that exceed the prescribed amount;

(5) Suffering an overdose, intentional or nonintentional;

(6) Having a drug screen result that is inconsistent with the treatment plan or refusing to participate in a drug screen;

(7) Having been arrested, convicted, or received diversion, or intervention in lieu of conviction for a drug-related offense while under the APRN's care;

(8) Receiving reported drugs from multiple prescribers, without clinical basis;

(9) Traveling with a group of other patients to the APRN's office, where all or most of the patients request controlled substances prescriptions;

(10) Traveling an extended distance or from out of state to the APRN's office;

(11) Having a family member, friend, law enforcement officer or health care professional express concern related to the patient's use of illegal or reported drugs;

(12) A known history of chemical abuse or dependency;

(13) Appearing impaired or overly sedated during an office visit or examination;

(14) Requesting reported drugs by specific name, street name, color, or identifying marks;

(15) Frequently requesting early refills of reported drugs;

(16) Frequently losing prescriptions for reported drugs;

(17) A history of illegal drug use;

(18) Sharing reported drugs with another person; or

(19) Recurring visits to non-coordinated sites of care, such as emergency departments, urgent care facilities, or walk-in clinics to obtain reported drugs.

(D) OARRS review; opioid analgesics and benzodiazepines.

Except as provided in paragraph (G) of this rule, an APRN shall:

(1) Obtain and review an OARRS report before initially prescribing to a patient a reported drug that is an opioid analgesic or benzodiazepine;

(2) Obtain and review an OARRS report when prescribing opioid analgesics for the treatment of sub-acute and chronic pain as set forth in rule 4723-9-10 of the Administrative Code;

(3) If the patient continues to receive opioid analgesics or benzodiazepines for more than ninety days after the initial report is requested, the APRN shall obtain and review OARRS reports for the patient at intervals not exceeding ninety days, determined according to the date the initial request was made, and until the course of treatment has ended; and

(4) In obtaining and reviewing OARRS reports, comply with paragraph (F) of this rule.

(E) OARRS review; reported drugs that are not opioid analgesics or benzodiazepines.

Except as provided in paragraph (G) of this rule, an APRN shall:

(1) Obtain and review an OARRS report following a course of treatment for a period of more than ninety days if the treatment includes the prescribing or personally furnishing of reported drugs that are not opioid analgesics or benzodiazepines;

(2) Obtain and review an OARRS report at least annually thereafter until the course of treatment utilizing these reported drugs has ended; and

(3) In obtaining and reviewing OARRS reports, comply with paragraph (F) of this rule.

(F) OARRS reports; time period; adjoining state: for purposes of paragraphs (C), (D), and (E) of this rule:

(1) OARRS reports may be requested by the APRN's delegate but must be personally reviewed by the APRN;

(2) Receipt and assessment of the OARRS report information, including consultation with the collaborating physician that occurred based on the OARRS report information or as required by paragraph (H) of this rule, shall be documented in the patient record;

(3) Initial reports requested shall cover at least twelve months immediately preceding the date of the request;

(4) If the APRN practices in a county of this state that adjoins another state, the APRN or the APRN's delegate shall also request a report of any information available in the drug database that pertains to prescriptions issued or drugs furnished to the patient in the state adjoining the county; and

(5) If an OARRS report regarding the patient is not available, the APRN shall document in the patient's record the reason that the report is not available and any efforts made in follow-up to obtain the requested information.

(G) OARRS report exceptions: an APRN shall not be required to review and assess an OARRS report when prescribing or personally furnishing a reported drug under the following circumstances, unless the APRN believes or has reason to believe that the patient may be abusing or diverting reported drugs;

(1) The reported drug is prescribed or personally furnished to a hospice patient in a hospice care program as those terms are defined in section 3712.01 of the Revised Code;

(2) The reported drug is prescribed or personally furnished to a patient who has been diagnosed with terminal cancer or another terminal condition, as defined in section 2133.01 of the Revised Code;

(3) The reported drug is prescribed for administration in a hospital, nursing home, or residential care facility;

(4) The reported drug is prescribed or personally furnished in an amount indicated for a period not to exceed seven days; or

(5) The reported drug is prescribed for treatment of non-terminal cancer or another condition associated with non-terminal cancer, except if prescribed for sub-acute or chronic pain and an OARRS report review is required by rule 4723-9-10 of the Administrative Code.

(H) Physician consultation: an APRN who prescribes or personally furnishes a reported drug to a patient following review of an OARRS report under paragraph (C), (D), or (E) of this rule, and determines, based on the OARRS report or red flags described in paragraph (C) of this rule that the patient may be abusing or diverting reported drugs, shall first consult with a physician prior to personally furnishing or prescribing a reported drug at the patient's next visit.

(1) Consultation shall include and result in:

(a) Review and documentation of the reasons why the APRN believes or has reason to believe that the patient may be abusing or diverting drugs;

(b) Review and documentation of the patient's progress toward treatment objectives over the course of treatment; and

(c) Review and documentation of the functional status of the patient, including activities for daily living, adverse effects, analgesia and aberrant behavior over the course of treatment.

(2) Consultation may include and result in:

(a) Utilization of a patient treatment agreement that includes more frequent and periodic review of OARRS reports, more frequent office visits, different treatment options, drug screens, use of one pharmacy, use of one provider for the prescription or personally furnishing of reported drugs, and consequences for non-compliance with the terms of the agreement. The patient treatment agreement shall be maintained as part of the patient record; and

(b) Consultation with or referral to a substance use disorder specialist.

Last updated March 26, 2026 at 8:29 AM

History

Effective: March 26, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4723-9-13 Office-based opioid treatment.

(A) Definitions; for purposes of this rule and interpretation of the formulary set forth in rule 4723-9-10 of the Administrative Code:

(1) "Community addiction services provider" has the same meaning as in section 5119.01 of the Revised Code.

(2) "Community mental health services provider" has the same meaning as in section 5119.01 of the Revised Code.

(3) "Controlled substance," "schedule III," "schedule IV," and "schedule V" have the same meanings as in section 3719.01 of the Revised Code.

(4) "FDA" means the United States food and drug administration.

(5) "Induction phase" means the phase of medications for opioid use disorder treatment during which the patient is started on an FDA approved medication for substance use disorder treatment.

(6) "Maintenance phase" means the ongoing period of time when the patient's medication dose reaches a therapeutic level, allowing the patient to focus on other recovery activities.

(7) "Medications for Opioid Use Disorder" or "MOUD" refers to all medications approved by the FDA for the treatment of opioid use disorder.

(8) "Office-based opioid treatment" or "OBOT" means pharmacotherapy in a private office or public sector clinic that is not otherwise regulated, by practitioners who are authorized to prescribe outpatient supplies of medications approved by the FDA for the treatment of opioid use disorder . OBOT includes treatment with all controlled substance medications approved by the FDA for such treatment. OBOT does not include treatment utilizing non-controlled medications. OBOT does not include treatment that occurs in the following settings:

(a) A state or local correctional facility, as defined in section 5163.45 of the Revised Code;

(b) A hospital, as defined in section 3722.01 of the Revised Code;

(c) A provider certified to provide residential and inpatient substance use disorder services, including withdrawal management, by the Ohio department of mental health and addiction services;

(d) An opioid treatment program certified by SAMHSA and accredited by an independent, SAMHSA-approved accrediting body; or

(e) A youth services facility, as defined in section 103.75 of the Revised Code.

(f) An emergency medical services agency as authorized under Chapter 4729. of the Revised Code.

(9) "OARRS" means the "Ohio Automated RX Reporting System" drug database established and maintained pursuant to section 4729.75 of the Revised Code.

(10) "Overdose reversal drug" has the same meaning as in Chapter 4729. of the Revised Code.

(11) "Qualified behavioral healthcare provider" means the following healthcare providers practicing within the scope of professional licensure:

(a) A medical doctor or doctor of osteopathic medicine and surgery who is a board certified addiction medicine specialist or addiction psychiatrist , or a psychiatrist, licensed under Chapter 4731. of the Revised Code;

(b) A licensed independent chemical dependency counselor-clinical supervisor, licensed independent chemical dependency counselor, licensed chemical dependency counselor III, licensed chemical dependency counselor II, or licensed chemical dependency counselor assistant licensed under Chapter 4758. of the Revised Code;

(c) A professional clinical counselor, licensed professional counselor, licensed independent social worker, licensed social worker, or marriage and family therapist, licensed under Chapter 4757. of the Revised Code;

(d) An advanced practice registered nurse licensed as a clinical nurse specialist or certified nurse practitioner licensed by the board, who holds national certification in psychiatric mental health, or clinical nurse specialist who was not required to obtain national certification according to section 4723.41 of the Revised Code, and whose specialty is psychiatric mental health; or

(e) A psychologist, as defined in division (A) of section 4732.01 of the Revised Code, licensed under Chapter 4732. of the Revised Code; or

(f) An advanced practice registered nurse licensed by the board who holds additional certification as a certified addictions registered nurse-advanced practice issued by the addictions nursing certification board.

Nothing in this paragraph shall be construed to prohibit an advanced practice registered nurse who collaborates with a physician licensed under Chapter 4731. of the Revised Code and board certified as an addiction psychiatrist, board certified addiction medicine specialist , or psychiatrist, from providing services within the normal course of practice and expertise of the collaborating physician, including addiction services, other mental health services, and prescriptive services in compliance with Ohio and federal law and rules.

(12) "SAMHSA" means the United States substance abuse and mental health services administration.

(13) "Stabilization phase" means the period of time following the induction phase, when medication doses are adjusted to target a reduction in substance use disorder symptoms.

(14) "Substance use disorder" indicates a problematic pattern of substance use leading to clinically significant impairment or distress as determined by application of the diagnostic criteria in the "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-Text Revision" or "DSM-5-TR."

(B) An advanced practice registered nurse with a current valid license issued by the board and designated as a clinical nurse specialist, certified nurse midwife or certified nurse practitioner may provide treatment, including prescribing controlled substances in schedule III, IV or V, if the advanced practice registered nurse:

(1) Complies with section 3719.064 of the Revised Code, and all federal and state laws and regulations governing the prescribing of the medication, including but not limited to incorporating into the advanced practice registered nurse's practice knowledge of Chapter 4729. of the Revised Code, and Chapter 4731. of the Revised Code and rules adopted under that Chapter that govern the practice of the advanced practice registered nurse's collaborating physician;

(2) Completes at least eight hours of continuing nursing education in each renewal period related to substance use disorder and addiction. Courses completed in compliance with this requirement shall be accepted toward meeting the continuing education requirements for biennial renewal of the advanced practice registered nurse license; and

(3) Only provides medication-assisted treatment if the treatment is within the collaborating physician's normal course of practice and expertise.

(C) In addition to the requirements for treatment set forth in paragraph (B) of this rule, an advanced practice registered nurse with a current valid license issued by the board and designated as a clinical nurse specialist or certified nurse practitioner may provide OBOT under the following circumstances:

(1) The standard care arrangement statement of services offered includes OBOT;

(2) The advanced practice registered nurse performs, or confirms the completion of, an assessment of the patient to gather sufficient information and data to justify the use of this treatment intervention. The assessment shall include a thorough medical history, examination and laboratory testing. If any part of the assessment cannot be completed prior to the initiation of OBOT, the advanced practice registered nurse shall complete it as soon as possible following the initiation of treatment;

(3) The advanced practice registered nurse shall provide accurate, objective, and complete documentation of all patient encounters, including referrals, test results, and significant changes to the treatment plan.

(4) The advanced practice registered nurse establishes and documents a treatment plan that includes all of the following:

(a) The advanced practice registered nurse's rationale for selection of the specific drug to be used in the treatment based upon discussion of all MOUDs and non-medication options with the patient;

(b) Patient education;

(d) Random urine-drug screens or oral fluid drug testing;

(e) A signed treatment agreement with the patient that outlines the responsibilities of the patient and the advanced practice registered nurse;

(f) Documentation regarding psychosocial interventions as discussed in paragraph (C)(5) of this rule;

(g) The treatment plan shall be revised if the patient does not show improvement with the original plan.

(5) The advanced practice registered nurse shall provide OBOT in accordance with an acceptable treatment protocol for assessment, induction, stabilization, maintenance and tapering. Acceptable protocols are any of the following:

(a) TIP 63 "Medications for Opioid Use Disorder" (2021) available from the SAMHSA website at: https://library.samhsa.gov/product/tip-63-medications-opioid-use-disorder/pep21-02-01-002;

(b) "ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update," available from the website of the American society of addiction medicine at https://www.asam.org/quality-care/clinical-guidelines/national-practice-guideline.

(6) The advanced practice registered nurse shall do the following with respect to psychosocial treatment for patients receiving OBOT:

(a) Assess for psychosocial treatment needs in addition to medication;

(b) Offer psychosocial interventions or referrals for psychosocial interventions to all patients, but OBOT should not be declined or discontinued if the patient is unable or unwilling to engage in psychosocial interventions;

(c) Ensure that psychosocial interventions are person-centered and tailored to the patient's insight, motivation, and stage of recovery;

(d) Focus the psychosocial interventions on retaining the patient in treatment, stabilizing the patient and assisting with progress in the patient's treatment and recovery;

(e) If the psychosocial interventions are not available or if the patient declines to participate, the advanced practice registered nurse shall continue to treat the patient with OBOT provided that the patient adheres to all other treatment requirements;

(f) Psychosocial treatment or intervention includes the following:

(i) Cognitive behavioral treatment;

(ii) Community reinforcement approach;

(iii) Contingency management and motivational incentives;

(iv) Motivational interviewing;

(v) Behavioral couples counseling;

(vi) Twelve-step facilitation; and

(vii) Other therapies based on the patient's individual needs;

(g) When necessary, the advanced practice registered nurse may make referrals for psychosocial treatment to qualified behavioral healthcare providers, community addiction services or community mental health services providers as defined in paragraph (A) of rule 4723-9-13 of the Administrative Code; and

(h) The advanced practice registered nurse may also refer patients for treatment with non-licensed paraprofessionals such as case managers and peer support specialists if the advanced practice registered nurse determines such intervention would benefit the patient.

(7) The advanced practice registered nurse who provides OBOT shall offer the patient a prescription for an overdose reversal drug, directly provide the patient with an overdose reversal drug, or direct the patient to an easily accessible source to obtain an overdose reversal drug, such as, http://www.naloxone.ohio.gov, a local health department, or other agency or facility that provides overdose reversal drugs.

(a) The advanced practice registered nurse shall ensure that the patient, and if possible, those residing with the patient, receives instruction on the overdose reversal drug's use including, but not limited to, recognizing the signs and symptoms of opioid overdose and calling 911 in an overdose situation.

(b) The advanced practice registered nurse shall offer the patient a new prescription for an overdose reversal drug upon expiration or use of the old overdose reversal drug .

(c) The advanced practice registered nurse shall be exempt from this requirement if the patient refuses the prescription. If the patient refuses the prescription the advanced practice registered nurse shall provide the patient with information on where to obtain an overdose reversal drug without a prescription.

(8) If the advanced practice registered nurse provides OBOT using buprenorphine products, the following additional requirements must be met:

(a) Treatment with a buprenorphine product must be in compliance with the FDA approved "Risk Evaluation and Mitigation Strategy" for buprenorphine products, which can be found on the FDA website at the following address: https://www.accessdata.fda.gov/scripts/cder/rems/index.cfm. With the exception of those conditions listed in paragraph (C)(9)(b) of this rule, the advanced practice registered nurse who treats an opioid use disorder with a buprenorphine product shall only prescribe buprenorphine/naloxone combination products for use in OBOT.

(b) The advanced practice registered nurse may prescribe buprenorphine without naloxone (buprenorphine mono-product) only in the following situations, and shall fully document the evidence for the decision to use buprenorphine mono-product in the patient's record:

(i) When the patient is pregnant or breast-feeding;

(ii) When converting the patient from buprenorphine mono-product to a buprenorphine/naloxone combination product;

(iii) In formulations other than tablet or film form for indications approved by the FDA; or

(iv) When the patient has a genuine allergy to or intolerance of a buprenorphine/naloxone combination product.

(c) Due to a higher risk of fatal overdose when buprenorphine is prescribed with other opioids, benzodiazepines, sedative hypnotics, carisoprodol, gabapentin, or tramadol, the advanced practice registered nurse shall only co-prescribe these substances when it is medically necessary, and only if:

(i) The advanced practice registered nurse verifies the diagnosis for which the patient is receiving the other drug and coordinates care with the prescriber for the other drug, including whether acceptable alternative treatments are available and whether it is possible to lower the dose or discontinue the drug . If the advanced practice registered nurse prescribing buprenorphine is the prescriber of the other drug, the advanced practice registered nurse shall also consider these options and consider consultation with another healthcare provider . The advanced practice registered nurse shall educate the patient about the serious risks of the combined use; and

(ii) The advanced practice registered nurse documents the rationale for discontinuing, lowering, or continuing the medication given potential risks and benefits .

(d) During the induction phase, the advanced practice registered nurse shall not prescribe a dosage that exceeds the recommendation in the FDA approved labeling, except for medically indicated circumstances as documented in the patient record. The advanced practice registered nurse shall see the patient at least once per week during this phase.

(e) During the maintenance phase, the advanced practice registered nurse shall prescribe a dosage of buprenorphine that avoids intoxication or sedation, prevents withdrawal, and suppresses significant drug craving. For the first twelve months of treatment, the advanced practice registered nurse shall prescribe no more than a one-month supply of the buprenorphine product unless utilizing a formulation with duration of action exceeding one month, such as injections or implants.

(f) The advanced practice registered nurse shall reduce the risk of buprenorphine diversion by using the lowest effective dose, scheduling appropriate frequency of office visits, conducting random pill counts, checking OARRS, and utilizing drug testing, serum medication levels, and oral fluid testing to assess for patient adherence to prescribed buprenorphine treatment.

(g) When using any sublingual formulation of buprenorphine, the advanced practice registered nurse shall not prescribe a dosage exceeding twenty-four milligrams of buprenorphine per day, unless the advanced practice registered nurse is licensed as a clinical nurse specialist or certified nurse practitioner who holds a national certification in psychiatric mental health, or clinical nurse specialist who was not required to obtain national certification according to section 4723.41 of the Revised Code, and whose specialty is psychiatric mental health, or an advanced practice registered nurse who holds additional certification as a certified addictions advanced practice registered nurse issued by the addictions nursing certification board, or a consultation has been obtained from a physician who is a board certified addiction specialist or addiction psychiatrist recommending the higher dose. Dosage shall not exceed thirty-two milligrams of buprenorphine per day .

(h) The advanced practice registered nurse shall incorporate relapse prevention strategies into counseling or assure that they are addressed by a qualified behavioral healthcare provider, as defined in this rule, who has the education and experience to provide substance use disorder counseling.

(i) The advanced practice registered nurse may treat a patient using the administration of extended-release, injectable, or implanted buprenorphine under the following circumstances:

(i) The advanced practice registered nurse strictly complies with any required risk evaluation and mitigation strategy program for the drug;

(ii) The advanced practice registered nurse shall prescribe an extended-release buprenorphine product strictly in accordance with the FDA's approved labeling for the drug's use;

(iii) The advanced practice registered nurse documents in the patient record the rationale for the use of the extended-release product; and

(iv) The advanced practice registered nurse who orders or prescribes extended-release, injectable, or implanted buprenorphine product shall administer the drug, or require it to be administered by another Ohio licensed health care provider acting in accordance with the scope of their professional license.

(9) If the clinical nurse specialist or certified nurse practitioner is using naltrexone to treat opioid use disorder, the advanced practice registered nurse shall comply with the following additional requirements:

(a) Before initiating naltrexone, the advanced practice registered nurse shall take measures to ensure that the patient is opioid abstinent for an adequate period of time after completing opioid withdrawal to avoid precipitated withdrawal. The advanced practice registered nurse shall alert the patient of the risk of potentially lethal opioid overdose if they stop naltrexone and use opioids.;

(b) The advanced practice registered nurse shall use oral naltrexone only for treatment of patients who are highly motivated;

(i) The dosage regime shall strictly comply with the FDA approved labeling for naltrexone hydrochloride tablets;

(ii) The patient shall be encouraged to have a support person administer and supervise the medication. Examples of a support person are a family member, close friend, or employer;

(c) The advanced practice registered nurse shall require urine drug screens, serum medication levels or oral fluid drug testing at least every three months for the first year of treatment and at least every six months thereafter;

(d) The advanced practice registered nurse shall incorporate relapse prevention strategies into counseling or assure that they are addressed by a qualified behavioral healthcare or mental health services provider who has eduction and experience to provide substance abuse counseling.

(e) The advanced practice registered nurse may treat a patient with extended-release naltrexone for opioid or alcohol dependence or for co-occurring opioid and alcohol use disorders.

(i) The advanced practice registered nurse should consider treatment with extended-release naltrexone for patients who have difficulties with treatment adherence;

(ii) The dosage shall strictly comply with FDA labeling for extended-release naltrexone; and

(iii) The advanced practice registered nurse shall incorporate relapse prevention strategies into counseling or assure that they are addressed by a qualified behavioral healthcare provider or mental health services provider who has the education and experience to provide substance abuse counseling.

Last updated September 15, 2025 at 7:36 AM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-9-14 Standards and procedures for withdrawal management for substance use disorder.

(A) Definitions; for purposes of this rule and interpretation of the formulary set forth in rule 4723-9-10 of the Administrative Code:

(1) The definitions set forth in rule 4723-9-13 of the Administrative Code apply in addition to those definitions set forth in this paragraph;

(2) "Ambulatory withdrawal management " means withdrawal management delivered in a medical office, public sector clinic, or urgent care facility by trained practitioners authorized to prescribe outpatient supplies of drugs approved by the FDA for the treatment of substance use disorder. Ambulatory withdrawal management is the provision of medically supervised evaluation, treatment, and referral services without extended onsite monitoring. For purposes of this rule, ambulatory withdrawal management does not include withdrawal management that occurs in the following settings:

(a) A state or local correctional facility, as defined in section 5163.45 of the Revised Code;

(b) In-patient treatment in a hospital, as defined in section 3722.01 of the Revised Code;

(d) A youth services facility, as defined in section 103.75 of the Revised Code;

(e) A provider certified to provide residential and inpatient substance use disorder services, including withdrawal management, by the Ohio department of mental health and addiction services; or

(f) An emergency medical services agency as authorized under chapter 4729 of the Revised Code.

(3) "ASAM" means the American society of addiction medicine;

(4) "Withdrawal management" is a set of medical interventions aimed at managing the acute physical symptoms of intoxication and withdrawal. Withdrawal management occurs when the patient has a substance use disorder and either evidence of the characteristic withdrawal syndrome produced by withdrawal from that substance, or evidence that supports the expectation that such syndrome would develop without the provision of medical withdrawal management services. Withdrawal management alone does not constitute completed substance use disorder treatment or rehabilitation.

(B) A clinical nurse specialist, certified nurse midwife or certified nurse practitioner who holds a current valid advanced practice registered nurse license may provide ambulatory withdrawal management consistent with this rule if the advanced practice registered nurse:

(1) Only provides withdrawal management in collaboration with a physician who provides withdrawal management as part of the physician's normal course of practice and with whom the advanced practice registered nurse has a current standard care arrangement;

(2) Complies with the medication withdrawal policies of the healthcare facilities in which the advanced practice registered nurse engages in withdrawal management practice; and

(3) Complies with all state and federal laws and rules applicable to prescribing.

(C) Prior to providing ambulatory withdrawal management for any substance use disorder the advanced practice registered nurse shall inform the patient that ambulatory withdrawal management alone is not complete treatment for a substance use disorder. If the patient prefers continuing treatment for a substance use disorder, the advanced practice registered nurse shall comply with the requirements of section 3719.064 of the Revised Code.

(D) The advanced practice registered nurse shall provide accurate, objective, and complete documentation of all patient encounters, including referrals, test results, and significant changes to the treatment plan.

(E) When providing withdrawal management for opioid use disorder an advanced practice registered nurse may be authorized to use a medical device that is approved by the FDA as an aid in the reduction of opioid withdrawal symptoms.

(F) Ambulatory withdrawal management for opioid use disorder.

(1) An advanced practice registered nurse shall provide ambulatory withdrawal management only when all of the following conditions are met:

(a) The patient has adequate social, medical, and psychiatric stability to engage in and safely complete ambulatory withdrawal management; and

(b) There is little risk of medication diversion.

(2) The advanced practice registered nurse shall provide ambulatory withdrawal management under a defined set of policies and procedures or medical protocols, with patient placement in outpatient or residential settings consistent with American society of addiction medicine's level of care criteria. Such services are designed to treat the patient's level of clinical severity, to achieve safe and comfortable withdrawal from a drug, and to effectively facilitate the patient's transition into treatment and recovery. In the event that ambulatory withdrawal management is unsafe or inappropriate for a patient, referral to a higher level of care, such as inpatient hospitalization shall be completed. The ASAM criteria can be obtained from the website of ASAM at https://www.asam.org/, and may be reviewed at the board office, located at 8995 East Main Street, Reynoldsburg, Ohio 43068 during normal business hours.

(3) Prior to providing ambulatory withdrawal management, the advanced practice registered nurse shall perform an assessment of the patient to gather information and data to justify the use of this treatment intervention. The assessment shall include a thorough medical history and physical examination sufficient to assure safety in commencing ambulatory withdrawal management and shall include a review of the patient's prescription history in OARRS. The assessment must focus on signs and symptoms associated with opioid use disorder and include assessment with a nationally recognized scale, such as one of the following:

(a) Objective opioid withdrawal scale ("OOWS");

(b) Clinical opioid withdrawal scale ("COWS");

(4) If any part of the assessment cannot be completed prior to the initiation of the treatment, the advanced practice registered nurse shall complete it as soon as possible following the initiation of treatment.

(5) The advanced practice registered nurse shall inform the patient about the following before treatment for opioid withdrawal is initiated:

(a) The withdrawal management process and importance of subsequent treatment for substance use disorder, including information about all medications approved by the FDA for use in MOUD treatment;

(b) The risk of relapse and lethal overdose following completion of withdrawal without entry into continuation of MOUD treatment;

(6) The advanced practice registered nurse shall not establish standardized regimens of medications for management of substance withdrawal symptomatology but shall formulate an individualized treatment plan based on the needs of the specific patient.

(7) For persons projected to be involved in withdrawal management for six months or less, the advanced practice registered nurse shall offer the patient counseling and follow the procedures described in paragraphs (C)(5) and (C)(6) of rule 4723-9-13 of the Administrative Code.

(8) The advanced practice registered nurse shall require the patient to undergo urine and/or other toxicological screenings during withdrawal management in order to assess for use of licit and/or illicit drugs. The advanced practice registered nurse shall consider revising the treatment plan or referring a patient who has a positive toxicological screening result to a higher level of care, with such consideration documented in the patient's medical record, and confer with the collaborating physician prior to prescribing a buprenorphine/naloxone combination product to the patient.

(9) The advanced practice registered nurse shall comply with the following requirements for the use of medication:

(a) The advanced practice registered nurse may treat the patient's withdrawal symptoms by use of any of the following medications as determined to be the most appropriate for the patient:

(i) A medication, that is specifically FDA approved for the alleviation of withdrawal symptoms. Methadone may only be utilized with strict adherence to the stipulations of 21 C.F.R. 1306.07(b);

(ii) An alpha-2 adrenergic agent along with other non-narcotic medications as recommended in "The ASAM National Practice Guideline For the Use of Medications in the Treatment of Addiction Involving Opioid Use," available at: https://www.asam.org, and available on the board's website at https://nursing.ohio.gov;

(iii) A combination of buprenorphine and low dose naloxone (buprenorphine/naloxone combination product) unless contraindicated, in which case buprenorphine mono-product may be utilized.

(b) The advanced practice registered nurse shall not use anesthetic agents to treat the patient's withdrawal symptoms.

(i) Treatment with a buprenorphine product must be in compliance with the FDA approved "Risk Evaluation and Mitigation Strategy" for buprenorphine products, which can be found on the FDA website at: https://www.accessdata.fda.gov/scripts/cder/rems/index.cfm.

(ii) Determine on an individualized basis the appropriate dosage of medication to ensure stabilization during withdrawal management.

(a) The dosage level shall be that which is effective in suppressing withdrawal symptoms and is well-tolerated by the patient.

(b) The dosage level shall be consistent with the currently accepted standards of care.

(iii) In withdrawal management programs of thirty days or less duration, the advanced practice registered nurse shall not prescribe nor dispense more than one week of unsupervised or take-home medications for the patient.

(10) The advanced practice registered nurse shall offer the patient a prescription for an overdose reversal drug, directly provide them with an overdose reversal drug, or direct the patient to an easily accessible source to obtain an overdose reversal drug, such as, http://www.naloxone.ohio.gov, a local health department or other agency or facility that provides overdose reveral drugs and shall:

(a) Ensure that the patient, and if possible, those residing with the patient receives instruction on the overdose reversal drug's use including, but not limited to, recognizing the signs and symptoms of opioid overdose and calling 911 in an overdose situation;

(b) Offer the patient a new prescription for an overdose reversal drug upon expiration or use of the old overdose reversal drug;

(c) Be exempt from this requirement if the patient refuses the prescription. If the patient refuses the prescription the advanced practice registered nurse shall provide the patient with information on where to obtain an overdose reversal drug without a prescription.

(11) The advanced practice registered nurse shall take steps to reduce the risk of medication diversion by doing one or more of the following: frequent office visits, pill counts, urine drug screening, and frequent checks of OARRS.

(G) The advanced practice registered nurse who provides ambulatory withdrawal management for benzodiazepines or other sedatives shall comply with paragraphs (B), (C), and (D) of this rule and "TIP 45, A Treatment Improvement Protocol for Detoxification and Substance Abuse Treatment" by SAMHSA, available from the SAMHSA website at: https://store.samhsa.gov/ (search for "TIP 45") and available on the board's website at: https://nursing.ohio.gov. In addition, ambulatory withdrawal management with medication shall only be provided if:

(1) The patient has sufficient social, medical, and psychiatric stability;

(2) The patient's use of benzodiazepines was mainly in therapeutic ranges;

(3) The patient does not have polysubstance dependence;

(4) The patient exhibits no more than mild to moderate withdrawal symptoms;

(5) The patient has no comorbid medical condition or severe psychiatric disorder;

(6) The patient has no history of withdrawal seizures or withdrawal delirium;

(7) Prior to providing ambulatory withdrawal management, the advanced practice registered nurse performs and documents an assessment of the patient that focuses on signs and symptoms associated with benzodiazepine or other sedative use disorder, including assessment with a nationally recognized scale, such as the "Clinical Institute Withdrawal Assessment for Benzodiazepines" ("CIWA-B");

(8) Prior to providing ambulatory withdrawal management, the advanced practice registered nurse conducts and documents a biomedical and psychosocial evaluation of the patient to gather sufficient information and data to justify the use of this treatment intervention.

(9) The advanced practice registered nurse instructs the patient about the following before treatment for benzodiazepine withdrawal management is initiated:

(a) Not to drive or operate dangerous machinery during treatment;

(b) The withdrawal management process and importance of subsequent treatment for substance use disorder, including information about all medications approved by the FDA for use in substance use disorder treatment;

(c) The risk of relapse and lethal overdose following completion of withdrawal without entry into continuation of treatment for substance use disorder; and

(d) The safe storage and disposal of prescribed medications.

(10) The advanced practice registered nurse regularly assesses the patient during the course of ambulatory withdrawal management so that medication dosage can be adjusted if needed;

(a) The patient shall be required to undergo urine and/or other toxicological screening during withdrawal management in order to assess for the use of licit and/or illicit drugs;

(b) The advanced practice registered nurse shall document consideration of revising the treatment plan or referral of the patient who has a positive toxicological screen to a higher level of care;

(c) The advanced practice registered nurse shall take steps to reduce the risk of diversion by doing one or more of the following: frequent office visits, pill counts, urine drug screening, and frequent checks of OARRS.

(H) An advanced practice registered nurse who provides ambulatory withdrawal management for withdrawal from alcohol shall comply with paragraphs (B), (C), and (D) of this rule and "Clinical Practice Guidelines on Alcohol Withdrawal Management" by the ASAM available from the ASAM website at the following link: https://www.asam.org/quality-care/clinical-guidelines/alcohol-withdrawal-management-guideline. In addition, ambulatory withdrawal management with medication shall only be provided if:

(1) The patient has sufficient social, medical, and psychiatric stability to adhere to prescribed treatments and successfully complete withdrawal with minimal risk of complications;

(2) The patient is not at risk for serious withdrawal from substances other than alcohol;

(3) The patient has no history of withdrawal seizures or withdrawal delirium;

(4) The advanced practice registered nurse performs and documents an assessment of the patient that focuses on signs and symptoms associated with alcohol use disorder, including assessment with a nationally recognized scale, such as the "Clinical Institute Withdrawal Assessment for Alcohol-revised" ("CIWA-Ar");

(5) The advanced practice registered nurse conducts and documents a biomedical and psychosocial evaluation to gather sufficient information and data to justify the use of this treatment intervention;

(6) The advanced practice registered nurse regularly assesses the patient during the ambulatory withdrawal management so the dosage can be adjusted if needed. The advanced practice registered nurse shall:

(a) Require the patient to undergo toxicological screening in order to assess for the presence of alcohol metabolites, licit or illicit drugs;

(b) Document the consideration of revising the treatment plan or referral of the patient who has a positive toxicological screening test to a higher level of care;

(c) Take steps to reduce the risk of diversion by doing one or more of the following: frequent office visits, pill counts, urine drug screening, and frequent checks of OARRS.

Last updated September 16, 2025 at 3:19 PM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Chapter 4723-11 Nurse Licensure Compact

Ohio Adm.Code 4723-11-02 Fees.

(A) In addition to any other requirements for multistate licensure, an applicant for multistate licensure shall submit to the board the applicable multistate licensure application fee as authorized by section 4723.112 of the Revised Code, in the following amounts.

(1) One time conversion fee from an Ohio single-state license to a multistate license: one hundred dollars.

(2) First-time license issued as an Ohio multistate license: one hundred dollars.

(3) Renewal fee for registered nurse or licensed practical nurse issued an Ohio multistate license: seventy-five dollars.

(4) Conversion to an Ohio multistate license within sixty days of initial single-state licensure: twenty-five dollars.

(B) In addition to any other requirements for licensure to practice as an advanced practice registered nurse, an applicant for licensure to practice as an advanced practice registered nurse in Ohio who has a current and valid out of state multistate registered nurse license shall submit to the board a fee as authorized by division (A)(2) of section 4723.08 of the Revised Code, in the amount of one hundred fifty dollars.

Last updated December 28, 2022 at 8:41 AM

History

Effective: December 22, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-11-03 Employer obligations regarding nurses holding multistate licenses issued by states other than Ohio.

(A) As used in this rule, "person" has the same meaning as in section 1.59 of the Revised Code.

(B) Beginning January 31, 2024, and each year thereafter, a person or governmental entity that employs, or contracts directly or through another person or governmental entity for the provision of services by, a nurse holding a multistate license shall do both of the following, if the multistate license was issued by a state other than Ohio:

(1) Report to the board of nursing the number of nurses holding multistate licenses, issued by a state other than Ohio, who were employed by, or providing services for, the person or governmental entity in the prior calendar year. The information will be reported to the board of nursing through e-notification at https://www.ncsbn.org/nursing-regulation/licensure/license-verification.page

(2) Provide each nurse holding a multistate license a copy of board-developed information concerning laws and rules specific to the practice of nursing in Ohio.

Last updated December 18, 2023 at 8:26 AM

History

Effective: December 17, 2023
Promulgated Under: 119.03

Ohio Adm.Code 4723-11-04 Application forfeiture.

If an applicant for multistate licensure fails to meet the requirements for licensure within one year from the date the application is received, or the application remains incomplete for one year, the application shall be considered void and the fee submitted with the application shall be forfeited. The application shall state the circumstances under which forfeiture may occur.

Last updated February 3, 2025 at 8:28 AM

History

Effective: February 1, 2025
Promulgated Under: 119.03

Chapter 4723-13 Delegation of Nursing Tasks

Ohio Adm.Code 4723-13-01 Definitions.

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

(A) "Board" means the Ohio board of nursing.

(B) "Delegation" means the transfer of responsibility for the performance of a selected nursing task from a licensed nurse authorized to perform the task to an individual who does not otherwise have the authority to perform the task.

(C) "Delegating nurse" means the nurse who delegates a nursing task or assumes responsibility for individuals who are receiving delegated nursing care.

(D) "Dialysis technician" means an individual who holds a current valid certificate issued under Chapter 4723. of the Revised Code that authorizes the provision of dialysis care.

(E) "Direction" means communicating a plan of care to a licensed practical nurse. Direction by a registered nurse is not meant to imply the registered nurse is supervising the licensed practical nurse in the employment context.

(F) "Licensed nurse" means a registered nurse or a licensed practical nurse licensed to practice nursing in Ohio.

(G) "Medication aide" means an individual who holds a current valid certificate issued under Chapter 4723. of the Revised Code that authorizes the individual to administer medications in nursing homes or residential care facilities

(H) "DODD" means the Ohio department of developmental disabilities.

(I) "Nursing tasks" means those activities that constitute the practice of nursing as a licensed nurse and may include, but are not limited to, assistance with activities of daily living that are performed to maintain or improve the client's well-being, when the client is unable to perform that activity for him or herself.

(J) " Unlicensed person" means an individual, not currently licensed by the board as a registered nurse or licensed practical nurse, or an individual who does not hold a current valid certificate to practice as a dialysis technician or administer medications as a medication aide.

Last updated September 11, 2023 at 11:15 AM

History

Effective: February 1, 2012
Promulgated Under: 119.03

Ohio Adm.Code 4723-13-02 General information.

(A) A nursing task may be delegated to an unlicensed person only by a licensed nurse who shall delegate in accordance with this chapter.

(B) Nothing in this chapter shall be construed to prevent any person registered, certified, licensed, or otherwise legally authorized in this state under any law from engaging in the practice for which such person is registered, certified, licensed, or authorized.

"Otherwise legally authorized" may include, but is not limited to, authorization for medication administration pursuant to section 3313.713 of the Revised Code, DODD personnel authorized to perform tasks or activities pursuant to sections 5123.41 to 5123.47 of the Revised Code, and individuals authorized to administer medications or perform tasks pursuant to Title 47 of the Revised Code.

(C) Nothing in this chapter shall prohibit an unlicensed person from assisting an individual who can safely self direct his or her own care, including, helping the individual with self-administration of medications in a facility where the substantial purpose of the setting is other than the provision of health care. An unlicensed person assisting with self-administration of medications may do only the following:

(1) Remind an individual when to take the medication and observe to ensure that the individual follows the directions on the container;

(2) Assist an individual in the self-administration of medication by taking the medication in its container from the area where it is stored and handing the container with the medication in it to the individual. If the individual is physically unable to open the container, the unlicensed person may open the container for the individual;

(3) Assist upon request by or with the consent of, a physically impaired but mentally alert individual, in removing oral or topical medication from the container and in taking or applying the medication. If an individual is physically unable to place a dose of medicine in the individual's mouth without spilling or dropping it, an unlicensed person may place the dose in another container and place that container to the mouth of the individual; or

(4) Assisting an individual with self-administration does not mean that an unlicensed person can administer medication to an individual, whether orally, by injection, or by any other route.

(D) Nothing in this chapter shall prohibit an unlicensed person from administering medication under the following circumstances:

(1) The giving of oral or the applying of topical medication in accordance with sections 5123.41 to 5123.47 of the Revised Code and in accordance with rules 5123-6-01 and 5123-6-07 of the Administrative Code;

(2) When medication is administered by an individual employed by a board of education, or a school charted by the state board of education, who has been designated according to section 3313.713 of the Revised Code to administer to a student a drug prescribed by an authorized prescriber; or

(3) In accordance with any other law or rule that authorizes an unlicensed person to administer medications.

Last updated February 1, 2022 at 8:56 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-13-03 Prohibitions.

(A) No person to whom a nursing task is delegated shall delegate the nursing task to any other person.

(B) An unlicensed person who performs a nursing task and does not comply with all the provisions as set forth in this chapter, and who is not otherwise excepted from licensure pursuant to section 4723.32 of the Revised Code, or otherwise legally authorized, shall be engaging in the unauthorized practice of nursing, which is prohibited by section 4723.03 of the Revised Code.

(C) Nothing in this chapter shall be construed to allow an unlicensed person to perform a delegated nursing task on any individual other than the individual specified by the delegating nurse.

Last updated September 11, 2023 at 11:15 AM

History

Effective: February 1, 2007
Promulgated Under: 119.03

Ohio Adm.Code 4723-13-05 Criteria and standards for a licensed nurse delegating to an unlicensed person.

(A) A registered nurse may delegate a nursing task to an unlicensed person if all the conditions for delegation set forth in this chapter are met.

(B) A licensed practical nurse may delegate to an unlicensed person only at the direction of the registered nurse and if all the conditions for delegation set forth in this chapter are met.

(C) An advanced practice registered nurse may delegate the administration of medication to an unlicensed person in accordance with the requirements set forth in division (B) of section 4723.48 of the Revised Code and section 4723.489 of the Revised Code.

(D) Except as otherwise authorized by law or this chapter, a licensed nurse may delegate to an unlicensed person the administration of only the following medications:

(1) Over-the-counter topical medications to be applied to intact skin for the purpose of improving a skin condition or providing a barrier; and

(2) Over-the-counter eye drop, ear drop, and suppository medications, foot soak treatments, and enemas.

(E) Prior to delegating a nursing task to an unlicensed person, the delegating nurse shall determine each of the following:

(1) That the nursing task is within the scope of practice of the delegating nurse as set forth in section 4723.01 of the Revised Code.

(2) That the nursing task is within the knowledge, skill, and ability of the nurse delegating the nursing task;

(3) That the nursing task is within the training, ability, and skill of the unlicensed person who will be performing the delegated nursing task;

(4) That appropriate resources and support are available for the performance of the task and management of the outcome; and

(5) That adequate and appropriate supervision by a licensed nurse of the performance of the nursing task is available in accordance with rule 4723-13-07 of the Administrative Code.

(6) That:

(a) The nursing task requires no judgment based on nursing knowledge and expertise on the part of the unlicensed person performing the task;

(b) The results of the nursing task are reasonably predictable;

(c) The nursing task can be safely performed according to exact, unchanging directions, with no need to alter the standard procedures for performing the task;

(d) The performance of the nursing task does not require that complex observations or critical decisions be made with respect to the nursing task;

(e) The nursing task does not require repeated performance of nursing assessments;

(f) The consequences of performing the nursing task improperly are minimal and not life-threatening; and

(g) Whether the nursing task, when added to the total number of delegated nursing tasks to be performed for an individual, indicates that the individual requires licensed nursing care rather than care provided by an unlicensed person.

(F) Prior to delegating a nursing task, the delegating nurse shall:

(1) Identify:

(a) The individual on whom the nursing task may be performed; and

(b) A specific time frame during which the delegated nursing task may be performed.

(2) Complete an evaluation of the conditions that relate to the delegation of the nursing task to be performed, including:

(a) An evaluation of the individual who needs nursing care;

(b) The types of nursing care the individual requires;

(d) The stability of the individual who needs nursing care; and

(e) A review of the evaluations performed by other licensed health care professionals.

(G) The delegating nurse shall be accountable for the decision to delegate nursing tasks to an unlicensed person.

(H) If a licensed nurse determines that an unlicensed person is not correctly performing a delegated nursing task, the licensed nurse shall immediately intervene.

Last updated February 1, 2022 at 8:56 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-13-06 Minimum curriculum requirements for teaching a nursing task.

A licensed nurse shall include all of the following when teaching an unlicensed person to perform a nursing task:

(A) Presentation of information on infection control and universal precautions;

(B) Presentation of information and directions on the concepts underlying the nursing task;

(C) Presentation of information and direction on how to correctly perform the specific nursing task according to current standards of practice following step-by-step directions readily available to the unlicensed person;

(D) Demonstration of the nursing task; and

(E) Observation and documentation of a satisfactory return demonstration by the unlicensed person of the nursing task.

Last updated September 11, 2023 at 11:15 AM

History

Effective: February 1, 2007
Promulgated Under: 119.03

Ohio Adm.Code 4723-13-07 Supervision of the performance of a nursing task performed by an unlicensed person.

(A) When a licensed nurse delegates a nursing task to an unlicensed person in accordance with this chapter, supervision of the performance of the nursing task by the unlicensed person shall be provided by the delegating nurse. For purposes of this rule, supervision includes initial and ongoing direction, procedural guidance, and evaluation, and may include direct observation of the performance of the nursing task. The delegating nurse shall evaluate the performance by the unlicensed person of the delegated nursing task, the need for further instruction, and the need to withdraw the delegation.

(B) If the substantial purpose of the setting, institution, or agency where a delegated nursing task is being performed is the provision of health care services, the supervision provided by the delegating nurse shall be on-site direct supervision.

(C) If the substantial purpose of the setting, institution, or agency where a delegated nursing task is being performed is other than the provision of health care services, the supervision provided by the delegating nurse may be on-site direct supervision, or indirect supervision provided by the delegating nurse who is always accessible through some form of telecommunication. Prior to the delegation of any nursing task in a setting, institution, or agency where the substantial purpose of the setting, institution, or agency is other than the provision of health care, a registered nurse shall conduct an assessment . The assessment and the following factors shall be used by the delegating nurse to determine the supervision required by the delegating nurse.

(1) The number of individuals who require nursing care and the health status of the individuals;

(2) The types and number of nursing tasks that will be delegated;

(3) The continuity, dependability, and reliability of the unlicensed person who will be performing the delegated nursing task;

(4) If the delegating nurse is assuming responsibility for more than one setting, the distance between settings, the accessibility of each setting, and any unusual problems that may be encountered in reaching each setting; and

(5) The availability of emergency aid should the nurse be too far from the setting to arrive at the setting in a timely manner.

Last updated September 11, 2023 at 11:15 AM

History

Effective: February 1, 2007
Promulgated Under: 119.03

Chapter 4723-14 Continuing Nursing Education

Ohio Adm.Code 4723-14-01 Definitions.

As used in this chapter:

(A) "Accredited provider" means an entity that has received accreditation through a nationally recognized system. An accredited provider is authorized to plan, present and award contact hours for continuing education activities.

(B) "Approved provider unit" means an entity whose continuing education system has been approved by an OBN approver according to this chapter, or who has been approved by a national accrediting body to provide continuing education in a health care field. An approved provider unit is authorized to plan, present and award contact hours for continuing education activities.

(C) "Asynchronous learning" means forms of education, instruction and learning that do not occur in the same space or at the same time.

(D) "Blended learning" is a combination of independent study materials and faculty directed education or enduring materials and faculty directed education.

(E) "Category A" means a continuing education activity that meets the one hour requirement directly related to Chapter 4723. of the Revised Code and the rules of the board as described in rule 4723-14-03 of the Administrative Code. To qualify as category A, the continuing education must be approved by the board, an OBN approver, accredited provider, or offered by an approved provider unit.

(F) "Clinical content" means that the continuing education being provided includes information about patients, patient care, clinical skills, or clinical knowledge.

(G) "Commercial support" means monetary or in-kind contributions given to the provider, or approved provider unit of a continuing education activity by an ineligible company that is used to pay for all or part of the costs of a continuing education activity.

(H) "Content integrity" means assuring the content of the education is evidence based and free from commercial bias and marketing.

(I) "Contact hour" means sixty minutes of continuing education, which may be determined by rounding to the nearest quarter hour.

(J) "Continuing education" means a learning activity that builds upon a prelicensure or precertification education program and enables a licensee or certificate holder to acquire or improve knowledge or skills that promote professional or technical development to enhance the licensee's or certificate holder's contribution to quality health care and pursuit of health care career goals according to rule 4723-14-05 of the Administrative Code.

(1) "Faculty-directed continuing education activity" means a continuing education activity in which faculty facilitate the pace and content of the activity, and the activity is one for which contact hours may be awarded. The activity may occur in settings such as a classroom, on-line, or via teleconference provided that one or more individuals is facilitating the pace of the activity.

(2) "Independent study continuing education activity" means a self-paced learning activity for which contact hours may be awarded that includes both a mechanism for evaluation of learning and feedback to the learner.

(3) "Enduring continuing education activity" means a provider-directed learner self-paced learning activity for which contact hours may be awarded.

(4) "Interprofessional continuing education" means a planned, organized learning experience designed for a target audience made up of members of two or more different professions.

(K) "Entity" means a corporation, whether for profit or nonprofit, a partnership, a limited liability company, or an unincorporated society or association, but does not include a natural person.

(L) "Ineligible Company" means an entity that produces, markets, re-sells or distributes health care goods or services consumed by or used on patients, or that is owned or controlled by an entity that produces, markets, re-sells or distributes health care goods or services consumed by, or used on patients.

(M) "Marketing" means the process of promoting, selling and distributing a product or service. It includes advertising, selling and delivering products.

(N) "OBN" means the Ohio board of nursing.

(O) "OBN approver" means an approver of continuing education, headquartered in the state of Ohio, that has successfully completed the approval or reapproval process set forth in rules 4723-14-09 and 4723-14-10 of the Administrative Code.

(P) "Planned learning activity" means an educational experience which meets the requirements of this chapter and that may include interprofessional continuing education.

(Q) "Proof of completion of continuing education" means a document or other verification that is issued by a continuing education provider as evidence of successful completion of a continuing education activity, and that meets the requirements set forth in rule 4723-14-06 of the Administrative Code.

(R) "Provider" means an entity that has received approval to plan and present faculty-directed, enduring, or independent study continuing education activities.

(S) "Reactivate" means to change the status of a license or certificate from inactive to active.

(T) "Reinstate" means to change the status of a license or certificate from lapsed or suspended to reinstated.

(U) "Reporting period" means:

(1) For a licensed practical nurse, July first through June thirtieth in the even numbered years;

(2) For a registered nurse, July first through June thirtieth in the odd numbered years;

(3) For an advanced practice registered nurse, July first through June thirtieth in the odd numbered years;

(4) For an Ohio certified dialysis technician, January first through December thirty-first in the odd numbered years;

(5) For a certified community health worker, January first through December thirty-first in the odd numbered years;

(6) For a state of Ohio certified doula, the reporting period specified in Chapter 4723-24 of the Administrative Code.

(V) "Waiver" means a one-time exception from meeting the continuing education requirement set forth in section 4723.24 of the Revised Code and rules 4723-8-10, 4723-14-03, 4723-23-06, and 4723-26-05 of the Administrative Code.

Last updated March 26, 2026 at 8:31 AM

History

Effective: March 26, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-03 Continuing education requirement for licensed practical and registered nurses.

(A) A nurse applying to renew an active license to practice nursing as a licensed practical nurse or registered nurse in Ohio must complete twenty-four contact hours of continuing education during the reporting period, unless an exception applies, and at least one of the required hours needs to be in category A continuing education.

(1) For the period immediately following licensure by examination, a nurse who holds an active license to practice nursing in Ohio is not required to complete any contact hours of continuing education for the first license renewal;

(2) A nurse who has been licensed by endorsement in Ohio for one year or less must complete twelve contact hours of continuing education;

(3) A nurse who has been licensed by endorsement in Ohio for more than one year must complete twenty-four contact hours of continuing education.

(B) A licensed practical nurse who has an active license as a registered nurse in Ohio is not required to meet the continuing education requirement for renewal of the license to practice as a practical nurse.

(C) A nurse from another jurisdiction who applies for licensure by endorsement to practice as a licensed practical nurse or registered nurse in Ohio is required to complete two contact hours of category A continuing education in order to be eligible for licensure.

(D) In order to renew, applicants must attest to completion of the continuing education required by this rule on the application for renewal. The board may require a renewal applicant to show proof of completion of continuing education. If the board requests proof of continuing education and the applicant fails to provide proof to the board before the end of the renewal period, the license shall lapse.

(E) To reactivate an inactive license or to reinstate a lapsed license to practice as a licensed practical nurse or registered nurse, the applicant must complete twenty-four contact hours of continuing education during the twenty-four month period immediately before the application date.

(1) If the license of a registered nurse or licensed practical nurse has been inactive or lapsed in Ohio less than two years, or the applicant holds a current, valid license in another jurisdiction, the continuing education shall be twenty-four contact hours of continuing education that includes one hour of category A.

(2) If the license of a registered nurse or licensed practical nurse has been inactive or lapsed in Ohio for two years or more, and the applicant does not hold a current, valid license in another jurisdiction, the continuing education must consist of twenty-four contact hours. The twenty-four contact hours must include two contact hours of category A with learning outcomes that address scopes of practice for registered and licensed practical nurses, standards of safe practice, and nursing delegation.

(F) A licensed practical nurse or registered nurse who requests that a license to practice be placed on inactive status is not required to meet the continuing education requirement for the period during which the license is on inactive status. To return to active status, the nurse must meet the continuing education requirements in paragraph (E) of this rule.

(G) A licensed practical nurse or registered nurse may use a waiver to satisfy the continuing education requirement for one renewal period only if the nurse notifies the board in writing requesting the waiver. Once a nurse notifies the board of the intent to use the waiver, the board will not accept a withdrawal of the request.

(H) A licensed practical nurse or registered nurse cannot use the waiver to satisfy the requirements of rule 4723-8-10 or 4723-14-07 of the Administrative Code, or to meet the requirements for reactivating or reinstating a license.

(I) A licensed practical nurse or registered nurse who earns more than the number of hours required by this chapter during a single renewal period cannot apply the extra hours to meet future renewal period continuing education requirements.

(J) One contact hour of education, that is directly related to recognition and handling of human trafficking victims, or victims of sexual assault, may qualify as part of the hours of continuing education required by paragraph (A), paragraph (E) or paragraph (K) of this rule for purposes of license or certificate renewal, reactivation or reinstatement.

(K) An individual holding a volunteer's certificate issued by the board according to section 4723.26 of the Revised Code must:

(1) To renew the certificate, complete twenty-four contact hours of continuing education in the twenty-four month period immediately before the renewal application date, that meets the requirements of Chapter 4723-14 of the Administrative Code, and includes:

(a) Two contact hours of category A with learning outcomes that address standards of safe practice and nursing delegation;

(b) One contact hour that includes content in patient abuse, patient rights, and professional boundaries;

(c) Two contact hours that include content in the scope of practice of the licensed practical nurse and the registered nurse;

(d) Two contact hours in nursing documentation;

(e) Three contact hours in principles of pain management;

(f) One contact hour that addresses the application of the nursing process and critical thinking related to patient care;

(g) One contact hour that includes content in maintaining patient confidentiality;

(h) Four contact hours in patient assessment and wound care;

(i) Four contact hours in medication administration and preventing medication errors; and

(j) Four contact hours relevant to the nurse's practice setting.

(2) To reactive an inactive certificate or reinstate a lapsed certificate, the applicant must complete the continuing education requirements specified in paragraph (K)(1) of this rule.

(L) For purposes of complying with the twenty-four hours of continuing education required by section 4723.24 of the Revised Code, a licensed practical nurse or registered nurse may satisfy up to eight hours by providing health care services as a volunteer if the following requirements are met:

(1) The licensee provides the health care services to an indigent and uninsured person as defined in section 2305.234 of the Revised Code;

(2) For registered nurses, the health care services provided are the practice of nursing as a registered nurse as defined in division (B) of section 4723.01 of the Revised Code;

(3) For licensed practical nurses, the health care services provided are the practice of nursing as a licensed practical nurse as defined in division (F) of section 4723.01 of the Revised Code;

(4) The health care services provided are provided as a volunteer, as that term is defined in section 2305.234 of the Revised Code;

(5) The licensee satisfies the requirements of section 2305.234 of the Revised Code to qualify for the immunity from liability granted under that section;

(6) One hour of continuing education may be awarded for each sixty minutes documented as spent providing health care services as a volunteer;

(7) The licensed practical nurse or registered nurse obtains, and maintains for a period of six years following the date the health care services are provided, a signed statement from a person at the health care facility or location where the health care services were performed indicating:

(a) The date and time period the licensee performed the health care services;

(b) That the recipient of the health care services was indigent and uninsured as defined in section 2305.234 of the Revised Code; and

(c) That the licensee provided the health care services as a volunteer as defined in section 2305.234 of the Revised Code.

Last updated March 26, 2026 at 8:29 AM

History

Effective: March 26, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-04 Determining the continuing education credit.

(A) The official unit of measure for continuing education credit for licensees and certificate holders is the contact hour, as defined in paragraph (I) of rule 4723-14-01 of the Administrative Code.

(B) The calculation of contact hours based on credit hours earned in an academic institution is as follows:

(1) For credit hours earned on an academic quarter system, one credit hour is equivalent to ten contact hours;

(2) For credit hours earned on an academic trimester system, one credit hour is equivalent to twelve contact hours;

(3) For credit hours earned on an academic semester system, one credit hour is equivalent to fifteen contact hours; and

(4) For credit hours that have not been identified as quarters, semesters, or trimesters, one credit hour is equivalent to ten contact hours.

(C) The amount of continuing education credit designated on a certificate issued according to rule 4723-14-06 of the Administrative Code by the provider or approval body will be the amount accepted by the board.

(D) The OBN approver shall determine the minimum number of contact hours to be awarded.

(E) A licensee or certificate holder who is engaged in active military duty may be eligible for an extension of time to complete continuing education as provided in rule 4723-2-04 of the Administrative Code.

Last updated February 1, 2023 at 8:58 AM

History

Effective: February 1, 2023
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-05 Educational activities that do and do not meet the continuing education requirement.

(A) Any of the following options may be used by a licensee or certificate holder to meet the continuing education requirements set forth in section 4723.24 of the Revised Code, this chapter, or Chapter 4723-23, 4723-26 or 4723-27 of the Administrative Code:

(1) A continuing education activity that has been approved by an OBN approver or provided by an approved provider unit;

(2) A continuing education activity that has been approved by a board or agency regulating the licensee or certificate holder in another jurisdiction;

(3) A continuing education activity that has been approved or provided by a nationally recognized accreditation system of continuing education or a national certifying organization that meets the requirements in division (A) of section 4723.46 of the Revised Code;

(4) A successfully completed course provided by an accredited educational institution for which academic credit is awarded to the licensee or certificate holder;

(5) An independent study continuing education activity, or an enduring continuing education activity, as defined in rule 4723-14-01 of the Administrative Code;

(6) Interprofessional continuing education as defined in rule 4723-14-01 of the Administrative Code;

(7) A continuing education activity that has been approved by a board or an agency that regulates a health care profession or related discipline in Ohio or another jurisdiction;

(8) Continuing education credit may be given to a licensee or certificate holder who develops and presents a course or activity, or develops an independent study continuing education activity, or an enduring continuing education activity, as follows:

(a) For the first time a presentation is given, the licensee or certificate holder who develops and presents the course or activity shall be awarded the same number of contact hours as the participant receives for the presentation. Contact hours shall only be awarded for the first time a presentation is given;

(b) For an independent study continuing education activity, or an enduring continuing education activity, the number of contact hours awarded to the licensee or certificate holder who develops the independent study or enduring activity shall be equal to the number of contact hours awarded to participants who complete the independent study or enduring activity;

(c) A licensee or certificate holder who presents a portion of an activity may receive continuing education contact hours for additional portions of the activity the licensee or certificate holder attends but does not present.

(9) The board may award contact hours for a board-approved continuing education activity.

(10) A nurse who completes CE activities defined in paragraphs (A)(1) to (A)(9) of the Administrative Code, shall retain and submit upon audit or request of the board proof of completion of continuing education as contained in rule 4723-14-06 of the Administrative Code.

(B) Except as provided for advanced practice registered nurses in paragraph (C) of this rule, the following activities cannot be used by a licensee or certificate holder to meet the continuing education requirements set forth in section 4723.24 of the Revised Code, this chapter, or Chapter 4723-23, 4723-26 or 4723-27 of the Administrative Code:

(1) Repetition of any educational activity with identical content and course outcomes within a single reporting period;

(2) Self-directed learning such as reading of texts or journal articles that has not been approved as an independent study or an enduring activity or awarded contact hours by an accredited or approved provider or provider unit;

(3) Participation in clinical practice or research that is not part of a continuing education activity;

(4) A personal development activity;

(5) Professional meetings or conventions except for those portions designated as a continuing education activity;

(6) Community service or volunteer practice, unless the service or practice qualifies under paragraph (L) of rule 4723-14-03 of the Administrative Code;

(7) Continuing education ordered by the board pursuant to section 4723.28, 4723.282, 4723.652 or 4723.86 of the Revised Code; or

(8) Membership in a professional organization.

(C) The continuing education required of an advanced practice registered nurse to maintain certification by a national certifying organization shall be applied toward the continuing education requirements for renewal of a license to practice as a registered nurse and advanced practice registered nurse if the continuing education is obtained through a program or course meeting the requirement of paragraph (A) of this rule. Notwithstanding paragraph (B) of this rule, if the activity is approved or provided by a national certifying organization, which meets the requirements of division (A) of section 4723.46 of the Revised Code, the activity may include the following:

(1) Self-directed learning such as reading or reviewing of texts or journal articles;

(2) Participation in clinical practice, research or mission trips;

(3) Professional meetings or conventions; or

(4) Precepting, teaching or conducting public education courses.

Last updated February 1, 2023 at 8:58 AM

History

Effective: February 1, 2023
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-06 Proof of completion of continuing education.

(A) A licensee or certificate holder must keep proof of completion of continuing education for six years.

(B) Upon board request, the licensee or certificate holder shall immediately provide the board proof of completion of continuing education, including the following:

(1) A copy of the certificate issued by the provider that meets the requirements set forth in this rule;

(2) A school transcript or grade report that meets the requirements set forth in this rule; or

(3) Other documentation that meets the requirements set forth in this rule.

(1) The authorized OBN approver number;

(2) Information about the accreditation system, if any;

(3) Space for the name of the attendee;

(4) Title of the program;

(5) Date of the program;

(6) Name and address of the provider;

(7) The number of contact hours earned; and

(8) When applicable, a statement that includes the number of category A hours and any other specific continuing education hours required under Chapter 4723. of the Revised Code and this chapter for certain licensees or certificate holders.

(D) The certificate issued by an approval body that meets the criteria of this chapter, but that is not an OBN approved provider, shall include the following:

(1) Space for the name of the attendee;

(2) Title of the program;

(3) Date of the program;

(4) Name of the provider;

(5) The number of contact hours earned; and

(6) The name of the authorized approver or the name of the approval body.

(E) For a course completed for academic credit, the school transcript or grade report shall include the following:

(1) The name of the student;

(2) The name of the school attended;

(3) The dates attended; and

(4) The credit hours awarded.

(F) Individuals seeking continuing education credit for first time presentation of a course for which contact hours were awarded, as referenced in paragraph (A)(8) of rule 4723-14-05 of the Administrative Code, shall supply the following:

(1) Original date of the activity;

(2) Length of the presentation;

(3) Title of the activity;

(4) The authorized OBN approver number, or name of the authorized approver if not OBN;

(5) Name of the provider;

(6) Outcomes for the activity; and

(7) Number of contact hours awarded for the presenter's presentation.

(G) If the information required by this rule is not included on the certificate, transcript, or grade report, the licensee or certificate holder shall obtain from the provider or academic institution a letter or other documentation satisfactory to the board that supplies the required information.

Last updated September 11, 2023 at 11:16 AM

History

Effective: February 1, 2015
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-07 Continuing education audit.

(A) The board may conduct an audit of any licensee or certificate holder to determine compliance with continuing education requirements. The audit shall be conducted as follows:

(1) The board will notify the licensee or certificate holder of the audit;

(2) The audit notice will reference the reporting period for which the licensee or certificate holder is required to provide proof of completion of continuing education;

(3) Within sixty days after the mailing of the audit notice, the licensee or certificate holder shall submit proof of completion of continuing education for the specified licensure or certification period to the board.

(B) If the documentation submitted to the board by the licensee or certificate holder in response to an audit notice indicates noncompliance with the continuing education requirements, the board shall send notice of noncompliance to the licensee or certificate holder. The notice may indicate any action the licensee or certificate holder is required to take to avoid being ineligible to renew the license or certificate on the next scheduled renewal date.

(C) A licensee or certificate holder who fails to respond to an audit or noncompliance notice, or who fails to provide proof to the board of meeting the required continuing education, will not be provided a renewal application, and is not eligible for renewal, reactivation or reinstatement of the license or certificate until all continuing education requirements are satisfied.

(D) A licensee or certificate holder who is ineligible to renew, reinstate or reactivate due to failure to comply with continuing education requirements is required to provide to the board proof of completion of up to forty-eight hours of continuing education in the forty-eight month period immediately before the application date in order to renew, reinstate, or reactivate their license or certificate.

(E) A licensee or certificate holder cannot use a waiver instead of providing the board proof of completed continuing education after receiving an audit notice.

Last updated September 11, 2023 at 11:16 AM

History

Effective: February 1, 2014
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-08 General requirements for an Ohio board of nursing (OBN) approver.

(A) A provider unit, headquartered in Ohio, that has been operating for a minimum of three years may apply to the board to become an OBN approver of continuing education if it is:

(1) A nursing or dialysis technician organization;

(2) A nursing education program;

(3) A dialysis technician training program; or

(4) A nursing or dialysis technician continuing education department.

(B) The OBN approver applicant shall demonstrate to the board its ability to determine that a provider of continuing education meets the standards set forth in this chapter.

(D) An OBN approver must use its assigned approver number on all written material and must have a mechanism to ensure that all providers approved by the OBN approver use the number.

Last updated September 11, 2023 at 11:16 AM

History

Effective: February 1, 2013
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-09 Process to obtain initial approval as an OBN approver.

(A) To become an OBN approver the following shall be submitted to the board:

(1) A completed "OBN Approver Application," that includes, with respect to the proposed OBN approver:

(a) Demographic data;

(b) An organizational overview and goals related to operating as an OBN approver;

(d) A budget plan;

(e) A description of the record-keeping system to be used;

(f) A description of the proposed evaluation process;

(g) An organizational table showing staff responsibilities;

(h) A description of the process for approving providers or provider units that includes peer review directed by a registered nurse who holds a current, valid license issued by the board, a master's degree and either:

(i) Has a background or education in adult education; or

(ii) Has documented knowledge of the continuing education process;

(i) A copy of the policies required by rule 4723-14-12 of the Administrative Code.

(2) An attestation that the information provided to the board is true and accurate.

(B) The board may conduct a site visit of the proposed OBN approver to verify the accuracy of the information submitted to the board in the application process.

(C) The board shall notify the proposed OBN approver in writing if additional information is needed. The notice shall specify a time frame for submission of the requested information.

(D) At a regularly scheduled board meeting the board shall review a summary of the completed application submitted by the proposed OBN approver and any other information required by the board to determine compliance with this chapter. After review the board will:

(1) Grant initial approval, and assign an OBN approver number, to the proposed OBN approver for a period of two years;

(2) Deny approval based on the proposed OBN approver's failure to meet requirements contained in this rule as identified by the board; or

(3) Defer action pending submission by the proposed OBN approver of additional information that addresses the requirements of this rule that were not met as identified by the board.

(E) The board shall provide written notice of its decision to the proposed OBN approver. A denial of approval shall comply with the requirements of Chapter 119. of the Revised Code.

(F) A proposed OBN approver shall not approve a continuing education activity or provider unit until authorized by the board to do so.

Last updated September 11, 2023 at 11:16 AM

History

Effective: January 1, 2018
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-10 Reapproval of an OBN approver.

(A) The board may conduct a site visit of the OBN approver to determine compliance with this chapter prior to reapproval of the approver.

(B) After reviewing a summary report and supporting documentation related to the site visit, the board shall:

(1) Grant reapproval to the OBN approver for no more than five years;

(2) Deny reapproval based on any of the reasons listed in paragraph (B) of rule 4723-14-11 of the Administrative Code;

(3) Defer action pending submission of additional information by the OBN approver that addresses the requirements of this chapter that were not met as identified by the board; or

(4) Extend the time period for approval in order to provide the board additional time to consider the reapproval application.

Last updated February 1, 2023 at 8:58 AM

History

Effective: February 1, 2023
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-11 Termination of OBN approver status.

(A) The board may conduct an audit of an OBN approver at any time. The audit may include a site visit or a request for any information needed to determine compliance with this chapter.

(B) The following may constitute grounds for termination of an OBN approver's approval status:

(1) Failure to maintain compliance with this chapter;

(2) Failure to submit information required by the board within the time frame established by the board;

(3) Refusal to cooperate during a site visit conducted by the board; or

(4) Providing false, misleading, or deceptive statements, or submitting or causing to be submitted any false, misleading or deceptive information, or documentation to the board or any representative of the board.

(C) A board proposal to terminate OBN approver status shall comply with the requirements of Chapter 119. of the Revised Code. The board may enter a settlement with the OBN approver, or may order continued approval, terminate approval, or continue approval with conditions or restrictions.

(D) An OBN approver may voluntarily surrender its approval status. Upon surrender, the OBN approver must comply with the requirements in rule 4723-14-18 of the Administrative Code.

Last updated September 11, 2023 at 11:16 AM

History

Effective: February 1, 2013
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-12 OBN approver processes and statements.

(A) An OBN approver shall establish, implement, and enforce processes that address the following:

(1) The scope of the approver's approval activities including identification of the target audience of providers and the type of applications to be approved;

(2) Qualifications and responsibilities of all paid or volunteer staff members of the approver, including a mechanism for identifying and handling potential conflicts of interest for individuals involved in the approval process;

(3) A peer review process to be used for review and approval of all continuing education activities;

(4) A process to ensure that documentation of a planned activity satisfies the requirements of this chapter;

(5) An application process and guidelines for approval and reapproval of faculty-directed, enduring, and independent study continuing education activities, according to rules 4723-14-15 and 4723-14-16 of the Administrative Code, that ensure:

(a) The approval or reapproval process is completed prior to the date the continuing education activity is offered; and

(b) The content of the activity meets the criteria for approval set forth in paragraph (J) of rule 4723-14-01 of the Administrative Code;

(6) An application process and guidelines for approval and reapproval to be used by an approved provider unit that applies to have its continuing education system approved according to rule 4723-14-17 of the Administrative Code. The process must ensure that the internal review and documentation used by the approved provider unit are completed before the date continuing education activity is offered;

(7) The documentation, review process, and record-keeping to be used by the OBN approver offering its own continuing education activities that ensure all documentation and reviews are completed before the date continuing education activity is offered;

(8) The process for awarding contact hours for a continuing education activity, including a statement of minimum requirements an individual must meet to receive contact hours;

(9) The process for ensuring content integrity and that the primary purpose of a continuing education activity is not to promote the sale of items or services;

(10) If any commercial support is provided for an educational activity, the continuing education provider will maintain control of the educational content and disclose the existence of the commercial support to the learner;

(11) For clinical content only, the provider will disclose to learners that there is no relevant financial relationship with an ineligible company involving anyone with the ability to control content of the educational activity, or, if there is a relevant relationship with an ineligible company, that it has been mitigated by the provider. The provider will disclose to the learner the name of the individual, the type of relationship and the name of the ineligible company;

(12) Exhibits shall not be set up or positioned in such a way that will influence or distract a learner from the educational activity;

(13) A system for record-keeping that ensures the following records are maintained, safely stored, and readily retrievable for a minimum of six years:

(a) A copy of the entire application package submitted to the board by the OBN approver and all reapproval applications;

(b) A copy of each continuing education application reviewed by the OBN approver with all attachments;

(d) A copy of any letter stating OBN approver decisions and all other pertinent correspondence; and

(e) All additional or clarifying information concerning the application;

(14) An evaluation process that provides for evaluation of the activities of the OBN approver;

(15) The process for assuring that the OBN approver number is used in all correspondence and advertising as required by paragraph (E) or (F) of rule 4723-14-14 of the Administrative Code;

(16) The process for development and distribution to the public of material related to approval activities including a current list of continuing education activities approved or offered by the OBN approver;

(17) Possible actions an OBN approver may take in response to an application for approval submitted by a continuing education provider, including the time period for notifying the applicant regarding the action taken;

(18) The actions a continuing education provider may take while an application for approval of a continuing education activity is pending before an OBN approver, including a process for appealing a negative decision by the approver;

(19) The process for withdrawal of approval of a continuing education provider's activity or system that includes a description of the circumstances that can lead to loss of approval and the process used to notify consumers regarding the loss of approval;

(20) Publication of deadlines for submitting continuing education provider applications and fees for the approval process;

(21) The process for documenting a review conducted by the OBN approver in response to complaints received about a provider or provider unit.

(B) An OBN approver must have goals that are consistent with the requirements of this chapter.

(C) An OBN approver must establish a means to review the provider unit during the three year approval period, that may include on-site visits to the provider unit, or review of documentation requested by the OBN approver.

Last updated February 1, 2024 at 9:33 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-13 Reports to the board by an OBN approver.

(A) An OBN approver must give written notice to the board within thirty days of any significant change in the:

(1) Approval system;

(2) Key personnel directly responsible for the approval system including peer reviewers and the primary contact for the OBN approver;

(3) Structure of the administration that influences the functioning of the approver;

(4) Ownership of the OBN approver; or

(5) The OBN approver's activities.

(B) An OBN approver must provide the board all data about its approval activities as requested by the board within the time frame established by the board.

Last updated February 1, 2023 at 8:59 AM

History

Effective: February 1, 2023
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-14 Approval of a continuing education provider or approved provider unit.

(A) An OBN approver may approve the individual continuing education activities offered by a provider or may approve the entire continuing education system of an approved provider unit.

(B) A continuing education activity offered by a provider or approved provider unit may be faculty-directed, an independent study, an enduring activity, or blended learning as defined in rule 4723-14-01 of the Administrative Code.

(C) An OBN approver may grant a provider approval of an individual continuing education activity for two years, or grant approval to an approved provider unit for its entire continuing education system for up to three years provided:

(1) For an individual continuing education activity, the provider notifies the OBN approver of all additional dates the activity will be offered and of any change to the activity; or

(2) For an approved provider unit whose entire continuing education system has been approved, the approved provider unit maintains records of additional dates and any change to the repeated activity.

(D) An OBN approver may present its own continuing education activity provided the approver ensures that documentation of a planned activity meets the requirements of this chapter.

(E) If approved by an OBN approver, all marketing for the continuing education activity must include the approval status and the OBN approver number.

(F) If approval by an OBN approver is not yet determined, marketing for a continuing education activity must include a statement that directs any interested party to contact the provider to obtain information regarding approval status.

Last updated February 1, 2023 at 9:00 AM

History

Effective: February 1, 2023
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-15 Approval of a faculty-directed continuing education activity.

(A) Each application for approval of a continuing education activity, other than an independent study activity, submitted by a continuing education provider to an OBN approver must document all of the following:

(1) Availability of adequate resources to be used for administering and planning the continuing education activity, including identification of the person responsible for its administration and planning;

(2) The process of assessment, planning, implementation and evaluation of a continuing education activity occurs under the direction of a registered nurse or a planning committee that includes at least one registered nurse, and at least one licensed practical nurse if the target audience includes licensed practical nurses;

(3) Identification of the target audience and appropriate outcomes for the identified target audience;

(4) Inclusion of learning outcomes for each segment of the continuing education activity that are appropriate for the identified target audience;

(5) Identification of a content outline reflecting continuing education principles, practice, and needs of the target audience;

(6) Identification of faculty credentials that include the specific qualifications of each faculty member for the topic area to be presented;

(7) A process ensuring the approved provider maintains control of, and responsibility for, all aspects of meeting and maintaining the continuing education requirements set forth in Chapter 4723-14 of the Administrative Code;

(8) If any commercial support is provided for an education activity the continuing education provider will maintain control of the educational content and disclose to the learner the existence of commercial support;

(9) The provider will disclose to learners that there is no relevant relationship with an ineligible company for anyone with the ability to control content of the educational activity, or if there is, it has been mitigated by the provider. The provider will disclose to the learner the name of the individual, the type of relationship and the name of the ineligible company;

(10) Exhibits shall not be set up or positioned in such a way that will influence or distract a learner from the educational activity;

(11) Evaluation of the continuing education activity that addresses the achievement of program outcomes;

(12) Identification of criteria for successful completion of the continuing education activity that are communicated to the participant before the continuing education activity; and

(13) The method used for determining the number of contact hours to be awarded.

(B) Any marketing materials for the continuing education activity must be completed according to rule 4723-14-14 of the Administrative Code and must be submitted to the OBN approver for review. A draft may be submitted with the application with a final copy to be submitted for the record.

(1) All marketing for the continuing education activity shall include the approval status and the OBN approver number; and

(2) If approval by the OBN approver is not yet determined, marketing for a continuing education activity shall include a statement that directs any interested party to contact the provider to obtain information regarding approval status.

(C) A document verifying completion of a continuing education activity must be given by the continuing education provider to all attendees who meet the requirements to receive contact hours. The document shall include:

(1) A space for the name of the attendee;

(2) The title of the program;

(3) The date of the program;

(4) The name and address of the provider of the continuing education activity;

(5) The name of the OBN approver and OBN approver number;

(6) The number of contact hours earned;

(7) When applicable, a statement that includes the number of category A hours, or a statement that includes the number of contact hours and a description of the following:

(a) Continuing education for non-certified clinical nurse specialists as described in rule 4723-8-10 of the Administrative Code;

(b) Continuing education for dialysis care as described in rule 4723-23-06 of the Administrative Code;

(c) Continuing education in advanced pharmacology for an advanced practice registered nurse designated as a clinical nurse specialist, certified nurse practitioner, or certified nurse-midwife as described in section 4723.24 of the Revised Code;

(d) Continuing education for an advanced practice registered nurse designated as a clinical nurse specialist or certified nurse practitioner in the detection of concussion, its clinical features, assessment techniques, and the principles of safe return to play protocols as set forth in rule 4723-8-11 of the Administrative Code; and

(8) When applicable, indication of contact hours for the initial presentation of the continuing education activity by the presenter.

(D) Records must be maintained by the provider offering the continuing education activity in a safe, secure, and accessible manner for at least six years and shall include the following for each continuing education activity approved:

(1) A complete copy of all application data;

(2) All correspondence with the OBN approver;

(3) A list of all attendees who were issued contact hours for each date the continuing education activity was offered that includes the number of contact hours granted to each;

(4) A summary evaluation of the continuing education activity; and

(5) Any change made to the program during its approval period.

(E) During the period of approval, the provider offering the continuing education activity approved by the OBN approver must notify the OBN approver of:

(1) Any additional presentation dates; and

(2) Any change made to the continuing education activity as submitted in the original application.

(F) An OBN approver may approve an individually submitted continuing education activity that complies with the standards set forth in this rule. The approval may be granted for up to two years.

(G) An application for reapproval of an individually submitted continuing education activity may be simplified according to policies established by the OBN approver.

Last updated February 1, 2023 at 9:00 AM

History

Effective: February 1, 2023
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-16 Approval of an independent study continuing education activity.

(A) An application for approval of an independent study continuing education activity submitted by a provider to an OBN approver must include documentation of all of the requirements contained in paragraphs (A) to (D) of rule 4723-14-15 of the Administrative Code in addition to the following:

(1) Documentation of the qualifications of the author of the independent study package and those of the individual providing feedback to the learner;

(2) A description of the entire independent study package that outlines all activities of the learner, all materials to be used, and the method the learner is to use to gain access to, or interact with, the provider of the independent study;

(3) Documentation of the effectiveness of the independent study in meeting outcomes, and of the rationale used to determine the number of contact hours to be awarded; and

(4) An evaluation mechanism that includes a method for providing feedback to the learner.

(B) An OBN approver may approve an individually submitted independent study continuing education activity that complies with the requirements of this rule. The approval may be valid for up to two years.

(C) An application for reapproval of an individually submitted independent study continuing education activity may be simplified according to policies established by the OBN approver.

Last updated June 8, 2023 at 9:30 AM

History

Effective: February 1, 2015
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-17 Approval of the continuing education system of a provider unit.

(A) An OBN approver may elect to approve and reapprove the continuing education system of a proposed provider unit for a specified period of time, not to exceed three years. The approval and reapproval processes shall be based on an in-depth analysis by the OBN approver of the ability of the proposed provider unit to meet the board continuing education requirements set forth in this chapter, and to maintain the requirements during the approval period. The applicant for initial approved provider unit status must include documentation demonstrating the proposed provider unit:

(1) Has the ability to meet the board continuing education requirements set forth in this chapter by having received approval for a specified number of continuing education activities or contact hours before applying for approval of the continuing education system;

(2) Is an identifiable unit and has goals consistent with the requirements of this chapter;

(3) Has sufficient resources to meet and maintain board requirements of this chapter including a registered nurse responsible for the planning and implementation of continuing education activities;

(4) Documents planned learning activities that meet the requirements of this chapter;

(5) The proposed provider unit must have the following ready to implement:

(a) A process ensuring that all continuing education requirements contained in this chapter are to be met and maintained;

(b) A process to ensure that all the required planning documentation is completed before presentation of the continuing education activity, and that the required records are completed after the presentation and maintained according to rule 4723-14-12 of the Administrative Code;

(c) A process ensuring the approved provider unit maintains control of, and responsibility for, all aspects of meeting and maintaining continuing education requirements set forth in this chapter;

(d) A process requiring that all marketing used by the provider meets the requirements of rule 4723-14-14 of the Administrative Code;

(e) A process requiring ongoing evaluation of the approved provider unit's system;

(f) If any commercial support is provided for an activity, the continuing education provider will maintain control of the educational content and disclose the existence of commercial support to the learner;

(g) For clinical content only, the provider will disclose to learners that there is no relevant financial relationship with an ineligible company for anyone with the ability to control content of the educational activity, or if there is, it has been mitigated by the provider. The provider will disclose to the learner the name of the individual, the type of relationship and the name of the ineligible company;

(h) Exhibits shall not be set up or positioned in such a way that will influence or distract a learner from the educational activity; and

(6) The applicant for approved provider unit status must submit to the OBN approver complete documentation of a continuing education activity that has been previously approved by an OBN approver. The documentation must demonstrate that the requirements for a continuing education activity required by this chapter are met.

(B) For reapproval, an approved provider unit must submit to the OBN approver, at a minimum, updated processes and sample documentation for a continuing education activity demonstrating that the requirements in rules 4723-14-15 and 4723-14-16 of the Administrative Code are met. The documentation must include the following:

(1) Marketing material;

(2) A description of how continuing education rules have been followed during the approval time period;

(3) Results of the approved provider unit's evaluation process; and

(4) Any additional information requested by the OBN approver.

(C) An approved provider unit must give written notice to the OBN approver within thirty days of any significant change in the:

(1) Provider system;

(2) Key personnel directly responsible for the provider system including the registered nurse responsible for the planning and implementation of activities as required by paragraph (A)(3) of rule 4723-14-17 of the Administrative Code, and the primary contact for the provider;

(3) Structure of the administration that influences the functioning of the provider;

(4) Ownership of the approved provider unit; or

(5) Approved provider unit activities.

(D) An approved provider unit shall not approve continuing education activities. An approved provider unit is authorized to award contact hours only for those continuing education activities that have been planned and implemented by the approved provider unit according to the requirements of this chapter, including having a registered nurse responsible for the planning and implementation of activities as required by paragraph (A)(3) of rule 4723-14-17 of the Administrative Code.

(E) Records must be maintained by the approved provider unit in a safe, secure, and accessible manner for at least six years, and must include:

(1) A complete copy of the provider unit application submitted to the OBN approver and all related correspondence;

(2) Copies of all continuing education activity files including:

(a) Documentation for a continuing education activity required by paragraphs (A) to (C) of rule 4723-14-15 of the Administrative Code, or documentation for an independent study required by rule 4723-14-16 of the Administrative Code;

(b) A list of all attendees who were awarded contact hours for each date the continuing education activity was offered that includes the number of contact hours awarded to each;

(d) Any changes made to the activity during the time the activity was offered to learners.

Last updated February 1, 2024 at 9:33 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-14-18 Voluntary termination of approval activities.

(A) An OBN approver who intends to terminate its approval status must establish and implement a plan for the orderly transfer of approver activities before the anticipated termination date, as follows:

(1) The OBN approver must give written notice to the board of its intent to surrender its OBN approver status at least six months before the anticipated termination date;

(2) The OBN approver must give written notice to all of its approved providers of continuing education activities that it intends to surrender its OBN approver status at least six months before the anticipated termination date;

(3) At least thirty days before the anticipated termination date, the OBN approver must give written notice to the board that includes the status of its approved provider units and the OBN approver's plan; and

(4) On or before the termination date, the OBN approver must identify a custodian of records and a record maintenance plan to ensure that the records will be maintained for at least six years, as required by rule 4723-14-12 of the Administrative Code.

(B) In the event an OBN approver must immediately cease its activities and is unable to comply with the time frames included in this rule, the OBN approver must identify a custodian of records and a record maintenance plan to ensure that the records will be maintained for at least six years, as required by rule 4723-14-12 of the Administrative Code.

Last updated September 11, 2023 at 11:16 AM

History

Effective: January 1, 2018
Promulgated Under: 119.03

Chapter 4723-16 Hearings

Ohio Adm.Code 4723-16-01 General information.

(A) For the purpose of this chapter of the Administrative Code:

(1) "Days" means calendar days.

(2) "Board hearing committee" means a standing committee of not less than three board members, appointed by the board at a public meeting, to conduct administrative hearings and provide a report and recommendation to the board as set forth in rule 4723-16-13 of the Administrative Code.

(3) "Hearing examiner" means the attorney appointed by the board to conduct a hearing pursuant to section 119.09 of the Revised Code.

(4) "Respondent" means the person who is requesting or has requested a hearing as provided in Chapter 119. of the Revised Code.

(5) "Representative of record" means the respondent or legal counsel for respondent who has filed a notice of appearance in accordance with rule 4723-16-02 of the Administrative Code or the assistant attorney general representing the state of Ohio.

(6) "Telecommunication" means communication by telephone conference or videoconference.

(B) The compilation of all time periods set forth in this chapter of the Administrative Code shall be in accordance with section 1.14 of the Revised Code.

(1) Any notice specifying the date, time, and place for a hearing mailed by the board shall be mailed by certified mail, or regular mail with a certificate of mailing, to respondent and, if applicable, respondent's representative of record.

(2) The mailing date of any document mailed by the board, including but not limited to, a notice of opportunity or adjudication order, shall be the date appearing on the certified mail receipt or certificate of mailing.

(3) A document is filed with the board when the document is received and time stamped at the board office located in Columbus, Ohio.

(4) A document may be filed by hand-delivery, mail, email or facsimile. If multiple copies of the same document are filed, only the first to be received by the board will be time stamped and retained by the board.

(D) A certified copy of a conviction, plea of guilty to, judicial finding of guilt, judicial finding of eligibility for pretrial diversion or similar program, or judicial finding of eligibility for intervention in lieu of conviction related to a felony or misdemeanor from a court of competent jurisdiction shall be conclusive proof of the commission of all elements of the felony or misdemeanor.

(E) The Ohio Rules of Evidence may be taken into consideration by the board, board hearing committee or the hearing examiner in determining the admissibility of evidence but shall not be controlling. The board, board hearing committee or hearing examiner may permit the use of electronic or photographic means for presentation of evidence.

Last updated December 2, 2024 at 11:49 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-16-02 Hearing representation and appearances.

(A) Respondents may be self represented or may be represented by an attorney, or attorneys, admitted to the practice of law in Ohio, and holding a current, active license to practice in Ohio.

(B) When respondent is represented by an attorney or attorneys, the attorney or attorneys each shall file a written notice of appearance with the board. The attorney or attorneys who have filed a notice of appearance with the board shall be considered by the board as the representative of record unless and until a written notice of withdrawal is filed with the board or until written notice of termination of representation is filed by respondent.

(C) A representative of record may present respondent's position, arguments, or contentions in writing rather than appearing in person at any hearing, provided the board has not subpoenaed respondent to appear at the hearing, and provided respondent has timely requested a hearing.

(D) Respondent is not required to appear in person at any hearing provided the board has not subpoenaed the respondent to appear at the hearing. For good cause shown, respondent may appear by telecommunication. Respondent's representative of record shall not be permitted to appear by telecommunication unless the hearing examiner or board hearing committee has ordered the hearing to be conducted by videoconference as specified in rule 4723-16-13 of the Administrative Code.

(E) The office of the attorney general shall identify one attorney from that office as the representative of record for purposes of service pursuant this chapter of the Administrative Code. Each assistant attorney general representing the board shall file his or her appearance in writing.

(F) Except as otherwise provided in Chapter 119. of the Revised Code, communications from the board, board hearing committee or hearing examiner shall be sent to the representative of record for each party.

Last updated December 2, 2024 at 11:49 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-16-03 Hearing continuances and motions for extensions of time.

(A) The board, board hearing committee, or hearing examiner may continue a hearing upon its or their own motion in order to more efficiently and effectively conduct its business, unless the circumstances establish that a continuance would not be in the interest of public safety.

(B) Upon written or oral motion of a representative of record, the board, board hearing committee or hearing examiner may continue the hearing. If a continuance is granted, the board, board hearing committee or the hearing examiner shall immediately establish a new hearing date unless otherwise agreed by the representatives of record.

(C) A hearing shall not be continued upon motion by a representative of record unless a showing of reasonable cause and due diligence is shown. Before granting a continuance, consideration shall be given to the harm to the public that may result from a delay in the proceedings.

(D) A motion for continuance filed by a representative of record fewer than five calendar days prior to the scheduled date of the hearing shall not be granted unless it is demonstrated that an extraordinary situation exists that could not have been anticipated and that would justify the granting of a continuance.

(E) Except as otherwise provided in Chapter 119. of the Revised Code or rules of the board, any motion or request for an extension of time in which to file a motion, brief, or objection, unless made upon the record at the hearing, shall be made in writing and filed with the board.

(F) No motion for an extension of time shall be granted by the board, board hearing committee or the hearing examiner unless:

(1) The representative of record filing the motion makes a showing of reasonable cause and due diligence; and

(2) If the extension of time will result in a delay in the proceedings, the representative of record can show that no harm to the public will result from the delay in the proceedings.

(G) In making a determination about harm to the public, the board, board hearing committee or the hearing examiner may consider whether the respondent holds an active license or certificate to practice in Ohio.

(H) If notice of opportunity for hearing has been given to respondent according to section 119.07 of the Revised Code, and respondent has timely requested a hearing, if respondent has failed to participate in prehearing conferences, or otherwise has failed to respond to the board hearing committee or hearing examiner, the hearing date shall not be continued based solely on the respondent's lack of participation or response.

Last updated December 2, 2024 at 11:49 AM

History

Effective: February 1, 2015
Promulgated Under: 119.03

Ohio Adm.Code 4723-16-04 Motions.

(A) Except as otherwise provided in Chapter 119. of the Revised Code, any motion, unless made upon the record at a hearing or as an oral motion for continuance in accordance with rule 4723-16-03 of the Administrative Code, shall be in writing and filed with the board.

(B) A written motion shall state the relief sought and shall be accompanied by a memorandum stating the grounds for the motion and citing the authorities relied upon. A motion shall be made no later than fourteen days before the scheduled date of the hearing, unless one of the following applies:

(1) The case involves a summary suspension issued pursuant to section 4723.281 of the Revised Code; or

(2) The board, board hearing committee or hearing examiner expressly grants an exception.

(C) A response to a motion must be filed within ten days after service of a motion, or within the time frame established by the board, board hearing committee or hearing examiner. The party who made the original motion may reply to a response to a motion only with the permission of the board, board hearing committee or hearing examiner.

(D) The board, board hearing committee or hearing examiner shall issue a ruling on a written motion, after considering all memoranda and supporting documentation filed with the motion, in writing, and issue copies of the ruling to each representative of record. The board, board hearing committee or hearing examiner shall include in each written ruling a short statement setting forth the reason for the ruling.

(E) The ruling on all oral and written motions made at a hearing shall be included in the record of the hearing. The board, board hearing committee or hearing examiner may also take motions made during a hearing under advisement and issue a written ruling at a later time.

(F) Except as otherwise provided in this chapter or Chapter 119. of the Revised Code, rulings on all motions filed after the report and recommendation is issued are to be decided by the board.

Last updated December 2, 2024 at 11:49 AM

History

Effective: February 1, 2015
Promulgated Under: 119.03

Ohio Adm.Code 4723-16-05 Prehearing processes.

(A) Any representative of record may serve upon the opposing representative of record a written request for a list of witnesses and copies of proposed exhibits intended to be introduced at hearing. Except in the case of summary suspensions, the opposing representative of record shall supply a list and copies to the requesting representative within a reasonable time, but not less than fourteen days before the hearing date.

(B) In cases of summary suspensions, the exchange of lists of witnesses and proposed exhibits intended to be introduced at hearing shall be completed as soon as possible, but not less than three days before the hearing date.

(C) If a representative of record fails to comply with a request for, or scheduling order requiring the timely exchange of, a list of witnesses, expert witness reports, if any, or copies of proposed exhibits, the opposing representative of record may request, and, absent extraordinary circumstances, the board, board hearing committee or hearing examiner shall grant, a motion to exclude from the hearing the testimony and proposed exhibits that were the subject of request.

(D) Upon written motion of any representative of record or upon the initiative of the board, board hearing committee or the hearing examiner, the board, board hearing committee or hearing examiner shall issue a scheduling order that may include but need not be limited to:

(1) A schedule for exchange of proposed hearing exhibits;

(2) A schedule for identifying lay and expert witnesses; and

(3) A schedule for the exchange of written reports, if any, from expert witnesses.

(E) If expert witness testimony is proposed, the expert may submit a written report. A written report by an expert shall set forth the opinions that the expert will testify about and the basis for the opinions. In order to be admitted as evidence at hearing, the written report must be provided to the opposing representative of record not less than thirty days before the hearing date. The expert may also testify as a fact witness.

(F) At any time before a hearing, with or without motion from a representative of record, the board, board hearing committee or hearing examiner may schedule a prehearing conference. The conference may be in person or by telecommunication. No witness testimony shall be taken during a prehearing conference. A prehearing conference may be held for reasons including but not limited to:

(1) Settlement negotiation;

(2) Identification of issues;

(3) Obtaining stipulations and admissions;

(4) Agreements limiting the number of witnesses;

(5) Discussion of proposed exhibits and witness lists;

(6) Estimating the time necessary for the hearing; and

(7) Discussion of any other matter tending to expedite the proceedings.

(G) The board, board hearing committee or hearing examiner may issue orders related to preparation for the hearing and the conduct of the hearing that facilitate the just and efficient disposition of the subject of the hearing. Orders may include, but are not limited to, requirements that by a date specified, a party or both parties submit:

(1) Legal briefs regarding the relevancy of proposed testimony or evidence;

(2) Legal briefs regarding a point of law; or

(3) Written opening statements and closing arguments.

(H) Any document that is a patient record or that contains information that is required to be kept confidential according to any state or federal law may, for purposes of the administrative hearing only, be provided to a representative of record or to a witness in the proceeding, but shall not be disseminated to any other person unless the confidential information is redacted.

Last updated December 2, 2024 at 11:49 AM

History

Effective: February 1, 2015
Promulgated Under: 119.03

Ohio Adm.Code 4723-16-06 Witnesses.

(A) A witness may be accompanied and advised by legal counsel. Participation by counsel for a witness other than the respondent, shall be limited to the protection of that witness's rights. The legal counsel shall neither examine nor cross-examine any witness.

(B) Pursuant to section 119.09 of the Revised Code, the board may institute contempt proceedings or file a motion to compel if a witness refuses to answer a question ruled proper at a hearing or disobeys a subpoena.

(C) A representative of record may move for, or the hearing examiner or board hearing committee may order, a separation of witnesses at the hearing.

(D) Each witness who appears before the board in response to a subpoena shall receive the fees and mileage provided for under section 119.094 of the Revised Code.

(E) For purposes of efficiency, the hearing examiner or board hearing committee may order that witnesses be called to testify out of order, by telecommunication, or by deposition.

Last updated December 2, 2024 at 11:50 AM

History

Effective: February 1, 2015
Promulgated Under: 119.03

Ohio Adm.Code 4723-16-07 Evidence or factors to be considered by the board.

(A) The board, board hearing committee or hearing examiner shall admit evidence of any prior action taken by the board against respondent. The evidence shall include a copy of the board adjudication order, including all records incorporated within the order, and the notice of opportunity for hearing, or a copy of any consent agreement entered between the board and respondent, including all records incorporated within the consent agreement. The board, board hearing committee or hearing examiner may admit other records related to prior board action against respondent if the evidence offered is:

(1) To prove notice to respondent that particular conduct was unacceptable;

(2) To prove a continuing problem justifying harsher discipline than might otherwise be warranted in the case;

(3) To demonstrate respondent's disregard for compliance with the laws regulating the practice of nursing or for the actions of the board; or

(4) For purposes of impeachment.

(B) When making a decision regarding disciplinary action, the board shall consider:

(1) Prior action taken by the board against respondent;

(2) Respondent's prior completion of the alternative program for substance use disorder, as set forth in paragraph (C) of rule 4723-6-04 of the Administrative Code, or prior completion of the practice intervention and improvement program, as set forth in paragraph (E) of rule 4723-18-09 of the Administrative Code.

(C) When making a decision regarding disciplinary action, the board may consider factors including, but not limited to, the following:

(1) Whether the act is willful, intentional, irresponsible, or unintentional;

(2) Whether the respondent failed to cooperate with the board investigation;

(3) Whether the respondent provided false, misleading or deceptive information to the board or board staff;

(4) The frequency of occurrence of the act at issue;

(5) Whether the act represents a pattern of commissions or omissions;

(6) The outcome of the actions of a licensee or certificate holder; or

(7) The level of harm or potential harm to a patient.

Last updated December 2, 2024 at 11:50 AM

History

Effective: February 1, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4723-16-08 Subpoenas for purpose of hearing.

(A) Upon written request, filed at least forty-five days before the hearing date, the board shall issue a subpoena for purposes of hearing to compel the attendance and testimony of a witness, or production of books, records or papers, at the hearing. The board, board hearing committee or hearing examiner may approve a subpoena request filed less than thirty days before the hearing date only upon a showing by the requestor of good cause for the short time frame.

(B) Each subpoena request shall specify the name and address of the individual to be served, or the books, records or papers to be produced and name and address of the person who is to appear at the hearing to produce the books, records or papers. The board shall not be responsible for determining the address of any individual named in a subpoena.

(C) Unless a subpoena is challenged as described in paragraph (E) of this rule, the board shall issue each subpoena requested within fourteen days of request. Subpoenas shall be directed to the sheriff of the county where the witness resides and returned in the same manner as a subpoena in a criminal case, as specified in section 119.09 of the Revised Code.

(D) Upon agreement of the parties, the board, board hearing committee or hearing examiner may approve an alternative means of obtaining a witness's testimony, including, but not limited to, affidavit, deposition or testimony by telecommunication.

(E) Upon written motion filed according to rule 4723-16-04 of the Administrative Code, the board, board hearing committee or hearing examiner may order any subpoena quashed or modified for good cause shown. Good cause may be shown for reasons including but not limited to:

(1) The total number of subpoenas requested by a party is unreasonable and a showing of necessity has not been made;

(2) A subpoena does not provide a reasonable time to comply;

(3) A subpoena requires disclosure of information that is privileged or confidential under law and no exception or waiver applies;

(4) A subpoena for books, records or papers does not specify dates or time frames or specifies dates or time frames that are unreasonable or not relevant to the incidents described in the notice of opportunity for hearing; or

(5) A subpoena subjects a witness to undue burden. For purposes of this rule, the board, board hearing committee or hearing examiner may approve an alternative means of obtaining a witness's testimony, including but not limited to, affidavit, deposition, or testimony by telephone or other means of telecommunication. If no reasonable means can be used to alleviate an undue burden on a witness, the board, board hearing committee or hearing examiner may quash the subpoena. A finding of an undue burden requires the showing of an extraordinary hardship that is more than the usual and expected inconvenience of attending a hearing. In considering whether a burden is undue, the board, board hearing committee or hearing examiner shall consider the magnitude of the burden on the witness and the materiality of the witness's testimony.

(F) In the event the number of subpoenas requested appears to be unreasonable, the board hearing committee or hearing examiner may require a showing of necessity for the witnesses or records, and in the absence of such showing, may limit the number of subpoenas.

(G) At any point after a hearing has begun, the board, board hearing committee or hearing examiner may order that a subpoena be issued to compel the attendance and testimony of a witness or production of books, records or papers.

Last updated December 2, 2024 at 11:50 AM

History

Effective: February 1, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4723-16-09 Ex parte communication.

(A) No representative of record shall communicate with a board member or hearing examiner concerning a pending adjudication without the participation of the opposing representative of record, unless the communication relates solely to a procedural matter.

(B) No board member or hearing examiner shall engage in communication with or on behalf of any representative of record without the participation of the opposing representative of record, unless the communication relates to a procedural matter.

(C) A board member or hearing examiner shall disclose to the representatives of record and members of the board, any communication or attempted communication that appears to violate paragraph (A) or (B) of this rule. Such disclosure shall be made prior to the completion of deliberations on the pending adjudication.

Last updated December 2, 2024 at 11:50 AM

History

Effective: February 1, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4723-16-10 Settlements.

(A) Any matter that is the subject of an investigation may be settled at any time by the board.

(B) A settlement shall be authorized on behalf of the board by the supervising member for disciplinary matters. In cases assigned for hearing, the parties may inform the board hearing committee or the hearing examiner that a settlement has been reached in lieu of proceeding with the hearing, and the board hearing committee or hearing examiner may continue the hearing pending ratification of the agreement by the board.

(D) A settlement agreement shall not be effective until the agreement is ratified by the board and signed by respondent, respondent's legal counsel, if any, and the president of the board.

Last updated February 3, 2025 at 8:29 AM

History

Effective: February 1, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-16-12 Request to address the board regarding a hearing.

(A) A representative of record may be permitted to address the board at the time of the board's consideration of the report and recommendation, provided that prior to addressing the board, the representative of record has filed a written request with the board not less than seven days before the board meeting.

(B) If a representative of record addresses the board, the opposing representative of record shall also be given an opportunity to address the board. The representative of record who submitted a request to address the board first shall make the initial presentation before the board, and if both parties submit a request on the same date, the respondent of record for the state of Ohio shall make the initial presentation.

(C) Each representative of record who addresses the board shall be given not more than seven minutes in which to do so. The representative of record may request that time for rebuttal be deducted from their allotted time.

Last updated December 2, 2024 at 11:50 AM

History

Effective: February 1, 2016
Promulgated Under: 119.03

Ohio Adm.Code 4723-16-13 Authority and duties of board hearing committee or hearing examiners.

(A) Adjudication hearings may be conducted before the board, a board hearing committee or a hearing examiner appointed by the board.

(B) The hearing examiner shall be licensed to practice law in Ohio and may be an employee of the board or an independent contractor.

(C) The board hearing committee shall be composed of at least three board members, and one or more alternates, appointed by the board at a public meeting, to serve for a term of one year. One board hearing committee member shall preside and be responsible for conduct of the hearing. The presiding board member shall also be responsible for approving the report and recommendation discussed in paragraph (H) of this rule. The board hearing committee may request advice on legal questions from a staff attorney employed by the board, or an attorney with whom the board contracts as a hearing examiner, related to procedural or evidentiary questions or in preparation of the report and recommendation. This legal consultation shall not be deemed an ex parte communication.

(D) All hearings shall be open to the public, but the board hearing committee or hearing examiner conducting a hearing may close the hearing to the extent necessary to protect compelling interests or to comply with statutory requirements. In the event this occurs, the board hearing committee or hearing examiner shall state on the public record the reasons for closing the hearing.

(E) If the hearing examiner or board hearing committee determines that permitting broadcasting, televising, recording or the taking of photographs in the hearing room would not distract participants, impair the dignity of the proceedings, violate patient confidentiality or otherwise materially interfere with the achievement of a fair administrative hearing, the broadcasting, televising, recording or taking of photographs during hearing proceedings open to the public may be permitted under the following conditions and upon request:

(1) Requests for permission for the broadcasting, televising, recording or taking of photographs in the hearing room shall be made in writing and submitted to the hearing examiner or board hearing committee prior to the start of the hearing, and shall be made part of the record of the proceedings;

(2) Written permission is granted prior to the start of the hearing by the hearing examiner or board hearing committee and is made part of the record of the proceedings;

(3) The filming, videotaping, recording or taking of photographs of witnesses who object shall not be permitted; and

(4) Any film, video, photograph or audio recording created during a hearing, except for an audio recording made by the court reporter hired by the board to prepare the stenographic hearing record, shall not be part of the record of the proceeding.

(F) The board hearing committee or hearing examiner shall conduct hearings so as to prevent unnecessary delay, maintain order and ensure the development of a clear record. The authority of the board hearing committee or hearing examiner conducting a hearing includes, but is not limited to, the following:

(1) Administering oaths or affirmations;

(2) Ordering that subpoenas be issued or that depositions in lieu of live testimony be conducted;

(3) Examining witnesses and directing witnesses to testify;

(4) Making rulings on admissibility of evidence;

(5) Making rulings on procedural motions, whether such motions are oral or written;

(6) Holding prehearing conferences, as discussed in rule 4723-16-05 of the Administrative Code;

(7) Requesting briefs, before, during or after a hearing;

(8) Issuing scheduling orders for exchange of documents and filing deadlines;

(9) Determining the order of the hearing;

(10) Requiring or disallowing oral or written opening statements and closing arguments;

(11) Consolidating two or more matters involving the same respondent into one hearing;

(12) Preparing entries, proposed findings, and reports and recommendations to the board, as discussed in paragraph (H) of this rule; and

(13) Based upon a conflict in schedule, complexity of the issues involved, or for reasons of administrative efficiency, the board hearing committee may reassign the matter to a hearing examiner, or a hearing examiner may reassign to another hearing examiner or to the board hearing committee.

(14) In the sole discretion of the board hearing committee or hearing examiner, the hearing may be conducted by live, real-time video conference if requested and agreed upon by both parties. The board hearing committee or hearing examiner shall issue instructions as to how the proceeding is to be conducted. The video conference platform selected must enable the parties, hearing examiner, court reporter and witnesses to see and converse with each other and to display documentary and physical evidence. The video conference platform selected must be widely available to the general public without charge, and accessible to the public to watch and listen to the hearing, upon request, unless the hearing or portions thereof are closed to the public by the hearing examiner according to paragraph (D) of this rule.

(G) The board hearing committee or hearing examiner may recommend in the report and recommendation that factual or legal allegations set forth in the notice of opportunity for hearing issued to respondent be dismissed, however, the authority of the board hearing committee or hearing examiner does not include authority to grant motions for dismissal of, or to otherwise dismiss, factual or legal allegations, or to modify, compromise or settle factual or legal allegations.

(H) Within one hundred twenty days of the date an adjudication hearing is closed, the board hearing committee or hearing examiner assigned to the case shall submit a written report to the board setting forth the proposed findings of fact and conclusions of law, or in the case of the board hearing committee, conclusions, and a recommendation of action to be taken by the board. A copy of the written report shall be mailed by certified mail to representatives of record for both parties. Either party may, within ten days of receipt of the report and recommendation, file written objections. Written objections, if filed in a timely manner, shall be considered by the board in determining whether to approve, modify or reject the report and recommendation.

(I) At a board meeting scheduled after the time for filing objections to a report and recommendation has passed, the board may approve, modify or reject the report and recommendation of the board committee or hearing examiner. Members of the board hearing committee that heard a case shall abstain from voting on a matter heard as members of the board hearing committee.

Last updated February 3, 2025 at 8:29 AM

History

Effective: February 1, 2025
Promulgated Under: 119.03

Chapter 4723-18 Practice Intervention and Improvement Program (PIIP)

Ohio Adm.Code 4723-18-01 Definitions.

As used in this chapter:

(A) "Certificate holder" means an individual holding a current, valid certificate issued by the board to provide dialysis care as a dialysis technician or dialysis technician intern.

(B) "Educational intervention" means the following:

(1) One or more learning activities that meet the requirements of rule 4723-18-06 of the Administrative Code, with content and objectives that address a participant's prescribed learning needs;

(2) An activity with content and objectives that meet a participant's prescribed learning needs provided by the participant's employer through a registered nurse who meets the qualifications set forth in rule 4723-18-06 of the Administrative Code.

(C) "Employer" means any person for whom a participant works, or may work in the future, or any institution that grants practice privileges enabling an individual to practice at the institution, while participating in the practice intervention and improvement program.

(D) "Licensee" means any individual holding a current valid license issued by the board to practice nursing as an advanced practice registered nurse, registered nurse or licensed practical nurse.

(E) "Participant" means a licensee or certificate holder undergoing a remedial process in the practice intervention and improvement program.

(F) "Participatory agreement" means a voluntary, written contract between an individual and the board's practice intervention and improvement program (PIIP) in which the board abstains from taking disciplinary action against the individual for violation of Chapter 4723. of the Revised Code and the individual agrees to be monitored by the board and remediated according to the terms and conditions of the program. The participatory agreement includes, but is not limited to, the following:

(1) Stipulation by the individual to one of more identified practice deficiencies;

(2) Agreement of the individual to completion of the remediation process required by the board;

(3) Authorization by the individual to the release of records and information to PIIP by employers, workplace monitors and other parties involved in the individual's remediation process; and

(4) Acknowledgment by the individual that their failure to comply with the terms and conditions of the participatory agreement will result in disciplinary action by the board.

(G) "Practice intervention and improvement program" or "PIIP" means the program authorized by section 4723.282 of the Revised Code that allows the board to abstain from taking disciplinary action against a licensee or certificate holder, who has a practice deficiency that has been identified by the board through an investigation conducted under section 4723.28 of the Revised Code.

(H) "Practice deficiency" means a practice activity that does not meet acceptable and prevailing standards of safe nursing care as set forth in Chapter 4723-4 of the Administrative Code, Chapter 4723-8 of the Administrative Code, Chapter 4723-9 of the Administrative Code, or the acceptable and prevailing standards of safe dialysis care set forth in Chapter 4723-23 of the Administrative Code.

(I) "Remediation" means a prescribed educational intervention that is designed to correct an individual's identified practice deficiency. Remediation includes, but is not limited to, successful demonstration by the individual that the learned knowledge and skills have been incorporated into the individual's practice.

(J) "Supervising member" means the board member elected to serve as the supervising member for disciplinary matters in accordance with section 4723.02 of the Revised Code.

(K) "Workplace monitor" means the individual who observes and evaluates, for a specified time period, the practice of a participant in PIIP to determine whether the participant has incorporated applicable learned knowledge and skills into workplace practice.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2019
Promulgated Under: 119.03

Ohio Adm.Code 4723-18-02 Process and criteria to use when identifying an individual's practice deficiency.

(A) The board shall investigate, according to section 4723.28 of the Revised Code, evidence that appears to show that a licensee or certificate holder has failed to practice in accordance with acceptable and prevailing standards of safe care as set forth in Chapter 4723-4 of the Administrative Code, Chapter 4723-8 of the Administrative Code, Chapter 4723-9 of the Administrative Code, or Chapter 4723-23 of the Administrative Code.

(B) The supervising member shall review the evidence obtained during the investigation to determine whether the individual's identified practice deficiency can be corrected through participation in the practice intervention and improvement program (PIIP) rather than through formal disciplinary action. Criteria to use when making this determination include, but are not limited to, the following:

(1) Whether the public will be adequately protected from unsafe practice if the individual enters PIIP;

(2) Whether the individual's practice deficiency resulted in harm or other untoward outcome for the patient;

(3) The likelihood that the identified practice deficiency at issue is a deficiency that can be corrected through remediation;

(4) The extent of the individual's cooperation with the board during the investigation;

(5) Whether the individual's identified practice deficiency represented an intentional or willful commission or omission by the individual;

(6) The frequency of the occurrence of the identified practice deficiency;

(7) The adverse impact of the identified practice deficiency on others;

(8) Whether the identified practice deficiency affected a particularly vulnerable patient;

(9) Whether the individual is eligible for participation in PIIP as specified in rule 4723-18-03 of the Administrative Code; and

(10) Whether the individual has a mental or physical impairment that contributed to the practice deficiency.

(C) When the supervising member has reason to believe, after an investigation and review of evidence, that the individual's identified practice deficiency can be successfully corrected through participation in PIIP, the board may abstain from taking disciplinary action provided the individual enters into an agreement with PIIP according to rule 4723-18-04 of the Administrative Code, complies with the terms and conditions of PIIP, and successfully completes PIIP.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2014
Promulgated Under: 119.03

Ohio Adm.Code 4723-18-03 Eligibility requirements for participation in the practice intervention and improvement program (PIIP).

An individual may participate in the practice intervention and improvement program if the supervising member determines that the public will be adequately protected from unsafe practice if the individual enters PIIP, and:

(A) The individual has not been the subject of formal disciplinary action by any regulatory board or entity located in Ohio or in another jurisdiction, unless the supervising member determines that the previous disciplinary action was for a violation that should not preclude participation in PIIP;

(B) The individual is not concurrently under investigation by the board for a violation of Chapter 4723. of the Revised Code or the rules of the board that does not constitute a practice deficiency;

(C) The supervising member determines that the nature of the individual's identified practice deficiency is such that it may be corrected through remediation;

(D) The individual holds a current valid, license or certificate issued by the board;

(E) The individual is otherwise eligible to renew the license or certificate issued by the board;

(F) At the time of PIIP eligibility determination by the supervising member, the individual is working in a position in the state of Ohio, whether as an employee or contractor, that requires a nursing license, if the individual is a licensed nurse, or a dialysis technician certificate, if the individual is a dialysis technician; and

(G) The individual does not have any impairment as defined in rule 4723-3-02 of the Administrative Code.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2019
Promulgated Under: 119.03

Ohio Adm.Code 4723-18-04 Provisions of the participatory agreement for the practice intervention and improvement program (PIIP).

(A) When an individual has been determined by the supervising member to be eligible for the practice intervention and improvement program, the individual shall execute a participatory agreement with PIIP that includes, but is not limited to, provisions that:

(1) Set forth the identified practice deficiencies;

(2) Identify the specific remediation including educational interventions the participant must complete;

(3) Specify the time frame for the participant to submit to PIIP copies of the educational intervention content and objectives that demonstrate it fulfills the prescribed education intervention requirements;

(4) Require the participant to pay all expenses the participant incurs as a result of the required remediation;

(5) Require the participant to provide the participatory agreement to a manager, or a person with administrative responsibilities equivalent to or higher than a manager, for all of the participant's employers or contracting entities with respect to which the participant provides nursing or dialysis care, and provide documentation to the board of the manager's receipt of the participatory agreement;

(6) Require a participant who is an advanced practice registered nurse to provide a copy of the participatory agreement to the following, and submit documentation to the board of their receipt:

(a) The credentialing body of each institution at which the licensee provides advanced practice registered nursing services or nursing care;

(b) Each collaborating physician with whom the licensee works as a clinical nurse specialist, certified nurse practitioner, or certified nurse midwife;

(7) Require the participant to participate in workplace monitoring;

(8) Require the participant to cooperate with any entity, including the educational provider and workplace monitor;

(9) Require the participant to cause all workplace monitors, selected according to paragraph (B) of rule 4723-18-08 of the Administrative Code, and educational providers, selected according to rule 4723-18-06 of the Administrative Code, to provide remediation and to send written progress reports regarding the participant's progress in remediation to PIIP at specified intervals;

(10) Require the participant to sign all waivers necessary to secure all reports required by PIIP;

(11) Require the participant to meet with a PIIP representative at specified intervals;

(12) Require the participant to obey all federal, state, and local laws, including all laws and rules regulating nursing practice or dialysis care in Ohio;

(13) Specify that the prescribed educational intervention cannot be used to satisfy the continuing education requirements set forth in Chapter 4723. of the Revised Code and the rules of the board;

(14) Specify the terms and conditions the participant must meet to successfully complete the remediation, including the time frames for successfully completing both the educational intervention and workplace monitoring components of the remediation; and

(15) Set forth the grounds for termination from PIIP.

(B) An individual determined by the supervising member to be eligible for PIIP who refuses to enter into the participatory agreement set forth in this rule within the time frame specified by PIIP may be subject to disciplinary action according to section 4723.28 of the Revised Code.

Last updated February 1, 2024 at 9:34 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-18-05 Grounds for termination from the practice intervention and improvement program (PIIP).

(A) A participant may be terminated from PIIP for any of the following:

(1) Failure to comply with any term of the participatory agreement entered into by the participant;

(2) Receipt of evidence from an employer educational intervention provider indicating that the participant has failed to progress through or to successfully complete the prescribed educational intervention in the manner and during the time frame prescribed by the supervising member;

(3) Receipt of evidence from the workplace monitor indicating that the participant has failed to incorporate learned knowledge and skills into practice or has continued to demonstrate the practice deficiency;

(4) Failure to complete the remediation including the educational intervention; or

(5) Failure to maintain eligibility for PIIP.

(B) When a licensee or certificate holder is terminated from PIIP for one of the reasons specified in paragraph (A) of this rule, the board shall proceed with disciplinary action according to section 4723.28 of the Revised Code. The board may consider an individual's termination from PIIP when determining the sanction to be imposed.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2014
Promulgated Under: 119.03

Ohio Adm.Code 4723-18-06 Requirements for educational intervention.

(A) The practice intervention and improvement program shall utilize educational interventions that contain content and objectives that meet the participant's learning needs as prescribed by the supervising member.

(B) An educational intervention shall be one of the following:

(1) A continuing education activity that meets the requirements of Chapter 4723-14 of the Administrative Code;

(2) An activity conducted by a national certifying organization approved by the board according to section 4723.46 of the Revised Code;

(3) A course provided by a post-secondary educational institution that is approved, authorized or registered by the board, the Ohio department of higher education, the state board of career colleges and schools, or a substantially similar authorizing body in another jurisdiction, for which academic credit is awarded to the participant; or

(4) An activity that is provided by the participant's employer through an employed or contracted registered nurse who holds a master's degree and has at least two years experience in nursing education or adult education.

(C) According to section 4723.021 of the Revised Code, an entity that provides services related to remediation, including but not limited to a participant's educational intervention shall not be held liable in damages to any person as the result of any act, omission, proceeding, conduct, or decision related to official duties undertaken or performed pursuant to this chapter.

(D) Educational intervention shall not be used for purposes of satisfying the participant's continuing education requirements.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2019
Promulgated Under: 119.03

Ohio Adm.Code 4723-18-07 Standards and procedures for remediation.

(A) An individual shall be notified in writing of a determination by the supervising member that their identified practice deficiency may be remediated through participation in the practice intervention and improvement program.

(B) In order to participate in PIIP, an eligible licensee or certificate holder shall enter into the participatory agreement set forth in rule 4723-18-04 of the Administrative Code.

(C) The participant shall notify PIIP in writing of the educational intervention selected within the time frame specified in the participatory agreement. The written notification shall include a copy of the learning activity's content and objectives that demonstrate it meets the prescribed educational intervention requirements.

(D) When the participant's educational intervention is provided by an employer through an employed or contracted registered nurse, the participant shall provide the registered nurse with a copy of the participatory agreement and provide PIIP with documentation of the registered nurse's receipt of the agreement.

(E) The participant shall provide documentation acceptable to PIIP that all educational interventions have been successfully completed within the specified timeframe.

(F) According to rule 4723-18-08 of the Administrative Code, PIIP shall establish workplace monitoring requirements that a participant must meet in order to demonstrate that the learned knowledge and skills have been incorporated into the participant's practice and shall notify the participant and the participant's workplace monitor in writing of these requirements.

(G) Upon receipt of evidence that the participant has failed to successfully complete the remediation, PIIP shall immediately notify the supervising member.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2014
Promulgated Under: 119.03

Ohio Adm.Code 4723-18-08 Standards and procedures for workplace monitoring.

(A) A PIIP participant shall be monitored by PIIP to determine whether the participant satisfactorily demonstrates that the learned knowledge and skills have been incorporated into the participant's practice.

(B) A participant, in collaboration with his or her employer, shall identify one or more individuals who meet the requirements of paragraph (D) of this rule who will act as a workplace monitor of the participant's nursing or dialysis care.

(1) As directed by PIIP, observe specific aspects of the participant's practice at the intervals identified by PIIP;

(2) Evaluate specific aspects of the participant's practice and report to PIIP whether that practice, with respect to the identified practice deficiency, meets acceptable and prevailing standards of safe nursing care set forth in Chapter 4723-4 of the Administrative Code, Chapter 4723-8 of the Administrative Code or Chapter 4723-9 of the Administrative Code, or the acceptable and prevailing standards of safe dialysis care set forth in Chapter 4723-23 of the Administrative Code;

(3) Report the participant's progress in remediation to PIIP at the intervals required by PIIP; and

(4) Maintain the confidentiality of the participant's participation in PIIP and of all records associated with the participant's remediation.

(D) A workplace monitor shall meet the following requirements:

(1) When monitoring a licensed nurse the workplace monitor shall be a registered nurse with a current, valid license;

(2) When monitoring an advanced practice registered nurse, the workplace monitor shall be an advanced practice registered nurse with a current, valid license issued under section 4723.41 of the Revised Code, or a holder of a current, valid license issued under Chapter 4731. of the Revised Code to practice medicine and surgery or osteopathic medicine and surgery, or podiatric medicine and surgery;

(3) When monitoring a dialysis technician, the workplace monitor shall be a registered nurse with a current, valid license or a holder of a current, valid license issued under Chapter 4731. of the Revised Code to practice medicine and surgery or osteopathic medicine and surgery.

(E) In addition to meeting the requirements of paragraph (D) of this rule, a workplace monitor shall:

(1) Have no disciplinary action imposed on their license or certificate, or any disciplinary action with respect to a similar license or certificate issued by another jurisdiction;

(2) Be in a position that enables the monitor to directly observe the participant's clinical performance;

(3) Have a minimum of five years experience or less as approved by the Supervising Member as a registered nurse, advanced practice registered nurse, physician, or podiatrist; and

(4) Cooperate with the participant and PIIP to meet the requirements set forth in the participatory agreement entered into by the participant and PIIP.

(F) When the individual to be monitored is a licensed practical nurse, the workplace monitor may direct a licensed practical nurse to observe specific tasks related to the identified practice deficiency and to report those observations to the monitor.

(G) When the individual to be monitored is a dialysis technician or dialysis technician intern, the workplace monitor may direct an Ohio certified dialysis technician or licensed practical nurse to observe specific tasks related to the identified practice deficiency and to report those observations to the monitor.

(H) For purposes of providing the remediation directed by the supervising member, a workplace monitor shall be considered a representative of the board and, according to section 4723.021 of the Revised Code, shall not be held liable in damages to any person as the result of any act, omission, proceeding, conduct, or decision related to official duties undertaken or performed pursuant to this chapter.

Last updated February 8, 2024 at 1:24 PM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-18-09 Terms and conditions a participant must meet to successfully complete the practice intervention and improvement program (PIIP).

(A) An individual eligible for the practice intervention and improvement program shall enter into a participatory agreement, as set forth in rule 4723-18-04 of the Administrative Code, and shall comply with all of the terms and conditions set forth in the agreement.

(B) A participant shall provide or cause to be provided all of the following to PIIP:

(1) Written verification acceptable to PIIP that the participant has successfully completed the educational intervention prescribed by the supervising member; and

(2) Written verification from a workplace monitor who meets the requirements set forth in rule 4723-18-08 of the Administrative Code that, at the time of verification with respect to the identified practice deficiency, the participant's practice meets the acceptable and prevailing standards of safe nursing care set forth in Chapter 4723-4 of the Administrative Code, Chapter 4723-8 of the Administrative Code, or Chapter 4723-9 of the Administrative Code, or the acceptable and prevailing standards of safe dialysis care set forth in Chapter 4723-23 of the Administrative Code.

(C) Upon receipt of the documents required by paragraph (B) of this rule, the supervising member shall review all information relevant to the participant's remediation to determine whether the participant's practice as a licensed nurse or dialysis technician meets the acceptable and prevailing standards of safe nursing care set forth in Chapter 4723-4 of the Administrative Code, Chapter 4723-8 of the Administrative Code, or Chapter 4723-9 of the Administrative Code, or the acceptable and prevailing standards of safe dialysis care set forth in Chapter 4723-23 of the Administrative Code.

(D) When the supervising member determines that the participant's identified practice deficiency has been sufficiently corrected so as to meet the acceptable and prevailing standards of safe care, the supervising member shall notify the participant in writing that remediation has been successfully completed and participation in PIIP is completed.

(E) When making a decision regarding disciplinary action for violations of Chapter 4723. of the Revised Code or the rules of the board, the board will be notified by written communication from board staff, marked as confidential according to division (D) of section 4723.282 of the Revised Code if the individual who is the subject of proposed board action previously successfully completed PIIP.

(F) A participant who successfully completes PIIP shall not be reported to the national council of state boards of nursing's disciplinary data bank or the federally mandated national practitioner database unless the board imposes disciplinary action against the participant.

(G) When the supervising member determines that remediation has not occurred or the participant has otherwise violated the terms and conditions of the participatory agreement, the board shall proceed with disciplinary action in accordance with section 4723.28 of the Revised Code.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2019
Promulgated Under: 119.03

Ohio Adm.Code 4723-18-10 Confidentiality of records for the practice intervention and improvement program (PIIP).

(A) Information and records obtained by the practice intervention and improvement program pursuant to an investigation conducted in accordance with section 4723.28 of the Revised Code shall be confidential and are not public records pursuant to division (I) of section 4723.28 of the Revised Code.

(B) All records regarding an individual's participation in PIIP are confidential and are not public records pursuant to division (I) of section 4723.28 of the Revised Code and division (D) of section 4723.282 of the Revised Code.

(C) All employers providing educational intervention and workplace monitors selected to provide remediation by a participant in PIIP shall, as representatives of the board, maintain the confidentiality of all records regarding the participant's remediation.

(D) All PIIP records maintained by the board shall be kept in a secure storage area according to the board's record retention schedule.

(E) Notwithstanding paragraphs (A) and (B) of this rule, PIIP may prepare public reports setting forth in general terms statistical information regarding the program as requested by the board.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2014
Promulgated Under: 119.03

Chapter 4723-19 Safe Haven Program

Ohio Adm.Code 4723-19-01 Requirements for safe haven program.

(A) Safe haven program is a confidential, non-disciplinary program for treatment of impaired licensees, certificate holders, or applicants of the nursing board established pursuant to section 4723.35 of the Revised Code.

(B) Monitoring organization is an entity which conducts the safe haven program and performs monitoring services for impaired licensees, certificate holders, or applicants under a contract with the nursing board.

(C) Treatment provider is an entity approved by the monitoring organization to provide evaluation, treatment, and/or continuing care to impaired licensees, certificate holders, or applicants participating in the safe haven program.

(D) For purposes of this chapter, licensee, certificate holder, or applicant includes those licensees, certificate holders, or applicants whose license or certificate is subject to disciplinary action by the board or who is an applicant for a license or certificate that is subject to disciplinary action by the board.

(E) Licensees, certificate holders, or applicants of the board who may be impaired or potentially impaired in the ability to practice in accordance with acceptable and prevailing standards of care and who want to participate in the safe haven program shall complete the following requirements:

(1) The licensee, certificate holder, or applicant shall register with the monitoring organization under contract with the board and obtain a list of the approved treatment providers;

(2) If the licensee, certificate holder, or applicant reports directly to an approved treatment provider, the licensee, certificate holder, or applicant shall register with the monitoring organization upon referral from the approved treatment provider;

(3) The treatment provider shall conduct an evaluation in accordance with the recommendation of the monitoring organization;

(4) The treatment provider shall provide the information regarding the diagnosis and the treatment plan to the monitoring organization for confirmation of eligibility;

(5) If the licensee, certificate holder, or applicant is determined to be impaired and not to be eligible for the safe haven program, the monitoring organization shall report this information to the board.

(F) Once a licensee, certificate holder, or applicant is determined to be eligible for the safe haven program, the licensee, certificate holder, or applicant shall report to an approved treatment provider for treatment within the timeframe recommended by the monitoring organization. The treatment provider shall develop an individualized treatment plan that may include a combination of inpatient, residential, partial hospitalization intensive outpatient treatment, outpatient, continuing care, or other therapy or treatment.

(1) The licensee or certificate holder shall be required to immediately refrain from practice if it is recommended by the treatment provider or the monitoring organization. The licensee or certificate holder shall refrain from practice until the licensee or certificate holder is determined to be able to practice according to acceptable and prevailing standards by the treatment provider and the medical director of the monitoring organization, or his or her designee.

(2) The monitoring organization shall notify the board of any licensee or certificate holder who returns to work prior to obtaining the release from the treatment provider and the monitoring organization medical director, or his or her designee.

(3) The monitoring organization shall notify the board of any licensee, certificate holder, or applicant who does not successfully complete the prescribed treatment.

(G) If continuing care is recommended, the monitoring organization shall confirm that the licensee, certificate holder, or applicant completes continuing care sessions in accordance with the recommendation until released by the continuing care provider and the monitoring organization medical director, or his or her designee.

(H) In order to continue participation in the safe haven program, after successful completion of any recommended treatment, the licensee, certificate holder, or applicant shall enter into an agreement with the monitoring organization. An individual who chooses not to continue in the safe haven program shall be referred to the board for further investigation or disciplinary action. The agreement may include the following provisions:

(1) Random toxicology testing, if applicable;

(2) Attendance at drug and alcohol support meetings (e.g. alcoholics anonymous or narcotics anonymous) or other support group, as directed by the monitoring organization, if applicable;

(3) Treatment and therapy plan;

(4) Continuing care participation;

(5) Case management;

(6) Duration of monitoring. Relapses and other failure to comply with terms of the agreement may result in a longer period of monitoring;

(7) Releases for information or records related to the licensee, certificate holder, or applicant's impairment, including but not limited to family, peers, health care personnel, employers, and treatment providers;

(8) Grounds for dismissal from participation in the safe haven program for failure to comply with program requirements;

(9) Any required fees associated with participation in the safe haven program, including but not limited to fees for toxicology testing;

(10) The licensee, certificate holder, or applicant shall be released from monitoring by the medical director of the monitoring organization, or his or her designee, upon successful completion of monitoring.

(I) The board shall develop guidelines in collaboration with the monitoring organization for the reporting of non-compliance with conditions of the safe haven program. Non-compliance shall be reported to the board by the monitoring organization.

Last updated September 15, 2025 at 7:37 AM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-19-02 Monitoring organization for safe haven program.

(A) The board shall enter into a contract with a monitoring organization to monitor licensees, certificate holders, and applicants participating in the safe haven program.

(1) The monitoring organization shall provide licensees, certificate holders, and applicants with a list of treatment providers approved to provide evaluations and treatment for the safe haven program.

(2) The monitoring organization shall, along with the treatment provider, review and determine whether a licensee, certificate holder, or applicant is able to practice according to acceptable and prevailing standards of care.

(3) The monitoring organization shall, along with the continuing care provider, review and determine whether a licensee, certificate holder, or applicant is eligible for release from continuing care, if applicable.

(4) At the request of the board, the medical director of the monitoring organization, or his or her designee, shall provide testimony in any disciplinary proceeding involving a licensee, certificate holder, or applicant reported to the board by the monitoring organization.

(B) The agreements between the monitoring organization and licensee, certificate holder, or applicant shall establish the monitoring terms including the minimum duration and the events which could lead to a longer duration.

(C) The medical director of the monitoring organization, or his or her designee, shall review each licensee, certificate holder, or applicant and make a determination as to whether the licensee, certificate holder, or applicant is released from monitoring.

(D) The monitoring organization shall, within seventy-two hours, report to the board any of the following:

(1) Any licensee, certificate holder, or applicant referred to the safe haven program who was found to be impaired and ineligible to participate in the program;

(2) Any licensee, certificate holder, or applicant who fails to attend an evaluation recommended by the monitoring organization;

(3) Any licensee, certificate holder, or applicant found to be impaired who fails to enter or complete treatment as recommended by the treatment provider and the monitoring organization;

(4) Any licensee, certificate holder, or applicant found to be impaired who fails to enter or complete continuing care as recommended by the treatment provider and the monitoring organization;

(5) Any licensee, certificate holder, or applicant found to be impaired who fails to enter into a monitoring agreement as recommended by the monitoring organization;

(6) Any licensee, certificate holder, or applicant who fails to comply with a monitoring agreement and that failure results in an imminent risk of harm to the public or the licensee, certificate holder, or applicant;

(7) Any licensee, certificate holder, or applicant who presents an imminent danger to the public or themselves as a result of their impairment; and

(8) Any licensee, certificate holder, or applicant whose impairment has not been substantially alleviated by participation in the program.

(E) The monitoring organization shall provide annual and quarterly reports to the board regarding the safe haven program.

(F) The monitoring organization, in coordination with the board, shall provide education to the licensees, certificate holders, applicants, and treatment providers regarding eligibility criteria and the board's statutes, rules, and policies regarding the safe haven program.

Last updated September 15, 2025 at 7:37 AM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-19-03 Treatment providers in the safe haven program.

(A) The monitoring organization shall review individuals and entities providing evaluations and treatment to licensees, certificate holders, and applicants who are impaired or potentially impaired.

(1) As part of the review the monitoring organization shall determine whether the individual or entity has the capability to evaluate impaired or potentially impaired licensees, certificate holders, or applicants for conditions which impair the ability to practice in accordance with acceptable and prevailing standards of care, including mental or physical illness, including substance use disorder.

(2) As part of the review the monitoring organization shall determine whether the individual or entity has the capability to provide treatment to impaired licensees, certificate holders, or applicants, which may include inpatient, residential, extended residential, medical detoxification, partial hospitalization or intensive outpatient treatment, outpatient, continuing care, or other therapy or treatment.

(B) The monitoring organization shall prepare a list of approved evaluators and treatment providers and make that available to licensees, certificate holders, or applicants referred to the monitoring organization.

(C) The monitoring organization shall provide training to evaluators and treatment providers regarding the eligibility and the board's statutes, rules, and policies regarding the safe haven program on an annual basis.

(D) The monitoring organization shall periodically review the operations and outcomes of the evaluators and treatment providers to determine that standard of care is met. If the monitoring organization determines that any evaluators or treatment providers no longer meet the standard of care, the monitoring organization may remove the evaluator or treatment provider from the list provided to impaired or potentially impaired licensees, certificate holders, or applicants.

(E) The treatment provider shall perform an evaluation appropriate to the licensee, certificate holder, or applicant's condition to determine the degree of impairment of the licensee, certificate holder, or applicant and shall develop an individualized treatment plan. The individualized treatment plan may include a combination of in-patient, residential, partial hospitalization, intensive outpatient treatment, outpatient, continuing care, or other appropriate therapy or treatment appropriate to the licensee, certificate holder, or applicant's condition.

(F) The treatment provider may recommend that the licensee or certificate holder immediately refrain from practice upon determination of impairment. Clearance from the treatment provider and monitoring organization are required for return to practice. Failure of the licensee or certificate holder to follow the recommendation shall be reported to the board by the monitoring organization.

(G) The treatment provider shall notify the monitoring organization of the determination of impairment and the treatment plan.

(H) The treatment plan shall include education regarding the nursing board's statutes, rules, and policies with respect to impairment.

(I) The treatment plan shall include education and group therapy to assist the patient to transition back to work.

(J) The treatment provider shall complete and maintain records for each licensee, certificate holder, or applicant seen for evaluation or treatment under the safe haven program.

Last updated September 15, 2025 at 7:37 AM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Chapter 4723-20 Prevention of Disease Transmission

Ohio Adm.Code 4723-20-01 Definitions pertaining to prevention of disease transmission and infection control.

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

(A) "Aseptic technique" means practices used to reduce or eliminate microorganisms.

(B) "Exposure-prone activity" means an activity in which there is a risk of disease transmission by virtue of any of the following:

(1) Direct contact with a disease source that includes:

(a) Airborne transmission or droplet;

(b) Eating or drinking contaminated food or water;

(2) Invasive procedure;

(3) Any other direct contact with disease source, including bodily contact; or

(4) Contact with contaminated environmental surfaces.

(C) "Hand washing" as that term is used in division (K)(1) of section 4723.07 of the Revised Code is a component of hand hygiene achieved by washing and rinsing hands with non-antimicrobial soap or antimicrobial soap and water, or by using alcohol-based waterless hand sanitizers or other antimicrobial agents.

(D) "Invasive procedure" means any procedure involving manual or instrumental contact with, or entry into, any blood, body fluid, cavity, internal organ, subcutaneous tissue, mucous membrane or percutaneous wound of the human body. If percutaneous injury occurs to a licensee or certificate holder during an exposure-prone activity, the licensee's or certificate holder's blood is likely to contact the patient's body cavity, subcutaneous tissues, or mucous membranes.

(E) "Respiratory hygiene" is an element of standard precautions that requires the licensee or certificate holder to engage in source control practices to control the spread of respiratory infection, including but not limited to:

(1) Covering coughs or sneezes, promptly disposing of used tissues, and performing hand hygiene;

(2) Source control measures, including but not limited to using masks on a coughing patient when tolerated and appropriate; or

(3) Spatial separation of patients and other persons with respiratory infections in common waiting areas when possible.

(F) "Universal and standard precautions" are infection prevention practices that apply to all patients, regardless of suspected or confirmed infection status, in any setting in which healthcare is delivered, and include but are not limited to the following:

(1) Practices used to mitigate exposure to disease-causing agents when exposure-prone activity occurs;

(2) Hand hygiene;

(3) Disinfection and sterilization of equipment;

(4) Appropriate handling and disposal of needles and other sharp instruments; and

(5) Appropriate use of personal protective equipment, including wearing and disposal of gloves and other protective barriers or devices.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4723-20-02 Practices to control infection and minimize exposure to disease.

During the delivery of healthcare, licensees and certificate holders shall be familiar with, observe, and rigorously adhere to the acceptable and prevailing standard precautions to minimize being exposed to or exposing others to disease causing agents and prevent infection, including at least the following:

(A) Appropriate use of hand hygiene;

(B) Appropriate use of respiratory hygiene;

(D) Safe injection practices;

(E) Safe handling and disposal of needles and other sharp instruments;

(F) Safe handling and disposal of blood and body fluid; and

(G) Appropriate use of personal protective equipment, including wearing and disposal of gloves and other protective garments and devices.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2019
Promulgated Under: 119.03

Ohio Adm.Code 4723-20-03 Hand hygiene.

During the delivery of healthcare, licensees and certificate holders shall follow acceptable and prevailing standard precautions for hand hygiene, including but not limited to the following:

(A) Appropriate handwashing prior to performing or participating in an exposure-prone activity and after performing or participating in an exposure-prone activity;

(B) Washing the hands and other skin surfaces immediately and thoroughly when hands have had contact with mucous membranes, blood or body fluids, secretions or excretions, or after touching contaminated items; and

(D) For the purposes of this chapter, hand washing may include the use of alcohol-based waterless hand sanitizers or other antimicrobial agents. If contact with spores, such as C. difficile or bacillus anthracis, has likely occurred, the physical action of washing and rinsing hands with antimicrobial soap and water is the recommended standard precaution.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4723-20-04 Disinfection and sterilization.

An instrument or other reusable equipment used by a licensee or certificate holder who performs or participates in an exposure-prone activity shall be appropriately disinfected and sterilized according to acceptable and prevailing standards for disinfection and sterilization which shall include at least the following:

(A) Single use items used in treating a patient, which have become contaminated by blood or other body fluids, shall be discarded and not reused, unless sterilized and reused in accordance with current guidelines established by the FDA. Single use items being reused in treating a patient shall be adequately cleaned and sterilized. Single use items shall not be reused if the item's physical characteristics and quality have been adversely affected or if the items are incapable of being reused safely and effectively for their intended use;

(B) Equipment and devices that enter a normally sterile area of the body shall be sterilized before being used for each patient;

(C) Equipment and devices that touch an intact mucous membrane but do not penetrate the patient's body surfaces shall be sterilized when possible, or undergo high-level disinfection if the equipment or device cannot be sterilized before being used for each patient;

(D) A licensee or certificate holder shall use aseptic technique, as appropriate.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2019
Promulgated Under: 119.03

Ohio Adm.Code 4723-20-05 Handling and disposal of a sharp or waste.

(A) To prevent injury, a licensee or certificate holder performing or participating in an exposure-prone activity shall not recap a needle, or purposely bend or break a needle or other sharp instrument or item by hand.

(B) After a licensee or certificate holder, who is performing or participating in an exposure-prone activity, uses a disposable needle, syringe, scalpel blade or other sharp item, the licensee or certificate holder shall place the disposable sharp item used in a puncture-resistant container for disposal. The puncture-resistant container shall be located as close as practicable to the use area.

(C) In addition to the requirements of this rule, any sharp instrument, needle or contaminated waste shall be handled and disposed in accordance with all requirements established by the licensee or certificate holder's employer, facilities or organizations in which the licensee or certificate holder is providing care, and requirements established for independent providers by Ohio departments under Title 51 of the Revised Code the delivery of home care.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2019
Promulgated Under: 119.03

Ohio Adm.Code 4723-20-06 Personal protective equipment.

During the delivery of healthcare, licensees and certificate holders shall follow acceptable and prevailing standards precautions regarding the use of personal protective equipment, including at least the following:

(A) Gloves:

(1) A licensee or certificate holder shall wear disposable gloves when performing or participating in an exposure-prone invasive procedure;

(2) The licensee's or certificate holder's hands shall be washed when gloves are removed;

(3) Before performing or participating in an exposure-prone invasive procedure on another patient, the licensee or certificate holder shall wash hands and reglove with another pair of disposable gloves;

(4) If a glove is torn or a needlestick or other injury occurs, the glove shall be removed and a new glove put on as promptly as patient safety permits. The needle or instrument involved in the incident shall be removed from the sterile field;

(B) Masks and protective eyewear. A licensee or certificate holder shall use personal protective equipment such as masks and protective eyewear during patient procedures and activities that are likely to generate splashes or sprays of blood, body fluids and excretions; and

(C) Gowns or aprons. A gown or apron made of material that provides an effective barrier shall be worn by a licensee or certificate holder who is performing or participating in an exposure-prone activity if during the procedure there is a possibility of spattering or splashing of blood or other body fluid.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2019
Promulgated Under: 119.03

Ohio Adm.Code 4723-20-07 Failure to use universal and standard precautions.

During the delivery of healthcare, a licensee or certificate holder who fails to follow universal and standard precautions when engaging in exposure-prone activity, as set forth in rules 4723-20-01 to 4723-20-06 of the Administrative Code, may be subject to disciplinary action according to section 4723.28 of the Revised Code.

Last updated October 2, 2023 at 1:52 PM

History

Effective: February 1, 2020
Promulgated Under: 119.03

Chapter 4723-23 Dialysis Technicians

Ohio Adm.Code 4723-23-01 Definitions.

For purposes of this chapter the following definitions apply:

(A) "Delegation" means the transfer of responsibility for the performance of a selected task or activity from a licensed health care professional authorized to perform the task or activity to an individual who does not have the authority to perform the task or activity.

(B) "Dialysis care" means performing and monitoring dialysis procedures which include initiating or discontinuing dialysis, drawing blood, administering medications authorized by division (C) of section 4723.72 of the Revised Code, and responding to complications that arise in conjunction with dialysis.

(C) "Dialysis technician" or "DT" means an individual who is certified by the board according to section 4723.75 of the Revised Code.

(D) "Dialysis technician intern" or "DTI" means an individual who has not passed the dialysis technician certification examination required by section 4723.751 of the Revised Code, but who has successfully completed a dialysis training program approved by the board of nursing under section 4723.74 of the Revised Code within the previous eighteen months.

(E) "Dialysis training program" means a program approved by the board according to rule 4723-23-07 of the Administrative Code that consists of not less than three hundred twenty clock hours of instruction including both of the following:

(1) A minimum of one hundred clock hours of faculty-interactive theoretical instruction, which may be on-line; and

(2) A minimum of two hundred twenty clock hours of supervised clinical experience.

(F) "Discontinue" means to cease or stop.

(G) "Inactive status" means the status of the certificate of an individual who has made a written request that the board place the certificate on inactive status. An individual with an inactive certificate does not hold a current, valid certificate and is not authorized to provide dialysis care.

(H) "Initiate" means to start or to begin.

(I) "Monitor" means to collect objective and subjective data and observe the dialysis patient for signs or symptoms of any change in physiological or psychosocial status or complications related to dialysis, to check or regulate the performance of the machines used in performing dialysis, and to report any irregularity to the physician or licensed nurse as appropriate.

(J) "Home" means the private residence of a patient, and does not mean a residential care facility, assisted living facility, rehabilitation facility, nursing home, long term care facility, or group home licensed by the state of Ohio.

(K) "Lapsed" means the status of a certificate of an individual who did not meet all the requirements of certificate renewal, and who did not request that the board place the certificate on inactive status prior to the renewal deadline.

(L) "Supervise" or "supervision" means initial and ongoing direction, procedural guidance, observation, and evaluation; and, except when dialysis care is being performed in the patient's home, requires a dialysis technician to be in the immediate presence of a physician or registered nurse.

Last updated March 26, 2026 at 8:30 AM

History

Effective: March 26, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4723-23-03 Dialysis technician certificate.

(A) To obtain a certificate to practice as an Ohio certified dialysis technician an applicant who meets the qualifications set forth in section 4723.75 of the Revised Code shall:

(1) Submit a "Dialysis Technician Application";

(2) Submit an application fee of thirty-five dollars; and

(3) As required by section 4723.75 of the Revised Code, submit to a criminal records check completed by the bureau of criminal identification and investigation the results of which indicate that the individual has not been convicted of, pleaded guilty to, or had a judicial finding of guilt for any violation set forth in section 4723.092 of the Revised Code.

(B) Prior to the board determining an applicant is eligible for a dialysis technician certificate, the board must receive documentation that demonstrates the applicant is competent to practice as a dialysis technician. This may be established by one of the following routes:

(1) The board has received:

(a) Written notice of the applicant's successful completion of a dialysis technician training program, approved by the board under section 4723.74 of the Revised Code, submitted directly by the program administrator or designee;

(b) Written attestation, submitted directly to the board by the applicant's employer or employers, that the applicant has performed dialysis care for not less than six months immediately prior to the date of application for certification; and

(c) Written notice, submitted to the board directly by a testing organization approved by the board, that the applicant has passed a certification examination demonstrating competence to perform dialysis care not later than eighteen months after successfully completing a dialysis training program approved by the board under section 4723.74 of the Revised Code, as required by division (B)(1)(b) of section 4723.75 of the Revised Code. For purposes of calculating the eighteen-month period, the board shall subtract the total amount of time the applicant was enrolled in one or more training programs approved by the board from the eighteen-month period.

(2) The board has received:

(a) Written notice, submitted to the board directly by a testing organization approved by the board, that the applicant has passed a certification examination in another jurisdiction demonstrating competence to perform dialysis care;

(b) Written attestation, submitted directly to the board by the applicant's employer or employers, that the applicant has been employed to perform dialysis care in another jurisdiction for not less than six months immediately prior to the date of application for certification; and

(c) Evidence satisfactory to the board that the applicant has completed two contact hours of education that is directly related to Chapter 4723. of the Revised Code or rules adopted by the board, and that meets the requirements set forth in paragraph (C) of rule 4723-14-01 of the Administrative Code for category A education.

For purposes of this paragraph, the word "immediately" means not more than sixty days prior to the date the individual submits an application for a dialysis technician certificate to the board.

(C) If an applicant for a certificate to practice as an Ohio certified dialysis technician is not determined eligible for a certificate within two year from receipt of the application, the application shall be considered void and the fee forfeited. The application form shall state the circumstances under which this forfeiture may occur.

(D) A certificate to practice as an Ohio certified dialysis technician shall be considered current until the next scheduled renewal period for an Ohio certified dialysis technician certificate. When a certificate to practice as an Ohio certified dialysis technician is issued on or after January first of an odd numbered year, that certificate shall be considered current through March thirty-first of the next odd numbered year.

(E) The board may propose to deny certification as a dialysis technician pursuant to an adjudication under Chapter 119. of the Revised Code. Based on the results of the adjudication, the board may issue the certificate, deny certification, or condition certification on the applicant's successful correction of the area of deficiency identified by the board.

Last updated February 18, 2026 at 8:16 AM

History

Effective: February 1, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-23-04 Dialysis technician certification by endorsement.

(A) An applicant for dialysis technician certification by endorsement shall satisfy the following:

(1) Submit a completed "Certified Dialysis Technician by Endorsement Application" and the certification application fee as required by section 4723.79 and Chapter 4796. of the Revised Code;

(2) Submit to a criminal records check completed by the bureau of criminal investigation;

(3) The applicant has not surrendered or had revoked a license, out-of-state occupational license, or government certification because of negligence or intentional misconduct related to the applicant's practice as a dialysis technican;

(4) The applicant has not been convicted of, found guilty pursuant to a judicial finding of, or plead guilty to a criminal offense for which a licensing authority may deny an application for a license or government certification or that would otherwise disqualify the applicant for the license or government certification under the applicable law of this state governing the profession, occupation, or occupational activity for which the applicant is applying;

(5) Submit any other documentation required by the board.

(B) Pursuant to section 4796.03 of the Revised Code, the board shall issue a dialysis technician certificate in accordance with Chapter 4796. of the Revised Code to an applicant if the applicant holds a substantially similar out-of-state occupational license to engage in practice as a dialysis technician, or, holds a government certification to engage in practice as dialysis technician from one of the uniformed services or from a state that does not issue a license for practice as a dialysis technician, if the applicant:

(1) Has held the license or government certification for at least one year immediately preceding the date the application is submitted to the board;

(2) Has been actively engaged in practice as a dialysis technician for at least one of the five years immediately preceding the date the application is submitted to the board;

(3) Is in good standing in all jurisdictions in which the applicant holds the license or government certification; and

(4) Was required to satisfy minimum education, training, or experience requirements or pass an examination to receive the license or government certification.

The applicant shall have verification of licensure or government certification to practice as a dialysis technician submitted directly to the board from the issuing state or uniformed services. The applicant shall also have verification of having been actively engaged in practice as a dialysis technician for at least one of the past five years submitted directly to the board by the employer or employer designee for whom the applicant practiced as a dialysis technician.

(C) Pursuant to section 4796.04 of the Revised Code, the board shall issue a dialysis technician certificate in accordance with Chapter 4796. of the Revised Code to an applicant who has held a private certification as a dialysis technican in a state that does not issue an occupational license or government certification to practice as a dialysis technican, if the applicant:

(1) Held the private certification for at least two years immediately preceding the date the application is submitted;

(2) Has been actively engaged in practice as a dialysis technician in a state that does not issue an occupational license or government certification to practice as a dialysis technician, for at least two of the five years immediately preceding the date the application is submitted; and

(3) Is in good standing with the private organization that issued the private certification.

The applicant shall have verification of private certification as a dialysis technican submitted directly to the board by the private organization that issued the certification. The applicant shall also have verification of having been actively engaged in practice as a dialysis technican for at least two of the past five years, submitted directly to the board by the employer or employer designee for whom the applicant practiced as a dialysis technician.

(D) Pursuant to section 4796.05 of the Revised Code, the board shall issue a dialysis technician certificate in accordance with Chapter 4796. of the Revised Code to an applicant who, for at least three of the five years immediately preceding the date the application is submitted to the board, has been actively engaged in practice as a dialysis technician, in either:

(1) A state that does not issue an occupational license or government certificate to practice as a dialysis technician, or

(2) Service of the uniformed services.

The applicant shall have verification of having been actively engaged in practice as a dialysis technician for at least three of the past five years submitted directly to the board by the employer or employer designee or the uniformed services for whom the applicant practiced as a dialysis technician.

(E) The board may propose to deny certification by endorsement pursuant to an adjudication conducted in accordance with Chapter 119. of the Revised Code.

(F) If an applicant for certification by endorsement as a dialysis technician fails to meet the requirements for certification within one year from the date the application is received, or the application remains incomplete for one year, the application shall be considered void and the fee forfeited. The application shall state the circumstances under which forfeiture may occur.

Last updated March 26, 2026 at 8:30 AM

History

Effective: March 26, 2026
Promulgated Under: 119.03

Ohio Adm.Code 4723-23-05 Renewal of a certificate to practice as a dialysis technician.

(A) The board shall provide access to an on-line "Dialysis Technician Renewal Application," for renewal to every holder of a current, valid dialysis technician certificate, except when the board is aware that the individual may be ineligible for renewal for any reason, including those reasons set forth in section 4723.092 of the Revised Code.

(B) To renew a dialysis technician certificate, a holder of a current, valid certificate shall complete the continuing education requirements set forth in rule 4723-23-06 of the Administrative Code and submit:

(1) A completed "'Dialysis Technician Renewal Application"; and

(2) A renewal fee of thirty-five dollars,

(C) If a completed renewal application is not submitted on-line by March first of odd numbered years, in order to renew the applicant shall pay a late processing fee according to division (A)(13) of section 4723.08 of the Revised Code. The late processing fee is in addition to the renewal fee specified in paragraph (B) of this rule.

(D) A certificate holder with a current, valid certificate who does not intend to practice as a dialysis technician in Ohio may request that the certificate be placed on inactive status at any time by submitting to the board a written statement or electronic request asking that the certificate be placed on inactive status.

(E) A certificate holder who has requested that their dialysis technician certificate be placed on inactive status is not required to pay a renewal fee unless the holder seeks to reactivate the certificate. If the certificate holder placed a certificate on inactive status after March first of the year in which the certificate was to be renewed, and then notifies the board on or before March thirty-first of the same renewal year of the intent to reactivate, the certificate holder must still pay the late processing fee required by paragraph (C) of this rule.

(F) A dialysis technician who does not renew a certificate on or before March thirty-first of odd numbered years, and has not requested inactive status according to paragraph (E) of this rule, shall have a lapsed certificate.

(G) An individual who continues to practice in Ohio as a dialysis technician with an inactive or lapsed certificate shall be subject to disciplinary action under section 4723.28 of the Revised Code.

(H) To reactivate an inactive certificate or reinstate a lapsed certificate, an individual must complete the continuing education requirements set forth in rule 4723-23-06 of the Administrative Code and submit:

(1) A completed "Dialysis Technician Reactivation or Reinstatement Application"; and

(2) A reactivation fee of thirty-five dollars.

(I) A dialysis technician certificate holder who is a service member or veteran, as defined in rule 4723-2-01 of the Administrative Code, or who is the spouse or surviving spouse of a service member or veteran, may be eligible for a waiver of the late application fee and the reinstatement fee according to rule 4723-2-03 of the Administrative Code.

Last updated February 18, 2026 at 8:16 AM

History

Effective: February 1, 2022
Promulgated Under: 119.03

Ohio Adm.Code 4723-23-06 Continuing education requirements.

(A) Except in the case of the first renewal of a dialysis technician certificate, in order to renew the applicant must have completed fifteen contact hours of continuing education approved by the board in accordance with Chapter 4723-14 of the Administrative Code and this rule. The required fifteen contact hours shall include both of the following:

(1) At least ten hours directly related to dialysis care; and

(2) At least one hour directly related to the law and rules governing the provision of nursing or dialysis care as set forth in Chapter 4723. of the Revised Code, and rules adopted by the board.

(B) A dialysis technician who placed a certificate on inactive status shall not be required to meet the continuing education requirement for the period of time the certificate is on inactive status. To reactivate the certificate, the dialysis technician shall complete fifteen hours of continuing education during the twenty-four months immediately preceding application. The fifteen hours of continuing education shall comply with the requirements set forth in paragraph (A) of this rule.

(C) To reinstate a lapsed dialysis technician certifcate, the holder of the certificate shall complete fifteen hours of continuing education during the twenty-four months immediately preceding application to reinstate the certificate. The fifteen hours of continuing education shall comply with the requirements set forth in paragraph (A) of this rule.

(D) A dialysis technician shall verify completion of the continuing education required by this rule on the "Dialysis Technician Renewal Application," and at the discretion of the board, may be required to show proof of completion of the approved continuing education. Failure to so verify or provide such proof shall result in ineligibility to renew, reactivate, or reinstate a dialysis technician certificate until the continuing education requirements are met.

(E) A dialysis technician who earns in excess of the number of contact hours of continuing education required for a single reporting period shall not apply the excess hours to satisfy future continuing education requirements.

(F) A dialysis technician, who is ineligible to renew, reactivate, or reinstate a certificate due to failure to meet the continuing education requirements, may be required to show completion of up to thirty contact hours of continuing education, that meets the requirements of this rule, before being issued a current certificate by the board. The continuing education shall be obtained within the forty-eight months immediately preceding renewal, reactivation, or reinstatement of the certificate.

(G) A dialysis technician may use a waiver to satisfy the continuing education requirement only one time, and the dialysis technician shall notify the board in writing requesting the waiver. Once the dialysis technician notifies the board of the intent to use the waiver, the waiver shall not be rescinded and use of the waiver shall be documented on the dialysis technician's certificate record.

(H) Notwithstanding paragraph (G) of this rule, the holder of a lapsed or inactive dialysis technician certificate may not use the one time continuing education waiver when reinstating a lapsed certificate or reactivating an inactive certificate.

(I) Contact hours based on credit hours earned in an academic institution shall be calculated according to paragraph (B) of rule 4723-14-04 of the Administrative Code.

(J) Educational activities that satisfy the requirements of this rule are the same as those set forth in rule 4723-14-05 of the Administrative Code.

(K) The board may conduct a retrospective audit of any holder of a dialysis technician certificate to determine compliance with this rule. The audit shall be conducted according to rule 4723-14-07 of the Administrative Code. A dialysis technician shall retain proof of completion of approved continuing education for a period of six years.

(L) A dialysis technician who is engaged in active military duty may be eligible for an extension of time to complete continuing education as provided in rule 4723-2-04 of the Administrative Code.

Last updated February 18, 2026 at 8:16 AM

History

Effective: February 1, 2021
Promulgated Under: 119.03

Ohio Adm.Code 4723-23-07 Procedures for obtaining approval or reapproval as a dialysis technician training program.

The board shall approve and reapprove dialysis technician training programs as follows:

(A) A dialysis technician training program that seeks to be approved by the board shall:

(1) Submit a completed "Dialysis Technician Training Programs Application for Initial Board Approval" form to the board, that includes the following:

(a) Identifying information;

(b) Information regarding administrative processes of the program;

(c) A description of the record-keeping system to be used by the training program to assure accurate reporting to the board of individuals who have enrolled in and who did or did not successfully complete the program;

(d) A copy of the policies required by rule 4723-23-08 of the Administrative Code; and

(e) Any other information requested by the board.

(2) Submit payment of a program approval fee of three hundred dollars.

No more than one hundred twenty days after receipt of a complete application for approval, the board shall make a determination regarding the approval status of the training program.

(B) Approval shall be current for two years provided the program demonstrates that the standards set forth in rule 4723-23-08 of the Administrative Code are met and maintained throughout the two-year approval period.

(C) At least ninety days prior to expiration of program approval, a dialysis technician training program seeking reapproval shall submit to the board the following:

(1) A "Dialysis Technician Training Program Re-Approval Application," that includes, but is not limited to, verification that the program meets and has maintained the standards set forth in rule 4723-23-08 of the Administrative Code;

(2) Payment of a program reapproval fee of three hundred dollars; and

(3) Any other information requested by the board.

(D) The board shall provide written notification to the dialysis technician training program seeking approval or reapproval if additional information is needed. The notice shall specify a time frame for submission of the required information. The additional information may include but is not limited to the documentation required by paragraph (A)(1) of this rule.

(E) At a regularly scheduled board meeting the board shall review the completed application for approval or reapproval and other necessary documentation to determine compliance with the rules of this chapter. The board shall approve or reapprove a program when the program meets the requirements for approval or reapproval.

(F) The board shall provide the program with written notification of its approval status.

(G) When a complete application for reapproval is submitted to the board in accordance with paragraph (C) of this rule and the board fails to make a determination before the program's approval expires, the board shall issue a notice to the nurse responsible for administering the program extending approval of the program until board action is taken on the reapproval application.

(H) If at any time a dialysis training program approved by the board or a program seeking approval or reapproval appears not to meet or maintain the minimum standards set forth in this chapter:

(1) The board shall submit to the nurse responsible for administering the program a written deficiency report which identifies the standard or standards not being met or maintained and shall include the date on which the board is to consider the deficiency report;

(2) The nurse responsible for administering the program may submit to the board, at least forty-five days prior to the date the board is to consider the deficiency report, either:

(a) A written plan of correction which sets forth the steps taken by the program to meet or maintain each minimum standard identified in the report as not being met or maintained; or

(b) A written response to the report disputing its findings and setting forth evidence that the program is meeting and maintaining each minimum standard identified in the report as not being met or maintained.

(3) The board may grant approval, reapproval, or propose to deny or withdraw approval of the program based on the deficiency report, the program's response to the report, and any other relevant evidence.

The board shall deny or withdraw approval of a program only pursuant to an adjudication in accordance with Chapter 119. of the Revised Code.

Last updated February 18, 2026 at 8:16 AM

History

Effective: February 1, 2021
Promulgated Under: 119.03

Ohio Adm.Code 4723-23-08 Requirements for a dialysis technician training program approved by the board.

To be approved by the board a dialysis technician training program shall meet and maintain the following standards and requirements:

(A) In accordance with paragraph (D) of rule 4723-23-01 of the Administrative Code, an approved training program shall consist of not less than three hundred twenty clock hours of instruction and shall include a minimum of one hundred clock hours of faculty-interactive theoretical instruction, and a minimum of two hundred twenty clock hours of supervised clinical experience. The curriculum shall include content that ensures sufficient preparation for safe and effective practice as a dialysis technician. The curriculum shall include, but is not limited to, the following content:

(1) Theoretical instruction that includes:

(a) Completion of the "Dialysis Technician Application";

(b) A review of the relevant laws and rules regulating the practice of a dialysis technician and appropriate program policies;

(d) Infection control and universal precautions;

(e) Basic chemistry of body fluids and electrolytes;

(f) Manifestations of renal failure;

(g) Blood work and laboratory values related to dialysis;

(h) Principles of dialysis;

(i) Pharmacology of the drugs commonly used during dialysis;

(j) Medication administration techniques specific to the drugs used in dialysis;

(k) Management of the complications of dialysis and renal failure;

(l) The role of the dialysis technician in a dialysis setting including, but not limited to, legal and ethical considerations and concepts of delegation;

(m) Water treatment relevant to dialysis;

(n) Principles of patient education related to renal failure;

(o) Principles of and requirements for documentation;

(p) Communication and team work skills;

(q) Operation of dialysis delivery systems that includes the machines, dialysate, and dialyzer;

(r) Principles of safe effective dialysis care;

(s) Principles related to the nutritional considerations for patients receiving dialysis;

(t) Psychosocial aspects of renal disease;

(u) Principles of dialyzer reprocessing;

(v) Principles for initiating, monitoring, and discontinuing dialysis;

(w) Principles related to the adequacy of dialysis; and

(x) Establishing and maintaining professional boundaries with a patient.

(2) Supervised clinical instruction which:

(a) Provides the dialysis technician trainee with the opportunity to practice the cognitive, psychomotor, and affective skills required for the safe performance of dialysis care by the dialysis technician;

(b) Meets the learning needs of each trainee;

(d) Is provided concurrently with the related classroom theory instruction.

(B) The program shall be administered by a registered nurse who meets the following qualifications:

(1) Current, valid licensure in Ohio to practice nursing as a registered nurse;

(2) At least thirty-six months experience in the practice of nursing as a registered nurse, of which at least twenty-four months has been in the care of renal patients, with at least six of those months in dialysis care; and

(3) Education or experience in adult education.

(C) The registered nurse who is responsible for administering the program may utilize other health care professionals to assist in conducting classroom and clinical portions of the program in accordance with the professional's educational background and applicable scope of practice as set forth in the appropriate sections of the Revised Code.

(D) The registered nurse who is responsible for administering the program shall:

(1) Assure that the governing body of the training program establishes in writing the policies required by paragraph (E) of this rule; and

(2) Implement the policies as written.

(E) The program shall adopt and implement policies that establish:

(1) Criteria for trainee enrollment and continuation in the program that require, at a minimum, that the individual be able to safely perform the essential functions of a dialysis technician;

(2) Criteria for successful completion of the program;

(3) A process for determining achievement of the skills required for the safe performance of dialysis care which shall include, at a minimum, written verification that the trainee has been taught the required skills, signed by both a registered nurse and the trainee;

(4) A process for maintaining trainee records including but not limited to:

(a) The date the trainee began the program;

(b) The date the trainee completed the program; and

(5) An accurate, timely process for providing written notice to the board regarding enrollment and program completion that includes the dates of trainee enrollment and successful completion, as determined by the nurse who is responsible for administering the program.

(6) A process for monitoring the status of the dialysis technician intern certificate a trainee may hold;

(7) A process for evaluation of the program which includes, but is not limited to:

(a) Feedback from trainees enrolled in the program regarding the program and the instructional personnel assisting with the program;

(b) Feedback from the employers of the trainees who have successfully completed the program; and

(8) Those individuals who have authority to notify the board regarding trainee enrollment, re-enrollment, withdrawal from, and completion of the program.

(9) A procedure in accordance with paragraph (F) of this rule for dealing with the unexpected vacancy of the nurse responsible for administering the program.

(10) For individuals with experience in the armed forces of the United States, or in the national guard or in a reserve component, the program shall have a process in place to:

(a) Review the individual's military education and skills training;

(b) Determine whether any of the military education or skills training is substantially equivalent to the curriculum established in Chapter 4723-23 of the Administrative Code; and

(F) When the nurse responsible for administering the program vacates the position or is replaced, the board shall be informed in writing within forty-five days of the effective date of the vacancy; and informed in writing within forty-five days of a new appointment, including the name and qualifications of the new administrator. A training program shall not initiate a new dialysis technician training course unless an administrator who meets the requirements of paragraph (B) of this rule is in place.

(G) When a decision is made to close a training program, the board shall be notified in writing of the decision and shall be provided with the following information:

(1) The tentative date of the closing;

(2) The location of the program's records, including but not limited to trainees' records; and

(3) The name and address of the custodian of the records.

Last updated February 18, 2026 at 8:17 AM

History

Effective: February 1, 2021
Promulgated Under: 119.03

Ohio Adm.Code 4723-23-09 Information required when attesting to the competence of an applicant for a certificate to practice as dialysis technician.

(A) The employer of an applicant, for a dialysis technician certificate , or the employer's designee, shall provide written information directly to the board when attesting to the competence to perform dialysis care of the applicant.

(B) The information required by this rule shall include a statement that the employer, prior employer, or the employer or prior employer's designee, in good faith affirms that the applicant has the knowledge, skills, and ability to provide dialysis care in accordance with acceptable and prevailing standards of safe dialysis care as set forth in section 4723.72 of the Revised Code and this chapter.

(C) The employer or the employer's designee shall provide assurance that the verification or statement required by paragraph (B) of this rule has been sent directly to the board by the employer.

Last updated February 18, 2026 at 8:17 AM

History

Effective: December 17, 2023
Promulgated Under: 119.03

Ohio Adm.Code 4723-23-10 Requirements for approval and reapproval of a testing organization that conducts an examination of a dialysis technician.

(A) To be approved by the board a testing organization that conducts an examination of a dialysis technician candidate shall meet all of the following requirements:

(1) Be national in the scope of its testing and credentialing;

(2) Maintain files for each candidate who passes the organization's examination for dialysis technicians;

(3) Issue a certificate to each individual who passes the organization's examination for dialysis technicians;

(4) Periodically conduct an analysis of the tasks, role delineation, skills, and knowledge required of a dialysis technician with a minimum of six month's experience in providing dialysis care and revise the examination as needed to reflect the findings of the analysis;

(5) Require a minimum of six months experience in dialysis care before the candidate is allowed to take the examination;

(6) Provide a formal process by which an affected individual may appeal the organization's decision to revoke certification when the organization has such revocation authority;

(7) Provide a mechanism for assuring the security of the examination;

(8) Not be affiliated in any way with a provider of dialysis care or with a dialysis technician training program; and

(9) Include on the examination material that comprehensively tests the following:

(a) Patient care activities that include but are not limited to:

(i) Collection of objective and subjective data about the patient's condition;

(ii) The patient's response to dialysis; and

(iii) Appropriate interventions when complications arise in conjunction with dialysis;

(b) Principles of dialysis delivery systems and machine technology which include but are not limited to:

(i) Operation of the machines used in dialysis;

(ii) Machine set-up; and

(iii) Machine evaluation;

(i) System components and design;

(ii) Maintenance of the water treatment system;

(iii) Monitoring of the water treatment system; and

(iv) Evaluation of the system;

(d) Principles of dialyzer reprocessing including but not limited to reprocessing procedures, testing, and evaluation; and

(e) Responsibilities of the dialysis technician with respect to documentation, patient education, and professional development.

The board may also require a testing organization to demonstrate that the test administered by the organization is psychometrically sound.

(B) A testing organization seeking approval by the board shall submit to the board an "Application for Initial Approval/Reapproval of a Testing Organization that Conducts an Examination of Dialysis Technicians" that includes the information required by the board to determine whether the organization meets the requirements set forth in paragraph (A) of this rule. The board shall verify compliance of each testing organization with the criteria contained in paragraph (A) of this rule.

(C) Annually, at a time specified by the board, the board shall provide to each testing organization approved by the board for the prior year an "Application for Initial Approval/Reapproval of a Testing Organization that Conducts an Examination of Dialysis Technicians" on which the organization shall indicate whether it complies with the criteria contained in paragraph (A) of this rule. The board shall verify continued compliance of each testing organization with the criteria contained in paragraph (A) of this rule.

(D) The board shall issue a written notification to each testing organization that is approved by the board.

(E) No later than January thirty-first of each year, the board shall make available a list of approved testing organizations that meet the requirements of paragraph (A) of this rule.

(F) The board may discontinue approval of a testing organization that does not meet the criteria contained in paragraph (A) of this rule or that fails to timely return to the board the form indicating compliance with paragraph (A) of this rule.

Last updated February 18, 2026 at 8:18 AM

History

Effective: February 1, 2021
Promulgated Under: 119.03

Ohio Adm.Code 4723-23-12 Standards for medication administration by a dialysis technician.

(A) A dialysis technician shall administer only the following medications:

(1) Intradermal lidocaine or another single therapeutically equivalent local anesthetic for the purpose of initiating dialysis treatment;

(2) Intravenous heparin or other single therapeutically equivalent anticoagulant for the purpose of initiating and maintaining dialysis treatment;

(3) Intravenous normal saline;

(4) Patient specific dialysate to which the dialysis technician may add only electrolytes; and

(5) Oxygen, when the administration of the oxygen has been delegated to the dialysis technician by a registered nurse.

(B) When administering the medications set forth in paragraph (A) of this rule, the dialysis technician shall:

(1) Assure that the right dose of the right medication is given to the right individual through the right route of administration at the right time;

(2) Accurately and timely document the administration of the medication and notify a physician or licensed nurse of the patient's response to the medication as appropriate;

(3) Consult with an appropriate licensed practitioner when the dialysis technician believes or has reason to believe that a prescribed medication is inaccurate, not properly authorized, harmful or potentially harmful to a patient, or contraindicated by other documented information; and

(4) Take any other action needed to assure the safety of the patient.

(C) A dialysis technician shall administer the medications authorized by this rule only if the task has been delegated to the dialysis technician by a registered nurse in accordance with Chapter 4723-13 of the Administrative Code or by a licensed physician.

(D) The dialysis technician shall be in the immediate presence of a registered nurse or physician when administering medications.

(E) Notwithstanding paragraph (D) of this rule, when a dialysis technician administers medications while providing dialysis care in the patient's home a registered nurse shall supervise the technician in accordance with rule 4723-23-13 of the Administrative Code.

Last updated February 18, 2026 at 8:18 AM

History

Effective: February 1, 2016
Promulgated Under: 119.03

Ohio Adm.Code 4723-23-13 Standards and procedures for supervising a dialysis technician who provides dialysis care in the home.

(A) A dialysis technician may provide dialysis care in the home of a patient only if the technician holds a current, valid certificate issued by the board to practice as a dialysis technician.

(B) When a dialysis technician provides dialysis care in the home of a patient a registered nurse shall supervise the care provided by the dialysis technician. The registered nurse who is supervising the dialysis technician shall meet the following requirements:

(1) Hold a current, valid license to practice nursing as a registered nurse in Ohio; and

(2) Be employed by or under contract with a medicare-approved home dialysis program.

(C) When a registered nurse is supervising the care provided by a dialysis technician in accordance with paragraph (B) of this rule the nurse shall:

(1) Visit the patient's home at least one time per month while the dialysis technician is providing dialysis care to the patient to determine whether the care is being provided in accordance with the standards for safe dialysis care as set forth in this chapter; and

(2) Assess the quality of the care provided by the dialysis technician and provide a written report of each visit to the medicare-approved home dialysis program.

(D) When a registered nurse determines that a dialysis technician is not providing care in accordance with the standards for safe dialysis care as set forth in this chapter, the nurse shall immediately notify the medicare-approved home dialysis program and take whatever additional steps are needed to assure the safety of the patient.

Last updated February 18, 2026 at 8:18 AM

History

Effective: February 1, 2021
Promulgated Under: 119.03

Ohio Adm.Code 4723-23-14 Standards for safe dialysis care.

(A) This rule sets forth the minimal acceptable standards of safe and effective dialysis care and provides criteria for the board to evaluate a dialysis technician's adherence to the acceptable standards of safe dialysis care. For purposes of this rule, "dialysis technician" means an individual holding a dialysis technician certificate or a dialysis technician intern certificate.

(B) In accordance with section 4723.72 of the Revised Code and this chapter, a dialysis technician shall provide dialysis care only when the performance of the care is delegated to the dialysis technician by a physician or registered nurse.

(C) A dialysis technician shall demonstrate competence and accountability in all areas of dialysis care in which the technician is engaged including, but not limited to, the following:

(1) Consistent performance of all aspects of dialysis care according to acceptable standards; and

(2) Appropriate recognition, referral, consultation, or intervention when a complication arises in conjunction with dialysis or when a change in patient status occurs;

(D) A dialysis technician shall timely:

(1) Implement the prescribed dialysis care order for a patient unless the technician believes or should have reason to believe that the prescribed order is inaccurate, not properly authorized, not current or valid, harmful or potentially harmful to the patient, or contraindicated by other documented information; and

(2) Clarify any prescribed dialysis care order for a patient when the technician believes or should have reason to believe that the order is inaccurate, not properly authorized, not current or valid, harmful or potentially harmful to the patient, or contraindicated by other documented information.

(E) When clarifying the prescribed dialysis care order, the dialysis technician shall timely:

(1) Consult with an appropriate licensed practitioner;

(2) Notify the practitioner when the technician decides not to follow the prescribed dialysis care order;

(3) Document that the practitioner was notified of the decision not to follow the direction or the prescribed dialysis care order; and

(4) Take any other action needed to assure the safety of the patient.

(F) A dialysis technician shall timely report to and consult as necessary with other members of the dialysis care team, including, but not limited to, the licensed nurse or physician when a patient refuses to follow the prescribed dialysis care order.

(G) A dialysis technician shall maintain the confidentiality of patient information obtained in the course of practice. The dialysis technician shall communicate patient information with other members of the health care team for health care purposes only, shall access patient information only for purposes of patient care or for otherwise fulfilling the dialysis technician's assigned job responsibilities, and shall not disseminate patient information for purposes other than patient care or for otherwise fulfilling the dialysis technician's assigned job responsibilities through social media, texting, emailing, or any other form of communication.

(H) A dialysis technician shall do the following to promote patient safety:

(1) Display the applicable title or initials set forth in section 4723.73 of the Revised Code at all times when providing dialysis care;

(2) Completely, accurately, and timely document and report all patient data obtained while providing dialysis care and the patient's response to the care;

(3) Completely, accurately and, timely document and report to the appropriate practitioner all errors in or deviations from the prescribed dialysis care regimen;

(4) Not falsify any patient record or any other documents prepared in the course of or in conjunction with the provision of dialysis care. This includes, but is not limited to, case management documents or reports, time records or reports, and other documents related to billing for dialysis services;

(5) Implement measures to provide a safe environment for the patient;

(6) Delineate, establish, and maintain professional boundaries with each patient;

(7) Not engage in behavior that causes or may cause physical, verbal, mental, or emotional abuse to a patient, or in behavior that may reasonably be interpreted as physical, verbal, mental or emotional abuse;

(8) Not misappropriate a patient's property, engage in behavior to seek or obtain personal gain at the patient's expense, or engage in behavior that constitutes inappropriate involvement in a patient's personal relationships;

(9) Not engage in sexual misconduct or in conduct that may reasonably be interpreted as sexual, or in any verbal behavior that is seductive or sexually demeaning to a patient, or in behavior that may reasonably be interpreted as seductive or sexually demeaning to a patient; and

(10) Treat each patient with courtesy, respect, and with full recognition of the dignity of each individual.

The patient is always presumed incapable of giving free, full, or informed consent to the behaviors by a dialysis technician set forth in paragraphs (H)(7), (H)(8) and (H)(9) of this rule.

(I) A dialysis technician shall not make any false, misleading, or deceptive statements, or submit or cause to be submitted any false, misleading or deceptive information or documentation to:

(1) The board or any representative of the board;

(2) Current employers;

(3) Prospective future employers when applying for positions requiring a certificate to practice dialysis care;

(4) Facilities in which, or organizations for whom, the dialysis technician is working a temporary or agency assignment;

(5) Other members of the patient's health care team; or

(6) Law enforcement personnel.

(J) For purposes of paragraphs (H)(6), (H)(7), (H)(8), (H)(9), and (H)(10) of this rule, a dialysis technician shall not use social media, texting, emailing, or other forms of communication with, or about, a patient, for non-health care purposes or for purposes other than fulfilling the dialysis technician's assigned job responsibilities.

Last updated February 18, 2026 at 8:18 AM

History

Effective: February 1, 2016
Promulgated Under: 119.03

Chapter 4723-24 Doula Certification

Ohio Adm.Code 4723-24-01 Definition of terms.

For the purpose of this chapter, the following definitions apply:

(A) Those definitions found in section 4723.89 of the Revised Code, and the following.

(B) "Board" means the Ohio board of nursing.

(C) "Certificate to practice" means the certificate issued by the board in accordance with section 4723.89 of the Revised Code.

(D) "Certified doula" means an individual who holds a certificate to practice issued or renewed by the board under section 4723.89 of the Revised Code.

(E) "Client" means the recipient of doula services as defined in section 4723.89 of the Revised Code.

(F) "Continuing education" means a planned learning activity that builds upon a certified doula's certification program, and/or education and work experience, and enables a certified doula to acquire or improve skills, knowledge or best practice that promotes professional or technical development and is approved by the board under Chapter 4723-14 of the Administrative Code, or that is offered by a doula certifying organization that is recognized on an international, national, state, or local level, for training and certifying doulas, or that is accepted by such an organization to satisfy its own continuing education requirements for maintenance of, or renewal of, its doula certification.

(G) "Doula" means a trained, nonmedical professional who advocates for, and provides continuous physical, emotional, and informational support to, a pregnant woman through the delivery of a child and immediately after the delivery, including any of the following periods:

(1) The antepartum period;

(2) The intrapartum period;

(3) The postpartum period.

(H) "Inactive certificate" means the status of the certificate that an individual has placed on inactive status. An individual with an inactive certificate does not hold a current, valid certificate.

(I) "Lapsed certificate" means the status of a certificate of an individual who did not meet all of the requirements of certificate renewal and has not requested prior to the renewal deadline that the board place the certificate on inactive status.

Last updated September 30, 2024 at 8:31 AM

History

Effective: September 30, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-24-02 Doula certification.

(A) To obtain a certificate to practice as a doula, an applicant who meets the qualifications set forth in division (A) of section 4723.89 of the Revised Code shall:

(1) Submit a completed "Doula Application."

(2) Be at least eighteen years of age at the time of submitting the doula application.

(3) Submit an application fee of thirty-five dollars as authorized by section 4723.89 of the Revised Code.

(4) Be certified by a doula certification organization that is recognized on an international, national, state, or local level, for training and certifying doulas, or, if not certified, have education and experience considered by the board to be appropriate, as specified in this chapter.

(a) If applying based on certification by a doula certification organization recognized on an international, national, state, or local level, for training and certifying doulas, the certification must be current and must either be:

(i) Provided directly to the board by the doula certifying organization; or

(ii) If provided by the applicant, the applicant must provide contact information sufficient for the board to verify the certification, including but not limited to the certification organization's name, mailing address, telephone number, email address if one is available, website if one is available, and any other information necessary for the board to verify the certification.

(iii) In addition, the applicant must attest that they have completed four hours of training directly related to racial bias, health disparities, and cultural competency either through their doula certification organization or otherwise.

(b) If applying based on education and experience:

(i) The applicant must have completed ten hours of education that meets the requirements of rule 4723-24-04 for doula continuing education.

(ii) At least four of those hours must be training directly related to racial bias, health disparities, and cultural competency. The remaining six hours should relate to the doula's practice.

(iii) The applicant's education may be demonstrated by attestation to having completed education meeting these requirements. At the discretion of the board, the applicant may be required to show proof of completion of the education. Failure to provide proof of completion shall result in ineligibility to be issued a certificate by the board until proof of completion is provided to the board.

(iv) In addition, the applicant must have been actively engaged in practice as a doula for three years immediately prior to the date the application is submitted to the board. The applicant may have verification of having been actively engaged in practice as a doula for three years submitted directly to the board by an employer or an employer designee. Alternatively, the applicant may attest to having provided doula services to five clients over the three years immediately prior to the date of the application. At the board's discretion, an applicant may be required to provide date spans and a general description of the doula services provided for each of the five clients.

(5) In accordance with division (A) of section 4723.091 of the Revised Code, submit a request to the bureau of criminal identification and investigation for a criminal records check. The results of the criminal records check shall:

(a) Be received by the board before a certificate can be issued; and

(b) Indicate that the individual has not been convicted of, pled guilty to, or had a judicial finding of guilt for any violation set forth in section 4723.092 of the Revised Code.

(B) The board shall issue a certificate to practice as a doula to applicants who satisfy the requirements of paragraph (A) of this rule, after receipt of written documentation meeting all requirements of this rule.

(C) If an applicant fails to meet the requirements for certification within one year from the time the board receives the application, the application shall be considered void and the fee shall be forfeited. The application shall state the circumstances under which this forfeiture may occur.

(D) A doula certificate shall be considered current until the next scheduled renewal period for certified doula. When a certificate is issued on or after January first of an even numbered year, that certificate shall be considered current through March thirty-first of the next even numbered year.

Last updated September 30, 2024 at 8:31 AM

History

Effective: September 30, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-24-03 Renewal of doula certificate.

(A) The board shall provide on-line access to a "Certified Doula Renewal Application" to every holder of a current, valid certificate, except when the board is aware that the individual may be ineligible for certificate renewal for any reason, including those reasons set forth in section 4723.092 of the Revised Code. Failure of the certificate holder to receive an application for renewal from the board does not excuse the certificate holder from the requirements of section 4723.89 of the Revised Code and this chapter, except as provided in section 5903.10 of the Revised Code.

(B) To renew a certificate to practice as a certified doula a holder of a current, valid certificate shall meet the continuing education requirements set forth in rule 4723-24-04 of the Administrative Code and submit:

(1) A completed on-line "Certified Doula Renewal Application," and

(2) A renewal fee of thirty-five dollars as authorized by section 4723.89 of the Revised Code.

(C) If a completed renewal application is not submitted on-line on or before March first of each even numbered year, the application shall be considered late and a late fee of fifty dollars shall be imposed in addition to the thirty-five dollar renewal fee.

(D) A certificate holder with a current, valid certificate may place the certificate on inactive status at any time by electronic request.

(E) To reactivate an inactive certificate or reinstate a lapsed certificate the certificate holder must meet the continuing education requirements set forth in rule 4723-24-04 of the Administrative Code and submit:

(1) A completed "Certified Doula Reactivation and Reinstatement Application" including all required documentation; and

(2) A reactivation fee in the amount of thirty-five dollars as authorized by section 4723.89 of the Revised Code.

(F) A certificate holder who has placed a certified doula certificate on inactive status is not required to pay a renewal fee unless the holder seeks to reactivate the certificate. If the certificate holder placed a certificate on inactive status after March second of the year in which the certificate was to be renewed, and notifies the board on or before March thirty-first of the same year of the intent to reactivate, the certificate holder must still pay the late processing fee required by paragraph (C) of this rule.

(G) If a certificate to practice as a certified doula is not renewed by March thirty-first of each even numbered year and the certificate holder has failed by that time to request that the certificate be placed on inactive status, the certificate will lapse.

(H) When a certified doula certificate is inactive or lapsed, the individual shall not represent or imply to the public that he or she is certified by the board as a certified doula.

(I) An individual who continues to represent to the public that he or she is a certified doula during the time that his or her certificate is inactive or lapsed, may be subject to disciplinary action by the board in accordance with rule 4723-24-07 of the Administrative Code.

(J) A doula certificate holder who is a service member or veteran, as defined in rule 4723-2-01 of the Administrative Code, or who is the spouse or surviving spouse of a service member or veteran, may be eligible for a waiver of the late application fee and the reinstatement fee according to rule 4723-2-03 of the Administrative Code.

Last updated September 30, 2024 at 8:32 AM

History

Effective: September 30, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-24-04 Continuing education requirements.

(A) Except in the case of the first renewal of a current, valid certificate to practice as a certified doula, to be eligible to renew a certificate, a certified doula shall complete ten contact hours of continuing education, as defined in rule 4723-24-01 of the Administrative Code, during each certification period. For each reporting period, at least four of the required hours of continuing education must be training on racial bias, health disparities, and cultural competency. The remaining six hours should relate to other topics relevant to the doula's practice.

(B) A certified doula who requests that the certificate be placed on inactive status shall not be required to meet the continuing education requirement for the period of time the certificate is on inactive status. To reactivate the certificate the certified doula shall complete ten hours of continuing education that meet the requirements as set forth in paragraph (A) of this rule, during the twenty-four months immediately prior to the application for reactivation.

(C) The holder of a lapsed certificate shall complete ten hours of continuing education that meet the requirements of paragraph (A) of this rule during the twenty-four months immediately prior to the application for reinstatement of the certificate.

(D) A certified doula shall verify completion of the continuing education required by this rule on the "Certified Doula Renewal Application" or "Certified Doula Reactivation and Reinstatement Application" for certificate renewal, reactivation or reinstatement, and at the discretion of the board, may be required to show proof of completion of the continuing education. Failure to verify or provide proof of completion shall result in ineligibility to renew, reactivate, or reinstate a certificate until proof of completion of the continuing education requirements is provided to the board.

(E) A certified doula who earns more than the number of contact hours of continuing education required for a single reporting period can apply up to five of the excess hours to satisfy future continuing education requirements.

(F) A certified doula who is ineligible to renew or reinstate a certificate due to failure to meet the continuing education requirements may be required to show completion of the required number of ten hours of continuing education, that meets the requirements of this rule, before their certificate is renewed or reinstated by the board.

(G) A certified doula may use a waiver to satisfy the continuing education requirement only one time, and must notify the board in writing requesting the waiver. Once requested the waiver cannot be rescinded and use of the waiver shall be documented on the board certified doula's record.

(H) The calculation of continuing education hours based on credit hours earned in an academic institution is as follows:

(1) For credit hours earned on an academic quarter system, one credit hour is equivalent to ten continuing education hours;

(2) For credit hours earned on an academic trimester system, one credit hour is equivalent to twelve continuing education hours;

(3) For credit hours earned on an academic semester system, one credit hour is equivalent to fifteen continuing education hours; and

(4) For credit hours that have not been identified as quarters, semesters, or trimesters, one credit hour is equivalent to ten continuing education hours.

(I) Educational activities that satisfy the requirements of this rule are set forth in rule 4723-24-01 of the Administrative Code.

(J) The board may conduct a retrospective audit of any holder of a certificate to practice as a certified doula to determine compliance with this rule. The audit shall be conducted according to rule 4723-14-07 of the Administrative Code. A certified doula shall retain proof of completion of continuing education that meets the requirements of rule 4723-24-01 of the Administrative Code, for a period of six years.

(K) A certified doula who is engaged in active military duty may be eligible for an extension of time to complete continuing education as provided in rule 4723-2-04 of the Administrative Code.

Last updated September 30, 2024 at 8:32 AM

History

Effective: September 30, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-24-05 Doula certification by endorsement.

(A) An applicant for doula certification by endorsement shall satisfy the following:

(1) Submit a comleted "Certified Doula by Endorsement Application" and the certification application fee required by section 4723.89 of the Revised Code and rule 4723-24-02 of the Administrative Code and Chapter 4796. of the Revised Code;

(2) Submit to a criminal records check completed by the bureau of criminal identification and investigation;

(5) The applicant attests to having completed four hours of training on racial bias, health disparities, and cultural competency within one year prior to the date of the application. The training shall meet the requirements for doula continuing education as defined in rule 4723-24-01 of the Administrative Code. At the discretion of the board, the applicant may be required to show proof of completion of the education. Failure to provide proof of completion shall result in ineligibility to be issued a certificate by the board until proof of completion is provided to the board.

(6) Submit any other documentation required by the board.

(B) Pursuant to section 4796.03 of the Revised Code, the board shall issue a doula certificate in accordance with Chapter 4796. of the Revised Code to an applicant if the applicant holds a substantially similar out-of-state occupational license to engage in practice as a doula, or, holds a government certification to engage in practice as a doula from one of the uniformed services or from a state that does not issue a license for practice as a doula, if the applicant:

(1) Has held the license or government certification for at least one year immediately preceding the date the application is submitted to the board;

(2) Has been actively engaged in practice as a doula for at least one of the five years immediately preceding the date the application is submitted to the board;

(3) Is in good standing in all jurisdictions in which the applicant holds the license or government certification; and

(4) Was required to satisfy minimum education, training, or experience requirements or pass an examination to receive the license or government certification.

The applicant shall have verification of licensure or government certification to practice as a doula submitted directly to the board from the issuing state or uniformed services. The applicant shall also have verification of having been actively engaged in practice as a doula for at least one of the past five years submitted directly to the board by the employer or employer designee for whom the applicant practiced as a doula.

(C) Pursuant to section 4796.04 of the Revised Code, the board shall issue a doula certificate in accordance with Chapter 4796. of the Revised Code to an applicant who has held a private certification as a doula in a state that does not issue an occupational license or governmental certification to practice as a doula, if the applicant:

(1) Held the private certification for at least two years immediately preceding the date the application is submitted;

(2) Has been actively engaged in practice as a doula in a state that does not issue an occupational license or government certification to practice as a doula, for at least two of the five years immediately preceding the date the application is submitted;

(3) Is in good standing with the private organization that issued the private certification; and

(4) The private certification must be current and must either be:

(a) Provided directly to the board by the doula certifying organization; or

(b) If the private certification is provided by the applicant, the applicant must provide contact information sufficient for the board to verify the certification, including but not limited to the certification organization's name, mailing address, telephone number, email address if one is available, website if one is available, and any other information necessary for the board to verify the certification.

The applicant shall also have verification of having been actively engaged in practice as a doula for at least two of the past five years, submitted directly to the board by the employer or employer designee for whom the applicant practiced as a doula.

(D) Pursuant to section 4796.05 of the Revised Code, the board shall issue a doula certificate in accordance with Chapter 4796. of the Revised Code to an applicant who, for at least three of the five years immediately preceding the date the application is submitted to the board, has been actively engaged in practice as a doula, in either:

(1) A state that does not issue an occupational license or government certificate to practice as a doula, or

(2) Service of the uniformed services.

The applicant shall have verification of having been actively engaged in practice as a doula for at least three of the past five years submitted directly to the board by the employer or employer designee or the uniformed services for whom the applicant practiced as a doula. Alternatively, the applicant may attest to having provided doula services to five clients over the three years immediately prior to the date of the application. At the board's discretion, an applicant may be required to provide date spans and a general description of the doula services provided for each of the five clients.

The applicant must have completed ten hours of education that meets the requirements of rule 4723-24-04 of the Administrative Code for doula continuing education.

At least four of those hours must be training directly related to racial bias, health disparities, and cultural competency as required by paragraph (A) of the Administrative Code. The remaining six hours should relate to the doula's practice.

The applicant's education may be demonstrated by attestation to having completed education meeting these requirements. At the discretion of the board, the applicant may be required to show proof of comletion of the education. Failure to provide proof of completion shall result in ineligibility to be issued a certificate by the board until proof of completion is provided to the board.

(E) The board may propose to deny certification by endorsement pursuant to an adjudication conducted in accordance with Chapter 119. of the Revised Code.

(F) If an applicant for certification by endorsement as a doula fails to meet the requirements for certification within one year from the date the application is received, or the application remains incomplete for one year, the application shall be considered void and the fee forfeited. The application shall state the circumstances under which forfeiture may occur.

Last updated September 30, 2024 at 8:32 AM

History

Effective: September 30, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-24-06 Standards of doula practice.

(A) The purpose of this chapter is to establish minimal acceptable standards of practice by doulas holding a certificate issued by the board of nursing pursuant to Chapter 4723. of the Revised Code.

(B) A doula shall maintain knowledge of the duties, responsibilities, and accountabilities of a doula and shall practice in accordance with the following:

(1) Laws regulating the provision of care by a doula as set forth in Chapter 4723. of the Revised Code;

(2) Rules adopted by the board in accordance with Chapter 119. of the Revised Code; and

(3) Any other applicable state or federal laws and rules.

(C) A doula shall, in a timely manner, document their practice with a client sufficiently to meet the needs of the practice.

(D) A doula shall maintain the confidentiality of client information obtained in the course of the doula's practice. A doula shall communicate client information to others and shall access client information only for purposes of client services, or to otherwise fulfill the doula's responsibilities, and shall not share client information for purposes other than client services, or to otherwise fulfill the doula's responsibilities, through social media, texting, emailing, or any other form of communication, unless the client has consented to the doula's sharing of client information.

(E) To the maximum extent feasible, indentifiable client information shall not be disclosed by a doula unless the client has consented to the disclosure of the information. A doula shall only report individually indentifiable client information without written consent in limited circumstances and in accordance with an authorized law, rule, or other recognized legal authority.

(F) A doula shall do all of the following to promote client safety:

(1) Not falsify any client record or other document prepared in the course of, or in conjunction with, the performance of the doula's practice;

(2) Implement measures to promote a safe environment for the client including any time that the doula suspects client abuse or neglect;

(3) Establish, delineate, and maintain professional boundaries with each client;

(4) Refrain from all behavior that causes or may cause physical, verbal, mental, or emotional abuse or distress to a client, or in behavior that may be reasonably interpreted to cause physical, verbal, mental, or emotional abuse or distress to the client;

(5) Not misappropriate a client's property, engage in behavior to seek or obtain a client's property or behavior that may reasonably be interpreted as seeking or obtaining, personal gain at the client's expense, or engage in behavior that constitutes, or that may reasonably be interpreted as constituting, inappropriate involvement in a client's personal relationships or financial matters;

(6) Not engage in sexual conduct or in conduct that may reasonably be interpreted as sexual, or in any verbal behavior that is seductive or sexually demeaning to a client, or in verbal behavior that may reasonably be interpreted as seductive or sexually demeaning to a client;

(7) Treat each client with courtesy, respect, and with full recognition of dignity and individuality; and

(8) Provide each client with privacy while engaged in doula practice.

For purposes of paragraphs (F)(3) to (F)(6) of this rule, a client is always considered to be incapable of giving free, full, or informed consent to the actions of a doula.

(G) A doula shall not make any false, misleading, or deceptive statements, or submit or cause to be submitted any false, misleading or deceptive information or documentation to:

(1) The board or any representative of the board;

(2) Current employers or clients;

(3) Prospective employers or clients when applying for positions requiring a doula certificate;

(4) Facilities in which, or organizations for whom, the doula is working on a temporary or agency assignment;

(5) A state or private entity from which the doula seeks payment for services;

(6) Members of the client's health care team; or

(7) Law enforcement personnel.

(H) Nothing in this rule precludes a client from providing consent to a doula to use the client's likeness and information in social media or other promotional materials.

Last updated September 30, 2024 at 8:32 AM

History

Effective: September 30, 2024
Promulgated Under: 119.03

Ohio Adm.Code 4723-24-07 Disciplinary actions against certified doulas; investigations.

(A) The board of nursing, by the vote of a quorum, may impose one or more of the following sanctions if it finds that a person committed fraud, misrepresentation, or deception in applying for a doula certificate: deny, revoke, suspend, or place restrictions on a certficate issued by the board; reprimand or otherwise discipline a certificate holder; or impose a fine of not more than five hundred dollars per violation.

(B) By the vote of a quorum, the board may impose one or more of the following sanctions on an individual who applies for or holds a doula certificate: deny, revoke, suspend, or place restrictions on a doula certificate, or reprimand or otherwise discipline a holder of a doula certificate. The sanctions may be imposed for any of the following:

(1) Denial, revocation, suspension, or restriction of authority to engage in a licensed profession or practice a health care occupation, or to practice as a doula, in Ohio or another state or jurisdiction, including but not limited to nursing, practice as a dialysis technician, nurse aide, community health care worker, medication aide, or doula, for any reason other than a failure to renew;

(2) Using or assuming the title "certified doula" having failed to renew a doula certificate issued under Chapter 4723. of the Revised Code, or while a doula certificate is under suspension or inactive;

(3) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction for a misdemeanor committed in the course of practice as a doula;

(4) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction for any felony or any crime involving gross immorality or moral turpitude;

(5) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction for violating any municipal, state, county, or federal drug law;

(6) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction for an act in another jurisdiction that would constitute a felony or crime of moral turpitude in Ohio;

(7) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction for an act in the course of practice in another jurisdiction that would constitute a misdemeanor in Ohio;

(8) Self-administering or otherwise taking into the body any dangerous drug, as defined in section 4729.01 of the Revised Code, in any way not in accordance with a legal, valid prescription issued for that individual, or self-administering or otherwise taking into the body any drug that is a schedule I controlled substance;

(9) Habitual or excessive use of controlled substances, other habit-forming drugs, or alcohol or other chemical substances to an extent that impairs the individual's ability to comply with the standards of safe practice established in rule 4723-24-06 of the Administrative Code;

(10) Impairment of the ability to comply with standards of practice established in rule 4723-24-06 of the Administrative Code because of the use of drugs, alcohol, or other chemical substances;

(11) Impairment, as defined in rule 4723-3-02 of the Administrative Code, of the ability to comply with standards of practice established in rule 4723-24-06 of the Administrative Code because of a physical or mental disability;

(12) Assaulting or causing harm to a client or depriving a client of their autonomy;

(13) Misappropriation or attempted misappropriation of money or anything of value in the course of practice as a doula;

(14) Adjudication by a probate court of being mentally ill or mentally incompetent. The board may restore the person's doula certificate upon adjudication by a probate court of the person's restoration to competency or upon submission to the board of other proof of competency;

(15) The suspension or termination of employment by the department of defense or the veterans administration of the United States for any act that violates or would violate this chapter;

(16) Violation of Chapter 4723. of the Revised Code or any rules adopted under it;

(17) Violation of any restrictions placed on a doula certificate by the board;

(18) Failure to use standard and universal precautions including those set forth in Chapter 4723-20 of the Administrative Code, as applicable to the doula's practice;

(19) Engaging in activities that exceed those permitted under section 4723.89 of the Revised Code or this chapter;

(20) Failure by a certified doula to conform to the standards of practice established in rule 4723-24-06 of the Administrative Code;

(21) Regardless of whether the contact or verbal behavior is consensual, engaging with a client other than the spouse or partner of the doula in any of the following:

(a) Sexual contact, as defined in section 2907.01 of the Revised Code; or

(b) Verbal behavior that is sexually demeaning to the client or may be reasonably interpreted by the client as sexually demeaning.

(C) The hearings of the board shall be conducted in accordance with Chapter 119. of the Revised Code and Chapter 4723-16 of the Administrative Code. The board may appoint a hearing examiner, as provided in section 119.09 of the Revised Code, to conduct any hearing the board is authorized to hold under Chapter 119. of the Revised Code.

(D) In any instance in which the board is required under Chapter 119. of the Revised Code to give notice of an opportunity for a hearing and the applicant or certificate holder does not make a timely request for a hearing in accordance with section 119.07 of the Revised Code:

(1) The board is not required to hold a hearing but may adopt, by vote of quorum, a final order that contains the board's findings; and

(2) In the final order, the board may order any of the sanctions listed in paragraph (A) or (B) of this rule.

(E) If a criminal action is brought against a doula for an act or crime described in paragraphs (B)(3) to (B)(7) of this rule and the action is dismissed by the trial court other than on the merits:

(1) The board shall conduct an adjudication to determine whether the certified doula committed the act upon which the action was based.

(2) If the board determines on the basis of the adjudication that the certified doula committed the act, or if the certified doula fails to participate in the adjudication, the board may take action as though the certified doula had been convicted of the act.

(F) If the board takes action on the basis of a conviction, plea, or a judicial finding as described in paragraphs (B)(3) to (B)(7) of this rule that is overturned on appeal, the certified doula may, on exhaustion of the appeal process, petition the board for reconsideration of its action.

(1) On receipt of the petition and supporting court documents, the board shall temporarily rescind its action.

(2) If the board determines that the decision on appeal was a decision on the merits, it shall permanently rescind its action.

(3) If the board determines that the decision on appeal was not a decision on the merits, it shall conduct an adjudication to determine whether the certified doula committed the act on which the original conviction, plea, or judicial finding was based.

(a) If the board determines on the basis of the adjudication that the certified doula committed such act, or if the certified doula does not request an adjudication, the board shall reinstate its action.

(b) If the board determines that the certified doula did not commit such act, the board shall permanently rescind its action.

(G) The board may investigate an individual's criminal background in performing its duties under this rule and sections 4723.89 to 4723.90 of the Revised Code. As part of such investigation, the board may order the individual to submit, at the individual's expense, a request to the bureau of criminal identification and investigation for a criminal records check and check of federal bureau of investigation records in accordance with the procedure described in section 4723.091 of the Revised Code.

(H) During the course of an investigation the board may compel any certified doula, or applicant under section 4723.89 of the Revised Code, to submit to a mental or physical examination, or both, as required by the board and at the expense of the individual, if the board finds reason to believe that the individual under investigation may have a physical or mental impairment, as defined in rule 4723-3-02 of the Administrative Code, that may affect the individual's ability to perform doula services. Failure of any individual to submit to a mental or physical examination when directed constitutes an admission of the allegations, unless the failure is due to circumstances beyond the individual's control, and a default and final order may be entered without the taking of testimony or presentation of evidence.

(I) If the board finds that an individual is impaired in accordance with paragraph (H) of this rule, the board shall require the individual to submit to care, counseling, or treatment approved or designated by the board, as a condition for an initial, continued, reinstated, or renewed certified doula certificate.

(1) The individual shall be afforded an opportunity to demonstrate to the board that the individual can begin or resume the performance of practice as a doula in accordance with standards established under rule 4723-24-06 of the Administrative Code.

(2) For purposes of this paragraph, any certified doula or applicant under this rule shall be deemed to have given consent to submit to a mental or physical examination when directed to do so in writing by the board and to have waived all objections to the admissibility of testimony or examination reports that constitute a privileged communication.

(J) The provisions of division (I) of section 4723.28 of the Revised Code apply to information, investigations and adjudications involving certified doulas or applicants under sections 4723.89 to 4723.90 of the Revised Code and this chapter.

(K) The provisions of section 4723.29 of the Revised Code apply with respect to any matter that the board has authority to investigate, inquire into, or hereunder sections 4723.89 to 4723.90 of the Revised Code and this chapter.

(L) When the board refuses to grant a doula certificate to an applicant, revokes a certificate, or refuses to reinstate a certificate, the board may specify that its action is permanent. An individual subject to permanent action taken by the board is forever ineligible to hold a doula certificate and the board shall not accept from the individual an application for reinstatement of the certificate or for a new certificate.

(M) No unilateral surrender of a doula certificate issued under Chapter 4723. of the Revised Code shall be effective unless accepted by majority vote of the board. No application for a doula certificate issued under Chapter 4723. of the Revised Code may be withdrawn without a majority vote of the board. The board's jurisdiction to take disciplinary action is not removed or limited when an individual has a certificate classified as inactive or fails to renew a certificate.

Last updated September 30, 2024 at 8:32 AM

History

Effective: September 30, 2024
Promulgated Under: 119.03

Chapter 4723-25 Nurse Education Grant Program

Ohio Adm.Code 4723-25-01 Purpose of nurse education grant program.

The board shall award grants to nurse education programs that have partnerships with health care facilities, community health agencies, patient centered medical homes or other education programs to establish or support partnerships that will increase the enrollment capacity of the nurse education programs. Methods of increasing a program's enrollment capacity may include hiring faculty and instructional personnel or purchasing educational equipment and materials if the grant applicant can clearly demonstrate that additional faculty and instructional personnel, or equipment and materials, are directly related and necessary to increasing the enrollment capacity of the nurse education program.

Last updated December 2, 2024 at 1:12 PM

History

Effective: February 1, 2015
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-02 Definitions.

For purposes of this chapter, the following definitions apply:

(A) "Nurse education program" means a prelicensure nurse education program approved by the board of nursing under section 4723.06 of the Revised Code, or a postlicensure nurse education program approved by the board of regents under section 3333.04 of the Revised Code.

(B) "Health care facility" means:

(1) A hospital registered under section 3701.07 of the Revised Code;

(2) A nursing home licensed under section 3721.02 of the Revised Code, or by a political subdivision certified under section 3721.09 of the Revised Code;

(3) A county home or a county nursing home as defined in section 5155.31 of the Revised Code that is certified under Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, amended;

(4) A freestanding dialysis center;

(5) A freestanding inpatient rehabilitation facility;

(6) An ambulatory surgical facility;

(7) A freestanding cardiac catheterization facility;

(8) A freestanding birthing center;

(9) A freestanding or mobile diagnostic imaging center;

(10) A freestanding radiation therapy center.

(C) "Partnership" means a written agreement between a nurse education program and one or more health care facilities, community health agencies, patient centered medical homes or other education programs, that is signed by the legal signatory for each party and that shows how the partnership will increase the enrollment capacity of the nurse education program or programs.

(D) "Community health agency" means any program or agency that provides or contracts to provide health care services and is not a health care facility as defined in paragraph (B) of this rule.

(E) "Board" means the Ohio board of nursing.

(F) "Nurse education grant program" means the program established in division (B) of section 4723.063 of the Revised Code.

(G) "Faculty and instructional personnel" means:

(1) For prelicensure nursing education programs, persons who satisfy the standards for faculty and instructional personnel as set forth in rules 4723-5-10 and 4723-5-11 of the Administrative Code; or

(2) For postlicensure nursing education programs, persons who satisfy standards established by the credentialing organization that accredits the program in accordance with paragraph (H) of this rule.

(H) "Education program" means a program approved or accredited by any of the following:

(1) The Ohio board of nursing under section 4723.06 of the Revised Code;

(2) The chancellor of higher education under section 3333.04 of the Revised Code;

(3) The Ohio department of education under section 3313.90 of the Revised Code;

(4) The state board of career colleges and schools under section 3332.05 of the Revised Code;

(5) The higher learning commission of the north central association of colleges and schools;

(6) The accrediting council for independent colleges and schools; or

(7) Any other national or regional post-secondary education accreditation entity recognized by the board.

(I) "Grantee" means a nurse education program to which the board has awarded a grant from the nurse education grant program.

(J) "Administrator of the program" has the same meaning as set forth in paragraph (A) of rule 4723-5-01 of the Administrative Code.

(K) "Patient centered medical home" is an advanced model of primary care in which care teams attend to the multifaceted needs of patients, providing whole person comprehensive and coordinated patient centered care.

(L) "Preceptor" has the same meaning as set forth in paragraph (CC) of rule 4723-5-01 of the Administrative Code.

Last updated December 2, 2024 at 1:13 PM

History

Effective: February 1, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-03 Fund balance.

The board may recommend that the office of budget and management retain a percentage of money, which the office of budget and management determines to be fiscally responsible, in the nurse education grant program fund that it maintains to accomplish the goals of the nurse education grant program established in section 4723.063 of the Revised Code.

Last updated December 2, 2024 at 1:13 PM

History

Effective: February 1, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-04 Program administrative costs.

In accordance with division (D) of section 4723.063 of the Revised Code, no more than ten per cent of the nurse education grant program funds shall be used by the board for administrative costs associated with the program.

Last updated December 2, 2024 at 1:13 PM

History

Effective: February 1, 2005
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-05 Distribution of grants to prelicensure and postlicensure nurse education programs.

(A) Except as provided in paragraphs (B), (C), and (D) of this rule, nurse education grant program funds available for distribution in a two year grant cycle shall be distributed as follows:

(1) Approximately one third of the available funds shall be awarded in grants to prelicensure education programs for licensed practical nurses approved by the board under section 4723.06 of the Revised Code, if the program allows students, following licensure as a licensed practical nurse, to transition into a registered nursing program approved by the board during the student's second year (a one plus one program);

(2) Approximately one third of the available funds shall be awarded in grants to prelicensure education programs for registered nurses approved by the board under section 4723.06 of the Revised Code; and

(3) Approximately one third of the available funds shall be awarded in grants to postlicensure nurse education programs approved or accredited as described in paragraph (H) of rule 4723-25-02 of the Administrative Code, for the purpose of preparing nursing faculty or instructional personnel.

(B) The board has discretion to reallocate funds among one or more of the three grant categories set forth in paragraphs (A)(1) to (A)(3) of this rule to one or more other grant categories if no grant proposals are submitted in a category, if none of the proposals received in a category meet the funding criteria established in section 4723.063 of the Revised Code, or if funds remain in a category after all eligible grant applications have been considered by the board.

(C) A nurse education program may submit one grant proposal in each of the grant proposal categories set forth in paragraphs (A)(1) to (A)(3) of this rule for the same grant cycle.

(D) Grant awards shall not exceed two hundred thousand dollars per grant, per grant cycle.

(E) While no grant is guaranteed for renewal in subsequent grant periods, the board may elect to renew a grant approved for initial funding if both of the following conditions are met:

(1) A new grant proposal is submitted within the time frame for the next grant cycle; and

(2) The new proposal meets the standards contained in the request for proposals for the next grant cycle.

(F) Total awards to a nurse education program from each of the three grant categories set forth in paragraphs (A)(1) to (A)(3) of this rule shall not exceed one million dollars between January 2, 2024 and December 31, 2033.

Last updated February 3, 2025 at 8:29 AM

History

Effective: February 1, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-06 Eligibility criteria for funding consideration.

To be eligible for consideration to receive nurse education program grant funds, all of the following must be satisfied:

(A) Applicant is a nurse education program as defined in division (A)(2) of section 4723.063 of the Revised Code and this chapter;

(B) Applicant has entered into a partnership with one or more health care facilities, community health agencies, patient centered medical homes, or other education programs that will result in increased enrollment capacity in the applicant's nurse education program or programs;

(C) Applicant has submitted a completed "NEGP RFP" form, discussed in rule 4723-25-09 of the administrative code, by the proposal deadline date.

Last updated December 2, 2024 at 1:13 PM

History

Effective: February 1, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-07 Publication of notice for requests for proposals.

(A) Not less than thirty days prior to issuing a request for proposals, the board shall, by regular or electronic mail, provide notice of the issuance of a request for proposals to the administrator of all nurse education programs approved by the board under section 4723.06 of the Revised Code, or approved by the chancellor of higher education under section 3333.04 of the Revised Code.

(B) In addition to the notice required in paragraph (A) of this rule, the board shall also post notice of the issuance of the request for proposals on the board's website, distribute electronic notice to all persons included on the board's electronic subscriber list, and mail notice to any persons who do not have access to electronic mail but who have requested to be placed on a courtesy mailing list maintained by the board.

Last updated December 2, 2024 at 1:13 PM

History

Effective: February 1, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-08 Funding cycle.

Grant cycles will begin on November first of odd number calendar years and extend for a period of two years, to October thirty-first of odd number years.

Last updated December 2, 2024 at 1:14 PM

History

Effective: February 1, 2021
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-09 Grant proposal form.

(A) Grant applicants shall a "NEGP RFP" form to be considered for the nurse education grant program.

(B) Information to be provided in the proposal shall be consistent with the request for proposal issued by the board and shall at minimum include the following:

(1) Specifics as to how the requested grant funds will allow the nurse education program to increase its enrollment capacity and the specific role to be played by the health care facility, community health agency, or other education program with which it has entered a partnership;

(2) The name of the administrator of the program employed by, or under contract with, the nurse education program who will be principally responsible for the grant and his or her academic and professional credentials;

(3) A projection of the amount that the nurse education program's enrollment capacity will be increased as a result of the grant;

(4) A detailed description of how the proposal is consistent with the standards for nurse education programs set forth in Chapter 4723-5 of the Administrative Code;

(5) Any faculty or instructional personnel positions to be supported with funds from the grant and how they will directly contribute to increasing the enrollment capacity of the nurse education program;

(6) Type and uses of any equipment requested to be leased or purchased with funds from the grant and how it will directly contribute to increasing the enrollment capacity of the nurse education program;

(7) If an applicant is a postlicensure nursing education program, how it will increase the number of faculty and instructional personnel to serve as educators in nurse education programs;

(8) How the program will maintain the increased enrollment capacity in a nurse education program following conclusion of the grant funding cycle;

(9) Other sources of funding, if any, that will be used to support efforts by the nurse education program and its partnership to increase the enrollment capacity of the program; and

(10) How grant funds will be accounted for separately from other sources of funding received by the nurse education program.

(C) Grant proposals that are received by the board after the proposal deadline date will not be considered for funding during the grant cycle for which they were submitted. A nurse education program submitting a late proposal may resubmit a grant request in a subsequent grant cycle according to standards set forth in the subsequent request for proposals.

Last updated December 2, 2024 at 1:14 PM

History

Effective: February 1, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-10 Grant review.

The board may delegate its authority, as it deems appropriate, to a committee of the board and staff members of the board, to review grants and make recommendations for funding to the full board.

Last updated December 2, 2024 at 1:14 PM

History

Effective: February 1, 2005
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-11 Grant review criteria.

(A) Grant awards shall be made at the sole discretion of the board according to section 4723.063 of the Revised Code and the rules contained in this chapter.

(B) Preference in the award of grants shall be given to partnerships between nurse education programs and the following:

(1) Hospitals registered under section 3701.07 of the Revised Code;

(2) Nursing homes licensed under section 3721.02 of the Revised Code, or by a political subdivision certified under section 3721.09 of the Revised Code;

(3) County homes or county nursing homes as defined in section 5155.31 of the Revised Code that are certified under Title XVIII or XIX of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, amended; and

(4) Education programs as defined in paragraph (H) of rule 4723-25-02 of the Administrative Code.

(C) Preference in the award of grants may be given to those programs seeking grant renewal that have demonstrated success in meeting the nurse education grant program goal of increasing the enrollment capacity of the applicant nurse education program.

(D) Preference in the award of grants may be given to programs that have a pass rate on the applicable nurse licensure examination that averages ninety-five per cent or higher of the national average for first time candidates in any given year for three consecutive years prior to submission of the grant proposal.

(E) Preference in the award of grants may be given to postlicensure nursing education programs that have demonstrated success in training and preparing graduate level nurses to serve as nurse educators in Ohio nurse education programs.

(F) Grants shall be awarded to prelicensure education programs for licensed practical nurses only if the program allows students, following licensure as a licensed practical nurse, to transition into a registered nursing program approved by the board during the student's second year (a one plus one program).

Last updated December 2, 2024 at 1:14 PM

History

Effective: February 1, 2015
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-12 Use of grant funds.

(A) Grant funds shall be used solely for purposes of increasing enrollment capacity in nurse education programs.

(B) Grant funds may be used to hire or contract with:

(1) Prelicensure nurse education program faculty and instructional personnel whose role will be the active supervision of one or more nursing students in a clinical setting; or

(2) Faculty or instructional personnel engaged in training and preparing graduate level nurses to serve as nurse educators in Ohio nurse education programs.

(C) Grant funds may be used for the lease or purchase of equipment only when it can be demonstrated that the equipment will be directly related to an increase in enrollment capacity at a nurse education program and only when the equipment will be leased or owned by the applicant nurse education program.

(D) Grant funds may be used as matching funds for other funding sources if both of the following are satisfied:

(1) Use of the funds from the other funding sources is consistent with the goal of the nurse education grant program of increasing the enrollment capacity in the nurse education program; and

(2) All grant requirements continue to be met.

Last updated December 2, 2024 at 1:14 PM

History

Effective: February 1, 2010
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-13 Prohibited uses of grant funds.

(A) Grant funds shall not be used for any of the following purposes:

(1) Administrative costs associated with the nurse education program, health care facility, community health agency, other education program, or partnership;

(2) The purchase of disposable items or disposable equipment;

(3) The purchase of personal items or equipment for students participating in a nurse education program;

(4) Costs associated with travel and lodging;

(5) Costs associated with meals and entertainment;

(6) Lease or purchase of vehicles;

(7) The construction or renovation of buildings;

(8) Liquidation of bad debts;

(9) Fines, penalties, interest, or other financial payments;

(10) The compensation of nurses who will be used as preceptors for prelicensure nursing education program students, except for the actual time a preceptor spends supervising no more than two nursing students at any one time in accordance with rule 4723-5-20 of the Administrative Code;

(11) The compensation of nurses who will be used as preceptors for postlicensure nursing education program students except for the actual time a preceptor spends supervising nursing students engaged in a clinical experience at the direction of faculty or instructional personnel of the nurse education program; or

(12) Student tuition assistance.

(B) Funds used for any purposes set forth in paragraph (A) of this rule must be repaid to the board within thirty days after the grantee is provided with notice of the board's determination that grant funds had previously been, or were currently being, used for purposes prohibited by this rule.

Last updated December 2, 2024 at 1:15 PM

History

Effective: February 1, 2015
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-14 Acknowledgment of terms.

(A) After receiving notification of approval of a grant proposal, the board and the nurse education program submitting the proposal shall execute a written agreement that contains the terms and conditions of the grant.

(B) This agreement, or acknowledgment of terms, shall be signed by the administrator of the nurse education program, or grantee, and by the board. The agreement may include but need not be limited to the following terms and conditions:

(1) Method for advising the board regarding a change of circumstances that may significantly impact the grantee's ability to comply with the terms of the grant;

(2) Method and schedule for disbursement of funds;

(3) Special reporting requirements specific to an individual grant proposal;

(4) Applicability of all relevant laws, regulations, and rulings; and

(5) Grantee indemnification requirements.

Last updated December 2, 2024 at 1:15 PM

History

Effective: February 1, 2010
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-15 Grantee reporting requirements.

(A) The administrator of a grantee nurse education program shall submit the following reports to the board according to the schedule determined by the board that identify how the grant funds were used to increase the enrollment capacity of the program:

(1) "NEGP Annual Report Year 1," for the first year of the grant funding cycle;

(2) "NEGP Annual Report Year 2" for the second year of the grant funding cycle; and

(3) "NEGP Quarterly Progress Report" form.

(B) At any time during the grant funding cycle the board may require that the grantee provide additional information or undergo an independent audit of the grant funds and how funds are being administered by the nurse education program or its partner health care facility, community health agency, or other education program.

(1) Any independent audits requested by the board shall be paid for by the grantee nurse education program.

(2) Grant funds shall not be used to pay the expenses of an independent audit requested by the board in accordance with this paragraph.

Last updated December 2, 2024 at 1:15 PM

History

Effective: February 1, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-16 Reversion of funding.

(A) Grant recipients shall return to the board any unexpended grant funds that remain at the end of the grant period.

(B) Unexpended grant funds shall also be promptly returned to the board upon receipt of notice that any of the following have occurred:

(1) The grantee has failed to spend the grant funds according to the grant proposal approved by the board;

(2) The grantee has failed to comply with any provision included in the acknowledgment of terms as required by rule 4723-25-14 of the Administrative Code; or

(3) The grantee no longer maintains its status as a nurse education program approved by the board under section 4723.06 of the Revised Code, or by the board of regents under section 3333.04 of the Revised Code.

Last updated December 2, 2024 at 1:15 PM

History

Effective: February 1, 2010
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-17 Grantee programs, products, or publications.

Any special programs, products, or publications developed by the grantee nurse education program shall indicate that such program, product, or publication, was funded in whole or part by a grant from the Ohio board of nursing.

Last updated December 2, 2024 at 1:15 PM

History

Effective: February 1, 2005
Promulgated Under: 119.03

Ohio Adm.Code 4723-25-18 Annual grantee report.

The board shall make available on an annual basis, in print or by electronic means, a current list of nurse education grant program grantees together with the following information:

(A) The amount of the grant received by each grantee;

(B) The health care facility, community health agency, patient centered medical home or other education program with which the grantee nurse education program has partnered;

(D) The proposed use of the grant funds;

(E) The extent to which funding of the grant proposal has resulted in an increase in the enrollment capacity of the grantee nurse education program; and

(F) Such other information the board deems appropriate.

Last updated December 2, 2024 at 1:15 PM

History

Effective: February 1, 2015
Promulgated Under: 119.03

Chapter 4723-26 Community Health Workers

Ohio Adm.Code 4723-26-01 Definition of terms.

For the purpose of this chapter, the following definitions apply:

(A) "Administrator" means the individual who is administratively responsible for a community health worker training program.

(B) "Board" means the Ohio board of nursing.

(C) "Certificate to practice" means the certificate issued by the board in accordance with section 4723.85 of the Revised Code.

(D) "Clinical experience" means a task or activity planned to meet course objectives or outcomes and to provide community health worker students with the opportunity to practice cognitive, psychomotor, and affective skills related to the delivery of care by community health workers. This experience may take place in a community setting or other appropriate site.

(E) "Community health worker" and "certified community health worker" mean an individual who satisfies both of the following:

(1) As a community representative, advocates for clients in the community by assisting them in accessing community health and supportive resources through the provision of such services as education, role modeling, outreach, home visits, or referrals; and

(2) Holds a certificate to practice issued or renewed by the board under section 4723.85 of the Revised Code.

(F) "Continuing education" means a planned learning activity that builds upon a community health worker's precertification education program and enables a community health worker to acquire or improve skills, knowledge or behavior that promotes professional or technical development or the enhancement of career goals and is approved by the board under Chapter 4723-14 of the Administrative Code.

(G) "Curriculum" means the standard minimum curriculum to be used in a board-approved training program for community health workers as provided in rule 4723-26-13 of the Administrative Code.

(H) "Delegation" means the transfer of responsibility for the performance of selected nursing tasks from a registered nurse to a community health worker.

(I) "Didactic" means the component of an educational program that provides faculty-interactive instruction and includes lecture, verbal instruction, or other means of exchanging theoretical information between instructor and students.

(J) "Inactive certificate" means the status of the certificate of an individual who has placed their certificate on inactive status. An individual with an inactive certificate does not hold a current, valid certificate.

(K) "Laboratory experience" means an activity planned to meet course objectives or outcomes and to provide a community health worker student with the opportunity to practice cognitive, psychomotor, and affective skills in the delivery of care, that takes place in a learning resource center or other appropriate location.

(L) "Lapsed certificate" means the status of a certificate of an individual who did not meet all of the requirements of certificate renewal and has not placed the certificate on inactive status prior to the renewal deadline.

(M) "Patient" means the recipient of a nursing task delegated by a registered nurse and may include an individual, group, or community.

(N) "Registered nurse" means an individual who holds a current, valid license issued under Chapter 4723. of the Revised Code that authorizes the practice of nursing as a registered nurse.

(O) "Representative of the board" means an employee of the board or an individual designated by the board to act on its behalf.

(P) "Survey" means an announced or unannounced survey of a community health worker training program by a representative of the board to determine whether the program meets or maintains the minimum standards required by the board. The survey may include a site visit.

(Q) "Supervision by a registered nurse" means initial and ongoing direction, procedural guidance, observation, and evaluation by a registered nurse who is continually available in person, or by some form of telecommunication, of the nursing tasks performed by a community health worker. For purposes of Chapter 4723-26 of the Administrative Code, supervision by a registered nurse is not required when a community health worker is performing non-nursing tasks.

Last updated February 3, 2025 at 8:30 AM

History

Effective: February 1, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-26-02 Community health worker certification.

(A) To obtain a certificate to practice as a community health worker, an applicant who meets the qualifications set forth in division (A) of section 4723.84 of the Revised Code shall:

(1) Submit a completed "Community Health Worker Application";

(2) Submit an application fee of thirty-five dollars; and

(3) In accordance with division (A) of section 4723.091 of the Revised Code, submit a request to the bureau of criminal identification and investigation for a criminal records check. The results of the criminal records check shall:

(a) Be received by the board before a certificate can be issued; and

(b) Indicate that the individual has not been convicted of, pled guilty to, or had a judicial finding of guilt for any violation set forth in section 4723.092 of the Revised Code.

(B) The board shall issue a certificate to practice as a community health worker to applicants who satisfy the requirements of paragraph (A) of this rule, after receipt of written notice from a community health worker training program approved by the board that the applicant has successfully completed the program, and that the applicant is competent to provide care as a community health worker.

(D) A community health worker certificate shall be considered current until the next scheduled renewal period for a certified community health worker. When a certificate is issued on or after January first of an odd numbered year, that certificate shall be considered current through March thirty-first of the next odd-numbered year.

Last updated December 2, 2024 at 1:16 PM

History

Effective: February 1, 2020
Promulgated Under: 119.03

Ohio Adm.Code 4723-26-03 Community health worker certification by endorsement.

(A) An applicant for community health worker certification by endorsement shall satisfy the following:

(1) Submit a completed "Certified Community Health Worker by Endorsement Application," and the certification application fee required by sections 4723.08 and 4723.88 and Chapter 4796. of the Revised Code;

(2) Submit to a criminal records check completed by the bureau of criminal identification and investigation;

(5) Submit any other documentation required by the board.

(B) Pursuant to section 4796.03 of the Revised Code, the board shall issue a community health worker certificate in accordance with Chapter 4796. of the Revised Code to an applicant if the applicant holds a substantially similar out-of-state occupational license to engage in practice as a community health worker, or, holds a government certification to engage in practice as a community health worker from one of the uniformed services or from a state that does not issue a license for practice as a community health worker, if the applicant:

(1) Has held the license or government certification for at least one year immediately preceding the date the application is submitted to the board;

(2) Has been actively engaged in practice as a community health worker for at least one of the five years immediately preceding the date the application is submitted to the board;

(3) Is in good standing in all jurisdictions in which the applicant holds the license or government certification; and

(4) Was required to satisfy minimum education, training, or experience requirements or pass an examination to receive the license or government certification.

The applicant shall have verification of licensure or government certification to practice as a community health worker submitted directly to the board from the issuing state or uniformed services. The applicant shall also have verification of having been actively engaged in practice as a community health worker for at least one of the past five years submitted directly to the board by the employer or employer designee for whom the applicant practiced as a community health worker.

(C) Pursuant to section 4796.04 of the Revised Code, the board shall issue a community health worker certificate in accordance with Chapter 4796. of the Revised Code to an applicant who has held a private certification as a community health worker in a state that does not issue an occupational license or governmental certification to practice as a community health worker, if the applicant:

(1) Held the private certification for at least two years immediately preceding the date the application is submitted;

(2) Has been actively engaged in practice as a community health worker in a state that does not issue an occupational license or government certification to practice as a community health worker, for at least two of the five years immediately preceding the date the application is submitted; and

(3) Is in good standing with the private organization that issued the private certification.

The applicant shall have verification of private certification as a community health worker submitted directly to the board by the private organization that issued the certification. The applicant shall also have verification of having been actively engaged in practice as a community health worker for at least two of the past five years, submitted directly to the board by the employer or employer designee for whom the applicant practiced as a community health worker.

(D) Pursuant to section 4796.05 of the Revised Code, the board shall issue a community health worker certificate in accordance with Chapter 4796. of the Revised Code to an applicant who, for at least three of the five years immediately preceding the date the application is submitted to the board, has been actively engaged in practice as a community health worker, in either:

(1) A state that does not issue an occupational license or government certificate to practice as a community health worker, or

(2) Service of the uniformed services.

The applicant shall have verification of having been actively engaged in practice as a community health worker for at least three of the past five years submitted directly to the board by the employer or employer designee or the uniformed services for whom the applicant practiced as a community health worker.

(E) The board may propose to deny certification by endorsement pursuant to an adjudication conducted in accordance with Chapter 119. of the Revised Code.

(F) If an applicant for certification by endorsement as a community health worker fails to meet the requirements for certification within one year from the date the application is received, or the application remains incomplete for one year, the application shall be considered void and the fee forfeited. The application shall state the circumstances under which forfeiture may occur.

Last updated February 3, 2025 at 8:30 AM

History

Effective: February 1, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-26-04 Renewal of community health worker certificate.

(A) The board shall provide on-line access to a "Community Healthworker Renewal Application" to every holder of a current, valid certificate, except when the board is aware that the individual may be ineligible for certificate renewal for any reason, including those reasons set forth in section 4723.092 of the Revised Code. Failure of the certificate holder to receive an application for renewal from the board does not excuse the certificate holder from the requirements of section 4723.85 of the Revised Code and this chapter, except as provided in section 5903.10 of the Revised Code.

(B) To renew a certificate to practice as a community health worker a holder of a current, valid certificate shall meet the continuing education requirements set forth in rule 4723-26-05 of the Administrative Code and submit:

(1) A completed on-line "Community Healthworker Renewal Application"; and

(2) A renewal fee of thirty-five dollars.

(C) If a completed renewal application is not submitted on-line on or before March first of each odd numbered year, the application shall be considered late and a late fee of fifty dollars shall be imposed in addition to the thirty-five dollar renewal fee.

(D) A certificate holder with a current, valid certificate may place the certificate on inactive status at any time by submitting to the board an electronic request to place the certificate on inactive status.

(E) To reactivate an inactive certificate or reinstate a lapsed certificate the certificate holder must meet the continuing education requirements set forth in rule 4723-26-05 of the Administrative Code and submit:

(1) A completed "Community Healthworker Reactivation and Reinstatement Application" including all required documentation; and

(2) A reactivation fee in the amount of thirty-five dollars.

(F) A certificate holder who has placed a community health worker certificate on inactive status is not required to pay a renewal fee unless the holder seeks to reactivate the certificate. If the certificate holder placed a certificate on inactive status after March second of the year in which the certificate was to be renewed, and notifies the board on or before March thirty-first of the same renewal year of the intent to reactivate, the certificate holder must still pay the late processing fee required by paragraph (C) of this rule.

(G) If a certificate to practice as a community health worker is not renewed by March thirty-first of each odd numbered year and the certificate holder has failed by that time to request that the certificate be placed on inactive status, the certificate will lapse.

(H) When a community health worker certificate is inactive or lapsed, the individual shall not represent or imply to the public that he or she is certified by the board as a community health worker.

(I) An individual who continues to represent to the public that he or she is a certified community health worker during the time that his or her certificate is inactive or lapsed, may be subject to disciplinary action by the board in accordance with rule 4723-26-11 of the Administrative Code.

(J) A community health worker certificate holder who is a service member or veteran, as defined in rule 4723-2-01 of the Administrative Code, or who is the spouse or surviving spouse of a service member or veteran, may be eligible for a waiver of the late application fee and the reinstatement fee according to rule 4723-2-03 of the Administrative Code.

Last updated February 3, 2025 at 8:30 AM

History

Effective: February 1, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-26-05 Continuing education requirements.

(A) Except in the case of the first renewal of a current, valid certificate to practice as a community health worker, to be eligible to renew a certificate, a community health worker shall complete fifteen contact hours of continuing education during each renewal period. For each reporting period, at least one of the required hours of continuing education must be directly related to Chapter 4723. of the Revised Code and the rules of the board in Chapters 4723-1 to 4723-27 of the Administrative Code. To qualify as continuing education directly related to Chapter 4723. of the Revised Code and the rules of the board, the continuing education must be approved by an OBN approver, or offered by an OBN approved provider unit headquartered in the state of Ohio. For each reporting period, at least one of the required hours of continuing education must be directly related to establishing and maintaining professional boundaries. This requirement applies to the reporting period set forth in paragraph (B) of this rule.

(B) A community health worker who places the certificate to practice as a community health worker on inactive status shall not be required to meet the continuing education requirement for the period of time the certificate is on inactive status. To reactivate the certificate the community health worker shall complete fifteen hours of continuing education that meet the requirements as set forth in paragraph (A) of this rule, during the twenty-four months immediately prior to the application for reactivation.

(C) The holder of a lapsed certificate shall complete fifteen hours of continuing education that meet the requirements of paragraph (A) of this rule during the twenty-four months immediately prior to the application for reinstatement of the certificate.

(D) A community health worker shall verify completion of the continuing education required by this rule on the "Community Health Worker Renewal Application" or "Community Health Worker Reactivation and Reinstatement Application" for certificate renewal, reactivation or reinstatement, and at the discretion of the board, may be required to show proof of completion of the approved continuing education. Failure to verify or provide proof of completion shall result in ineligibility to renew, reactivate or reinstate a certificate until proof of completion of the continuing education requirements is provided to the board.

(E) A community health worker who earns more than the number of contact hours of continuing education required for a single reporting period cannot apply the excess hours to satisfy future continuing education requirements.

(F) A community health worker who is ineligible to renew or reinstate a certificate due to failure to meet the continuing education requirements, may be required to show completion of up to thirty contact hours of continuing education, that meets the requirements of this rule, before their certificate is renewed or reinstated by the board. The continuing education shall be obtained within the forty-eight months immediately prior to the application for renewal or reinstatement.

(G) A community health worker may use a waiver to satisfy the continuing education requirement only one time, and must notify the board in writing requesting the waiver. Once requested the waiver cannot be rescinded and use of the waiver shall be documented on the community health worker's certification record.

(H) The calculation of contact hours based on credit hours earned in an academic institution shall be made according to paragraph (B) of rule 4723-14-04 of the Administrative Code.

(I) Educational activities that satisfy the requirements of this rule are the same as those set forth in rule 4723-14-05 of the Administrative Code.

(J) The board may conduct a retrospective audit of any holder of a certificate to practice as a community health worker to determine compliance with this rule. The audit shall be conducted according to rule 4723-14-07 of the Administrative Code. A community health worker shall retain proof of completion of approved continuing education for a period of six years.

(K) A community health worker certificate holder who is engaged in active military duty may be eligible for an extension of time to complete continuing education as provided in rule 4723-2-04 of the Administrative Code.

Last updated February 3, 2025 at 8:30 AM

History

Effective: February 1, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-26-06 Nurse delegation to community health workers.

(A) This chapter sets forth standards for the delegation and supervision of nursing tasks performed by a community health worker at the delegation of a registered nurse.

(B) Nothing in this chapter shall be construed to prevent any person registered, certified, licensed, or otherwise legally authorized under any law in this state from engaging in the practice for which such person is registered, certified, licensed, or authorized.

Last updated December 2, 2024 at 1:16 PM

History

Effective: February 1, 2010
Promulgated Under: 119.03

Ohio Adm.Code 4723-26-07 Prohibitions on delegation.

(A) Pursuant to division (B) of section 4723.82 of the Revised Code, a registered nurse shall not delegate to a community health worker the administration of medications.

(B) No community health worker to whom a nursing task is delegated shall delegate the nursing task to any other person.

(C) Employing a community health worker to engage in the unauthorized practice of nursing is prohibited by section 4723.03 of the Revised Code.

(D) If a community health worker delegates a nursing task, the community health worker shall be engaging in the unauthorized practice of nursing, which is prohibited by section 4723.03 of the Revised Code.

(E) If a community health worker performs a nursing task and does not comply with all the provisions set forth in this chapter, the community health worker shall be engaging in the unauthorized practice of nursing, in violation of section 4723.03 of the Revised Code.

Last updated December 2, 2024 at 1:16 PM

History

Effective: February 1, 2010
Promulgated Under: 119.03

Ohio Adm.Code 4723-26-08 Criteria and standards for a registered nurse delegating to a community health worker.

(A) A registered nurse may delegate a nursing task to a community health worker if all the conditions for delegation set forth in this chapter are met.

(B) Prior to delegating a nursing task to a community health worker, the delegating registered nurse shall determine each of the following:

(1) That the nursing task is within the scope of practice of a registered nurse as set forth in section 4723.01 of the Revised Code;

(2) That the nursing task is within the knowledge, skill, and ability of the registered nurse delegating the nursing task;

(3) That the nursing task is within the training, skill, and ability of the community health worker who will be performing the delegated nursing task;

(4) That appropriate resources and support are available for the performance of the nursing task, and for management of the outcome;

(5) That adequate and appropriate supervision by the registered nurse of the performance of the nursing task is available in accordance with this rule; and

(6) That:

(a) The nursing task requires no judgment based on nursing knowledge and expertise on the party of the community health worker performing the task;

(b) The results of the nursing task are reasonably predictable;

(c) The nursing task can be safely performed according to exact, unchanging directions, with no need to alter the standard procedures for performing the task;

(d) The performance of the nursing task does not require that complex observations or critical decisions be made with respect to the nursing task;

(e) The nursing task does not require repeated performance of nursing assessments by the delegating registered nurse; and

(f) The consequences of performing the nursing task improperly are minimal and not life threatening.

(1) Identify:

(a) The individual on whom the nursing task may be performed; and

(b) A specific time frame during which the delegated nursing task may be performed.

(2) Complete an evaluation of the conditions that relate to the delegation of the nursing task to be performed, including:

(a) An evaluation of the individual who needs nursing care;

(b) The types of nursing care the individual requires;

(d) The stability of the individual who needs nursing care; and

(e) A review of the evaluations performed by other licensed health care professionals.

(D) The delegating registered nurse shall be accountable for the acts of delegation to and supervision of the community health worker in the performance of the delegated nursing task.

(E) If a registered nurse determines that a community health worker is not correctly performing a delegated task the registered nurse shall immediately intervene.

(F) A registered nurse shall not be responsible for the delegation of a nursing task by another licensed health care practitioner to a community health worker.

Last updated December 2, 2024 at 1:16 PM

History

Effective: February 1, 2010
Promulgated Under: 119.03

Ohio Adm.Code 4723-26-09 Supervision of the performance of a nursing task performed by a community health worker.

(A) When a community health worker is performing a nursing task in accordance with this chapter, supervision shall be provided by a registered nurse. For purposes of this rule, supervision includes initial and ongoing direction, procedural guidance, and observation and evaluation. The registered nurse providing the supervision for a delegated nursing task shall evaluate and document the following on an ongoing basis:

(1) The degree to which the nursing care needs of the individual are being met;

(2) The performance by the community health worker of the delegated nursing task;

(3) The need for further instruction to the community health worker who is performing the nursing task; and

(4) The need to withdraw the delegation.

(B) For purposes of providing supervision to a community health worker performing a delegated nursing task, the registered nurse must be either:

(1) Continually accessible to the community health worker in person; or

(2) Continually available to the community health worker by some form of telecommunication.

(C) In determining the number of community health workers that a registered nurse may supervise, the registered nurse shall consider all of the following:

(1) A registered nurse may not supervise any more than five community health workers at one given time;

(2) The number of clients who require nursing care and the health status of those clients;

(3) The types and numbers of nursing tasks delegated to each community health worker;

(4) The competency, dependability, and reliability of each community health worker to be supervised;

(5) The number of different settings in which the community health workers will be providing services and the proximity between these settings and the location of the registered nurse; and

(6) The availability of emergency aid if the registered nurse is not able to reach, in a timely manner, the setting in which the community health workers are providing services.

Last updated December 2, 2024 at 1:16 PM

History

Effective: February 1, 2010
Promulgated Under: 119.03

Ohio Adm.Code 4723-26-10 Standards of safe care provided by the community health worker.

(A) The purpose of this chapter is to establish minimal acceptable standards of safe and effective care provided by community health workers holding a certificate issued by the board of nursing pursuant to Chapter 4723. of the Revised Code.

(B) A community health worker shall maintain knowledge of the duties, responsibilities, and accountabilities of a community health worker and shall practice in accordance with the following:

(1) Laws regulating the provision of care by a community health worker as set forth in Chapter 4723. of the Revised Code;

(2) Rules adopted by the board in accordance with Chapter 119. of the Revised Code; and

(3) Any other applicable state or federal laws and rules.

(C) A community health worker shall perform nursing tasks in accordance with sections 4723.81 and 4723.82 of the Revised Code, only as delegated and supervised by a registered nurse holding a current, valid license issued by the board under Chapter 4723. of the Revised Code.

(D) A community health worker shall demonstrate competence and accountability in performing nursing tasks as delegated by a registered nurse, including, but not limited to, the following:

(1) Consistent performance of nursing tasks as delegated by a registered nurse; and

(2) Consulting with the supervising nurse in a timely manner to facilitate referral, consultation, or intervention when a community health worker identifies factors or conditions adversely affecting, or potentially affecting, a patient's health status.

(E) A community health worker shall, in a timely manner:

(1) Perform the nursing tasks as delegated by a registered nurse, unless the community health worker believes or should have reason to believe any of the following:

(a) Performing the nursing task would be harmful or potentially harmful to the patient;

(b) The nursing task is contraindicated by other documented information; or

(2) Clarify the direction received from the delegating nurse if the community health worker believes, or should have reason to believe, any of the following:

(a) Performing the nursing task would be harmful or potentially harmful to the patient;

(b) The nursing task is contraindicated by other documented information;

(d) The condition of the patient has changed.

(F) When clarifying a nursing task the community health worker shall, in a timely manner:

(1) Consult with the supervising registered nurse to explain the cause of concern;

(2) Advise the supervising registered nurse if the community health worker decides not to perform the nursing task;

(3) Document that the supervising registered nurse was advised of the community health worker's decision not to perform the nursing task as delegated; and

(4) Take any other actions needed to assure the safety of the patient.

(G) A community health worker shall, in a timely manner, document, report to, and consult with, the supervising registered nurse when a patient refuses to follow the health care regimen.

(H) A community health worker shall maintain the confidentiality of patient information obtained in the course of the community health worker's duties and responsibilities. A community health worker shall communicate patient information to other members of the health care team for health care purposes only, shall access patient information only for purposes of patient care or for otherwise fulfilling the worker's assigned job responsibilities, and shall not disseminate patient information for purposes other than patient care or for otherwise fulfilling the worker's assigned job responsibilities through social media, texting, emailing, or any other form of communication.

(I) To the maximum extent feasible, identifiable patient health care information shall not be disclosed by a community health worker unless the patient has consented to the disclosure of identifiable patient health care information. A community health worker shall report individually identifiable patient information without written consent in limited circumstances only, and in accordance with an authorized law, rule, or other recognized legal authority.

(J) A community health worker shall do all of the following to promote patient safety:

(1) Display the applicable title set forth in section 4723.82 of the Revised Code at all times when providing direct patient care, or if interacting with a patient, or health care provider on behalf of the patient, through any form of telecommunication, the community health worker shall identify their certification to the patient or healthcare provider;

(2) In a timely manner, completely and accurately document and report all client data obtained while performing nursing tasks delegated by the supervising registered nurse, and the patient's response to the care;

(3) In a timely manner, completely and accurately document and report to the supervising registered nurse all errors in, or deviations from, the delegated nursing tasks;

(4) Not falsify any patient record or other document prepared in the course of, or in conjunction with, the performance of delegated nursing tasks;

(5) Implement measures to promote a safe environment for the patient including consulting with a supervising registered nurse any time that the community health worker suspects patient abuse or neglect;

(6) Establish, delineate, and maintain professional boundaries with each patient;

(7) Refrain from all behavior that causes or may cause physical, verbal, mental, or emotional abuse or distress to a patient, or in behavior that may be reasonably interpreted to cause physical, verbal, mental, or emotional abuse or distress;

(8) Not misappropriate a patient's property, engage in behavior to seek or obtain, behavior that may reasonably be interpreted as seeking or obtaining, personal gain at the patient's expense, or engage in behavior that constitutes, or that may reasonably be interpreted as constituting, inappropriate involvement in a patient's personal relationships or financial matters;

(9) Not engage in sexual conduct or in conduct that may reasonably be interpreted as sexual, or in any verbal behavior that is seductive or sexually demeaning to a patient, or in verbal behavior that may reasonably be interpreted as seductive or sexually demeaning to a patient;

(10) Treat each patient with courtesy, respect, and with full recognition of dignity and individuality; and

(11) Provide each patient with privacy while performing delegated nursing tasks.

For purposes of paragraphs (J)(6) to (J)(9) of this rule, a patient is always considered to be incapable of giving free, full, or informed consent to the actions of a community health worker.

(K) A community health worker shall not make any false, misleading, or deceptive statements, or submit or cause to be submitted any false, misleading or deceptive information or documentation to:

(1) The board or any representative of the board;

(2) Current employers;

(3) Prospective employers when applying for positions requiring a community health worker certificate;

(4) Facilities in which, or organizations for whom, the community health worker is working a temporary or agency assignment;

(5) Other members of the patient's health care team; or

(6) Law enforcement personnel.

(L) For purposes of paragraphs (J)(6), (J)(7), (J)(8), (J)(9), and (J)(10) of this rule, a certified community health worker shall not use social media, texting, emailing, or other forms of telecommunication with, or about, a patient, for non-health care purposes or for purposes other than fulfilling the worker's assigned job responsibilities.

Last updated December 2, 2024 at 1:17 PM

History

Effective: February 1, 2014
Promulgated Under: 119.03

Ohio Adm.Code 4723-26-11 Disciplinary actions against certified community health workers; investigations.

(A) The board of nursing, by the vote of a quorum, may impose one or more of the following sanctions if it finds that a person committed fraud in passing an examination required by a community health worker training program, or committed fraud, misrepresentation, or deception in applying for a community health worker certificate: deny, revoke, suspend, or place restrictions on a certificate issued by the board; reprimand or otherwise discipline a certificate holder; or impose a fine of not more than five hundred dollars per violation.

(B) By the vote of a quorum, the board may impose one or more of the following sanctions on an individual who applies for or holds, a community health worker certificate: deny, revoke, suspend, or place restrictions on a community health worker certificate, or reprimand or otherwise discipline a holder of a community health worker certificate. The sanctions may be imposed for any of the following:

(1) Denial, revocation, suspension, or restriction of authority to engage in a licensed profession or practice a health care occupation, in Ohio or another state or jurisdiction, including but not limited to nursing, practice as a dialysis technician, nurse aide, community health care worker or medication aide, for any reason other than a failure to renew;

(2) Performing a nursing task as a certified community health worker having failed to renew a community health worker certificate issued under Chapter 4723. of the Revised Code, or while a community health worker certificate is under suspension or inactive;

(3) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction for, of a misdemeanor committed in the course of performing care as a certified community health worker;

(4) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction for, any felony or any crime involving gross immorality or moral turpitude;

(5) Selling, giving away, or administering drugs or therapeutic devices for other than legal and legitimate therapeutic purposes; or conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction for, violating any municipal, state, county, or federal drug law;

(6) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction for, an act in another jurisdiction that would constitute a felony or a crime of moral turpitude in Ohio;

(7) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction for, an act in the course of practice in another jurisdiction that would constitute a misdemeanor in Ohio;

(9) Habitual or excessive use of controlled substances, other habit-forming drugs, or alcohol or other chemical substances to an extent that impairs the individual's ability to comply with the standards of safe care established in rule 4723-26-10 of the Administrative Code;

(10) Impairment of the ability to comply with standards of safe care established in rule 4723-26-10 of the Administrative Code because of the use of drugs, alcohol or other chemical substances;

(11) Impairment of the ability to comply with standards of safe care established in rule 4723-26-10 of the Administrative Code because of a physical or mental disability;

(12) Assaulting or causing harm to a patient or depriving a patient of the means to summon assistance;

(13) Misappropriation or attempted misappropriation of money or anything of value in the course of performing care as a certified community health worker;

(14) Adjudication by a probate court of being mentally ill or mentally incompetent. The board may restore the person's community health worker certificate upon adjudication by a probate court of the person's restoration to competency or upon submission to the board of other proof of competency;

(15) The suspension or termination of employment by the department of defense or the veterans administration of the United States for any act that violates or would violate his chapter;

(16) Violation of Chapter 4723. of the Revised Code or any rules adopted under it;

(17) Violation of any restrictions placed on a community health worker certificate by the board;

(18) Failure to use universal and standard precautions including those set forth in Chapter 4723-20 of the Administrative Code;

(19) Engaging in activities that exceed those permitted under sections 4723.81 to 4723.88 of the Revised Code or this chapter;

(20) Failure by a certified community health worker to conform to the standards of safe care established in rule 4723-26-10 of the Administrative Code;

(21) Aiding and abetting a person in that person's practice of nursing without a license, or practice as a dialysis technician or certified medication aide without a certificate issued under this chapter;

(22) Regardless of whether the contact or verbal behavior is consensual, engaging with a patient other than the spouse of the certified community health worker in any of the following:

(a) Sexual contact, as defined in section 2907.01 of the Revised Code;

(b) Verbal behavior that is sexually demeaning to the patient or may be reasonably interpreted by the patient as sexually demeaning; or

(23) Assisting suicide as defined in section 3795.01 of the Revised Code.

(1) The board is not required to hold a hearing, but may adopt, by vote of a quorum, a final order that contains the board's findings; and

(2) In the final order, the board may order any of the sanctions listed in paragraph (A) or (B) of this rule.

(E) If a criminal action is brought against a certified community health worker for an act or crime described in paragraphs (B)(3) to (B)(7) of this rule and the action is dismissed by the trial court other than on the merits:

(1) The board shall conduct an adjudication to determine whether the certified community health worker committed the act upon which the action was based.

(2) If the board determines on the basis of the adjudication that the certified community health worker committed the act, or if the certified community health worker fails to participate in the adjudication, the board may take action as though the certified community health worker had been convicted of the act.

(F) If the board takes action on the basis of a conviction, plea, or a judicial finding as described in paragraphs (B)(3) to (B)(7) of this rule that is overturned on appeal, the certified community health worker may, on exhaustion of the appeal process, petition the board for reconsideration of its action.

(1) On receipt of the petition and supporting court documents, the board shall temporarily rescind its action.

(2) If the board determines that the decision on appeal was a decision on the merits, it shall permanently rescind its action.

(3) If the board determines that the decision on appeal was not a decision on the merits, it shall conduct an adjudication to determine whether the certified community health worker committed the act on which the original conviction, plea, or judicial finding was based.

(a) If the board determines on the basis of the adjudication that the certified community health worker committed such act, or if the certified community health worker does not request an adjudication, the board shall reinstate its action.

(b) If the board determines that the certified community health worker did not commit such act, the board shall permanently rescind its action.

(G) The board may investigate an individual's criminal background in performing its duties under this rule and sections 4723.81 to 4723.88 of the Revised Code. As part of such investigation, the board may order the individual to submit, at the individual's expense, a request to the bureau of criminal identification and investigation for a criminal records check and check of federal bureau of investigation records in accordance with the procedure described in section 4723.091 of the Revised Code.

(H) During the course of an investigation the board may compel any certified community health worker, or applicant under section 4723.84 of the Revised Code, to submit to a mental or physical examination, or both, as required by the board and at the expense of the individual, if the board finds reason to believe that the individual under investigation may have a physical or mental impairment that may affect the individual's ability perform delegated nursing tasks. Failure of any individual to submit to a mental or physical examination when directed constitutes an admission of the allegations, unless the failure is due to circumstances beyond the individual's control, and a default and final order may be entered without the taking of testimony or presentation of evidence.

(1) The individual shall be afforded an opportunity to demonstrate to the board that the individual can begin or resume the performance of delegated nursing tasks in accordance with standards established under rule 4723-26-10 of the Administrative Code.

(2) For purposes of this paragraph, any certified community health worker or applicant under this rule shall be deemed to have given consent to submit to a mental or physical examination when directed to do so in writing by the board, and to have waived all objections to the admissibility of testimony or examination reports that constitute a privileged communication.

(J) The provisions of division (I) of section 4723.28 of the Revised Code apply to information, investigations and adjudications involving certified community health workers or applicants under sections 4723.81 to 4723.88 of the Revised Code and this chapter.

(K) The provisions of section 4723.29 of the Revised Code apply with respect to any matter that the board has authority to investigate, inquire into, or hear under sections 4723.81 to 4723.88 of the Revised Code and this chapter.

(L) When the board refuses to grant a community health worker certificate to an applicant, revokes a certificate, or refuses to reinstate a certificate, the board may specify that its action is permanent. An individual subject to permanent action taken by the board is forever ineligible to hold a community health worker certificate and the board shall not accept from the individual an application for reinstatement of the certificate or for a new certificate.

(M) No unilateral surrender of a community health worker certificate issued under Chapter 4723. of the Revised Code shall be effective unless accepted by majority vote of the board. No application for a community health worker certificate issued under Chapter 4723. of the Revised Code may be withdrawn without a majority vote of the board. The board's jurisdiction to take disciplinary action is not removed or limited when an individual has a certificate classified as inactive or fails to renew a certificate.

Last updated February 3, 2025 at 8:30 AM

History

Effective: February 1, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-26-12 Standards for community health worker training programs.

(A) To be approved by the board in accordance with division (G) of section 4723.88 of the Revised Code, a community health worker training program shall employ or contract with a person to serve as program administrator. Such person shall meet one of the following criteria:

(1) Hold a license or certificate to practice as one of the following health care professionals:

(a) A dentist licensed under Chapter 4715. of the Revised Code;

(b) A nurse licensed under Chapter 4723. of the Revised Code;

(d) A pharmacist licensed under Chapter 4729. of the Revised Code;

(e) A physician assistant certified under Chapter 4730. of the Revised Code;

(f) A physician licensed under Chapter 4731. of the Revised Code;

(g) A psychologist licensed under Chapter 4732. of the Revised Code;

(h) A chiropractor licensed under Chapter 4734. of the Revised Code;

(i) A nursing home administrator licensed under Chapter 4751. of the Revised Code;

(j) A counselor, social worker, or marriage and family therapist licensed under Chapter 4757. of the Revised Code; or

(k) A dietitian licensed under Chapter 4759. of the Revised Code.

(2) Hold credentials as an education professional that are recognized by:

(a) The Ohio department of education;

(b) The chancellor of higher education; or

(B) The administrator of a community health worker training program shall be responsible for the following:

(1) Assuring that the community health worker training program establishes written policies addressing the issues set forth in paragraph (C) of this rule;

(2) Assuring that the policies of the program are implemented as written;

(3) If the curriculum includes nursing tasks, assuring that the nursing tasks included in the curriculum of an approved community health worker training program are taught by an individual who:

(a) Has held an Ohio license to practice registered nursing for a minimum of two years;

(b) Is not prohibited by law from teaching nursing tasks;

(i) Has experience in working directly with community health workers for a minimum of six months prior to entering into an instructor role; or

(ii) Within six months after assuming instructor responsibilities in the community health worker training program, successfully completes the community health worker program coursework.

(4) Assuring that the training program utilizes other licensed health care professionals to provide portions of the relevant classroom and clinical instruction in accordance with the professional's educational background and licensed scope of practice.

(C) The program administrator of the community health worker training program shall establish and implement written program policies that address all of the following:

(1) Student enrollment;

(2) Student re-enrollment;

(3) The process for determining the amount of credit to be granted to an applicant with experience in the armed forces of the United States or in the national guard, or in a reserve component. The program shall have a process in place to:

(a) Review the individual's military education and skills training;

(b) Determine whether any of the military education or skill training is substantially equivalent to the curriculum established in Chapter 4723-26 of the Administrative Code;

(4) Student progression, which shall include the following:

(a) The level of achievement a student must maintain in order to remain in or to progress in the program;

(b) A process for determining that a student has sufficient knowledge and understanding to competently provide the care and services of a community health worker including both nursing tasks, if nursing tasks are in the curriculum, and non-nursing tasks.

(5) Requirements for completion of the program;

(a) A registered nurse shall provide written verification that a community health worker student has been taught the skills necessary to perform delegated nursing tasks, if nursing tasks are included in the curriculum;

(b) A registered nurse or other qualified community health worker training program instructor or administrator shall provide written verification that a student has been taught skills necessary to provide the non-nursing tasks provided by a community health worker.

(6) A process for maintaining student records including:

(a) The date a student began the program;

(b) The date a student completed the program; and

(7) An accurate, timely process to provide verification to the board that a student seeking certification as a community health worker has successfully completed the approved training program;

(8) A process for program evaluation that includes feedback from students, instructors and employers of individuals who have successfully completed the community health worker training program;

(9) Designation of those persons with authority to notify the board regarding student enrollment, re-enrollment, and completion of the program;

(10) A process for addressing the unexpected vacancy of the administrator of the program; and

(D) When the administrator of an approved community health worker training program vacates the position or is replaced, an authorized representative of the program shall provide written notice to the board within thirty days after the position is vacated and within thirty days after a new person assumes the role.

(E) An approved training program shall not initiate a new cohort of students for the community health worker training program unless an administrator who meets the requirements of paragraph (A) of this rule is in place.

(F) When a decision is made to close a community health worker training program, the board shall be notified in writing of the decision and provided with the following information:

(1) The tentative date of closing;

(2) The location of the program's records, including but not limited to, student records; and

(3) The name and address of the custodian of the records.

Last updated February 3, 2025 at 8:30 AM

History

Effective: February 1, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-26-13 Standard curriculum for community health worker training programs.

(A) An approved curriculum for a training program for community health workers shall be the standard minimum curriculum set forth in paragraph (B) of this rule and shall satisfy all of the following:

(1) Include a program philosophy, program objectives or outcomes, course objectives or outcomes, teaching strategies, and core competencies or other evaluation methods that are:

(a) Consistent with the law regulating the practice of the community health worker;

(b) Internally consistent;

(d) Distributed to community health worker students;

(2) Include a curriculum plan showing the sequence of courses, laboratory experiences, and units of credit or number of clock hours allotted to theory and laboratory experiences; and

(3) Include a curriculum content that is a minimum of one hundred hours of didactic instruction and one hundred thirty hours of clinical experience. Relevant laboratory experiences may be integrated into the curriculum.

(B) As part of the instruction required in paragraph (A) of this rule, related clinical and laboratory experiences shall provide a community health worker with an opportunity to practice cognitive, psychomotor, and affective skills in the performance of a variety of basic tasks and activities with individuals or groups across the life span. Portions of the relevant clinical experience shall be provided in a community setting similar to the settings in which a community health worker will provide services.

(C) The standard minimum curriculum for community health workers shall include courses, content, and expected outcomes, relative to the defined role of the community health worker, in the following major areas:

(1) Health care, including expected competencies in the areas of:

(a) The physical, mental, emotional and spiritual impacts on health;

(b) Basic anatomy and physiology of major body systems;

(d) Signs indicating a change in a client's health status;

(e) Obtaining accurate vital signs;

(f) Basic cardiopulmonary resuscitation skills;

(g) Medical terminology;

(h) Documentation methods;

(i) Utilization of local health and referral systems; and

(j) Social determinants of health.

(2) Community resources, including expected competencies in the areas of:

(a) Referral methods to assist various target population groups;

(b) Utilization of community resources and their referral processes;

(d) Recognizing and reporting signs of family violence, human trafficking, abuse and neglect; and

(e) Recognizing and making appropriate referral for signs of mental health and addiction problems.

(3) Communication skills, including expected competencies in the areas of:

(a) Interpersonal communication skills and support group facilitation skills;

(b) Effective interview techniques;

(d) Utilization of appropriate telecommunication technique.

(4) Individual and community advocacy, including expected competencies in the areas of:

(a) Recognition of diversity, and the role of the community health worker in an interdisciplinary team;

(b) Supporting development of self care skills in various target population groups;

(d) Methods of serving as a community liaison between different target population groups and local agencies and providers.

(5) Health education, including expected competencies in the areas of:

(a) Educating on healthy lifestyle choices, including nutrition, exercise, and stress management to reduce health risk factors;

(b) Educating on adverse health consequences of smoking, drinking, and drugs of abuse;

(d) Explaining basic prevention and wellness topics; and

(e) Explaining age-appropriate safety and injury prevention techniques.

(6) Service skills and responsibilities, including expected competencies in the areas of:

(a) Protocols and policies regarding:

(i) Confidentiality;

(ii) Care coordination;

(iii) Documentation;

(iv) Submission of documentation for review by a supervisor; and

(v) Release of client information.

(b) Skills necessary to carry out an effective home visit, including:

(i) Personal safety;

(ii) Emotional dynamics;

(iii) Setting appropriate boundaries with clients;

(iv) Time management; and

(v) Conflict management skills.

(D) The standard minimum curriculum for community health workers shall also educate students on needs throughout the span of a lifetime including the following:

(1) Content related to the family during childbearing years, including expected competencies in the areas of:

(a) Health education related to the childbearing years; and

(b) A basic understanding of related anatomy, physiology, and appropriate health care.

(2) Content related to the family during pregnancy, including expected competencies in the areas of:

(a) Basic anatomy, physiology, and normal signs related to pregnancy;

(b) Recognition of warning signs during pregnancy requiring immediate reporting to the registered nurse supervisor; and

(3) Content related to the newborn, infant, and young child, including expected competencies in the areas of:

(a) Routine infant feeding and newborn care;

(b) Recognizing and reporting problems that can occur in early infancy;

(d) Basic methods to enhance typical child development; and

(e) Identification of potential developmental delays.

(4) Content related to adolescents including expected competencies in the areas of:

(a) Age appropriate health education;

(b) Acute and chronic illnesses including, but not limited to asthma, obesity, and eating disorders; and

(5) Content related to adults and seniors, including expected competencies in the areas of:

(a) The aging process;

(b) Prevention strategies;

(d) Top causes of morbidity and mortality by age group; and

(e) Acute and chronic illnesses of adulthood including but not limited to heart disease, cancer, stroke, diabetes, and lung disease.

(6) Content related to special health care and social needs of target population groups including:

(a) Grandparents raising grandchildren;

(b) Adults caring for aging parents; and

(E) For purposes of paragraph (B) of this rule, students participating in a clinical practicum in a community setting shall be supervised by qualified instructional personnel utilized by, or under contract with, the community health worker training program.

(F) When a program has any type of cooperative relationship, including but not limited to relationships with clinical agencies, a written agreement with the cooperating entity shall:

(1) Exist and be current;

(2) Be signed by representatives of both the program and the entity with which it has entered into a cooperative relationship; and

(3) Be on file at the program.

(G) It is the intent of the board that this curriculum is structured in such a way as to assure that participants who successfully complete a program that provides the curriculum may be able to utilize a portion of the credit hours earned toward additional career-related education.

Last updated February 3, 2025 at 8:31 AM

History

Effective: February 1, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-26-14 Procedures for obtaining approval or reapproval of community health worker training programs.

The board shall approve and reapprove community health worker training programs as follows:

(A) A community health worker training program that seeks to be approved by the board shall submit to the board all of the following:

(1) A completed "Community Health Worker Training Program Approval Application";

(2) Payment of a program approval fee of three hundred dollars; and

(3) Any other information requested by the board.

(B) A community health worker training program seeking reapproval by the board shall submit the following to the board within ninety days prior to the expiration of its current approval:

(1) A completed "Community Health Worker Training Program Re-Approval Application";

(2) Payment of a program reapproval fee of three hundred dollars; and

(3) Any other information requested by the board.

(C) If the board determines that additional information is necessary to make a determination regarding an application for program approval or reapproval, the board shall provide written notice to the applicant requesting the information. An application will expire, and a new application must be submitted, if the requested information is not received by the board within one year of the date of the board's request.

(D) The board may conduct a survey, which may include a site visit, of a community health worker training program or applicant either prior to approving or reapproving a program application, or at any time during the two year period for which a program is approved.

(E) At a regularly scheduled board meeting the board shall review the completed application for approval or reapproval and all other relevant documentation to determine whether a program complies with standards set forth in this chapter. If the board finds that the program meets all the requirements of this chapter it shall issue its approval or reapproval, in writing, to the applicant program.

(F) Program approval shall extend for two years provided the program continues to meet the program standards set forth in this chapter.

(G) After a survey is completed by a representative of the board, a report of the survey shall be completed and submitted to the program administrator. The survey report shall indicate requirements that were not met and maintained by the program, when applicable, and the date that the report will be considered by the board. The survey report may include recommendations for enhancement of the program.

(H) If the survey report indicates that a requirement was not met and maintained, the program administrator may submit to the board documentation that the program is meeting and maintaining the requirements identified in the survey report as not being met and maintained. The program administrator's documentation must be submitted to the board not later than forty-five days prior to the date the board is to consider the survey report.

(I) When making a determination about a program's approval status, the board shall consider the survey report and any documentation submitted by the program administrator, provided the documentation was submitted by the program administrator at least forty-five days prior to the board meeting.

(J) Based on the survey report and the program's response to the survey report, if any, the board may grant approval, grant provisional approval, continue approval, or propose to deny or withdraw approval of the program. The board shall deny or withdraw approval of a program according to the procedures set forth in Chapter 119. of the Revised Code. In the alternative, the board an applicant or program may enter into a consent agreement specifying terms and conditions the applicant or program must satisfy in order to achieve or maintain an approval status.

(K) If at any time a program with full approval fails to meet and maintain the minimum standards set forth in this chapter, the board may place the program on provisional approval. When a program is placed on provisional approval, the board shall specify the minimum standard or standards the program is not meeting or maintaining and shall establish the time period during which the program will be on provisional approval. When the time period for provisional approval has expired, the board shall reconsider the program's approval status.

(L) If a program on provisional approval continues to fail to meet or maintain minimum standards at the end of the time period established for provisional approval, the board may propose to continue provisional approval for a period of time specified by the board or may propose to withdraw approval, according to the procedures set forth in Chapter 119. of the Revised Code. In the alternative, the board and applicant or program may enter into a consent agreement specifying terms and conditions the applicant or program must satisfy in order to achieve or maintain an approval status.

(M) When a complete application for reapproval is submitted to the board in accordance with paragraph (B) of this rule, and the board fails to make a determination before the current program approval expires, the board shall issue a notice to the administrator of the program extending approval of the program until board action is taken on the reapproval application.

Last updated February 3, 2025 at 8:31 AM

History

Effective: February 1, 2025
Promulgated Under: 119.03

Chapter 4723-27 Medication Administration by Certified Medication Aide

Ohio Adm.Code 4723-27-01 Definitions.

As used in this chapter:

(A) "Active certificate" means the certificate held by an individual who has fulfilled all the requirements of the board for initial certification or for certification renewal.

(B) "Approved drug" means a drug approved by the federal food and drug administration (FDA).

(D) "Examination" means the written examination and clinical skills examination offered by a testing organization or a medication aide training program approved by the board.

(E) "Certificate" means the certificate issued to a medication aide by the board in accordance with section 4723.651 of the Revised Code.

(F) "Certified medication aide" means a person who holds a current, valid certificate as a medication aide issued by the board of nursing under section 4723.651 of the Revised Code.

(G) "Contact hour" means sixty minutes of continuing education, which may be determined by rounding to the next quarter hour.

(H) "Didactic" means the component of an educational program that includes lecture, verbal instruction, or other means of exchanging theoretical information between instructor and students, typically in a classroom setting.

(I) "Direction" means communicating a plan of care to a licensed practical nurse. Direction by a registered nurse is not meant to imply the registered nurse is supervising the licensed practical nurse in an employment context.

(J) "Gastrostomy tube" means a percutaneously inserted catheter that terminates in the stomach.

(K) "Inactive certificate" means the status of the certificate of an individual who has requested that the board place the certificate on inactive status. An individual with an inactive certificate does not hold a current, valid certificate.

(L) "Jejunostomy tube" means a percutaneously inserted catheter that terminates in the jejunum.

(M) "Laboratory experience" means a component of classroom instruction consisting of a simulated clinical experience, in which the student is provided the opportunity to practice skills in the administration of medication while observed by a nurse.

(N) "Lapsed certificate" means a certified medication aide has failed to fulfill all requirements of certificate renewal and has not requested that the board place the certificate on inactive status.

(O) "Licensed practical nurse" or "L.P.N." means an individual who holds a current, valid license issued under Chapter 4723. of the Revised Code that authorizes the practice of nursing as a licensed practical nurse.

(P) "Medication" means a drug as defined in division (E) of section 4729.01 of the Revised Code.

(Q) "Medication aide training program" means the formal program of study approved by the board and required for certification as a certified medication aide in accordance with sections 4723.63 to 4723.69 of the Revised Code and this chapter.

(R) "Nasogastric tube" means a tube that is passed through the nose and down through the nasopharynx and esophagus into the stomach.

(S) "Nurse" means a registered nurse or a licensed practical nurse.

(T) "Nursing home" means a home as defined by division (A)(6) of section 3721.01 of the Revised Code.

(U) "Nursing home administrator" means the individual, licensed under Chapter 4751. of the Revised Code, who is responsible for planning, organizing, directing, and managing the operation of a nursing home.

(V) "Oral gastric tube" means a tube that is passed through the mouth and down through the nasopharynx and esophagus into the stomach.

(W) "Oral medication" means any medication that is prescribed to be taken by mouth.

(X) "Pediatric" means a resident under eighteen years of age.

(Y) "Pharmacist" means an individual licensed under Chapter 4729. of the Revised Code to practice pharmacy.

(Z) "Physician" means an individual licensed under Chapter 4731. of the Revised Code to practice medicine and surgery, osteopathic medicine and surgery, or podiatry.

(AA) "Professional boundaries" means the limits of the professional relationship that allow for a safe therapeutic relationship between the resident and the certified medication aide.

(BB) "Prescriber" has the same meaning as in division (I) of section 4729.01 of the Revised Code.

(CC) "Prescription" means a written, electronic, or oral order, issued by a licensed health professional authorized to prescribe drugs, for any drug, including an over the counter drug to be used by a particular resident. Prescription medication means a medication that may be dispensed only pursuant to a prescription.

(DD) "Rectal medication" means any medication that is prescribed to be administered by rectal insertion.

(EE) "Registered nurse" or "R.N." means an individual who holds a current, valid license issued under Chapter 4723. of the Revised Code that authorizes the practice of nursing as a registered nurse.

(FF) "Representative of the board" means an employee or member of the board, or another individual designated by the board to act on its behalf.

(GG) "Resident" means an individual who lives in, and receives services from, a nursing home or residential care facility.

(HH) "Residential care facility" means a home as defined by division (A)(7) of section 3721.01 of the Revised Code.

(II) "Residential care facility administrator" means the person responsible for the daily operation of a residential care facility.

(JJ) "Survey" means an announced or unannounced survey of a medication aide training program by a representative of the board to determine whether the program meets or maintains the minimum standards required by the board.

(KK) "Universal and standard precautions" are infection prevention practices that apply to all patients, regardless of suspected or confirmed infection status, in any setting in which healthcare is delivered, and include but are not limited to the following:

(1) Practices used to mitigate exposure to disease-causing agents when exposure-prone activity occurs;

(2) Hand hygiene;

(3) Disinfection and sterilization of equipment;

(4) Appropriate handling and disposal of needles and other sharp instruments; and

(5) Appropriate use of personal protective equipment, including wearing and disposal of gloves and other protective barriers or devices.

(LL) "Successful completion of a medication aide training program" means that a student has satisfactorily completed a board approved training program as set forth in rule 4723-27-08 of the Administrative Code, and has passed a examination.

(MM) "Supervised clinical practice" means a task or activity planned to provide students with the opportunity to administer prescription medications in a nursing home or residential care facility setting in which the student is supervised by a nurse as part of a medication aide training program approved by the board under section 4723.66 of the Revised Code and this chapter.

(NN) "Telecommunication" means the process of transmitting or receiving information over a distance by any electronic or electromagnetic medium. Information may take the form of voice, video, or data.

(OO) "Topical medication" means any prescribed medication that is applied to intact skin.

(PP) "Vaginal medication" means any medication that is prescribed to be administered by vaginal insertion.

Last updated September 15, 2025 at 7:38 AM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-27-02 Standards of safe medication administration by a certified medication aide.

(A) A certified medication aide shall administer prescription medications only with the supervision of a nurse according to section 4723.67 of the Revised Code, and this chapter, to residents of nursing homes and residential care facilities.

(B) Except as provided in paragraphs (C) and (D) of this rule, a certified medication aide may administer the following types of prescription medications:

(1) Oral medications;

(2) Topical medications;

(3) Medications administered as nasal spray, or as drops, or ointment to a resident's eye, ear, or nose;

(4) Rectal and vaginal medications; or

(5) Inhalants delivered by inhalers, nebulizers, or aerosols, that allow for a single dose of a fixed, pre-measured amount of medication.

(1) Medications, including inhalants delivered by inhalers, nebulizers, or aerosols, requiring dosage calculations;

(2) Medications that are not approved drugs;

(3) Medications being administered as part of clinical research; or

(4) Oxygen.

(D) A certified medication aide shall not administer medications by any of the following methods:

(1) Injection, except for insulin as provided in paragraph (E) of this rule;

(2) Intravenous therapy procedures;

(3) Splitting pills for purposes of changing the dose being given; or

(4) Through jejunostomy, gastrostomy, nasogastric, or oral gastric tubes.

(E) A medication aide may administer insulin to a resident by injection, but only if both of the following are satisfied:

(1) The medication aide satisfies training and competency requirements established by the aide's employer.

(2) The insulin is injected using an insulin pen device that contains a dosage indicator.

(F) In addition to the prohibitions in paragraphs (C) and (D) of this rule, a certified medication aide shall not:

(1) Receive, transcribe or alter a medication order;

(2) Administer medications to a person other than a resident of a nursing home or residential care facility as provided in paragraph (A) of this rule;

(3) Administer any medication without the task having been supervised by a nurse; or

(4) Administer medications to pediatric residents.

(G) A certified medication aide shall maintain knowledge of the duties, responsibilities, and accountabilities of a certified medication aide and shall act in accordance with the laws pertaining to the administration of medication by a certified medication aide as set forth in Chapter 4723. of the Revised Code and the rules adopted under that chapter.

(H) A certified medication aide shall display the title "certified medication aide" or "CMA" at all times when administering medications to residents of a nursing home or residential care facility.

(I) A certified medication aide shall demonstrate competence and accountability in the task of medication administration, including appropriate recognition, referral, and consultation with the supervising nurse.

(J) Immediately after administering a medication, a certified medication aide shall accurately document in the resident's record, the following information:

(1) The name of the medication and the dosage administered;

(2) The route of administration;

(3) The date and time of administration;

(4) The name of the certified medication aide administering the medication; and

(5) Refusal by a resident to comply with medication administration.

(K) A certified medication aide shall implement measures to promote a safe environment for nursing home or residential care facility residents.

(L) A certified medication aide shall take measures to ensure the safety of the resident including but not limited to:

(1) Reporting to a nurse in a timely manner all of the following:

(a) Refusal by a resident to comply with medication administration;

(b) Any deviation from the medication administration record;

(d) Anything about the condition of a resident that should cause concern to the certified medication aide.

(2) Preparing and storing medications in accordance with instructions of the manufacturer or the pharmacist;

(3) Removing medications only from a dispensed and properly labeled container that includes all of the following:

(a) Medication name;

(b) Medication dose;

(i) The medication is a contingency drug stored and supplied in accordance with Chapter 4729:5-9-03.1 of the Administrative Code and is supplied to the certified medication aide by the supervising nurse; or

(ii) Medication that is available over the counter and bears the original manufacturer's label and has been purchased and prescribed for the resident.

(d) Expiration date of the medication;

(4) Verifying the identity of the resident to whom the medication is to be administered;

(5) Witnessing the resident swallowing an oral medication that is to be ingested, or otherwise taking a medication in accordance with its prescribed route;

(6) Immediately documenting and reporting deviations from the medication administration record to a supervising nurse;

(7) Utilizing only the medication delivery process currently in use in the nursing home or residential care facility.

(M) A certified medication aide shall not accept a resident care assignment that would interrupt or conflict with the administration of medications or the performance of other tasks and activities that are directly related to the administration of medications. A certified medication aide may perform other resident care activities during such times that the certified medication aide is not engaged in, or scheduled to be engaged in, the administration of medications.

(N) A certified medication aide shall maintain the confidentiality of resident information obtained in the course of the certified medication aide's duties and responsibilities, shall access resident information only for purposes of resident care or for otherwise fulfilling the aide's assigned job responsibilities, and shall not disseminate resident information for purposes other than resident care or for otherwise fulfilling the aide's assigned job responsibilities through social media, texting, emailing, or any other form of communication.

(O) A certified medication aide to whom the administration of medication has been assigned shall not assign the task of medication administration to any other person.

(P) A certified medication aide shall not falsify any resident record or any other document prepared or utilized in the course of, or in conjunction with, the administration of medications.

(Q) A certified medication aide shall delineate, establish, and maintain professional boundaries with each resident.

(R) At all times when a certified medication aide is administering medications to residents in a nursing home or residential care facility the certified medication aide shall:

(1) Take reasonable measures to assure the privacy of the resident; and

(2) Treat each resident with courtesy, respect, and with full recognition of dignity and individuality.

(S) A certified medication aide shall not:

(1) Engage in behavior that causes or may cause physical, verbal, mental, or emotional abuse to a resident; or

(2) Engage in behavior toward a resident that may reasonably be interpreted as physical, verbal, mental, or emotional abuse.

(T) A certified medication aide shall not misappropriate a resident's property or:

(1) Engage in behavior to seek or obtain personal gain at the expense of a resident or that may reasonably be interpreted as behavior to seek or obtain personal gain at the expense of a resident; or

(2) Engage in behavior that constitutes inappropriate involvement in the personal relationships of a resident or that may reasonably be interpreted as inappropriate involvement in the personal relationships of a resident.

For purposes of this paragraph, the resident is always presumed incapable of giving free, full, or informed consent to the behaviors by the certified medication aide set forth in this paragraph.

(U) A certified medication aide shall not:

(1) Engage in sexual conduct with a resident or conduct that may reasonably be interpreted as sexual; or

(2) Engage in any verbal behavior that is seductive or sexually demeaning to a resident, or that may reasonably be interpreted as seductive, or sexually demeaning to a resident.

For purposes of this paragraph, the resident is always presumed incapable of giving free, full, or informed consent to sexual activity with a certified medication aide.

(V) A certified medication aide shall not make any false, misleading or deceptive statements, or submit or cause to be submitted any false, misleading, or deceptive information, or documentation to:

(1) The board or any representative of the board;

(2) Current employers;

(3) Prospective employers for positions requiring certification as a medication aide;

(4) Facilities in which, or organizations for whom, the medication aide is working a temporary or agency assignment;

(5) Other members of the client's health care team; or

(6) Law enforcement personnel.

(W) For purposes of paragraphs (Q), (R), (S), (T), and (U) of this rule, a certified medication aide shall not use social media, texting, emailing, or other forms of communication with, or about, a resident, for non-health care purposes or for purposes other than fulfilling the aide's assigned job responsibilities.

Last updated September 15, 2025 at 7:38 AM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-27-03 Supervision of medication administration to certified medication aides.

(A) A registered nurse or a licensed practical nurse acting at the direction of a registered nurse, who provides nursing care to residents in nursing homes or residential care facilities, may supervise the task of medication administration to by a certified medication aide according to section 4723.67 of the Revised Code and this chapter.

(B) A registered nurse may supervise the administration of medications to a certified medication aide only if the registered nurse holds a current, valid license issued under Chapter 4723. of the Revised Code that is not subject to restrictions relating to the administration of medications imposed under section 4723.28 of the Revised Code, or imposed by agreement entered under section 4723.282 or 4723.35 of the Revised Code.

(C) A licensed practical nurse, acting at the direction of a registered nurse, may supervise the administration of medications by a certified medication aide only if the licensed practical nurse holds a current, valid license issued under Chapter 4723. of the Revised Code that is not subject to restrictions relating to the administration of medications imposed under section 4723.28 of the Revised Code, or imposed by agreement entered under to section 4723.282 or 4723.35 of the Revised Code.

(D) When supervising the task of medication administration to a certified medication aide, a nurse shall evaluate the following:

(1) The resident and the medication needs of the resident, including:

(a) The resident's mental and physical stability;

(b) The medication to be administered;

(d) The route or method by which the medication is to be administered.

(2) The ability of the certified medication aide to safely administer the medication being administered.

(E) When supervising the task of medication administration to a certified medication aide, the nurse shall communicate the following:

(1) The residents to whom the certified medication aide shall administer medications;

(2) The medications the certified medication aide shall administer;

(3) The timeframes during which the medications are to be administered; and

(4) Any special instructions concerning the administration of medications to specific residents.

(F) In a nursing home or residential care facility that utilizes certified medication aides, a nurse remains responsible for all of the following:

(1) Reviewing the medication delivery process to assure there have been no errors in stocking or preparing the medications;

(2) Accepting, transcribing, and reviewing resident medication orders;

(3) Monitoring residents to whom medications are administered for side effects or changes in health status; and

(4) Reviewing documentation completed by a certified medication aide, including the medication administration record.

(G) A nurse shall supervise the certified medication aides as follows:

(1) In a nursing home, a nurse shall provide on-site supervision of a certified medication aide.

(2) In a residential care facility, supervision of a certified medication aide shall be provided by a nurse who is either on-site or is immediately and continuously available through some form of telecommunication.

Last updated September 16, 2025 at 3:19 PM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-27-04 Medication aide certification.

(A) To be issued a medication aide certificate the following requirements must be met:

(1) The applicant must be at least eighteen years of age;

(2) The applicant must have a high school diploma or a high school equivalence diploma as described in section 5107.40 of the Revised Code;

(3) The applicant must submit a completed "Certified Medication Aide Application";

(4) The board must receive written verification that the applicant has successfully completed an approved medication aide training program, and documentation indicating applicant passed an examination; and

(5) The applicant shall submit to the board the fee of fifty dollars.

(B) Medication aide certificates shall be renewed biennially according to rule 4723-27-05 of the Administrative Code, and shall be valid from May first of even numbered years until April thirtieth of the following even numbered year.

(C) If a medication aide certificate is issued by the board on or after February first of an even numbered year, the certificate shall be valid, unless the certificate is made inactive or if disciplinary action has rendered it invalid, through April thirtieth of the next even numbered year.

(D) An individual who holds a current, valid medication aide certificate issued by the board under section 4723.651 of the Revised Code and this chapter, may use the title "certified medication aide" or "CMA."

(E) If an applicant fails to meet the requirements for certification within one year of receipt of their application, the application is void and the fee forfeited. The application form shall state the circumstances under which this forfeiture may occur.

Last updated September 15, 2025 at 7:38 AM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-27-05 Renewal of a medication aide certificate.

(A) Medication aide certificates shall be renewed biennially on or before April thirtieth of even numbered years.

(1) The board shall provide access to an on-line "Medication Aide Renewal Application," or an application by mail, upon request, to every holder of a current, valid certificate, except when the board is aware that the individual may be ineligible for certificate renewal.

(2) To renew a medication aide certificate, a holder of a current, valid certificate shall submit:

(a) A completed "Certified Medication Aide Renewal Application";

(b) The renewal fee of fifty dollars; and

(c) Documentation that the applicant successfully completed eight contact hours of continuing education that included at least the following:

(i) One hour directly related to this chapter and any rules adopted under it;

(ii) One hour directly related to establishing and maintaining professional boundaries;

(iii) Six hours related to medications or the administration of prescription medications.

(B) A certified medication aide with a current, valid certificate who does not intend to practice as a medication aide in Ohio may request that the certificate be placed on inactive status at any time by submitting to the board a written statement or electronic request asking that the certificate be placed on inactive status.

(C) If a medication aide certificate is not renewed by April thirtieth of each even numbered year and the certificate holder fails by that time to request that the certificate be placed on inactive status, the certificate shall lapse.

(D) If a medication aide certificate is inactive or lapsed for two years or less, the board may reactivate or reinstate the certificate if the individual completes the contact hours set forth in paragraph (A) of this rule and submits to the board within two years from the date the certificate was made inactive or lapsed the following:

(1) A completed "Certified Medication Aide Reactivation and Reinstatement Application"; and

(2) The fee of one hundred dollars.

(E) If a medication aide certificate is inactive or lapsed for more than two years, it shall not be reactivated or reinstated unless the applicant submits to the board all of the following:

(1) A completed "Certified Medication Aide Reactivation and Reinstatement Application";

(2) The fee of one hundred dollars; and

(3) Written verification from an approved medication aide training program that the applicant has, within six months prior to submission of the application, successfully completed the medication aide training program.

(F) A certificate holder who has placed a medication aide certificate on inactive status is not required to pay a renewal fee unless the holder seeks to reactivate the certificate. If the certificate holder placed a certificate on inactive status on or after March first of the year in which the certificate was to be renewed, and then notifies the board on or before April thirtieth of the same renewal year of the intent to reactivate, the certificate holder must still pay the fee of one hundred dollars.

(G) During the time that an individual's certification as a medication aide is either inactive or lapsed, the holder may not administer medications as a certified medication aide.

(H) An individual who administers medications as a certified medication aide or represents to the public that the individual holds a current valid medication aide certificate, who has failed to renew a medication aide certificate issued under this chapter, or while the certificate is under suspension, inactive or lapsed, may be subject to disciplinary action under rule 4723-27-09 of the Administrative Code.

(I) A medication aide certificate holder who is a service member or veteran, as defined in rule 4723-2-01 of the Administrative Code, or who is the spouse or surviving spouse of a service member or veteran, may be eligible for a waiver of the late application fee and the reinstatement fee according to rule 4723-2-03 of the Administrative Code.

Last updated September 15, 2025 at 7:38 AM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-27-07 Medication aide training programs.

(A) An applicant seeking approval from the board to provide a medication aide training program shall submit a "Medication Aide Training Program Application."

(1) Applications shall be accompanied by the fee of fifty dollars.

(2) No applicant shall admit a student until the medication aide training program has been approved by the board.

(B) The application for approval of a medication aide training program shall contain the following information:

(1) The objectives and outcomes of the medication aide program;

(2) The program's organizational chart;

(3) The name and credentials of the program's registered nurse administrator;

(4) The name and credentials of all individuals serving as instructors in the program;

(5) A program curriculum that includes the number of hours to be spent on each topic area.

(1) The medication aide training program shall include thirty clock hours of instruction in medication administration that includes both classroom and at least sixteen clock hours of supervised clinical practice.

(2) The program shall include a mechanism for evaluating whether an individual's reading, writing, and mathematical skills are sufficient for the individual to be able to administer prescription medications safely.

(3) The registered nurse program administrator shall direct and supervise all aspects of the training program and ensure that the program meets and maintains the requirements set forth in this rule.

(4) The program shall disclose to all applicants at the time of admission the program's refund policy, the cost of the medication aide examination, the qualifications for certification as a medication aide, as set forth in section 4723.651 of the Revised Code, and that in order to be certified as a medication aide, an applicant will be tested to determine whether the applicant's reading, writing, and mathematical skills are sufficient to administer prescription medications safely.

(5) The supervised clinical practice component shall be provided in nursing homes that the Ohio department of health has found to be free from real and present danger related to the administration of medications, or in residential care facilities that the Ohio department of health has found to be free from real and present danger, related to the administration of medications and the provision of skilled nursing care, unless:

(a) The nursing home or residential care facility has an approved plan of correction as it relates to the real and present danger,

(b) The nursing home or residential care facility has resolved the real and present danger; or

(c) The supervised clinical practice component commenced prior to the Ohio department of health notifying the nursing home or residential care facility of real and present danger.

(6) A medication aide training program shall provide written certification to the board that:

(a) An applicant has completed the program and;

(b) That the applicant successfully passed an examination demonstrating their ability to administer prescription medication safely, unless the applicant utilized a testing organization separate from the program authorized by the board.

(7) A medication aide training program shall maintain records including results of examination for each student for a period of six years following the date the student enrolled in the program.

(8) A medication aide training program shall ensure an orderly transition between program administrators including providing written notification to the board within thirty days of the transition.

(9) A medication aide training program shall close a program, if necessary, in an orderly manner including providing thirty days advance written notice to the board, current students, and program applicants of the following:

(a) Tentative date of the closing;

(b) The location where the program's student and other records will be retained; and

(c) The name, address, and other contact information of the custodian of all program records after the program is closed;

(10) For individuals with experience in the armed forces of the United States, or in the national guard or in a reserve component, the program shall have a process in place to:

(a) Review the individual's military education and skills training;

(b) Determine whether any of the military education or skills training is substantially equivalent to the curriculum established in Chapter 4723-27 of the Administrative Code;

(D) Approval of a medication aide training program shall be effective for a period of two years from the date of approval.

(E) No later than ninety days prior to expiration of a medication aide training program approval period, a program seeking reapproval shall submit a "Medication Aide Training Program Re-Approval Application" and a program reapproval fee of fifty dollars.

(F) The board may conduct surveys of a medication aide training program or program applicant.

(G) The board shall review completed applications for approval or reapproval of a medication aide training program during a regularly scheduled board meeting.

(H) The board may deny, suspend or revoke approval or reapproval of a medication aide training program or applicant, in accordance with Chapter 119. of the Revised Code, based upon the following:

(1) Failure to meet or maintain the requirements set forth in section 4723.66 of the Revised Code; or

(2) Submitting false, misleading or deceptive statements, information or documentation to the board or its designees.

(I) If the board fails to act on a reapproval application prior to the expiration of the program's current two-year approval period, the board shall consider the program's current approval period effective until the board takes action with respect to the reapproval application.

Last updated September 15, 2025 at 7:39 AM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-27-08 Standard curriculum for medication aide programs.

(A) The curriculum for a training program for certified medication aides shall be the standard curriculum set forth in paragraph (C) of this rule, and shall include all of the following:

(1) Program objectives and outcomes, course objectives or outcomes, teaching strategies, and core competencies or other evaluation methods that are:

(a) Consistent with the law and rules applicable to certified medication aides, as set forth in Chapter 4723. of the Revised Code and this chapter;

(b) Internally consistent;

(d) Made available to students in medication aide training programs;

(2) A curriculum plan showing the sequence of courses, laboratory experiences, and the number of clock hours allotted to instruction and laboratory experience related to medication administration;

(3) Students must complete the didactic and laboratory component prior to participating in the supervised clinical component of the certified medication aide training program.

(B) The standard curriculum for certified medication aides shall include courses, content, and expected outcomes, relative to the defined role of the certified medication aide, in the following areas :

(1) The standards of safe medication administration by a certified medication aide, rule 4723-27-02 of the Administrative Code:

(2) Communication and interpersonal skills;

(3) Resident rights related to medication administration, including the right of a resident to refuse medications;

(4) The six rights of medication administration, including:

(a) The right person;

(b) The right drug;

(d) The right time;

(e) The right route; and

(f) The right documentation.

(5) Drug terminology, storage and disposal, including:

(a) Medical terminology, symbols, accepted abbreviations;

(b) Dosage measurement;

(d) Principles of safe medication storage and disposal.

(6) Basic pharmacology, drug classifications and medications affecting body systems, including:

(a) Purposes of various medications;

(b) Schedule II, III, IV, and V controlled substances.

(7) Safe administration of medications, including:

(a) Oral medications;

(b) Topical medications;

(d) Vaginal medications;

(e) Rectal medications;

(f) Oral inhalants;

(g) Transdermal medications;

(h) Proper resident positioning;

(i) Measurement of apical pulse and blood pressure in association with routine medication administration.

(8) Principles of standard precautions including those set forth in Chapter 4723-20 of the Administrative Code;

(9) Documentation of medications in residents' clinical records.

(C) The supervised clinical practice component of an approved medication aide training program shall be sufficient to assure that students are prepared to administer medications as a certified medication aide in a safe and effective manner, and shall satisfy the following:

(1) The supervised clinical practice component shall consist of not less than sixteen hours in the administration of medication, and shall be conducted under the direction and supervision of a nurse.

(2) The supervised clinical practice component shall take place in a nursing home or residential care facility with which the training program has a written agreement to provide nurse supervision of the student in accordance with this rule;

(3) While engaged in medication administration, a student shall be under the one-on-one direction and supervision of a nurse.

(4) During the supervised clinical practice, the nurse supervising the medication aide student shall inform the registered nurse program administrator of the student's progress in the supervised clinical practice.

Last updated September 16, 2025 at 3:19 PM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-27-09 Disciplinary actions against certified medication aides; investigations.

(A) The board, by a vote of a quorum, may impose a fine of not more than five hundred dollars per violation; or deny a certificate, revoke, suspend or place restrictions on a certificate, reprimand or otherwise discipline an applicant or certificate holder found by the board to have committed fraud in passing an examination required to obtain the certificate or to have committed fraud, misrepresentation, or deception in applying for or securing a medication aide certificate issued by the board.

(B) The board, by a vote of a quorum, may impose one or more of the following sanctions: deny, revoke, suspend, or place restrictions on any medication aide certificate issued by the board; reprimand or otherwise discipline a holder of a medication aide certificate; or impose a fine of not more than five hundred dollars per violation. The sanctions may be imposed for any of the following:

(2) Administering medications as a certified medication aide, having failed to renew a medication aide certificate issued under this chapter, or while a medication aide certificate is under suspension or inactive;

(3) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction for, of a misdemeanor committed in the course of practice;

(4) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction for, any felony or of any crime involving gross immorality or moral turpitude;

(6) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction for, an act in another jurisdiction that would constitute a felony or a crime of moral turpitude in Ohio;

(7) Conviction of, a plea of guilty to, a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction for, an act in the course of practice in another jurisdiction that would constitute a misdemeanor in Ohio;

(9) Habitual or excessive use of controlled substances, other habit-forming drugs, or alcohol or other chemical substances to an extent that impairs the individual's ability to comply with standards of safe medication administration established in rule 4723-27-02 of the Administrative Code;

(10) Impairment of the ability to comply with standards of safe medication administration established in rule 4723-27-02 of the Administrative Code because of the use of drugs, alcohol, or other chemical substances;

(11) Impairment of the ability to comply with standards of safe medication administration established in rule 4723-27-02 of the Administrative Code because of a physical or mental disability;

(12) Assaulting or causing harm to a resident or depriving a resident of the means to summon assistance;

(13) Misappropriation or attempted misappropriation of money or anything of value in the course of practice;

(14) Adjudication by a probate court of being mentally ill or mentally incompetent. The board may restore the person's medication aide certificate upon adjudication by a probate court of the person's restoration to competency or upon submission to the board of other proof of competency;

(15) The suspension or termination of employment by the department of defense or the veterans administration of the United States for any act that violates or would violate this chapter;

(16) Violation of Chapter 4723. of the Revised Code or any rules adopted under it;

(17) Violation of any restrictions placed on a medication aide certificate by the board;

(18) Failure to use universal and standard precautions including those set forth in Chapter 4723-20 of the Administrative Code;

(19) Engaging in activities that exceed those permitted under sections 4723.61 to 4723.69 of the Revised Code or this chapter;

(20) Failure by a certified medication aide to conform to the standards of safe medication administration established in rule 4723-27-02 of the Administrative Code.

(22) Regardless of whether the contact or verbal behavior is consensual, engaging with a resident other than the spouse of the certified medication aide in any of the following:

(a) Sexual contact, as defined in section 2907.01 of the Revised Code;

(b) Verbal behavior that is sexually demeaning to the resident or may be reasonably interpreted by the resident as sexually demeaning.

(23) Assisting suicide as defined in section 3795.01 of the Revised Code.

(C) The hearings of the board shall be conducted in accordance with Chapter 119. of the Revised Code and Chapter 4723-16 of the Administrative Code. The board may appoint a hearing examiner, as provided in section 119.09 of the Revised Code, or a board committee, to conduct any hearing the board is authorized to hold under Chapter 119. of the Revised Code.

(1) The board is not required to hold a hearing, but may adopt, by a vote of a quorum, a final order that contains the board's findings; and

(2) In the final order, the board may order any of the sanctions listed in paragraph (A) or (B) of this rule.

(E) If a criminal action is brought against a certified medication aide for an act or crime described in paragraphs (B)(3) to (B)(7) of this rule and the action is dismissed by the trial court other than on the merits:

(1) The board shall conduct an adjudication to determine whether the certified medication aide committed the act upon which the action was based.

(2) If the board determines on the basis of the adjudication that the certified medication aide committed the act, or if the certified medication aide fails to participate in the adjudication, the board may take action as though the certified medication aide had been convicted of the act.

(F) If the board takes action on the basis of a conviction, plea, or a judicial finding as described in paragraphs (B)(3) to (B)(7) of this rule that is overturned on appeal, the certified medication aide may, on exhaustion of the appeal process, petition the board for reconsideration of its action.

(1) On receipt of the petition and supporting court documents, the board shall temporarily rescind its action.

(2) If the board determines that the decision on appeal was a decision on the merits, it shall permanently rescind its action.

(3) If the board determines that the decision on appeal was not a decision on the merits, it shall conduct an adjudication to determine whether the certified medication aide committed the act on which the original conviction, plea, or judicial finding was based.

(a) If the board determines on the basis of the adjudication that the certified medication aide committed such act, or if the certified medication aide does not request an adjudication, the board shall reinstate its action;

(b) If the board determines that the certified medication aide did not commit such act, the board shall permanently rescind its action.

(G) The board may investigate an individual's criminal background in performing its duties under this rule and sections 4723.61 to 4723.69 of the Revised Code. As part of such investigation, the board may order the individual to submit, at the individual's expense, a request to the bureau of criminal identification and investigation for a criminal records check and check of federal bureau of investigation records in accordance with the procedure described in section 4723.091 of the Revised Code.

(H) During the course of an investigation authorized by section 4723.652 of the Revised Code, the board may compel any certified medication aide or applicant under sections 4723.61 to 4723.69 of the Revised Code to submit to a mental or physical examination, or both, as required by the board and at the expense of the individual, if the board finds reason to believe that the individual under investigation may have a physical or mental impairment that may affect the individual's ability to safely administer prescribed medication. Failure of any individual to submit to a mental or physical examination when directed constitutes an admission of the allegations, unless the failure is due to circumstances beyond the individual's control, and a default and final order may be entered without the taking of testimony or presentation of evidence.

(I) If the board finds that an individual is impaired in accordance with paragraph (H) of this rule, the board shall require the individual to submit to care, counseling, or treatment approved or designated by the board, as a condition for initial, continued, reinstated, or renewed certificate to administer prescribed medication.

(1) The individual shall be afforded an opportunity to demonstrate to the board that the individual can begin or resume the administration of prescribed medication in accordance with the standards established under rule 4723-27-02 of the Administrative Code.

(2) For purposes of this paragraph, any certified medication aide or applicant under this rule shall be deemed to have given consent to submit to a mental or physical examination when directed to do so in writing by the board, and to have waived all objections to the admissibility of testimony or examination reports that constitute a privileged communication.

(J) The provisions of division (I) of section 4723.28 of the Revised Code apply to information, investigations and adjudications involving certified medication aides or applicants under sections 4723.61 to 4723.69 of the Revised Code and this chapter.

(K) The provisions of section 4723.29 of the Revised Code apply with respect to any matter that the board has authority to investigate, inquire into, or hear under sections 4723.61 to 4723.69 of the Revised Code and this chapter.

(L) When the board refuses to grant a medication aide certificate to an applicant, revokes a certificate, or refuses to reinstate a certificate, the board may specify that its action is permanent. An individual subject to permanent action taken by the board is forever ineligible to hold a medication aide certificate and the board shall not accept from the individual an application for reinstatement of the certificate or for a new certificate.

(M) No unilateral surrender of a medication aide certificate issued under Chapter 4723. of the Revised Code shall be effective unless accepted by majority vote of the board. No application for a medication aide certificate issued under Chapter 4723. of the Revised Code may be withdrawn without a majority vote of the board. The board's jurisdiction to take disciplinary action is not removed or limited when an individual has a certificate classified as inactive or fails to renew a certificate.

Last updated June 10, 2022 at 8:37 AM

History

Effective: July 1, 2017
Promulgated Under: 119.03

Ohio Adm.Code 4723-27-10 Fees.

(A) All payments of fees shall be in the form required by the board.

(B) Except for duplicate payments, all fees are nonrefundable.

(C) An applicant whose initial payment is returned to the board before the renewal deadline may reissue payment to the board without jeopardizing the status of the applicant's certificate.

Last updated September 15, 2025 at 7:39 AM

History

Effective: September 14, 2025
Promulgated Under: 119.03

Ohio Adm.Code 4723-27-11 Medication aide certification by endorsement.

(A) An applicant for medication aide certification by endorsement shall satisfy the following:

(1) Submit a completed "Certified Medication Aide by Endorsement Application" and the certification application fee of fifty dollars;

(2) The applicant has not surrendered or had revoked a license, out-of-state occupational license, or government certification because of negligence or intentional misconduct related to the applicant's practice as a medication aide;

(3) The applicant has not been convicted of, found guilty pursuant to a judicial finding of, or plead guilty to a criminal offense for which a licensing authority may deny an application for a license or government certification or that would otherwise disqualify the applicant for the license or government certification under the applicable law of this state governing the profession, occupation, or occupational activity for which the applicant is applying;

(4) Submit any other documentation required by the board.

(B) Pursuant to section 4796.03 of the Revised Code, the board shall issue a medication aide certificate in accordance with Chapter 4796. of the Revised Code to an applicant if the applicant holds a substantially similar out-of-state occupational license to engage in practice as a medication aide, or, holds a government certification to engage in practice as a medication aide from one of the uniformed services or from a state that does not issue a license for practice as a medication aide, if the applicant:

(1) Has held the license or government certification for at least one of the last five years immediately preceding the date the application is submitted to the board;

(2) Has been actively engaged in practice as a medication aide for at least one of the five years immediately preceding the date the application is submitted to the board;

(3) Is in good standing in all jurisdictions in which the applicant holds the license or government certification; and

(4) Was required to satisfy minimum education, training, or experience requirements or pass an examination to receive the license or government certification.

The applicant shall have verification of licensure or government certification to practice as a medication aide submitted directly to the board from the issuing state or uniformed services. The applicant shall also have verification of having been actively engaged in practice as a medication aide for at least one of the past five years submitted directly to the board by the employer or employer designee for whom the applicant practiced as a medication aide.

(C) Pursuant to section 4796.04 of the Revised Code, the board shall issue a medication aide certificate in accordance with Chapter 4796. of the Revised Code to an applicant who has held a private certification as a medication aide in a state that does not issue an occupational license or government certification to practice as a medication aide, if the applicant:

(1) Has held a private certification for at least two years immediately preceding the date the application is submitted;

(2) Has been actively engaged in practice as a medication aide in a state that does not issue an occupational license or government certification to practice as a medication aide, for at least two of the five years immediately preceding date the application is submitted; and

(3) Is in good standing with the private organization that issued the private certification.

The applicant shall have verification of private certification as a medication aide submitted directly to the board by the private organization that issued the certification. The applicant shall also have verification of having been actively engaged in practice as a medication aide for at least two of the past five years, submitted directly to the board by the employer or employer designee for whom the applicant practiced as a medication aide.

(D) Pursuant to section 4796.05 of the Revised Code, the board shall issue a medication aide certificate in accordance with Chapter 4796. of the Revised Code to an applicant who, for at least three of the five years immediately preceding the date the application is submitted to the board, has been actively engaged in practice as a medication aide, in either:

(1) A state that does not issue an occupational license or government certificate to practice as a medication aide, or

(2) Service of the uniformed services.

The applicant shall have verification of having been actively engaged in practice as a medication aide for at least three of the past five years submitted directly to the board by the employer or employer designee of the uniformed services for whom the applicant practiced as a medication aide.

(E) The board may propose to deny certification by endorsement pursuant to an adjudication conducted in accordance with Chapter 119. of the Revised Code.

(F) If an applicant for certification by endorsement as a medication aide fails to meet the requirements for certification within one year from the date the application is received, or the application remains incomplete for one year, the application shall be considered void and the fee forfeited. The application shall state the circumstances under with forfeiture may occur.

Last updated September 15, 2025 at 7:39 AM

History

Effective: September 14, 2025
Promulgated Under: 119.03