As Introduced 1
123rd General Assembly 4
Regular Session H. B. No. 511 5
1999-2000 6
REPRESENTATIVE SCHURING 8
_________________________________________________________________ 9
A B I L L
To amend sections 121.22, 3313.68, 3701.85, 3702.51, 11
3719.13, 3721.34, 3727.01, 4113.51, 4113.52, 13
4723.02, 4723.04, 4723.051, 4723.06, 4723.061,
4723.07, 4723.08, 4723.09, 4723.15, 4723.151, 14
4723.24, 4723.28, 4723.281, 4723.31, 4723.32, 15
4723.34, 4723.341, 4723.35, 4723.42, 4723.43, 16
4723.431, 4723.47, 4723.48, 4723.55, 4723.56, 17
4723.57, 4723.58, 4723.59, 4731.22, 4731.27, 18
4731.281, 4743.05, 4751.05, and 5111.04; to 19
amend, for the purpose of adopting new section
numbers as indicated in parentheses, sections 20
4723.02 (4723.01), 4723.04 (4723.02), 4723.051 21
(4723.10), 4723.31 (4723.082), 4723.39 22
(4723.081), and 4723.48 (4723.17); to enact new 23
section 4723.48 and sections 4723.021 and 24
4723.591; to repeal sections 4723.342 and 4723.51 25
of the Revised Code; and to amend Section 3 of 26
Am. Sub. H.B. 478 of the 119th General Assembly, 27
as subsequently amended, to complete termination 28
of the advanced practice nurse pilot project on
January 1, 2010 by repealing sections 4723.561 29
and 4723.591 on that date and to revise the laws 30
regarding the practice of nursing and the
licensing and enforcement duties of the Board of 31
Nursing.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 33
2
Section 1. That sections 121.22, 3313.68, 3701.85, 35
3702.51, 3719.13, 3721.34, 3727.01, 4113.51, 4113.52, 4723.02, 36
4723.04, 4723.051, 4723.06, 4723.061, 4723.07, 4723.08, 4723.09, 37
4723.15, 4723.151, 4723.24, 4723.28, 4723.281, 4723.31, 4723.32, 38
4723.34, 4723.341, 4723.35, 4723.42, 4723.43, 4723.431, 4723.47, 39
4723.48, 4723.55, 4723.56, 4723.57, 4723.58, 4723.59, 4731.22,
4731.27, 4731.281, 4743.05, 4751.05, and 5111.04 be amended; 40
sections 4723.02 (4723.01), 4723.04 (4723.02), 4723.051 41
(4723.10), 4723.31 (4723.082), 4723.39 (4723.081), and 4723.48 42
(4723.17) be amended for the purpose of adopting new section 43
numbers as indicated in parentheses; and new section 4723.48 and 44
sections 4723.021 and 4723.591 of the Revised Code be enacted to 45
read as follows:
Sec. 121.22. (A) This section shall be liberally 54
construed to require public officials to take official action and 55
to conduct all deliberations upon official business only in open 56
meetings unless the subject matter is specifically excepted by 57
law. 58
(B) As used in this section: 60
(1) "Public body" means any of the following: 62
(a) Any board, commission, committee, council, or similar 64
decision-making body of a state agency, institution, or 65
authority, and any legislative authority or board, commission, 66
committee, council, agency, authority, or similar decision-making 68
body of any county, township, municipal corporation, school 69
district, or other political subdivision or local public 70
institution;
(b) Any committee or subcommittee of a body described in 72
division (B)(1)(a) of this section; 73
(c) A court of jurisdiction of a sanitary district 75
organized wholly for the purpose of providing a water supply for 76
domestic, municipal, and public use when meeting for the purpose 78
of the appointment, removal, or reappointment of a member of the 79
board of directors of such a district pursuant to section 6115.10
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of the Revised Code, if applicable, or for any other matter 80
related to such a district other than litigation involving the 81
district. As used in division (B)(1)(c) of this section, "court 82
of jurisdiction" has the same meaning as "court" in section 83
6115.01 of the Revised Code.
(2) "Meeting" means any prearranged discussion of the 85
public business of the public body by a majority of its members. 86
(3) "Regulated individual" means either of the following: 88
(a) A student in a state or local public educational 90
institution; 91
(b) A person who is, voluntarily or involuntarily, an 93
inmate, patient, or resident of a state or local institution 94
because of criminal behavior, mental illness or retardation, 95
disease, disability, age, or other condition requiring custodial 96
care. 97
(C) All meetings of any public body are declared to be 99
public meetings open to the public at all times. A member of a 100
public body shall be present in person at a meeting open to the 102
public to be considered present or to vote at the meeting and for 103
purposes of determining whether a quorum is present at the 104
meeting. 105
The minutes of a regular or special meeting of any public 108
body shall be promptly prepared, filed, and maintained and shall 109
be open to public inspection. The minutes need only reflect the 110
general subject matter of discussions in executive sessions 111
authorized under division (G) or (J) of this section.
(D) This section does not apply to a grand jury, to an 113
audit conference conducted by the auditor of state or independent 114
certified public accountants with officials of the public office 115
that is the subject of the audit, to the adult parole authority 116
when its hearings are conducted at a correctional institution for 117
the sole purpose of interviewing inmates to determine parole or 118
pardon, to the organized crime investigations commission 119
established under section 177.01 of the Revised Code, to the 120
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state medical board when determining whether to suspend a 121
certificate without a prior hearing pursuant to division (G) of 123
either section 4730.25 or 4731.22 of the Revised Code, to the 125
board of nursing when determining whether to suspend a license 126
without a prior hearing pursuant to division (B) of section 127
4723.181 4723.281 of the Revised Code, or to the executive 129
committee of the emergency response commission when determining 130
whether to issue an enforcement order or request that a civil 131
action, civil penalty action, or criminal action be brought to 132
enforce Chapter 3750. of the Revised Code.
(E) The controlling board, the development financing 134
advisory council, the industrial technology and enterprise 135
advisory council, the tax credit authority, or the minority 137
development financing advisory board, when meeting to consider 138
granting assistance pursuant to Chapter 122. or 166. of the 139
Revised Code, in order to protect the interest of the applicant 140
or the possible investment of public funds, by unanimous vote of 141
all board, council, or authority members present, may close the 143
meeting during consideration of the following information 145
confidentially received by the authority, council, or board from 146
the applicant: 148
(1) Marketing plans; 150
(2) Specific business strategy; 152
(3) Production techniques and trade secrets; 154
(4) Financial projections; 156
(5) Personal financial statements of the applicant or 158
members of the applicant's immediate family, including, but not 159
limited to, tax records or other similar information not open to 161
public inspection. 162
The vote by the authority, council, or board to accept or 166
reject the application, as well as all proceedings of the
authority, council, or board not subject to this division, shall 169
be open to the public and governed by this section.
(F) Every public body, by rule, shall establish a 171
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reasonable method whereby any person may determine the time and 172
place of all regularly scheduled meetings and the time, place, 173
and purpose of all special meetings. A public body shall not 174
hold a special meeting unless it gives at least twenty-four 175
hours' advance notice to the news media that have requested 176
notification, except in the event of an emergency requiring 177
immediate official action. In the event of an emergency, the 178
member or members calling the meeting shall notify the news media 179
that have requested notification immediately of the time, place, 180
and purpose of the meeting. 181
The rule shall provide that any person, upon request and 184
payment of a reasonable fee, may obtain reasonable advance
notification of all meetings at which any specific type of public 185
business is to be discussed. Provisions for advance notification 186
may include, but are not limited to, mailing the agenda of 187
meetings to all subscribers on a mailing list or mailing notices 188
in self-addressed, stamped envelopes provided by the person. 189
(G) Except as provided in division (J) of this section, 192
the members of a public body may hold an executive session only 193
after a majority of a quorum of the public body determines, by a 194
roll call vote, to hold an executive session and only at a 196
regular or special meeting for the sole purpose of the
consideration of any of the following matters: 197
(1) To consider the appointment, employment, dismissal, 199
discipline, promotion, demotion, or compensation of a public 200
employee or official, or the investigation of charges or 201
complaints against a public employee, official, licensee, or 202
regulated individual, unless the public employee, official, 203
licensee, or regulated individual requests a public hearing. 204
Except as otherwise provided by law, no public body shall hold an 205
executive session for the discipline of an elected official for 206
conduct related to the performance of the elected official's 207
official duties or for the elected official's removal from 209
office. If a public body holds an executive session pursuant to 211
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division (G)(1) of this section, the motion and vote to hold that 212
executive session shall state which one or more of the approved 213
purposes listed in division (G)(1) of this section are the 214
purposes for which the executive session is to be held, but need 215
not include the name of any person to be considered at the 216
meeting.
(2) To consider the purchase of property for public 218
purposes, or for the sale of property at competitive bidding, if 219
premature disclosure of information would give an unfair 220
competitive or bargaining advantage to a person whose personal, 221
private interest is adverse to the general public interest. No 222
member of a public body shall use division (G)(2) of this section 224
as a subterfuge for providing covert information to prospective 226
buyers or sellers. A purchase or sale of public property is void 227
if the seller or buyer of the public property has received covert 228
information from a member of a public body that has not been 229
disclosed to the general public in sufficient time for other 230
prospective buyers and sellers to prepare and submit offers. 231
If the minutes of the public body show that all meetings 233
and deliberations of the public body have been conducted in 234
compliance with this section, any instrument executed by the 235
public body purporting to convey, lease, or otherwise dispose of 236
any right, title, or interest in any public property shall be 237
conclusively presumed to have been executed in compliance with 238
this section insofar as title or other interest of any bona fide 239
purchasers, lessees, or transferees of the property is concerned. 240
(3) Conferences with an attorney for the public body 242
concerning disputes involving the public body that are the 243
subject of pending or imminent court action; 244
(4) Preparing for, conducting, or reviewing negotiations 246
or bargaining sessions with public employees concerning their 247
compensation or other terms and conditions of their employment; 248
(5) Matters required to be kept confidential by federal 250
law or regulations or state statutes; 251
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(6) Specialized details of security arrangements if 253
disclosure of the matters discussed might reveal information that 254
could be used for the purpose of committing, or avoiding 255
prosecution for, a violation of the law; 256
(7) In the case of a county hospital operated pursuant to 258
Chapter 339. of the Revised Code, to consider trade secrets, as 260
defined in section 1333.61 of the Revised Code.
If a public body holds an executive session to consider any 262
of the matters listed in divisions (G)(2) to (7) of this section, 264
the motion and vote to hold that executive session shall state 265
which one or more of the approved matters listed in those 266
divisions are to be considered at the executive session. 267
A public body specified in division (B)(1)(c) of this 270
section shall not hold an executive session when meeting for the
purposes specified in that division. 271
(H) A resolution, rule, or formal action of any kind is 273
invalid unless adopted in an open meeting of the public body. A 274
resolution, rule, or formal action adopted in an open meeting 275
that results from deliberations in a meeting not open to the 276
public is invalid unless the deliberations were for a purpose 277
specifically authorized in division (G) or (J) of this section 278
and conducted at an executive session held in compliance with 279
this section. A resolution, rule, or formal action adopted in an 280
open meeting is invalid if the public body that adopted the 281
resolution, rule, or formal action violated division (F) of this 282
section. 283
(I)(1) Any person may bring an action to enforce this 285
section. An action under division (I)(1) of this section shall 287
be brought within two years after the date of the alleged 288
violation or threatened violation. Upon proof of a violation or 289
threatened violation of this section in an action brought by any 290
person, the court of common pleas shall issue an injunction to 291
compel the members of the public body to comply with its 292
provisions. 293
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(2)(a) If the court of common pleas issues an injunction 295
pursuant to division (I)(1) of this section, the court shall 296
order the public body that it enjoins to pay a civil forfeiture 297
of five hundred dollars to the party that sought the injunction 298
and shall award to that party all court costs and, subject to 299
reduction as described in division (I)(2) of this section, 301
reasonable attorney's fees. The court, in its discretion, may 302
reduce an award of attorney's fees to the party that sought the 303
injunction or not award attorney's fees to that party if the 304
court determines both of the following: 305
(i) That, based on the ordinary application of statutory 307
law and case law as it existed at the time of violation or 308
threatened violation that was the basis of the injunction, a 309
well-informed public body reasonably would believe that the 310
public body was not violating or threatening to violate this 311
section; 312
(ii) That a well-informed public body reasonably would 314
believe that the conduct or threatened conduct that was the basis 315
of the injunction would serve the public policy that underlies 316
the authority that is asserted as permitting that conduct or 317
threatened conduct. 318
(b) If the court of common pleas does not issue an 320
injunction pursuant to division (I)(1) of this section and the 321
court determines at that time that the bringing of the action was 322
frivolous conduct, as defined in division (A) of section 2323.51 323
of the Revised Code, the court shall award to the public body all 324
court costs and reasonable attorney's fees, as determined by the 325
court. 326
(3) Irreparable harm and prejudice to the party that 328
sought the injunction shall be conclusively and irrebuttably 329
presumed upon proof of a violation or threatened violation of 330
this section. 331
(4) A member of a public body who knowingly violates an 333
injunction issued pursuant to division (I)(1) of this section may 334
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be removed from office by an action brought in the court of 335
common pleas for that purpose by the prosecuting attorney or the 336
attorney general. 337
(J)(1) Pursuant to division (C) of section 5901.09 of the 339
Revised Code, a veterans service commission shall hold an 340
executive session for one or more of the following purposes 341
unless an applicant requests a public hearing: 342
(a) Interviewing an applicant for financial assistance 344
under sections 5901.01 to 5901.15 of the Revised Code; 345
(b) Discussing applications, statements, and other 347
documents described in division (B) of section 5901.09 of the 348
Revised Code; 349
(c) Reviewing matters relating to an applicant's request 351
for financial assistance under sections 5901.01 to 5901.15 of the 352
Revised Code.
(2) A veterans service commission shall not exclude an 354
applicant for, recipient of, or former recipient of financial 355
assistance under sections 5901.01 to 5901.15 of the Revised Code, 356
and shall not exclude representatives selected by the applicant, 358
recipient, or former recipient, from a meeting that the
commission conducts as an executive session that pertains to the 359
applicant's, recipient's, or former recipient's application for 360
financial assistance.
(3) A veterans service commission shall vote on the grant 362
or denial of financial assistance under sections 5901.01 to 363
5901.15 of the Revised Code only in an open meeting of the 365
commission. The minutes of the meeting shall indicate the name, 366
address, and occupation of the applicant, whether the assistance 367
was granted or denied, the amount of the assistance if assistance 368
is granted, and the votes for and against the granting of 369
assistance.
Sec. 3313.68. The board of education of each city, 378
exempted village, or local school district may appoint one or 379
more school physicians and one or more school dentists. Two or 380
10
more school districts may unite and employ one such physician and 381
at least one such dentist whose duties shall be such as are 382
prescribed by law. Said school physician shall hold a license to 383
practice medicine in Ohio, and each school dentist shall be 384
licensed to practice in this state. School physicians and 385
dentists may be discharged at any time by the board of education. 386
School physicians and dentists shall serve one year and until 387
their successors are appointed and shall receive such 388
compensation as the board of education determines. The board of 389
education may also employ registered nurses, as defined by 390
section 4723.02 4723.01 and licensed as school nurses under 392
section 3319.22 of the Revised Code, to aid in such inspection in 393
such ways as are prescribed by it, and to aid in the conduct and
coordination of the school health service program. The school 394
dentists shall make such examinations and diagnoses and render 395
such remedial or corrective treatment for the school children as 396
is prescribed by the board of education; provided that all such 397
remedial or corrective treatment shall be limited to the children 398
whose parents cannot otherwise provide for same, and then only 399
with the written consent of the parents or guardians of such 400
children. School dentists may also conduct such oral hygiene 401
educational work as is authorized by the board of education. 402
The board of education may delegate the duties and powers 404
provided for in this section to the board of health or officer 405
performing the functions of a board of health within the school 406
district, if such board or officer is willing to assume the same. 407
Boards of education shall co-operate with boards of health in the 408
prevention and control of epidemics. 409
Sec. 3701.85. (A) As used in this section: 418
(1) "Automated external defibrillation" has the same 420
meaning as in section 2305.235 of the Revised Code. 421
(2) "Emergency medical services organization" has the same 423
meaning as in section 4765.01 of the Revised Code. 424
(3) "Emergency medical service provider" means a person 426
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who is an "emergency medical technician-basic," "emergency 427
medical technician-intermediate," "emergency medical 428
technician-paramedic," or "first responder" as defined in section 430
4765.01 of the Revised Code. 431
(4) "Physician" has the same meaning as in section 4765.01 434
of the Revised Code.
(5) "Registered nurse" and "licensed practical nurse" have 437
the same meanings as in section 4723.02 4723.01 of the Revised 438
Code.
(B) A person who possesses an automated external 440
defibrillator shall do all of the following: 441
(1) Require expected users to complete successfully a 443
course in automated external defibrillation and cardiopulmonary 444
resuscitation that is offered or approved by the American heart 445
association or another nationally recognized organization; 446
(2) Maintain and test the defibrillator according to the 448
manufacturer's guidelines; 449
(3) Consult with a physician regarding compliance with the 451
requirements of divisions (B)(1) and (2) of this section. 452
(C) A person who possesses an automated external 454
defibrillator may notify an emergency medical services 455
organization of the location of the defibrillator. 456
(D) A person who has obtained appropriate training on how 459
to perform automated external defibrillation and has successfully 460
completed a course in cardiopulmonary resuscitation may perform 461
automated external defibrillation, regardless of whether the 462
person is a physician, registered nurse, licensed practical 463
nurse, or emergency medical service provider. When automated 464
external defibrillation is not performed as part of an emergency 465
medical services system or at a hospital as defined in section 466
3727.01 of the Revised Code, an emergency medical services system 467
shall be activated as soon as possible. 468
Sec. 3702.51. As used in sections 3702.51 to 3702.62 of 477
the Revised Code: 478
12
(A) "Applicant" means any person that submits an 480
application for a certificate of need and who is designated in 481
the application as the applicant. 482
(B) "Person" means any individual, corporation, business 484
trust, estate, firm, partnership, association, joint stock 485
company, insurance company, government unit, or other entity. 486
(C) "Certificate of need" means a written approval granted 488
by the director of health to an applicant to authorize conducting 489
a reviewable activity. 490
(D) "Health service area" means a geographic region 492
designated by the director of health under section 3702.58 of the 493
Revised Code. 494
(E) "Health service" means a clinically related service, 496
such as a diagnostic, treatment, rehabilitative, or preventive 497
service. 498
(F) "Health service agency" means an agency designated to 500
serve a health service area in accordance with section 3702.58 of 501
the Revised Code. 502
(G) "Health care facility" means: 504
(1) A hospital registered under section 3701.07 of the 506
Revised Code; 507
(2) A nursing home licensed under section 3721.02 of the 509
Revised Code, or by a political subdivision certified under 510
section 3721.09 of the Revised Code; 511
(3) A county home or a county nursing home as defined in 513
section 5155.31 of the Revised Code that is certified under Title 514
XVIII or XIX of the "Social Security Act," 49 Stat. 620 (1935), 515
42 U.S.C.A. 301, as amended; 516
(4) A freestanding dialysis center; 518
(5) A freestanding inpatient rehabilitation facility; 520
(6) An ambulatory surgical facility; 522
(7) A freestanding cardiac catheterization facility; 524
(8) A freestanding birthing center; 526
(9) A freestanding or mobile diagnostic imaging center; 528
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(10) A freestanding radiation therapy center. 530
A health care facility does not include the offices of 532
private physicians and dentists whether for individual or group 533
practice, residential facilities licensed under section 5123.19 535
of the Revised Code, or habilitation centers certified by the 536
director of mental retardation and developmental disabilities
under section 5123.041 of the Revised Code, or an institution for 537
the sick that is operated exclusively for patients who use 538
spiritual means for healing and for whom the acceptance of 539
medical care is inconsistent with their religious beliefs, 540
accredited by a national accrediting organization, exempt from 541
federal income taxation under section 501 of the Internal Revenue 542
Code of 1986, 100 Stat. 2085, 26 U.S.C.A. 1, as amended, and 543
providing twenty-four hour nursing care pursuant to the exemption
in division (G)(E) of section 4723.32 of the Revised Code from 544
the licensing requirements of Chapter 4723. of the Revised Code. 545
(H) "Medical equipment" means a single unit of medical 547
equipment or a single system of components with related functions 548
that is used to provide health services. 549
(I) "Third-party payer" means a health insuring 551
corporation licensed under Chapter 1751. of the Revised Code, a 554
health maintenance organization as defined in division (K) of 555
this section, an insurance company that issues sickness and 556
accident insurance in conformity with Chapter 3923. of the 557
Revised Code, a state-financed health insurance program under 558
Chapter 3701., 4123., or 5111. of the Revised Code, or any 559
self-insurance plan.
(J) "Government unit" means the state and any county, 561
municipal corporation, township, or other political subdivision 562
of the state, or any department, division, board, or other agency 563
of the state or a political subdivision. 564
(K) "Health maintenance organization" means a public or 566
private organization organized under the law of any state that is 567
qualified under section 1310(d) of Title XIII of the "Public 568
14
Health Service Act," 87 Stat. 931 (1973), 42 U.S.C. 300e-9. 570
(L) "Existing health care facility" means a health care 572
facility that is licensed or otherwise approved to practice in 573
this state, in accordance with applicable law, is staffed and 574
equipped to provide health care services, and actively provides 575
health services or has not been actively providing health 576
services for less than twelve consecutive months. 577
(M) "State" means the state of Ohio, including, but not 579
limited to, the general assembly, the supreme court, the offices 580
of all elected state officers, and all departments, boards, 581
offices, commissions, agencies, institutions, and other 582
instrumentalities of the state of Ohio. "State" does not include 583
political subdivisions. 584
(N) "Political subdivision" means a municipal corporation, 586
township, county, school district, and all other bodies corporate 587
and politic responsible for governmental activities only in 588
geographic areas smaller than that of the state to which the 589
sovereign immunity of the state attaches. 590
(O) "Affected person" means: 592
(1) An applicant for a certificate of need, including an 594
applicant whose application was reviewed comparatively with the 595
application in question; 596
(2) The person that requested the reviewability ruling in 598
question;
(3) Any person that resides or regularly uses health care 600
facilities within the geographic area served or to be served by 601
the health care services that would be provided under the 602
certificate of need or reviewability ruling in question; 603
(4) Any health care facility that is located in the health 605
service area where the health care services would be provided 606
under the certificate of need or reviewability ruling in 607
question;
(5) Third-party payers that reimburse health care 609
facilities for services in the health service area where the 610
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health care services would be provided under the certificate of 611
need or reviewability ruling in question; 612
(6) Any other person who testified at a public hearing 614
held under division (B) of section 3702.52 of the Revised Code or 615
submitted written comments in the course of review of the 616
certificate of need application in question. 617
(P) "Osteopathic hospital" means a hospital registered 619
under section 3701.07 of the Revised Code that advocates 620
osteopathic principles and the practice and perpetuation of 621
osteopathic medicine by doing any of the following: 622
(1) Maintaining a department or service of osteopathic 624
medicine or a committee on the utilization of osteopathic 625
principles and methods, under the supervision of an osteopathic 626
physician; 627
(2) Maintaining an active medical staff, the majority of 629
which is comprised of osteopathic physicians; 630
(3) Maintaining a medical staff executive committee that 632
has osteopathic physicians as a majority of its members. 633
(Q) "Ambulatory surgical facility" has the same meaning as 635
in section 3702.30 of the Revised Code. 636
(R) Except as otherwise provided in division (T) of this 638
section, and until the termination date specified in section 639
3702.511 of the Revised Code, "reviewable activity" means any of 640
the following:
(1) The addition by any person of any of the following 643
health services, regardless of the amount of operating costs or 644
capital expenditures: 645
(a) A heart, heart-lung, lung, liver, kidney, bowel, 647
pancreas, or bone marrow transplantation service, a stem cell 648
harvesting and reinfusion service, or a service for 649
transplantation of any other organ unless transplantation of the 650
organ is designated by public health council rule not to be a 651
reviewable activity; 652
(b) A cardiac catheterization service; 654
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(c) An open-heart surgery service; 656
(d) Any new, experimental medical technology that is 659
designated by rule of the public health council.
(2) The acceptance of high-risk patients, as defined in 661
rules adopted under section 3702.57 of the Revised Code, by any 662
cardiac catheterization service that was initiated without a 663
certificate of need pursuant to division (R)(3)(b) of the version 665
of this section in effect immediately prior to April 20, 1995; 667
(3)(a) The establishment, development, or construction of 669
a new health care facility other than a new long-term care 670
facility or a new hospital; 671
(b) The establishment, development, or construction of a 673
new hospital or the relocation of an existing hospital; 674
(c) The relocation of hospital beds, other than long-term 676
care, perinatal, or pediatric intensive care beds, into or out of 677
a rural area. 678
(4)(a) The replacement of an existing hospital; 680
(b) The replacement of an existing hospital obstetric or 682
newborn care unit or freestanding birthing center. 684
(5)(a) The renovation of a hospital that involves a 688
capital expenditure, obligated on or after the effective date of
this amendment, of five million dollars or more, not including 690
expenditures for equipment, staffing, or operational costs. For
purposes of division (R)(5)(a) of this section, a capital 692
expenditure is obligated:
(i) When a contract enforceable under Ohio law is entered 694
into for the construction, acquisition, lease, or financing of a 695
capital asset; 696
(ii) When the governing body of a hospital takes formal 698
action to commit its own funds for a construction project 699
undertaken by the hospital as its own contractor; 700
(iii) In the case of donated property, on the date the 702
gift is completed under applicable Ohio law. 703
(b) The renovation of a hospital obstetric or newborn care 705
17
unit or freestanding birthing center that involves a capital 707
expenditure of five million dollars or more, not including 708
expenditures for equipment, staffing, or operational costs. 709
(6) Any change in the health care services, bed capacity, 711
or site, or any other failure to conduct the reviewable activity 712
in substantial accordance with the approved application for which 713
a certificate of need was granted, if the change is made prior to 714
the date the activity for which the certificate was issued ceases 715
to be a reviewable activity; 716
(7) Any of the following changes in perinatal bed capacity 718
or pediatric intensive care bed capacity: 719
(a) An increase in bed capacity; 721
(b) A change in service or service-level designation of 724
newborn care beds or obstetric beds in a hospital or freestanding 725
birthing center, other than a change of service that is provided
within the service-level designation of newborn care or obstetric 726
beds as registered by the department of health; 727
(c) A relocation of perinatal or pediatric intensive care 730
beds from one physical facility or site to another, excluding the 731
relocation of beds within a hospital or freestanding birthing 732
center or the relocation of beds among buildings of a hospital or 734
freestanding birthing center at the same site. 735
(8) The expenditure of more than one hundred ten per cent 737
of the maximum expenditure specified in a certificate of need; 738
(9) Any transfer of a certificate of need issued prior to 740
April 20, 1995, from the person to whom it was issued to another 742
person before the project that constitutes a reviewable activity 743
is completed, any agreement that contemplates the transfer of a 744
certificate of need issued prior to that date upon completion of 746
the project, and any transfer of the controlling interest in an 747
entity that holds a certificate of need issued prior to that
date. However, the transfer of a certificate of need issued 748
prior to that date or agreement to transfer such a certificate of 750
need from the person to whom the certificate of need was issued 751
18
to an affiliated or related person does not constitute a 752
reviewable transfer of a certificate of need for the purposes of 753
this division, unless the transfer results in a change in the 754
person that holds the ultimate controlling interest in the 755
certificate of need.
(10)(a) The acquisition by any person of any of the 757
following medical equipment, regardless of the amount of 759
operating costs or capital expenditure:
(i) A cobalt radiation therapy unit; 761
(ii) A linear accelerator; 763
(iii) A gamma knife unit. 765
(b) The acquisition by any person of medical equipment 767
with a cost of two million dollars or more. The cost of 768
acquiring medical equipment includes the sum of the following: 769
(i) The greater of its fair market value or the cost of 771
its lease or purchase; 772
(ii) The cost of installation and any other activities 774
essential to the acquisition of the equipment and its placement 775
into service.
(11) The addition of another cardiac catheterization 778
laboratory to an existing cardiac catheterization service. 779
(S) Except as provided in division (T) of this section, 782
"reviewable activity" also means any of the following activities, 784
none of which are subject to a termination date:
(1) The establishment, development, or construction of a 786
new long-term care facility; 787
(2) The replacement of an existing long-term care 789
facility; 790
(3) The renovation of a long-term care facility that 792
involves a capital expenditure of two million dollars or more, 793
not including expenditures for equipment, staffing, or 794
operational costs; 795
(4) Any of the following changes in long-term care bed 797
capacity: 798
19
(a) An increase in bed capacity; 800
(b) A relocation of beds from one physical facility or 803
site to another, excluding the relocation of beds within a 804
long-term care facility or among buildings of a long-term care 805
facility at the same site;
(c) A recategorization of hospital beds registered under 808
section 3701.07 of the Revised Code from another registration 810
category to skilled nursing beds or long-term care beds. 811
(5) Any change in the health services, bed capacity, or 813
site, or any other failure to conduct the reviewable activity in 814
substantial accordance with the approved application for which a 815
certificate of need concerning long-term care beds was granted, 816
if the change is made within five years after the implementation 817
of the reviewable activity for which the certificate was granted; 819
(6) The expenditure of more than one hundred ten per cent 821
of the maximum expenditure specified in a certificate of need 822
concerning long-term care beds; 823
(7) Any transfer of a certificate of need that concerns 825
long-term care beds and was issued prior to April 20, 1995, from 827
the person to whom it was issued to another person before the 828
project that constitutes a reviewable activity is completed, any 829
agreement that contemplates the transfer of such a certificate of 830
need upon completion of the project, and any transfer of the 831
controlling interest in an entity that holds such a certificate 832
of need. However, the transfer of a certificate of need that 833
concerns long-term care beds and was issued prior to April 20, 835
1995, or agreement to transfer such a certificate of need from 836
the person to whom the certificate was issued to an affiliated or 837
related person does not constitute a reviewable transfer of a 838
certificate of need for purposes of this division, unless the 839
transfer results in a change in the person that holds the 840
ultimate controlling interest in the certificate of need. 841
(T) "Reviewable activity" does not include any of the 843
following activities: 844
20
(1) Acquisition of computer hardware or software; 846
(2) Acquisition of a telephone system; 848
(3) Construction or acquisition of parking facilities; 850
(4) Correction of cited deficiencies that are in violation 852
of federal, state, or local fire, building, or safety laws and 853
rules and that constitute an imminent threat to public health or 854
safety; 855
(5) Acquisition of an existing health care facility that 857
does not involve a change in the number of the beds, by service, 858
or in the number or type of health services; 859
(6) Correction of cited deficiencies identified by 861
accreditation surveys of the joint commission on accreditation of 862
healthcare organizations or of the American osteopathic 863
association; 864
(7) Acquisition of medical equipment to replace the same 866
or similar equipment for which a certificate of need has been 867
issued if the replaced equipment is removed from service; 868
(8) Mergers, consolidations, or other corporate 870
reorganizations of health care facilities that do not involve a 871
change in the number of beds, by service, or in the number or 872
type of health services; 873
(9) Construction, repair, or renovation of bathroom 875
facilities; 876
(10) Construction of laundry facilities, waste disposal 878
facilities, dietary department projects, heating and air 879
conditioning projects, administrative offices, and portions of 880
medical office buildings used exclusively for physician services; 881
(11) Acquisition of medical equipment to conduct research 883
required by the United States food and drug administration or 884
clinical trials sponsored by the national institute of health. 885
Use of medical equipment that was acquired without a certificate 886
of need under division (T)(11) of this section and for which 888
premarket approval has been granted by the United States food and 889
drug administration to provide services for which patients or 890
21
reimbursement entities will be charged shall be a reviewable 891
activity. 892
(12) Removal of asbestos from a health care facility. 894
Only that portion of a project that meets the requirements 896
of division (T) of this section is not a reviewable activity. 898
(U) "Small rural hospital" means a hospital that is 900
located within a rural area, has fewer than one hundred beds, and 902
to which fewer than four thousand persons were admitted during 903
the most recent calendar year.
(V) "Children's hospital" means any of the following: 905
(1) A hospital registered under section 3701.07 of the 907
Revised Code that provides general pediatric medical and surgical 908
care, and in which at least seventy-five per cent of annual 909
inpatient discharges for the preceding two calendar years were 910
individuals less than eighteen years of age; 911
(2) A distinct portion of a hospital registered under 913
section 3701.07 of the Revised Code that provides general 914
pediatric medical and surgical care, has a total of at least one 915
hundred fifty registered pediatric special care and pediatric 916
acute care beds, and in which at least seventy-five per cent of 917
annual inpatient discharges for the preceding two calendar years 918
were individuals less than eighteen years of age; 919
(3) A distinct portion of a hospital, if the hospital is 921
registered under section 3701.07 of the Revised Code as a 922
children's hospital and the children's hospital meets all the 923
requirements of division (V)(1) of this section. 924
(W) "Long-term care facility" means any of the following: 926
(1) A nursing home licensed under section 3721.02 of the 928
Revised Code or by a political subdivision certified under 929
section 3721.09 of the Revised Code; 930
(2) The portion of any facility, including a county home 932
or county nursing home, that is certified as a skilled nursing 933
facility or a nursing facility under Title XVIII or XIX of the 934
"Social Security Act";
22
(3) The portion of any hospital that contains beds 936
registered under section 3701.07 of the Revised Code as skilled 937
nursing beds or long-term care beds. 938
(X) "Long-term care bed" means a bed in a long-term care 940
facility.
(Y) "Perinatal bed" means a bed in a hospital that is 942
registered under section 3701.07 of the Revised Code as a newborn 943
care bed or obstetric bed, or a bed in a freestanding birthing 944
center.
(Z) "Freestanding birthing center" means any facility in 946
which deliveries routinely occur, regardless of whether the 948
facility is located on the campus of another health care
facility, and which is not licensed under Chapter 3711. of the 950
Revised Code as a level one, two, or three maternity unit or a 952
limited maternity unit.
(AA)(1) "Reviewability ruling" means a ruling issued by 954
the director of health under division (A) of section 3702.52 of 955
the Revised Code as to whether a particular proposed project is 956
or is not a reviewable activity. 957
(2) "Nonreviewability ruling" means a ruling issued under 959
that division that a particular proposed project is not a 960
reviewable activity. 961
(BB)(1) "Metropolitan statistical area" means an area of 964
this state designated a metropolitan statistical area or primary 965
metropolitan statistical area in United States office of 967
management and budget bulletin No. 93-17, June 30, 1993, and its 969
attachments. 970
(2) "Rural area" means any area of this state not located 972
within a metropolitan statistical area. 973
Sec. 3719.13. Prescriptions, orders, and records, required 982
by Chapter 3719. of the Revised Code, and stocks of dangerous 983
drugs and controlled substances, shall be open for inspection 984
only to federal, state, county, and municipal officers, and 985
employees of the state board of pharmacy whose duty it is to 986
23
enforce the laws of this state or of the United States relating 987
to controlled substances. Such prescriptions, orders, records, 988
and stocks shall be open for inspection by employees of the state 989
medical board for purposes of enforcing Chapter 4731. of the 990
Revised Code AND EMPLOYEES OF THE BOARD OF NURSING FOR PURPOSES 991
OF ENFORCING CHAPTER 4723. OF THE REVISED CODE. No person having 992
knowledge of any such prescription, order, or record shall 993
divulge such knowledge, except in connection with a prosecution 994
or proceeding in court or before a licensing or registration 995
board or officer, to which prosecution or proceeding the person 996
to whom such prescriptions, orders, or records relate is a party. 997
Sec. 3721.34. For purposes of implementing sections 1,006
3721.28 to 3721.33 of the Revised Code, the director of health 1,007
may advise, consult or cooperate with, or enter into agreements 1,008
with the board of nursing, other state agencies and, political 1,010
subdivisions, the federal government, or any person. The 1,012
director may enter into agreements that provide for the board of 1,013
nursing or another A state agency to do any of the following: 1,014
(A) Approve or reapprove, in accordance with division (A) 1,016
of section 3721.31 of the Revised Code and the rules adopted by 1,017
the director under section 3721.30 of the Revised Code, 1,018
competency evaluation programs and training and competency 1,019
evaluation programs, or, in accordance with rules adopted by the 1,020
director under section 3721.30 of the Revised Code, programs to 1,021
train instructors and coordinators for training and competency 1,022
evaluation programs and evaluators for competency evaluation 1,023
programs, and to perform any functions related to approval and 1,024
reapproval of those programs including any of the following: 1,025
(1) Conduct adjudications under Chapter 119. of the 1,027
Revised Code; 1,028
(2) Conduct the inspections and examinations described in 1,030
division (A)(5) or (D) of section 3721.31 of the Revised Code; 1,031
(3) Deny, suspend, or revoke approval or reapproval, in 1,033
accordance with Chapter 119. of the Revised Code, of programs 1,034
24
that are not in compliance with sections 3721.30 and 3721.31 of 1,035
the Revised Code and the rules adopted thereunder; 1,036
(4) Collect the fees described in division (G) of section 1,038
3721.31 of the Revised Code in the amounts prescribed in rules 1,039
adopted by the director of health under section 3721.30 of the 1,040
Revised Code and deposit them into the nurse aide training fund 1,041
created by section 3721.33 of the Revised Code. 1,042
(B) Approve or deny, in accordance with Chapter 119. of 1,044
the Revised Code, the requests described in division (B)(2) of 1,045
section 3721.31 of the Revised Code. 1,046
Sec. 3727.01. As used in this section, "health maintenance 1,055
organization" means a public or private organization organized 1,056
under the law of any state that is qualified under section 1,057
1310(d) of Title XIII of the "Public Health Service Act," 87 1,058
Stat. 931 (1973), 42 U.S.C. 300e-9, or that does all of the 1,059
following: 1,060
(A) Provides or otherwise makes available to enrolled 1,062
participants health care services including at least the 1,063
following basic health care services: usual physician services, 1,064
hospitalization, laboratory, x-ray, emergency and preventive 1,065
service, and out-of-area coverage; 1,066
(B) Is compensated, except for copayments, for the 1,068
provision of basic health care services to enrolled participants 1,069
by a payment that is paid on a periodic basis without regard to 1,070
the date the health care services are provided and that is fixed 1,071
without regard to the frequency, extent, or kind of health 1,072
service actually provided; 1,073
(C) Provides physician services primarily in either of the 1,075
following ways: 1,076
(1) Directly through physicians who are either employees 1,078
or partners of the organization; 1,079
(2) Through arrangements with individual physicians or one 1,081
or more groups of physicians organized on a group practice or 1,082
individual practice basis. 1,083
25
As used in this chapter, "hospital" means an institution 1,085
classified as a hospital under section 3701.07 of the Revised 1,086
Code in which are provided to inpatients diagnostic, medical, 1,087
surgical, obstetrical, psychiatric, or rehabilitation care for a 1,088
continuous period longer than twenty-four hours; a tuberculosis 1,089
hospital; or a hospital operated by a health maintenance 1,090
organization. "Hospital" does not include a facility licensed 1,091
under Chapter 3721. of the Revised Code, a health care facility 1,092
operated by the department of mental health or the department of 1,093
mental retardation and developmental disabilities, a health 1,094
maintenance organization that does not operate a hospital, the 1,095
office of any private licensed health care professional, whether 1,096
organized for individual or group practice, or a clinic that 1,097
provides ambulatory patient services and where patients are not 1,098
regularly admitted as inpatients. "Hospital" also does not 1,099
include an institution for the sick that is operated exclusively 1,101
for patients who use spiritual means for healing and for whom the 1,102
acceptance of medical care is inconsistent with their religious 1,103
beliefs, accredited by a national accrediting organization,
exempt from federal income taxation under section 501 of the 1,104
Internal Revenue Code of 1986, 100 Stat. 2085, 26 U.S.C.A. 1, as 1,106
amended, and providing twenty-four hour nursing care pursuant to 1,107
the exemption in division (G)(E) of section 4723.32 of the 1,108
Revised Code from the licensing requirements of Chapter 4723. of 1,109
the Revised Code.
Sec. 4113.51. As used in sections 4113.51 to 4113.53 of 1,118
the Revised Code: 1,119
(A) "Employee" means any person who performs a service for 1,121
wages or other remuneration for an employer. 1,122
(B) "Employer" means any person who has one or more 1,124
employees. "Employer" includes an agent of an employer, the 1,125
state or any agency or instrumentality of the state, and any 1,126
municipal corporation, county, township, school district, or 1,127
other political subdivision or any agency or instrumentality 1,128
26
thereof. 1,129
(C) "Person" has the same meaning as in section 1.59 of 1,131
the Revised Code and also includes a public agency or any other 1,132
legal entity. 1,133
(D) "Peace officer" has the same meaning as in section 1,135
2935.01 of the Revised Code. 1,136
(E) "Political subdivision" has the same meaning as in 1,138
division (F) of section 2744.01 of the Revised Code. 1,139
(F) "Prosecuting authority" means the prosecuting attorney 1,141
of a county or the director of law, village solicitor, or similar 1,142
chief legal officer of a municipal corporation. 1,143
(G) "Inspector general" means the inspector general 1,145
appointed under section 121.48 of the Revised Code. 1,146
(H) "REGISTERED NURSE" AND "LICENSED PRACTICAL NURSE" HAVE 1,148
THE SAME MEANINGS AS IN SECTION 4723.02 OF THE REVISED CODE. 1,149
Sec. 4113.52. (A)(1)(a) If EXCEPT WHEN DIVISION (A)(3) OF 1,158
THIS SECTION APPLIES, IF an employee becomes aware in the course 1,160
of the employee's employment of a violation of any state or 1,161
federal statute or any ordinance or regulation of a political
subdivision that the employee's employer has authority to correct 1,163
and if the employee reasonably believes that the violation either 1,164
is a criminal offense that is likely to cause an imminent risk of 1,165
physical harm to persons or a hazard to public health or safety 1,166
or is a felony, the employee orally shall notify the employee's 1,167
supervisor or other responsible officer of the employee's 1,168
employer of the violation and subsequently shall file with that 1,169
supervisor or officer a written report that provides sufficient 1,170
detail to identify and describe the violation. If the employer 1,171
does not correct the violation or make a reasonable and good 1,172
faith effort to correct the violation within twenty-four hours 1,173
after the oral notification or the receipt of the report, 1,174
whichever is earlier, the employee may file a written report that 1,175
provides sufficient detail to identify and describe the violation 1,176
with the prosecuting authority of the county or municipal 1,177
27
corporation in which the violation occurred, with a peace 1,178
officer, with the inspector general if the violation is within 1,179
the inspector general's jurisdiction, or with any other
appropriate public official or agency that has regulatory 1,181
authority over the employer and the industry, trade, or business 1,182
in which the employer is engaged. 1,183
(b) If an employee makes a report under division (A)(1)(a) 1,185
of this section, the employer, within twenty-four hours after the 1,186
oral notification was made or the report was received or by the 1,187
close of business on the next regular business day following the 1,188
day on which the oral notification was made or the report was 1,189
received, whichever is later, shall notify the employee, in 1,190
writing, of any effort of the employer to correct the alleged 1,191
violation or hazard or of the absence of the alleged violation or 1,192
hazard. 1,193
(2) If an employee becomes aware in the course of the 1,195
employee's employment of a violation of Chapter 3704., 3734., 1,196
6109., or 6111. of the Revised Code that is a criminal offense, 1,197
the employee directly may notify, either orally or in writing, 1,198
any appropriate public official or agency that has regulatory 1,199
authority over the employer and the industry, trade, or business 1,200
in which the employer is engaged. 1,201
(3)(a) IF AN EMPLOYEE WHO IS A REGISTERED NURSE OR 1,203
LICENSED PRACTICAL NURSE BECOMES AWARE IN THE COURSE OF THE 1,205
NURSE'S EMPLOYMENT OF AN ACTION OR FAILURE TO ACT THAT MAY BE A 1,206
VIOLATION BY THE NURSE'S EMPLOYER OF A STATUTE OR ADMINISTRATIVE 1,207
RULE THAT A STATE AGENCY, AS DEFINED IN SECTION 1.60 OF THE
REVISED CODE, IS RESPONSIBLE FOR ENFORCING, THE NURSE SHALL 1,209
ORALLY NOTIFY THE NURSE'S SUPERVISOR OR OTHER RESPONSIBLE OFFICER 1,210
OF THE NURSE'S EMPLOYER OF THE VIOLATION AND SUBSEQUENTLY FILE 1,211
WITH THAT SUPERVISOR OR OFFICER A WRITTEN REPORT THAT PROVIDES 1,212
SUFFICIENT DETAIL TO IDENTIFY AND DESCRIBE THE VIOLATION. IF THE 1,213
EMPLOYER DOES NOT CORRECT THE VIOLATION OR MAKE A REASONABLE AND 1,214
GOOD FAITH EFFORT TO CORRECT THE VIOLATION WITHIN TWENTY-FOUR 1,215
28
HOURS AFTER THE ORAL NOTIFICATION WAS MADE, THE NURSE MAY NOTIFY 1,216
DIRECTLY, EITHER ORALLY OR IN WRITING, THE AGENCY RESPONSIBLE FOR 1,217
ENFORCING THE STATUTE OR RULE. 1,218
(b) IF A NURSE MAKES A REPORT UNDER DIVISION (A)(3)(a) OF 1,222
THIS SECTION, THE EMPLOYER, WITHIN TWENTY-FOUR HOURS AFTER THE
ORAL NOTIFICATION WAS MADE OR BY THE CLOSE OF BUSINESS ON THE 1,224
NEXT REGULAR BUSINESS DAY FOLLOWING THE DAY ON WHICH THE ORAL 1,225
NOTIFICATION WAS MADE, WHICHEVER IS LATER, SHALL NOTIFY THE 1,226
NURSE, IN WRITING, OF ANY EFFORT OF THE EMPLOYER TO CORRECT THE 1,227
ALLEGED VIOLATION OR OF THE ABSENCE OF THE ALLEGED VIOLATION. 1,228
(4) If an employee becomes aware in the course of the 1,230
employee's employment of a violation by a fellow employee of any 1,231
state or federal statute, any ordinance or regulation of a 1,232
political subdivision, or any work rule or company policy of the 1,233
employee's employer and if the employee reasonably believes that 1,234
the violation either is a criminal offense that is likely to 1,235
cause an imminent risk of physical harm to persons or a hazard to 1,236
public health or safety or is a felony, the employee orally shall 1,237
notify the employee's supervisor or other responsible officer of 1,238
the employee's employer of the violation and subsequently shall 1,239
file with that supervisor or officer a written report that 1,240
provides sufficient detail to identify and describe the 1,241
violation.
(B) Except as otherwise provided in division (C) of this 1,243
section, no employer shall take any disciplinary or retaliatory 1,244
action against an employee for making any report authorized by 1,245
division (A)(1) or, (2), OR (3) of this section or as a result of 1,247
the employee's having made any inquiry or taken any other action 1,248
to ensure the accuracy of any information reported under either 1,249
of those divisions. No employer shall take any disciplinary or 1,251
retaliatory action against an employee for making any report 1,252
authorized by division (A)(3)(4) of this section if the employee 1,253
made a reasonable and good faith effort to determine the accuracy 1,255
of any information so reported, or as a result of the employee's 1,256
29
having made any inquiry or taken any other action to ensure the 1,257
accuracy of any information reported under that division. For 1,258
purposes of this division, disciplinary or retaliatory action by 1,259
the employer includes, but is not limited to, doing any of the 1,261
following:
(1) Removing or suspending the employee from employment; 1,263
(2) Withholding from the employee salary increases or 1,265
employee benefits to which the employee otherwise is entitled; 1,267
(3) Transferring or reassigning the employee; 1,269
(4) Denying the employee a promotion that otherwise would 1,271
have been received; 1,272
(5) Reducing the employee in pay or position. 1,274
(C) An employee shall make a reasonable and good faith 1,276
effort to determine the accuracy of any information reported 1,277
under division (A)(1) or, (2), OR (3) of this section. If the 1,279
employee who makes a report under either ANY of those divisions 1,280
fails to make an effort of that nature, the employee may be 1,281
subject to disciplinary action by the employee's employer, 1,282
including suspension or removal, for reporting information 1,283
without a reasonable basis to do so under division (A)(1) or, 1,285
(2), OR (3) of this section. 1,286
(D) If an employer takes any disciplinary or retaliatory 1,288
action against an employee as a result of the employee's having 1,289
filed a report under division (A) of this section, the employee 1,290
may bring a civil action for appropriate injunctive relief or for 1,291
the remedies set forth in division (E) of this section, or both, 1,292
within one hundred eighty days after the date the disciplinary or 1,293
retaliatory action was taken, in a court of common pleas in 1,294
accordance with the Rules of Civil Procedure. A civil action 1,295
under this division is not available to an employee as a remedy 1,296
for any disciplinary or retaliatory action taken by an appointing 1,297
authority against the employee as a result of the employee's 1,298
having filed a report under division (A) of section 124.341 of 1,299
the Revised Code. 1,300
30
(E) The court, in rendering a judgment for the employee in 1,302
an action brought pursuant to division (D) of this section, may 1,303
order, as it determines appropriate, reinstatement of the 1,304
employee to the same position that the employee held at the time 1,305
of the disciplinary or retaliatory action and at the same site of 1,306
employment or to a comparable position at that site, the payment 1,307
of back wages, full reinstatement of fringe benefits and 1,308
seniority rights, or any combination of these remedies. The 1,309
court also may award the prevailing party all or a portion of the 1,310
costs of litigation and, if the employee who brought the action 1,311
prevails in the action, may award the prevailing employee 1,312
reasonable attorney's fees, witness fees, and fees for experts 1,313
who testify at trial, in an amount the court determines 1,314
appropriate. If the court determines that an employer 1,315
deliberately has violated division (B) of this section, the 1,316
court, in making an award of back pay, may include interest at 1,317
the rate specified in division (A) of section 1343.03 of the 1,318
Revised Code. 1,319
(F) Any report filed with the inspector general under this 1,321
section shall be filed as a complaint in accordance with section 1,322
121.46 of the Revised Code. 1,323
Sec. 4723.02 4723.01. As used in this chapter: 1,332
(A) "Registered nurse" means an individual who holds a 1,334
current, valid license issued under this chapter that authorizes 1,335
the practice of nursing as a registered nurse. 1,336
(B)(1) "Practice of nursing as a registered nurse" means 1,338
providing to individuals and groups nursing care requiring 1,339
specialized knowledge, judgment, and skill derived from the 1,340
principles of biological, physical, behavioral, social, and 1,341
nursing sciences. Such nursing care includes: 1,342
(1)(a) Identifying patterns of human responses to actual 1,344
or potential health problems amenable to a nursing regimen; 1,345
(2)(b) Executing a nursing regimen through the selection, 1,347
performance, management, and evaluation of nursing actions; 1,348
31
(3)(c) Assessing health status for the purpose of 1,350
providing nursing care; 1,351
(4)(d) Providing health counseling and health teaching; 1,353
(5)(e) Administering medications, treatments, and 1,355
executing regimens prescribed by licensed physicians; dentists; 1,357
optometrists; podiatrists; or, until January 1, 2010, advanced 1,359
practice nurses authorized to prescribe under section 4723.56 of 1,360
the Revised Code AUTHORIZED BY AN INDIVIDUAL WHO IS AUTHORIZED TO 1,361
PRACTICE IN THIS STATE AND IS ACTING WITHIN THE COURSE OF THE
INDIVIDUAL'S PROFESSIONAL PRACTICE; 1,362
(6)(f) Teaching, administering, supervising, delegating, 1,364
and evaluating nursing practice. 1,365
(2) "PRACTICE OF NURSING AS A REGISTERED NURSE" INCLUDES 1,367
PROVIDING THE NURSING CARE SPECIFIED IN DIVISION (A)(1) OF THIS 1,368
SECTION THROUGH ELECTRONIC COMMUNICATION. 1,369
(C) "Nursing regimen" may include preventative, 1,371
restorative, and health-promotion activities. 1,372
(D) "Assessing health status" means the collection of data 1,374
through nursing assessment techniques, which may include 1,375
interviews, observation, and physical evaluations for the purpose 1,376
of providing nursing care. 1,377
(E) "Licensed practical nurse" means an individual who 1,379
holds a current, valid license issued under this chapter that 1,380
authorizes the practice of nursing as a licensed practical nurse. 1,381
(F)(1) "The practice of nursing as a licensed practical 1,383
nurse" means providing to individuals and groups nursing care 1,384
requiring the application of basic knowledge of the biological, 1,385
physical, behavioral, social, and nursing sciences at the 1,386
direction of a licensed physician, dentist, podiatrist, 1,387
optometrist, or registered nurse AUTHORIZED BY AN INDIVIDUAL WHO 1,388
IS AUTHORIZED TO PRACTICE IN THIS STATE AND IS ACTING WITHIN THE 1,389
COURSE OF THE INDIVIDUAL'S PROFESSIONAL PRACTICE. Such nursing 1,390
care includes:
(1)(a) Observation, patient teaching, and care in a 1,392
32
diversity of health care settings; 1,393
(2)(b) Contributions to the planning, implementation, and 1,395
evaluation of nursing; 1,396
(3)(c) Administration of medications and treatments 1,398
prescribed by a licensed physician; dentist; optometrist; 1,400
podiatrist; or, until January 1, 2010, an advanced practice nurse 1,402
authorized to prescribe under section 4723.56 of the Revised Code 1,403
AUTHORIZED BY AN INDIVIDUAL WHO IS AUTHORIZED TO PRACTICE IN THIS 1,404
STATE AND IS ACTING WITHIN THE COURSE OF THE INDIVIDUAL'S 1,405
PROFESSIONAL PRACTICE, except that administration of intravenous 1,406
therapy shall be performed only in accordance with section
4723.48 4723.17 of the Revised Code. Medications may be 1,408
administered by a licensed practical nurse upon proof of 1,409
completion of a course in medication administration approved by 1,410
the board of nursing.
(4)(d) Administration to an adult of intravenous therapy 1,412
prescribed by a licensed physician; dentist; optometrist; 1,413
podiatrist; or, until January 1, 2010, an advanced practice nurse 1,414
authorized to prescribe under section 4723.56 of the Revised Code 1,416
AUTHORIZED BY AN INDIVIDUAL WHO IS AUTHORIZED TO PRACTICE IN THIS
STATE AND IS ACTING WITHIN THE COURSE OF THE INDIVIDUAL'S 1,417
PROFESSIONAL PRACTICE, on the condition that the licensed 1,418
practical nurse is authorized by the board of nursing pursuant to 1,419
section 4723.48 4723.17 of the Revised Code to perform 1,420
intravenous therapy and performs intravenous therapy only in 1,422
accordance with section 4723.48 4723.17 of the Revised Code. 1,423
(2) "PRACTICE OF NURSING AS A LICENSED PRACTICAL NURSE" 1,425
INCLUDES PROVIDING THE NURSING CARE SPECIFIED IN DIVISION (F)(1) 1,426
OF THIS SECTION THROUGH ELECTRONIC COMMUNICATION. 1,427
(G) "Certified registered nurse anesthetist" means a 1,430
registered nurse who holds a valid certificate of authority 1,431
issued under this chapter that authorizes the practice of nursing 1,432
as a certified registered nurse anesthetist in accordance with 1,433
section 4723.43 of the Revised Code and rules adopted by the 1,434
33
board of nursing. 1,435
(H) "Clinical nurse specialist" means a registered nurse 1,438
who holds a valid certificate of authority issued under this 1,439
chapter that authorizes the practice of nursing as a clinical 1,440
nurse specialist in accordance with section 4723.43 of the 1,441
Revised Code and rules adopted by the board of nursing. 1,442
(I) "Certified nurse-midwife" means a registered nurse who 1,444
holds a valid certificate of authority issued under this chapter 1,445
that authorizes the practice of nursing as a certified 1,446
nurse-midwife in accordance with section 4723.43 of the Revised 1,447
Code and rules adopted by the board of nursing. 1,448
(J) "Certified nurse practitioner" means a registered 1,450
nurse who holds a valid certificate of authority issued under 1,451
this chapter that authorizes the practice of nursing as a 1,452
certified nurse practitioner in accordance with section 4723.43 1,453
of the Revised Code and rules adopted by the board of nursing. 1,455
(K) "Physician" means an individual who holds a 1,458
certificate issued AUTHORIZED under Chapter 4731. of the Revised 1,459
Code authorizing the TO practice of medicine and surgery or 1,461
osteopathic medicine and surgery and is practicing in this state. 1,462
(L) "Dentist" means an individual who is licensed under 1,465
Chapter 4715. of the Revised Code to practice dentistry and is 1,466
practicing in this state. 1,467
(M) "Podiatrist" means an individual who holds a 1,470
certificate issued AUTHORIZED under Chapter 4731. of the Revised 1,471
Code authorizing the TO practice of podiatry and is practicing in 1,472
this state.
(N) "Collaboration" or "collaborating," EXCEPT AS IT 1,474
PERTAINS TO AN ADVANCED PRACTICE NURSE, means the following: 1,475
(1) In the case of a clinical nurse specialist, except as 1,478
provided in division (N)(3) of this section, or a certified nurse
practitioner, that a podiatrist ONE OR MORE PODIATRISTS acting 1,479
within the podiatrist's scope of practice in accordance with 1,481
SPECIFIED IN section 4731.51 of the Revised Code and with whom 1,482
34
the nurse has entered into a standard care arrangement or 1,483
physician ONE OR MORE PHYSICIANS with whom the nurse has entered 1,484
into a standard care arrangement is continuously available to 1,486
communicate with the clinical nurse specialist or certified nurse 1,487
practitioner either in person or by radio, telephone, or other 1,488
form of telecommunication;
(2) In the case of a certified nurse-midwife, that a 1,490
physician ONE OR MORE PHYSICIANS with whom the certified 1,491
nurse-midwife has entered into a standard care arrangement is 1,492
continuously available to communicate with the certified 1,493
nurse-midwife either in person or by radio, telephone, or other 1,494
form of telecommunication; 1,495
(3) In the case of a clinical nurse specialist whose 1,497
nursing specialty is mental health or psychiatric mental health, 1,498
that a physician ONE OR MORE PHYSICIANS is continuously available 1,500
to communicate with the nurse either in person or by radio,
telephone, or other form of telecommunication. 1,501
(O) "Supervision," AS IT PERTAINS TO A CERTIFIED 1,503
REGISTERED NURSE ANESTHETIST, means that a THE certified 1,504
registered nurse anesthetist is under the direction of a 1,505
podiatrist acting within the podiatrist's scope of practice in 1,506
accordance with section 4731.51 of the Revised Code, a dentist 1,508
acting within the dentist's scope of practice in accordance with 1,509
Chapter 4715. of the Revised Code, or a physician, and, when 1,511
administering anesthesia, the certified registered nurse 1,512
anesthetist is in the immediate presence of the podiatrist, 1,513
dentist, or physician.
(P) "Standard care arrangement," EXCEPT AS IT PERTAINS TO 1,515
AN ADVANCED PRACTICE NURSE, means a written, formal guide for 1,517
planning and evaluating a patient's health care that is developed 1,518
by a collaborating physician or podiatrist and a clinical nurse
specialist, certified nurse-midwife, or certified nurse 1,519
practitioner and meets the requirements of section 4723.431 of 1,520
the Revised Code. 1,521
35
(Q) "ADVANCED PRACTICE NURSE," UNTIL JANUARY 1, 2010, 1,523
MEANS A REGISTERED NURSE WHO HAS BEEN APPROVED BY THE BOARD OF 1,524
NURSING TO PARTICIPATE IN THE PILOT PROGRAMS ESTABLISHED UNDER 1,525
SECTION 4723.52 OF THE REVISED CODE.
Sec. 4723.04 4723.02. The state nurses' board shall be 1,534
known as the board of nursing. The board shall assume and 1,536
exercise all the powers and perform all the duties conferred and 1,537
imposed on it by this chapter concerning nurses and nursing and 1,538
the regulation thereof. The 1,539
THE board shall consist of thirteen members who shall be 1,542
citizens of the United States and residents of Ohio. Eight
members shall be registered nurses, each of whom shall be a 1,543
graduate of an approved program of nursing education that 1,544
prepares persons for licensure as a registered nurse, shall hold 1,545
a currently active license issued under this chapter to practice 1,546
nursing as a registered nurse, and shall have been actively 1,547
engaged in the practice of nursing as a registered nurse for the 1,548
five years immediately preceding the member's initial appointment 1,549
to the board. Four members shall be licensed practical nurses, 1,550
each of whom shall be a graduate of an approved program of 1,551
nursing education that prepares persons for licensure as a 1,552
practical nurse, shall hold a currently active license issued 1,553
under this chapter to practice nursing as a licensed practical 1,554
nurse, and shall have been actively engaged in the practice of 1,555
nursing as a licensed practical nurse for the five years 1,556
immediately preceding the member's initial appointment to the 1,557
board. One member shall represent the interests of consumers of 1,558
health care. Neither this member nor any person in the member's 1,559
immediate family shall be a member of or associated with a health 1,560
care provider or profession or shall have a financial interest in 1,561
the delivery or financing of health care. Representation of 1,562
nursing service and nursing education and of the various 1,563
geographical areas of the state shall be considered in making 1,564
appointments. As 1,565
36
AS the term of any member of the board expires, a successor 1,568
shall be appointed who has the qualifications the vacancy 1,569
requires. Terms of office shall be for five FOUR years,
commencing on the first day of January and ending on the 1,570
thirty-first day of December. Each 1,571
A CURRENT OR FORMER BOARD MEMBER WHO HAS SERVED NOT MORE 1,573
THAN ONE FULL TERM OR ONE FULL TERM AND NOT MORE THAN THIRTY 1,574
MONTHS OF ANOTHER TERM MAY BE REAPPOINTED FOR ONE ADDITIONAL 1,575
TERM.
EACH member shall hold office from the date of appointment 1,578
until the end of the term for which the member was appointed. 1,579
The term of a member shall expire if the member ceases to meet 1,580
any requirement of this section for the member's position on the 1,581
board. Any member appointed to fill a vacancy occurring prior to 1,582
the expiration of the term for which her THE MEMBER'S predecessor 1,583
was appointed shall hold office for the remainder of such term. 1,585
A person who has served a full term on the board or more than 1,586
thirty months of the remainder of the term of a predecessor shall 1,587
not be eligible for a subsequent appointment to the board. Any 1,588
member shall continue in office subsequent to the expiration date 1,589
of her THE MEMBER'S term until her THE MEMBER'S successor takes 1,590
office, or until a period of sixty days has elapsed, whichever 1,591
occurs first. Nursing 1,592
NURSING organizations of this state may each submit to the 1,594
governor the names of not more than five nominees for each 1,595
position to be filled on the board. From the names so submitted 1,596
or from others, at his THE GOVERNOR'S discretion, the governor 1,597
with the advice and consent of the senate shall make such 1,599
appointments.
Any member of the board may be removed by the governor for 1,601
neglect of any duty required by law or for incompetency or 1,602
unprofessional or dishonorable conduct, after a hearing as 1,603
provided in Chapter 119. of the Revised Code. Seven 1,604
SEVEN members of the board including at least four 1,607
37
registered nurses and at least one licensed practical nurse shall 1,608
at all times constitute a quorum. NO ACTION OF THE BOARD IS 1,609
VALID WITHOUT THE CONCURRENCE OF AT LEAST A QUORUM. 1,610
Each member of the board shall receive an amount fixed 1,612
pursuant to division (J) of section 124.15 of the Revised Code 1,613
for each day in attendance at board meetings and in discharge of 1,614
official duties, and in addition thereto, necessary expense 1,615
incurred in the performance of such duties. 1,616
The board shall elect one of its nurse members as president 1,618
and one as vice-president. THE BOARD SHALL ELECT ONE OF ITS 1,619
REGISTERED NURSE MEMBERS TO SERVE AS THE SUPERVISING MEMBER FOR 1,620
DISCIPLINARY MATTERS.
The board may establish advisory groups to serve in 1,622
consultation with the board or the executive director. Each 1,623
advisory group shall be given a specific charge in writing and 1,624
shall report to the board. Members of advisory groups shall 1,625
serve without compensation but shall receive their actual and 1,626
necessary expenses incurred in the performance of their official 1,627
duties. 1,628
Sec. 4723.021. IN THE ABSENCE OF FRAUD OR BAD FAITH, THE 1,631
BOARD OF NURSING, A CURRENT OR FORMER BOARD MEMBER, AN AGENT OF
THE BOARD, A REPRESENTATIVE OF THE BOARD, OR AN EMPLOYEE OF THE 1,633
BOARD SHALL NOT BE HELD LIABLE IN DAMAGES TO ANY PERSON AS THE 1,634
RESULT OF ANY ACT, OMISSION, PROCEEDING, CONDUCT, OR DECISION 1,635
RELATED TO OFFICIAL DUTIES UNDERTAKEN OR PERFORMED PURSUANT TO 1,636
THIS CHAPTER. IF A CURRENT OR FORMER BOARD MEMBER OR AGENT, 1,637
REPRESENTATIVE, OR EMPLOYEE OF THE BOARD ASKS TO BE DEFENDED BY 1,638
THE STATE AGAINST ANY CLAIM OR ACTION ARISING OUT OF ANY ACT, 1,640
OMISSION, PROCEEDING, CONDUCT, OR DECISION RELATED TO THE 1,641
PERSON'S OFFICIAL DUTIES, AND THE REQUEST IS MADE IN WRITING AT A 1,642
REASONABLE TIME BEFORE TRIAL AND THE PERSON REQUESTING DEFENSE 1,643
COOPERATES IN GOOD FAITH IN THE DEFENSE OF THE CLAIM OR ACTION, 1,644
THE STATE SHALL PROVIDE AND PAY FOR THE PERSON'S DEFENSE AND 1,645
SHALL PAY ANY RESULTING JUDGMENT, COMPROMISE, OR SETTLEMENT. AT 1,646
38
NO TIME SHALL THE STATE PAY ANY PART OF A CLAIM OR JUDGMENT THAT 1,647
IS FOR PUNITIVE OR EXEMPLARY DAMAGES.
Sec. 4723.06. (A) The board of nursing shall: 1,656
(1) Administer and enforce the provisions of this chapter, 1,658
including the taking of disciplinary action for violations of 1,659
section 4723.28 of the Revised Code, any other provisions of this 1,660
chapter, or rules promulgated ADOPTED under Chapter 119. of the 1,662
Revised Code THIS CHAPTER;
(2) Examine applicants DEVELOP CRITERIA THAT AN APPLICANT 1,664
MUST MEET TO BE ELIGIBLE TO SIT FOR THE EXAMINATION for licensure 1,665
to practice as a registered nurse or as a licensed practical 1,668
nurse;
(3) Issue and renew licenses as provided in this chapter; 1,670
(4) Define the minimum curricula and standards for 1,672
educational programs of the schools of professional nursing and 1,673
schools of practical nursing in this state; 1,674
(5) Survey, inspect, and grant full approval to 1,676
prelicensure nursing education programs that meet the standards 1,678
established by rules adopted under section 4723.07 of the Revised 1,679
Code. Prelicensure nursing education programs include, but are 1,680
not limited to, associate degree, baccalaureate degree, diploma, 1,681
and doctor of nursing programs leading to initial licensure to 1,682
practice nursing as a registered nurse and practical nurse 1,683
programs leading to initial licensure to practice nursing as a 1,684
licensed practical nurse.
(6) Grant conditional approval, by a vote of a quorum of 1,686
the board, to a new prelicensure nursing education program or a 1,687
program that is being reestablished after having ceased to 1,689
operate, if the program meets and maintains the minimum standards 1,691
of the board established by rules adopted under section 4723.07 1,692
of the Revised Code. If the board does not grant conditional 1,693
approval, it shall hold a hearing AN ADJUDICATION under Chapter 1,694
119. of the Revised Code to consider conditional approval of the 1,696
program. If the board grants conditional approval, at its first 1,697
39
meeting after the first class has completed the program, the 1,698
board shall determine whether to grant full approval to the 1,699
program. If the board does not grant full approval or if it 1,701
appears that the program has failed to meet and maintain 1,702
standards established by rules adopted under section 4723.07 of 1,703
the Revised Code, the board shall hold a hearing AN ADJUDICATION 1,704
under Chapter 119. of the Revised Code to consider the program. 1,706
Based on results of the hearing ADJUDICATION, the board may 1,707
continue or withdraw conditional approval, or grant full 1,709
approval.
(7) Place on provisional approval, for a period of time 1,711
specified by the board, a program that has ceased to meet and 1,713
maintain the minimum standards of the board established by rules 1,714
adopted under section 4723.07 of the Revised Code. At the end of 1,715
the period, the board shall reconsider whether the program meets 1,716
the standards and shall grant full approval if it does. If it 1,718
does not, the board may withdraw approval, pursuant to a hearing 1,719
AN ADJUDICATION under Chapter 119. of the Revised Code. 1,721
(8) Approve continuing nursing education programs and 1,723
courses under standards established in rules adopted under 1,724
section 4723.07 of the Revised Code; 1,725
(9) Approve peer support programs for nurses under rules 1,727
adopted under section 4723.07 of the Revised Code; 1,728
(10) Establish the alternative program for chemically 1,730
dependent nurses A PROGRAM FOR MONITORING CHEMICAL DEPENDENCY in 1,731
accordance with section 4723.35 of the Revised Code; 1,732
(11) Establish the practice intervention and improvement 1,734
program in accordance with section 4723.282 of the Revised Code; 1,735
(12) Issue and renew certificates of authority to practice 1,737
nursing as a certified registered nurse anesthetist, clinical 1,739
nurse specialist, certified nurse-midwife, or certified nurse 1,740
practitioner;
(13) Approve under section 4723.46 of the Revised Code 1,743
national certifying organizations for examination and 1,744
40
certification of certified registered nurse anesthetists, 1,745
clinical nurse specialists, certified nurse-midwives, or 1,746
certified nurse practitioners;
(14) PROVIDE GUIDANCE AND MAKE RECOMMENDATIONS TO THE 1,748
GENERAL ASSEMBLY, THE GOVERNOR, STATE AGENCIES, AND THE FEDERAL 1,749
GOVERNMENT WITH RESPECT TO THE PRACTICE OF NURSING; 1,750
(15) Make an annual report to the governor, which shall be 1,753
open for public inspection; 1,754
(15)(16) Maintain and have open for public inspection the 1,756
following records: 1,757
(a) A record of all its meetings and proceedings; 1,759
(b) A file of applicants for and holders of licenses, 1,761
registrations, and certificates granted under this chapter. The 1,762
file shall be maintained in the form prescribed by rule of the 1,763
board. 1,764
(c) A list of prelicensure nursing education programs 1,766
approved by the board; 1,767
(d) A list of approved peer support programs for nurses. 1,769
(B) The board may fulfill the requirement of division 1,771
(A)(8) of this section by authorizing persons who meet the 1,772
standards established in rules adopted under division (F) of 1,773
section 4723.07 of the Revised Code to approve continuing nursing 1,774
education programs and courses. Persons so authorized shall 1,775
approve continuing nursing education programs and courses in 1,776
accordance with standards established in rules adopted under 1,777
division (E) of section 4723.07 of the Revised Code. 1,778
Persons seeking authorization to approve continuing nursing 1,780
education programs and courses shall apply to the board and pay 1,781
the appropriate fee established under section 4723.08 of the 1,782
Revised Code. Authorizations to approve continuing nursing 1,783
education programs and courses shall expire at the end of the 1,784
two-year period beginning the date of issuance, and may be 1,785
renewed by the board, ACCORDING TO THE SCHEDULE ESTABLISHED IN 1,786
RULES ADOPTED UNDER SECTION 4723.07 OF THE REVISED CODE. 1,787
41
Sec. 4723.061. The THIS CHAPTER DOES NOT REQUIRE THE board 1,796
of nursing may enter into agreements with the director of health 1,798
under section 3721.34 of the Revised Code to assist the director 1,799
in implementing sections 3721.28 to 3721.34 of the Revised Code.
Any money received by the board from the department of health 1,800
pursuant to such agreements shall be deposited in the nurse aide 1,801
fund, which is hereby created in the state treasury. The board 1,802
shall use the fund to pay the costs it incurs in carrying out 1,804
such agreements TO ACT ON MINOR VIOLATIONS OF THIS CHAPTER OR THE 1,805
RULES ADOPTED UNDER IT, IF THE VIOLATIONS ARE COMMITTED BY
INDIVIDUALS LICENSED UNDER THIS CHAPTER AND THE BOARD DETERMINES 1,806
THAT THE PUBLIC IS ADEQUATELY PROTECTED BY ISSUING A NOTICE OR 1,807
WARNING TO THE ALLEGED OFFENDER. 1,808
Sec. 4723.07. In accordance with Chapter 119. of the 1,817
Revised Code, the board of nursing shall adopt and may amend and 1,818
rescind rules THAT ESTABLISH ALL OF THE FOLLOWING: 1,819
(A) Providing PROVISIONS for its THE BOARD'S government 1,822
and control of its actions and business affairs; 1,823
(B) Establishing minimum MINIMUM curricula and standards 1,825
for nursing education programs that prepare graduates to take 1,826
licensing examinations, BE LICENSED UNDER THIS CHAPTER and 1,827
establishing procedures for granting, renewing, and withdrawing 1,830
approval of those programs;
(C) Establishing requirements CRITERIA that applicants for 1,832
licensure must meet to be permitted ELIGIBLE to take licensing 1,834
examinations; 1,835
(D) Governing the administration and conduct of 1,837
examinations for licensure to practice nursing as a registered 1,839
nurse or as a licensed practical nurse; 1,840
(D) STANDARDS AND PROCEDURES FOR RENEWAL OF THE LICENSES 1,842
AND CERTIFICATES OF AUTHORITY ISSUED BY THE BOARD; 1,843
(E) Establishing standards STANDARDS for approval of 1,845
continuing nursing education programs and courses for registered 1,846
nurses, licensed practical nurses, certified registered nurse 1,847
42
anesthetists, clinical nurse specialists, certified 1,848
nurse-midwives, and certified nurse practitioners. The standards 1,849
may provide for approval of continuing nursing education programs 1,850
and courses that have been approved by other state boards of 1,851
nursing or by national accreditation systems for nursing, 1,852
including, but not limited to, the American nurses' credentialing 1,853
center and the national association for practical nurse education 1,854
and service.
(F) Establishing standards STANDARDS that persons must 1,856
meet to be authorized by the board to approve continuing nursing 1,858
education programs and courses and a schedule to have BY WHICH 1,859
that authorization EXPIRES AND MAY BE renewed; 1,860
(G) Establishing requirements REQUIREMENTS, including 1,862
continuing education requirements, for restoring inactive 1,864
licenses and licenses that have lapsed through failure to renew; 1,865
(H) Governing conditions CONDITIONS that may be imposed 1,867
for reinstatement following action taken under sections 2301.373, 1,868
4723.28, and 4723.281 of the Revised Code resulting in a 1,869
suspension from practice; 1,871
(I) Establishing standards STANDARDS for approval of peer 1,873
support programs for nurses; 1,875
(J) Establishing requirements REQUIREMENTS for board 1,877
approval of courses in medication administration by licensed 1,878
practical nurses; 1,879
(K) Establishing criteria for specialty certification of 1,882
registered nurses; 1,883
(L) Establishing criteria CRITERIA for evaluating the 1,885
qualifications of an applicant who is applying for a license by 1,888
endorsement to practice nursing as a registered nurse or licensed
practical nurse or for a certificate of authority issued under 1,889
division (E) of section 4723.41 of the Revised Code; 1,890
(M) Establishing universal (L) UNIVERSAL blood and body 1,893
fluid precautions that shall be used by each person licensed 1,894
under this chapter who performs exposure-prone invasive 1,895
43
procedures. The rules shall define and establish requirements 1,896
for universal blood and body fluid precautions that include the 1,897
following:
(1) Appropriate use of hand washing; 1,899
(2) Disinfection and sterilization of equipment; 1,901
(3) Handling and disposal of needles and other sharp 1,903
instruments; 1,904
(4) Wearing and disposal of gloves and other protective 1,906
garments and devices. 1,907
(N) Establishing standards (M) STANDARDS and procedures 1,910
for approving certificates of authority to practice nursing as a 1,911
certified registered nurse anesthetist, clinical nurse 1,912
specialist, certified nurse-midwife, or certified nurse 1,913
practitioner, and for renewal of those certificates; 1,914
(O) Establishing quality (N) QUALITY assurance standards 1,917
for certified registered nurse anesthetists, clinical nurse
specialists, certified nurse-midwives, or certified nurse 1,918
practitioners;
(P) Establishing additional (O) ADDITIONAL criteria for 1,921
the standard care arrangement required by section 4723.431 of the
Revised Code entered into by a clinical nurse specialist, 1,923
certified nurse-midwife, or certified nurse practitioner and the 1,924
nurse's collaborating physician or podiatrist; 1,925
(Q) Establishing continuing (P) CONTINUING education 1,927
standards for clinical nurse specialists who are exempt under 1,928
division (C) of section 4723.41 of the Revised Code from the 1,931
requirement of having passed a certification examination;
(Q) FOR PURPOSES OF DIVISION (B)(26) OF SECTION 4723.28 OF 1,934
THE REVISED CODE, THE ACTIONS, OMISSIONS, OR OTHER CIRCUMSTANCES
THAT CONSTITUTE A NURSE'S FAILURE TO ESTABLISH AND MAINTAIN 1,935
PROFESSIONAL BOUNDARIES WITH A PATIENT.
Subject to Chapter 119. of the Revised Code, the THE board 1,937
may adopt other rules necessary to carry out the provisions of 1,938
this chapter. THE RULES SHALL BE ADOPTED IN ACCORDANCE WITH 1,939
44
CHAPTER 119. OF THE REVISED CODE. 1,940
Sec. 4723.08. (A) The board of nursing may impose fees 1,949
not to exceed the following limits: 1,950
(1) For application for licensure by examination to 1,952
practice nursing as a registered nurse or as a licensed practical 1,953
nurse, fifty dollars; 1,954
(2) For application for licensure by endorsement to 1,956
practice nursing as a registered nurse or as a licensed practical 1,957
nurse, fifty dollars; 1,958
(3) For application for a certificate of authority to 1,960
practice nursing as a certified registered nurse anesthetist, 1,961
clinical nurse specialist, certified nurse-midwife, or certified 1,963
nurse practitioner, one hundred dollars; 1,964
(4) For verification of a license or certificate to 1,966
another jurisdiction, fifteen dollars; 1,968
(5) For providing a replacement copy of a license or 1,970
certificate, fifteen dollars; 1,971
(6) For biennial renewal of any license, thirty-five 1,973
dollars;
(7) For biennial renewal of a certificate of authority to 1,975
practice nursing as a certified registered nurse anesthetist, 1,976
clinical nurse specialist, certified nurse-midwife, or certified 1,978
nurse practitioner, one hundred EIGHTY-FIVE dollars; 1,979
(8) For processing a late application for renewal of any 1,981
license or certificate, fifty dollars; 1,982
(9) For application for authorization to approve 1,984
continuing nursing education programs and courses from an 1,985
applicant accredited by a national accreditation system for 1,986
nursing, five hundred dollars; 1,987
(10) For application for authorization to approve 1,989
continuing nursing education programs and courses from an 1,990
applicant not accredited by a national accreditation system for 1,991
nursing, one thousand dollars; 1,992
(11) For each year for which authorization to approve 1,995
45
continuing nursing education programs and courses is renewed, one 1,998
hundred fifty dollars;
(12) FOR REINSTATEMENT OF A LAPSED LICENSE OR CERTIFICATE, 2,000
ONE HUNDRED DOLLARS; 2,001
(13) FOR APPLICATION FOR APPROVAL TO PRACTICE AS AN 2,003
ADVANCED PRACTICE NURSE, FIFTY DOLLARS; 2,004
(14) FOR BIENNIAL RENEWAL OF APPROVAL TO PRACTICE AS AN 2,006
ADVANCED PRACTICE NURSE, FIFTY DOLLARS; 2,007
(15) For written verification of a license or certificate, 2,010
other than verification to another jurisdiction, five dollars. 2,011
The board may contract for services pertaining to this 2,012
verification process and the collection of the fee, and may 2,013
permit the contractor to retain a portion of the fees as 2,014
compensation, before any amounts are deposited into the state 2,015
treasury. 2,016
(B) Each quarter, FOR PURPOSES OF TRANSFERRING FUNDS UNDER 2,018
SECTION 4743.05 OF THE REVISED CODE TO THE NURSE EDUCATION 2,019
ASSISTANCE FUND CREATED IN SECTION 3333.28 OF THE REVISED CODE, 2,020
the board of nursing shall certify to the director of budget and 2,021
management the number of biennial licenses renewed under this 2,022
chapter during the preceding quarter and the amount equal to that 2,023
number times five dollars.
Sec. 4723.39 4723.081. The board of nursing, subject to 2,032
the approval of the controlling board, may establish fees in 2,035
excess of the amounts provided by section 4723.08 of the Revised 2,036
Code, provided that such fees do not exceed those amounts by more 2,037
than fifty per cent.
Sec. 4723.31 4723.082. Except as provided in division 2,046
(A)(4) of section 3721.34 and section 4723.061 of the Revised 2,048
Code, all ALL receipts of the board of nursing, from any source, 2,050
shall be deposited in the state treasury to the credit of the
occupational licensing and regulatory fund. All vouchers of the 2,051
board shall be approved by the board president or executive 2,052
director, or both, as authorized by the board. 2,053
46
Sec. 4723.09. (A) An application for licensure by 2,062
examination to practice as a registered nurse or as a licensed 2,063
practical nurse shall be submitted to the board of nursing in the 2,064
form prescribed by rules of the board. The application shall 2,065
include evidence that the applicant has completed requirements of 2,066
a nursing education program approved by the board or approved by 2,067
another jurisdiction's board that regulates nurse licensure. The 2,068
application also shall include any other information required by 2,070
rules of the board. The application shall be accompanied by the 2,071
application fee required by section 4723.08 of the Revised Code. 2,072
If the board determines that the applicant meets the requirements 2,073
to take the examination, it shall admit the applicant to the 2,074
examination. 2,075
The board shall grant a license to practice nursing as a 2,077
registered nurse or as a licensed practical nurse if the 2,078
applicant passes the examination ACCEPTED BY THE BOARD UNDER 2,079
SECTION 4723.10 OF THE REVISED CODE and the board determines that 2,080
the applicant has not committed any act that is grounds for 2,081
disciplinary action under section 2301.373 or 4723.28 of the 2,082
Revised Code, or determines that an applicant who has committed 2,083
such acts has made restitution or has been rehabilitated, or 2,084
both. The board is not required to afford a hearing AN 2,085
ADJUDICATION to an individual to whom it has refused to grant a 2,088
license because of that individual's failure to pass the 2,089
examination. 2,090
(B) An application for license by endorsement to practice 2,092
nursing as a registered nurse or as a licensed practical nurse 2,093
shall be submitted to the board in the form prescribed by rules 2,094
of the board and shall be accompanied by the application fee 2,095
required by section 4723.08 of the Revised Code. The application 2,096
shall include evidence that the applicant holds a license in good 2,097
standing in another jurisdiction granted after passing an 2,098
examination approved by the board of that jurisdiction that is 2,099
equivalent to the examination requirements under this chapter for 2,100
47
a license to practice nursing as a registered nurse or licensed 2,101
practical nurse, and shall include other information required by 2,103
rules of the board of nursing. The board shall grant a license 2,104
by endorsement if the applicant is licensed or certified by 2,105
another jurisdiction and the board determines, pursuant to rules 2,106
established under section 4723.07 of the Revised Code, that all 2,107
of the following apply:
(1) The educational preparation of the applicant is 2,109
substantially similar to the minimum curricula and standards for 2,110
nursing education programs established by the board under section 2,111
4723.07 of the Revised Code;
(2) The examination, at the time it is successfully 2,113
completed, is equivalent to the examination requirements in 2,114
effect at that time for applicants who successfully completed the 2,115
WERE LICENSED BY examination in this state; 2,116
(3) The applicant has not committed any act that is 2,118
grounds for disciplinary action under section 2301.373, 4723.28, 2,119
or 4723.281 of the Revised Code, or determines that an applicant 2,121
who has committed such acts has made restitution or has been 2,122
rehabilitated, or both.
The board may grant a nonrenewable temporary permit to 2,124
practice nursing as a registered nurse or as a licensed practical 2,125
nurse to an applicant for license by endorsement if the board is 2,126
satisfied by the evidence that the applicant holds a current, 2,127
active license in good standing in another jurisdiction. The 2,129
temporary permit shall expire at the earlier of one hundred 2,130
twenty days after issuance or upon the issuance of a license by 2,131
endorsement.
Sec. 4723.051 4723.10. The WITH RESPECT TO INDIVIDUALS 2,141
APPLYING FOR LICENSURE BY EXAMINATION, THE board of nursing, in 2,142
administering examinations for licensure under this chapter, may 2,144
make use of SHALL ACCEPT all or any part of the licensure 2,145
examination of the national council of state boards of nursing or 2,146
any other national standardized nursing examination that 2,147
48
determines THE BOARD CONSIDERS TO BE AN APPROPRIATE MEASURE OF 2,148
whether a person is competent to commence practicing nursing as a 2,149
registered nurse or as a licensed practical nurse. The IF THE 2,151
BOARD INCURS ANY COST IN ITS ACCEPTANCE OF AN EXAMINATION UNDER 2,152
THIS SECTION OR IN MAKING THE ACCEPTED EXAMINATION AVAILABLE TO 2,153
APPLICANTS, THE board may require applicants for licensure by
examination to practice nursing as a registered nurse or as a 2,155
licensed practical nurse to pay the application fee required by 2,157
section 4723.08 of the Revised Code and to pay for any related 2,159
materials from the organization providing the examination PAY AN 2,160
AMOUNT SUFFICIENT TO COVER THE COST INCURRED. 2,161
Sec. 4723.15. (A) A certificate of registration to 2,170
practice professional nursing as a registered nurse issued by the 2,171
state nurses board or the board of nursing education and nurse 2,172
registration under former provisions of this chapter or by the 2,173
nurses' examining committee of the state medical board as 2,174
provided in former sections 1295-01 to 1295-20 and 1347 et seq. 2,175
of the General Code shall remain valid and shall confer the same 2,176
privileges and impose the same responsibilities and requirements 2,177
as a license issued by the board of nursing under this chapter on 2,178
or after the effective date of this section JUNE 14, 1988. 2,180
(B) A license to practice practical nursing as a licensed 2,182
practical nurse issued by the board of nursing education and 2,183
nurse registration under former provisions of this chapter shall 2,184
remain valid and shall confer the same privileges and impose the 2,185
same responsibilities and requirements as a license issued by the 2,186
board of nursing under this chapter on or after the effective 2,187
date of this section JUNE 14, 1988. 2,188
(C) Any person who on the effective date of this section 2,191
JUNE 14, 1988, holds a current, valid certificate or license to 2,192
practice nursing as a registered nurse or as a licensed practical 2,193
nurse in this state shall, for the purposes of this chapter, be 2,194
deemed to hold a license. 2,195
(D) Any licensed practical nurse who on the effective date 2,197
49
of this section JUNE 14, 1988, holds proof of successful 2,199
completion of a course in medication administration approved by 2,200
the board of nursing shall be considered to be qualified to 2,201
administer medication as defined in division (F)(3)(1)(c) of 2,202
section 4723.02 4723.01 of the Revised Code. 2,203
Sec. 4723.151. Medical diagnosis, prescription of medical 2,212
measures, and the practice of medicine or surgery or any of its 2,213
branches by a nurse are prohibited. 2,214
Nothing in this section prohibits a certified registered 2,216
nurse anesthetist, clinical nurse specialist, certified 2,217
nurse-midwife, or certified nurse practitioner from practicing 2,218
within the nurse's scope of practice in accordance with section 2,219
4723.43 of the Revised Code.
NOTHING IN THIS SECTION OR IN SECTION 4731.35 OF THE 2,221
REVISED CODE PROHIBITS A REGISTERED NURSE OR LICENSED PRACTICAL 2,222
NURSE FROM ADMINISTERING TOPICAL OR INTRADERMAL MEDICATIONS FOR 2,223
THE PURPOSE OF PRODUCING LOCALIZED DECREASED SENSATION IN
CONJUNCTION WITH PROCEDURES PERFORMED BY AN INDIVIDUAL WHO IS 2,224
AUTHORIZED TO PRACTICE IN THIS STATE AND IS ACTING WITHIN THE 2,225
COURSE OF THE INDIVIDUAL'S PROFESSIONAL PRACTICE. 2,226
Sec. 4723.48 4723.17. (A) The board of nursing may 2,235
authorize a licensed practical nurse to administer to an adult 2,237
intravenous therapy prescribed by a licensed physician; dentist; 2,240
optometrist; podiatrist; or, until January 1, 2010, an advanced 2,241
practice nurse authorized to prescribe under section 4723.56 of
the Revised Code AN INDIVIDUAL WHO IS AUTHORIZED TO PRACTICE IN 2,242
THIS STATE AND IS ACTING WITHIN THE COURSE OF THE INDIVIDUAL'S 2,243
PROFESSIONAL PRACTICE, if all of the following are true of the 2,244
licensed practical nurse: 2,245
(1) The nurse has a current, valid license issued under 2,247
this chapter that includes authorization to administer 2,248
medications.
(2) The nurse has successfully completed a course in 2,250
intravenous administration approved by the board of nursing that 2,251
50
includes both of the following: 2,252
(a) A minimum of forty hours of training that includes all 2,254
of the following: 2,255
(i) The curriculum established by rules adopted by the 2,257
board of nursing and in effect on January 1, 1999; 2,259
(ii) Training in the anatomy and physiology of the 2,261
cardiovascular system, signs and symptoms of local and systemic 2,262
complications in the administration of fluids and antibiotic 2,264
additives, and guidelines for management of these complications; 2,265
(iii) Any other training or instruction the board 2,267
considers appropriate. 2,268
(b) A testing component that includes three venipunctures 2,270
supervised by a physician or registered nurse in a health care 2,271
setting. 2,272
(B) A licensed practical nurse may perform intravenous 2,274
therapy only if authorized by the board of nursing pursuant to 2,276
division (A) of this section and only if it is performed in 2,277
accordance with this section.
A licensed practical nurse authorized to perform 2,279
intravenous therapy may perform an intravenous therapy procedure 2,280
only at the direction of one of the following: 2,281
(1) A licensed physician, dentist, optometrist, or 2,283
podiatrist who AN INDIVIDUAL WHO IS AUTHORIZED TO PRACTICE IN 2,284
THIS STATE, IS ACTING WITHIN THE COURSE OF THE INDIVIDUAL'S 2,285
PROFESSIONAL PRACTICE, AND, except as provided in division (C)(2) 2,286
of this section, is present and readily available at the facility 2,287
where the intravenous therapy procedure is performed; 2,288
(2) A registered nurse in accordance with division (C) of 2,291
this section.
(C)(1) Except as provided in division (C)(2) of this 2,293
section, when a licensed practical nurse authorized to perform 2,294
intravenous therapy performs an intravenous therapy procedure at 2,295
the direction of a registered nurse, the registered nurse or 2,297
another registered nurse shall be readily available at the site 2,298
51
where the intravenous therapy is performed, and before the 2,299
licensed practical nurse initiates the intravenous therapy, the 2,300
registered nurse shall personally perform an on-site assessment 2,301
of the individual who is to receive the intravenous therapy. 2,302
(2) When a licensed practical nurse authorized to perform 2,304
intravenous therapy performs an intravenous therapy procedure in 2,305
a home as defined in section 3721.10 of the Revised Code, or in 2,306
an intermediate care facility for the mentally retarded as 2,307
defined in section 5111.20 of the Revised Code, at the direction 2,309
of a registered nurse or licensed physician, dentist, 2,310
optometrist, or podiatrist, a registered nurse shall be on the 2,311
premises of the home or facility or accessible by some form of 2,312
telecommunication.
(D) No licensed practical nurse shall perform any of the 2,314
following intravenous therapy procedures: 2,315
(1) Initiating or maintaining any of the following: 2,317
(a) Blood or blood components; 2,319
(b) Solutions for total parenteral nutrition; 2,321
(c) Any cancer therapeutic medication including, but not 2,323
limited to, cancer chemotherapy or an anti-neoplastic agent; 2,324
(d) Solutions administered through any central venous line 2,326
or arterial line or any other line that does not terminate in a 2,328
peripheral vein, except that a licensed practical nurse may 2,329
maintain the solutions specified in division (D)(6) of this 2,330
section that are being administered through a central venous line 2,331
or peripherally inserted central catheter; 2,332
(e) Any investigational or experimental medication. 2,334
(2) Initiating intravenous therapy in any vein other than 2,336
a vein of the hand, forearm, or antecubital fossa; 2,337
(3) Discontinuing a central venous, arterial, or any other 2,339
line that does not terminate in a peripheral vein; 2,340
(4) Initiating or discontinuing a peripherally inserted 2,342
central catheter; 2,343
(5) Mixing, preparing, or reconstructing any medication 2,345
52
for intravenous therapy, except that a licensed practical nurse 2,346
authorized to perform intravenous therapy may prepare or 2,347
reconstitute an antibiotic additive; 2,348
(6) Administering medication via the intravenous route 2,350
including all of the following: 2,351
(a) Adding medication to an intravenous solution or to an 2,353
existing infusion, except that a licensed practical nurse 2,355
authorized to administer intravenous therapy may initiate an 2,356
intravenous infusion containing one or more of the following 2,357
elements:
(i) Dextrose 5%; 2,359
(ii) Normal saline; 2,361
(iii) Lactated ringers; 2,363
(iv) Sodium chloride .45%; 2,365
(v) Sodium chloride 0.2%; 2,367
(vi) Water. 2,369
(b) Initiating or maintaining an intravenous piggyback 2,371
infusion, except that a licensed practical nurse authorized to 2,372
administer intravenous therapy may initiate or maintain an 2,373
intravenous piggyback infusion containing an antibiotic additive; 2,374
(c) Injecting medication via a direct intravenous route, 2,376
except that a licensed practical nurse authorized to administer 2,377
intravenous therapy may inject heparin or normal saline to flush 2,379
an intermittent infusion device or heparin lock including, but 2,380
not limited to, bolus or push.
(7) Aspirating any intravenous line to maintain patency; 2,382
(8) Changing tubing on any line other than one that 2,384
terminates in a peripheral vein including, but not limited to, an 2,385
arterial line or a central venous line; 2,386
(9) Programming or setting any function of a patient 2,388
controlled infusion pump. 2,389
(E) Notwithstanding division (D) of this section, at the 2,391
direction of a licensed physician or a registered nurse, a 2,392
licensed practical nurse authorized to perform intravenous 2,394
53
therapy may perform the following activities for the purpose of 2,395
performing dialysis;
(1) The routine administration and regulation of saline 2,397
solution for the purpose of maintaining an established fluid 2,398
plan;
(2) The administration of a heparin dose intravenously; 2,400
(3) The administration of a heparin dose peripherally via 2,402
a fistula needle; 2,403
(4) The loading and activation of a constant infusion pump 2,405
or the intermittent injection of a dose of medication prescribed 2,406
by a licensed physician for dialysis. 2,407
(F) No person shall employ or direct a licensed practical 2,409
nurse to perform an intravenous therapy procedure without first 2,410
verifying that the licensed practical nurse has been approved by 2,411
the board of nursing to perform intravenous therapy. 2,412
(G) The board of nursing shall maintain a registry of the 2,414
names of licensed practical nurses authorized pursuant to 2,415
division (A) of this section to perform intravenous therapy. 2,416
Sec. 4723.24. (A) All active licenses issued under this 2,425
chapter shall be renewed biennially according to a schedule 2,426
established by the board of nursing. The board shall mail 2,427
PROVIDE an application for renewal to every holder of an active 2,429
license, EXCEPT WHEN THE BOARD IS AWARE THAT AN INDIVIDUAL IS 2,430
INELIGIBLE FOR LICENSE RENEWAL FOR ANY REASON, INCLUDING PENDING 2,431
CRIMINAL CHARGES IN THIS STATE OR ANOTHER JURISDICTION, FAILURE 2,432
TO COMPLY WITH A DISCIPLINARY ORDER FROM THE BOARD OR THE TERMS 2,433
OF A CONSENT AGREEMENT ENTERED INTO WITH THE BOARD, FAILURE TO
PAY FINES OR FEES OWED TO THE BOARD, OR FAILURE TO PROVIDE ON THE 2,434
BOARD'S REQUEST DOCUMENTATION OF HAVING COMPLETED THE CONTINUING 2,435
NURSING EDUCATION REQUIREMENTS SPECIFIED IN DIVISION (C) OF THIS 2,436
SECTION.
IF THE BOARD PROVIDES A RENEWAL APPLICATION BY MAIL, THE 2,438
APPLICATION SHALL BE addressed to the last known post-office 2,440
address of the holder AND MAILED before the date specified in the 2,441
54
board's schedule. Failure of the holder to receive an 2,443
application for renewal from the board shall not excuse the 2,444
holder from the requirements contained in this section. The 2,445
THE LICENSE holder shall complete the renewal form and 2,447
return it to the treasurer of state with the renewal fee required 2,448
by section 4723.08 of the Revised Code on or before the date 2,449
specified by the board. The LICENSE holder shall report any 2,450
CONVICTION, PLEA, OR JUDICIAL FINDING REGARDING A criminal 2,451
offense that constitutes grounds for denial of a license THE 2,453
BOARD TO IMPOSE SANCTIONS under section 4723.28 of the Revised 2,454
Code of which the holder has been found guilty or to which the 2,455
holder has entered a plea of guilty or no contest since the 2,456
submission of the holder's HOLDER last preceding SUBMITTED AN 2,457
application TO THE BOARD. The 2,458
THE treasurer shall immediately forward the renewal 2,460
application to the board, and on. ON receipt of the renewal 2,462
application, the board shall verify that the applicant meets the 2,463
renewal requirements and shall renew the license for the 2,464
following two-year period. If 2,465
IF a renewal application that meets the renewal 2,469
requirements is submitted after the date specified in the board's 2,470
schedule, but before expiration of the license, the board shall 2,471
grant a renewal upon payment of the late renewal fee authorized 2,472
under section 4723.08 of the Revised Code.
(B) Every LICENSE holder shall give written notice to the 2,474
board of any change of name or address within thirty days of the 2,476
change. The board shall require the holder to document a change 2,477
of name in a manner acceptable to the board. 2,478
(C)(1) Except in the case of a first renewal after 2,480
licensure by examination, effective January 1, 1992, to be 2,481
eligible for renewal of an active license to practice nursing as 2,482
a registered nurse or licensed practical nurse, each individual 2,483
who holds an active license must SHALL, in each two-year period 2,484
specified by the board, complete continuing nursing education as 2,486
55
follows:
(A)(a) For renewal of a license that was issued for a 2,488
two-year renewal period, twenty-four hours of continuing nursing 2,489
education; 2,490
(B)(b) For renewal of a license that was issued for less 2,492
than a two-year renewal period, the number of hours of continuing 2,494
nursing education specified by the board in rules adopted in 2,495
accordance with Chapter 119. of the Revised Code; 2,496
(c) OF THE HOURS OF CONTINUING NURSING EDUCATION COMPLETED 2,498
IN ANY RENEWAL PERIOD, AT LEAST ONE HOUR OF THE EDUCATION MUST BE 2,499
DIRECTLY RELATED TO THE STATUTES AND RULES PERTAINING TO THE 2,500
PRACTICE OF NURSING IN THIS STATE.
(2) The board shall adopt rules establishing the procedure 2,502
for an applicant A LICENSE HOLDER to certify to the board 2,503
completion of the REQUIRED continuing nursing education. 2,505
Continuing nursing education THE BOARD MAY CONDUCT A RANDOM 2,506
SAMPLE OF LICENSE HOLDERS AND REQUIRE THAT THE LICENSE HOLDERS 2,507
INCLUDED IN THE SAMPLE SUBMIT SATISFACTORY DOCUMENTATION OF 2,508
HAVING COMPLETED THE REQUIREMENTS FOR CONTINUING NURSING
EDUCATION. ON THE BOARD'S REQUEST, A LICENSE HOLDER INCLUDED IN 2,509
THE SAMPLE SHALL SUBMIT THE REQUIRED DOCUMENTATION. 2,510
(3) AN EDUCATIONAL ACTIVITY may be applied to meet this 2,514
TOWARD MEETING THE CONTINUING NURSING EDUCATION requirement ONLY 2,515
if it is obtained through a program or course approved by the 2,516
board or A person authorized by the board HAS AUTHORIZED TO 2,517
APPROVE CONTINUING NURSING EDUCATION PROGRAMS AND COURSES. On 2,519
request of the board, an applicant or license holder shall submit 2,520
satisfactory documentation of completion of the required
continuing nursing education. The 2,521
(4) THE continuing education required of a certified 2,524
registered nurse anesthetist, clinical nurse specialist, 2,525
certified nurse-midwife, or certified nurse practitioner to
obtain or maintain certification by a national certifying 2,527
organization shall be applied toward the applicant's continuing 2,529
56
education requirements for renewal of the applicant's A license 2,530
to practice nursing as a registered nurse.
(D) Except as otherwise provided in section 4723.28 of the 2,532
Revised Code, a LICENSE holder of a license who does not intend 2,533
to practice in Ohio may send to the board written notice to that 2,535
effect on or before the renewal date, and the board shall 2,536
classify the license as inactive. During the period that the 2,537
license is classified as inactive, the holder may not engage in 2,539
the practice of nursing in Ohio and is not required to pay the
renewal fee. 2,540
The holder of an inactive license or an individual who has 2,542
failed to renew the individual's license may have the license 2,543
restored or renewed upon meeting the requirements for restoring 2,545
and renewing licenses established in rules adopted under section 2,546
4723.07 of the Revised Code. 2,547
Sec. 4723.28. As used in this section, dangerous drug and 2,557
prescription have the same meanings as in section 4729.01 of the 2,558
Revised Code.
(A) The board of nursing, pursuant to an adjudication 2,560
conducted under Chapter 119. of the Revised Code and by a vote of 2,561
a quorum, may revoke or may refuse to grant a license or 2,562
certificate to a person found by the board to have committed 2,564
fraud in passing the examination or to have committed fraud, 2,565
misrepresentation, or deception in applying for or securing any 2,566
license or certificate issued by the board. 2,568
(B) The board of nursing, pursuant to an adjudication 2,570
conducted under Chapter 119. of the Revised Code and by a vote of 2,571
a quorum, may impose one or more of the following sanctions: 2,572
deny, revoke permanently, suspend, or place restrictions on any 2,573
license or certificate issued by the board; reprimand or 2,575
otherwise discipline a holder of a license or certificate; or 2,576
impose a fine of not more than five hundred dollars per 2,578
violation. The sanctions may be imposed for any of the
following: 2,579
57
(1)(a) Denial, revocation, suspension, or restriction of a 2,581
license to practice nursing, for any reason other than a failure 2,582
to renew, in another state or jurisdiction; or denial 2,583
(b) BEING SUBJECT TO SANCTIONS BY THE BOARD WITH RESPECT 2,585
TO EITHER A LICENSE TO PRACTICE NURSING AS A REGISTERED NURSE OR 2,586
LICENSED PRACTICAL NURSE WHILE HOLDING THE OPPOSING LICENSE OR 2,587
PRIOR TO APPLYING FOR THE OPPOSING LICENSE; 2,588
(c) DENIAL, revocation, suspension, or restriction of a 2,591
license to practice a health care occupation other than nursing, 2,592
for any reason other than a failure to renew, in Ohio or another 2,593
state or jurisdiction;.
(2) Engaging in the practice of nursing, having failed to 2,595
renew a license issued under this chapter, or while a license is 2,596
under suspension; 2,597
(3) Conviction of, a plea of guilty to, or a judicial 2,599
finding of guilt of, A JUDICIAL FINDING OF GUILT RESULTING FROM A 2,600
PLEA OF NO CONTEST TO, OR A JUDICIAL FINDING OF ELIGIBILITY FOR 2,601
TREATMENT IN LIEU OF CONVICTION FOR, a misdemeanor committed in 2,602
the course of practice; 2,603
(4) Conviction of, a plea of guilty to, or a judicial 2,605
finding of guilt of, A JUDICIAL FINDING OF GUILT RESULTING FROM A 2,606
PLEA OF NO CONTEST TO, OR A JUDICIAL FINDING OF ELIGIBILITY FOR 2,607
TREATMENT IN LIEU OF CONVICTION FOR, any felony or of any crime 2,609
involving gross immorality or moral turpitude; 2,610
(5) Selling, giving away, or administering drugs for other 2,612
than legal and legitimate therapeutic purposes; or conviction of, 2,613
a plea of guilty to, or a judicial finding of guilt of, A 2,614
JUDICIAL FINDING OF GUILT RESULTING FROM A PLEA OF NO CONTEST TO, 2,615
OR A JUDICIAL FINDING OF ELIGIBILITY FOR TREATMENT IN LIEU OF 2,616
CONVICTION FOR, violating any municipal, state, county, or 2,617
federal drug law;
(6) Conviction of, a plea of guilty to, or a judicial 2,619
finding of guilt of, A JUDICIAL FINDING OF GUILT RESULTING FROM A 2,620
PLEA OF NO CONTEST TO, OR A JUDICIAL FINDING OF ELIGIBILITY FOR 2,621
58
TREATMENT IN LIEU OF CONVICTION FOR, an act in another 2,623
jurisdiction that would constitute a felony or a crime of moral 2,624
turpitude in Ohio;
(7) Conviction of, a plea of guilty to, or a judicial 2,626
finding of guilt of, A JUDICIAL FINDING OF GUILT RESULTING FROM A 2,627
PLEA OF NO CONTEST TO, OR A JUDICIAL FINDING OF ELIGIBILITY FOR 2,628
TREATMENT IN LIEU OF CONVICTION FOR, an act in the course of 2,629
practice in another jurisdiction that would constitute a 2,630
misdemeanor in Ohio;
(8) Self-administering or otherwise taking into the body 2,632
any dangerous drug, AS DEFINED IN SECTION 4729.01 OF THE REVISED 2,633
CODE, in any way not in accordance with a legal, valid 2,636
prescription ISSUED FOR THAT INDIVIDUAL;
(9) Habitual indulgence in the use of controlled 2,638
substances, other habit-forming drugs, or alcohol or other 2,639
chemical substances to an extent that impairs ability to 2,640
practice; 2,641
(10) Impairment of the ability to practice according to 2,643
acceptable and prevailing standards of safe nursing care because 2,644
of habitual or excessive use of drugs, alcohol, or other chemical 2,647
substances that impair the ability to practice; 2,648
(11) Impairment of the ability to practice according to 2,650
acceptable and prevailing standards of safe nursing care because 2,651
of a physical or mental disability; 2,652
(12) Assaulting or causing harm to a patient or depriving 2,654
a patient of the means to summon assistance; 2,655
(13) Obtaining or attempting to obtain money or anything 2,657
of value by intentional misrepresentation or material deception 2,658
in the course of practice; 2,659
(14) Adjudication by a probate court that the license 2,661
applicant or license holder is mentally ill or mentally 2,662
incompetent. The board may restore the license upon adjudication 2,663
by a probate court of the person's restoration to competency or 2,664
upon submission to the board of other proof of competency. 2,665
59
(15) The suspension or termination of employment by the 2,667
department of defense or the veterans administration of the 2,668
United States for any act that violates or would violate this 2,669
chapter; 2,670
(16) Violation of this chapter or any rules adopted under 2,672
it; 2,673
(17) Violation of any restrictions placed on a license by 2,675
the board; 2,676
(18) Failure to use universal blood and body fluid 2,678
precautions established by rules adopted under section 4723.07 of 2,679
the Revised Code; 2,680
(19) Failure to practice in accordance with acceptable and 2,683
prevailing standards of safe nursing care; 2,684
(20) In the case of a registered nurse, engaging in 2,686
activities that exceed the practice of nursing as a registered 2,687
nurse under section 4723.02 of the Revised Code; 2,688
(21) In the case of a licensed practical nurse, engaging 2,690
in activities that exceed the practice of nursing as a licensed 2,691
practical nurse under section 4723.02 of the Revised Code; 2,692
(22) Aiding and abetting in the unlicensed practice of 2,694
nursing; 2,695
(23) In the case of a certified registered nurse 2,697
anesthetist, clinical nurse specialist, certified nurse-midwife, 2,699
or certified nurse practitioner, or a registered nurse approved 2,700
as an advanced practice nurse under section 4723.55 of the 2,701
Revised Code, EXCEPT AS PROVIDED IN DIVISION (M) OF THIS SECTION, 2,703
either of the following:
(a) Waiving the payment of all or any part of a deductible 2,705
or copayment that a patient, pursuant to a health insurance or 2,706
health care policy, contract, or plan that covers such nursing 2,707
services, would otherwise be required to pay if the waiver is 2,708
used as an enticement to a patient or group of patients to 2,709
receive health care services from that provider; 2,710
(b) Advertising that the nurse will waive the payment of 2,712
60
all or any part of a deductible or copayment that a patient, 2,713
pursuant to a health insurance or health care policy, contract, 2,714
or plan that covers such nursing services, would otherwise be 2,715
required to pay. 2,716
(24) Failure to comply with the terms and conditions of 2,718
participation in the alternative CHEMICAL DEPENDENCY MONITORING 2,720
program for chemically dependent nurses created by ESTABLISHED 2,721
UNDER section 4723.35 of the Revised Code; 2,722
(25) Failure to comply with the terms and conditions 2,724
required under the practice intervention and improvement program 2,725
established under section 4723.282 of the Revised Code; 2,726
(26) FAILURE TO ESTABLISH AND MAINTAIN PROFESSIONAL 2,729
BOUNDARIES WITH A PATIENT, AS SPECIFIED IN RULES ADOPTED UNDER 2,730
SECTION 4723.07 OF THE REVISED CODE;
(27) IN THE CASE OF AN ADVANCED PRACTICE NURSE, FAILURE TO 2,732
COMPLY WITH SECTION 4723.59 OF THE REVISED CODE; 2,733
(28) In the case of a certified registered nurse 2,735
anesthetist, clinical nurse specialist, certified nurse-midwife, 2,737
or certified nurse practitioner: 2,738
(a) Engaging in activities that exceed those permitted for 2,741
the nurse's nursing specialty under section 4723.43 of the
Revised Code; 2,742
(b) Failure to meet the quality assurance standards 2,744
established under section 4723.07 of the Revised Code. 2,746
(27)(29) In the case of a clinical nurse specialist, 2,748
certified nurse-midwife, or certified nurse practitioner, failure 2,750
to maintain a standard care arrangement in accordance with 2,751
section 4723.431 of the Revised Code or to practice in accordance 2,752
with the standard care arrangement. 2,753
(C) DISCIPLINARY ACTIONS TAKEN BY THE BOARD UNDER 2,755
DIVISIONS (A) AND (B) OF THIS SECTION SHALL BE TAKEN PURSUANT TO 2,756
AN ADJUDICATION CONDUCTED UNDER CHAPTER 119. OF THE REVISED CODE, 2,757
EXCEPT THAT IN LIEU OF A HEARING, THE BOARD MAY ENTER INTO A 2,758
CONSENT AGREEMENT WITH AN INDIVIDUAL TO RESOLVE AN ALLEGATION OF 2,759
61
A VIOLATION OF THIS CHAPTER OR ANY RULE ADOPTED UNDER IT. A
CONSENT AGREEMENT, WHEN RATIFIED BY A VOTE OF A QUORUM, SHALL 2,760
CONSTITUTE THE FINDINGS AND ORDER OF THE BOARD WITH RESPECT TO 2,761
THE MATTER ADDRESSED IN THE AGREEMENT. IF THE BOARD REFUSES TO 2,762
RATIFY A CONSENT AGREEMENT, THE ADMISSIONS AND FINDINGS CONTAINED 2,763
IN THE AGREEMENT SHALL BE OF NO EFFECT.
(D) THE HEARINGS OF THE BOARD SHALL BE CONDUCTED IN 2,765
ACCORDANCE WITH CHAPTER 119. OF THE REVISED CODE. THE BOARD MAY 2,766
APPOINT A HEARING EXAMINER, AS PROVIDED IN SECTION 119.09 OF THE 2,767
REVISED CODE, TO CONDUCT ANY HEARING THE BOARD IS AUTHORIZED TO 2,769
HOLD UNDER CHAPTER 119. OF THE REVISED CODE.
IN ANY INSTANCE IN WHICH THE BOARD IS REQUIRED UNDER 2,771
CHAPTER 119. OF THE REVISED CODE TO GIVE NOTICE OF AN OPPORTUNITY 2,772
FOR A HEARING AND THE APPLICANT OR LICENSE HOLDER DOES NOT MAKE A 2,773
TIMELY REQUEST FOR A HEARING IN ACCORDANCE WITH SECTION 119.07 OF 2,774
THE REVISED CODE, THE BOARD IS NOT REQUIRED TO HOLD A HEARING,
BUT MAY ADOPT, BY A VOTE OF A QUORUM, A FINAL ORDER THAT CONTAINS 2,775
THE BOARD'S FINDINGS. IN THE FINAL ORDER, THE BOARD MAY ORDER 2,776
ANY OF THE SANCTIONS LISTED IN DIVISION (A) OR (B) OF THIS 2,777
SECTION.
(E) If a criminal action is brought against a license 2,779
holder for an act or crime described in divisions (B)(3) to (7) 2,780
of this section and the action is dismissed by the trial court 2,781
other than on the merits, the board shall hold CONDUCT an 2,782
adjudication hearing to determine whether the license holder 2,783
committed the act on which the action was based. If the board 2,785
determines on the basis of the hearing ADJUDICATION that the 2,786
license holder committed the act, or if the license holder fails 2,788
to participate in the hearing ADJUDICATION, the board may take 2,790
action as though the license holder had been convicted of the 2,791
act.
If the board takes action on the basis of a conviction, 2,793
plea of guilty, or a judicial determination of guilt FINDING as 2,795
described in divisions (B)(3) to (7) of this section that is 2,796
62
overturned on appeal, the license holder may, on exhaustion of 2,797
the appeal process, petition the board for reconsideration of its 2,798
action. On receipt of the petition and supporting court 2,799
documents, the board shall temporarily rescind its action. If 2,800
the board determines that the decision on appeal was a decision 2,801
on the merits, it shall permanently rescind its action. If the 2,802
board determines that the decision on appeal was not a decision 2,803
on the merits, it shall hold CONDUCT an adjudicatory hearing 2,804
ADJUDICATION to determine whether the license holder committed 2,806
the act on which the original conviction, plea, or judicial 2,807
determination was based. If the board determines on the basis of 2,808
the hearing ADJUDICATION that the license holder committed such 2,810
act, or if the license holder does not request a hearing AN 2,811
ADJUDICATION, the board shall reinstate its action; otherwise, 2,813
the board shall permanently rescind its action.
Notwithstanding the provision of division (C)(2) of section 2,815
2953.32 of the Revised Code specifying that if records pertaining 2,816
to a criminal case are sealed under that section the proceedings 2,817
in the case shall be deemed not to have occurred, sealing of the 2,818
records of a conviction on which the board has based an action 2,819
under this section shall have no effect on the board's action or 2,820
any sanction imposed by the board under this section. 2,821
(D) In enforcing division (B) of THE BOARD SHALL NOT BE 2,824
REQUIRED TO SEAL, DESTROY, REDACT, OR OTHERWISE MODIFY ITS 2,825
RECORDS TO REFLECT THE COURT'S SEALING OF CONVICTION RECORDS. 2,826
(F) THE BOARD MAY INVESTIGATE AN INDIVIDUAL'S CRIMINAL 2,828
BACKGROUND BY REQUESTING INFORMATION FROM THE BUREAU OF CRIMINAL 2,829
IDENTIFICATION AND INVESTIGATION PURSUANT TO SECTION 109.57 OF 2,830
THE REVISED CODE. THE BOARD MAY APPLY FOR ACCESS TO THE 2,831
COMPUTERIZED DATABASES ADMINISTERED BY THE NATIONAL CRIME
INFORMATION CENTER AND THE LAW ENFORCEMENT AUTOMATED DATA SYSTEM 2,832
OPERATED PURSUANT TO SECTION 5503.10 OF THE REVISED CODE, AS WELL 2,833
AS OTHER COMPUTERIZED DATABASES ADMINISTERED FOR THE PURPOSE OF 2,834
MAKING CRIMINAL JUSTICE INFORMATION ACCESSIBLE TO STATE AGENCIES. 2,835
63
THE BOARD IS HEREBY DESIGNATED TO BE A CRIMINAL JUSTICE AGENCY
FOR PURPOSES OF ANY STATE OR FEDERAL LAW REQUIRING, AS A 2,836
CONDITION OF BEING AUTHORIZED TO APPLY FOR ACCESS TO THESE 2,837
DATABASES, THAT AN ENTITY BE RECOGNIZED UNDER STATE LAW AS A 2,838
CRIMINAL JUSTICE AGENCY.
(G) DURING THE COURSE OF AN INVESTIGATION CONDUCTED UNDER 2,840
this section, the board may compel any individual licensed by 2,842
this chapter or who has applied for licensure to submit to a 2,843
mental or physical examination, or both, as required by the board 2,844
and at the expense of the individual, IF THE BOARD FINDS REASON 2,845
TO BELIEVE THAT THE INDIVIDUAL UNDER INVESTIGATION MAY HAVE A 2,846
PHYSICAL OR MENTAL IMPAIRMENT THAT MAY AFFECT THE INDIVIDUAL'S 2,847
ABILITY TO PROVIDE SAFE NURSING CARE. Failure of any individual 2,848
to submit to a mental or physical examination when directed 2,849
constitutes an admission of the allegations, unless the failure 2,850
is due to circumstances beyond the individual's control, and a 2,851
default and final order may be entered without the taking of 2,852
testimony or presentation of evidence. If 2,853
IF the board finds that an individual is impaired, the 2,856
board shall require the individual to submit to care, counseling, 2,857
or treatment approved or designated by the board, as a condition 2,858
for initial, continued, reinstated, or renewed licensure to 2,859
practice. The individual shall be afforded an opportunity to 2,860
demonstrate to the board that the individual can BEGIN OR resume 2,861
the individual's occupation PRACTICE OF NURSING in compliance 2,862
with acceptable and prevailing standards OF CARE under the 2,865
provisions of the individual's license. For the purpose 2,866
FOR PURPOSES of this section DIVISION, any individual who 2,869
is licensed by this chapter or makes application for licensure 2,871
shall be deemed to have given consent to submit to a mental or 2,872
physical examination when directed to do so in writing by the 2,873
board, and to have waived all objections to the admissibility of 2,874
testimony or examination reports that constitute a privileged 2,875
communication.
64
(E)(H) The board shall investigate evidence that appears 2,877
to show that any person has violated any provision of this 2,878
chapter or any rule of the board. Any person may report to the 2,879
board any information the person may have that appears to show a 2,880
violation of any provision of this chapter or rule of the board. 2,881
In the absence of bad faith, any person who reports such 2,882
information or who testifies before the board in any adjudication 2,883
conducted under Chapter 119. of the Revised Code shall not be 2,884
liable for civil damages as a result of the report or testimony. 2,885
(I) ALL OF THE FOLLOWING APPLY UNDER THIS CHAPTER WITH 2,887
REGARD TO THE CONFIDENTIALITY OF INFORMATION: 2,888
(1) Information received by the board pursuant to an 2,890
investigation is confidential and not subject to discovery in any 2,891
civil action, except that the board may disclose information to 2,892
law enforcement officers and government entities investigating a 2,893
person licensed by the board OR A PERSON WHO MAY HAVE ENGAGED IN 2,894
THE UNAUTHORIZED PRACTICE OF NURSING. No law enforcement officer 2,895
or government entity with knowledge of any information disclosed 2,896
by the board pursuant to this division shall divulge the 2,897
information to any other person or government entity except for 2,898
the purpose of an adjudication by a court or licensing or
registration board or officer to which the person to whom the 2,899
information relates is a party. 2,900
(2) If the AN investigation requires a review of patient 2,903
records, the investigation and proceeding shall be conducted in 2,904
such a manner as to protect patient confidentiality. 2,905
(3) All hearings ADJUDICATIONS and investigations of the 2,908
board shall be considered civil actions for the purposes of 2,909
section 2305.251 of the Revised Code. 2,910
The hearings of the board shall be conducted in accordance 2,912
with Chapter 119. of the Revised Code. The board may appoint a 2,913
hearing examiner as provided in section 119.09 to conduct any 2,914
hearing the board is empowered to hold under Chapter 119. of the 2,915
Revised Code. 2,916
65
In the absence of fraud or bad faith, neither the board nor 2,918
any current or former members, agents, representatives, or 2,919
employees of the board shall be held liable in damages to any 2,920
person as the result of any act, omission, proceeding, conduct, 2,921
or decision related to their official duties undertaken or 2,922
performed pursuant to this chapter. If a current or former 2,923
member, agent, representative, or employee requests the state to 2,924
defend the individual against any claim or action arising out of 2,925
any act, omission, proceeding, conduct, or decision related to 2,927
the individual's official duties, if the request is made in 2,929
writing at a reasonable time before trial, and if the individual 2,930
requesting defense cooperates in good faith in the defense of the 2,931
claim or action, the state shall provide and pay for such defense 2,932
and shall pay any resulting judgment, compromise, or settlement. 2,933
At no time shall the state pay that part of a claim or judgment 2,934
that is for punitive or exemplary damages. 2,935
(F)(4) ANY BOARD ACTIVITY THAT INVOLVES CONTINUED 2,937
MONITORING OF AN INDIVIDUAL AS PART OF OR FOLLOWING ANY 2,938
DISCIPLINARY ACTION TAKEN UNDER THIS SECTION SHALL BE CONDUCTED 2,939
IN A MANNER THAT MAINTAINS THE INDIVIDUAL'S CONFIDENTIALITY. 2,940
INFORMATION RECEIVED OR MAINTAINED BY THE BOARD WITH RESPECT TO 2,941
THE BOARD'S MONITORING ACTIVITIES IS CONFIDENTIAL AND NOT SUBJECT 2,942
TO DISCOVERY IN ANY CIVIL ACTION.
(J) Any action taken by the board under this section 2,944
resulting in a suspension from practice shall be accompanied by a 2,945
written statement of the conditions under which the person may be 2,946
reinstated to practice. 2,947
(G)(K) WHEN THE BOARD REFUSES TO GRANT A LICENSE OR 2,949
CERTIFICATE OF AUTHORITY TO AN APPLICANT, REVOKES A NURSE'S 2,950
LICENSE OR CERTIFICATE, OR REFUSES TO REINSTATE A LICENSE OR 2,951
CERTIFICATE, THE BOARD MAY SPECIFY THAT ITS ACTION IS PERMANENT. 2,952
AN INDIVIDUAL SUBJECT TO PERMANENT ACTION TAKEN BY THE BOARD IS 2,953
FOREVER INELIGIBLE TO HOLD A LICENSE OR CERTIFICATE OF THE TYPE 2,954
THAT WAS REFUSED OR REVOKED AND THE BOARD SHALL NOT ACCEPT FROM 2,955
66
THE INDIVIDUAL AN APPLICATION FOR REINSTATEMENT OF THE LICENSE OR
CERTIFICATE OR FOR A NEW LICENSE OR CERTIFICATE. 2,956
(L) No unilateral surrender of a license issued under this 2,958
chapter shall be effective unless accepted by majority vote of 2,959
the board. No application for a license issued under this 2,960
chapter may be withdrawn without a majority vote of the board. 2,961
THE BOARD'S JURISDICTION TO TAKE DISCIPLINARY ACTION UNDER THIS 2,962
SECTION IS NOT REMOVED OR LIMITED WHEN AN INDIVIDUAL HAS A 2,963
LICENSE OR CERTIFICATE OF AUTHORITY CLASSIFIED AS INACTIVE OR 2,964
FAILS TO RENEW A LICENSE OR CERTIFICATE OF AUTHORITY. 2,965
(H) Notwithstanding division (B)(23) of this section, 2,967
sanctions (M) SANCTIONS shall not be imposed UNDER DIVISION 2,970
(B)(23) OF THIS SECTION against any licensee who waives
deductibles and copayments AS FOLLOWS: 2,971
(1) In compliance with the health benefit plan that 2,973
expressly allows such a practice. Waiver of the deductibles or 2,974
copayments shall be made only with the full knowledge and consent 2,975
of the plan purchaser, payer, and third-party administrator. The 2,976
DOCUMENTATION OF THE consent shall be made available to the board 2,977
upon request. 2,978
(2) For professional services rendered to any other person 2,980
licensed pursuant to this chapter to the extent allowed by this 2,981
chapter and the rules of the board. 2,982
Sec. 4723.281. (A) As used in this section, with regard 2,991
to offenses committed in Ohio, "aggravated murder," "murder," 2,992
"voluntary manslaughter," "felonious assault," "kidnapping," 2,993
"rape," "sexual battery," "GROSS SEXUAL IMPOSITION," "aggravated 2,995
arson," "AGGRAVATED ROBBERY," and "aggravated burglary" mean such 2,997
offenses as defined in Title XXIX of the Revised Code; with 2,998
regard to offenses committed in other jurisdictions, the terms 2,999
mean offenses comparable to offenses defined in Title XXIX of the 3,000
Revised Code.
(B) The board of nursing may impose a summary suspension 3,002
without a hearing on a person licensed under this chapter if it 3,003
67
determines that there is evidence that the license holder is 3,004
subject to actions under division (B) of section 4723.28 of the 3,005
Revised Code and that WHEN there is clear and convincing evidence 3,006
that continued practice by the license holder AN INDIVIDUAL 3,008
LICENSED UNDER THIS CHAPTER presents a danger of immediate and 3,010
serious harm to the public. The, AS DETERMINED ON CONSIDERATION 3,011
OF THE EVIDENCE BY THE president and the executive director of 3,012
the board OF NURSING, THE PRESIDENT AND DIRECTOR shall make a 3,013
preliminary determination and describe the evidence on which they 3,014
made their determination to the other members of the board. The 3,015
board may by resolution designate another board member to act in 3,016
place of the president of the board and another employee to act 3,017
in the place of the executive director, in the event that the 3,018
board president or executive director is unavailable or unable to 3,019
act. On consideration of the evidence, the board may by an 3,020
affirmative vote of seven members, not including the president of 3,021
the board or the person named to act in place of the president, 3,022
impose ON the INDIVIDUAL A summary suspension WITHOUT A HEARING. 3,023
The description of the evidence and information may be given and 3,024
the vote taken by telephone conference call AN INDIVIDUAL SERVING 3,025
AS PRESIDENT OR EXECUTIVE DIRECTOR IN THE ABSENCE OF THE 3,026
PRESIDENT OR EXECUTIVE DIRECTOR MAY TAKE ANY ACTION THAT THIS 3,027
SECTION REQUIRES OR AUTHORIZES THE PRESIDENT OR EXECUTIVE 3,028
DIRECTOR TO TAKE.
Immediately following the decision to impose a summary 3,030
suspension under this division, the board shall issue a written 3,031
order of suspension and cause it to be delivered by certified 3,032
mail or in person in accordance with section 119.07 of the 3,033
Revised Code. The order shall not be subject to suspension by 3,034
the court during the pendency of any appeal filed under section 3,035
119.12 of the Revised Code. If the license holder INDIVIDUAL 3,036
SUBJECT TO THE SUSPENSION requests an adjudication hearing, the 3,038
date set for the hearing ADJUDICATION shall be within fifteen 3,040
days but not earlier than seven days after the license holder has 3,041
68
requested a hearing INDIVIDUAL MAKES THE REQUEST, unless another 3,042
date is agreed to by both the license holder INDIVIDUAL and the 3,043
board. The summary suspension shall remain in effect, unless 3,045
reversed by the board, until a final adjudication order issued by 3,046
the board pursuant to this section and Chapter 119. of the 3,047
Revised Code becomes effective. 3,048
The board shall issue its final adjudication order within 3,050
ninety days after completion of the hearing ADJUDICATION. If the 3,052
board does not issue such A FINAL order within the ninety-day 3,053
period, the summary suspension shall be void, but any final 3,055
adjudication order issued subsequent to the ninety-day period 3,056
shall not be affected.
(C) The license of a person licensed ISSUED TO AN 3,058
INDIVIDUAL under this chapter is automatically suspended on that 3,060
person's INDIVIDUAL'S conviction OF, plea of guilty TO, or 3,062
judicial determination of guilt of FINDING WITH REGARD TO any of 3,063
the following in Ohio or any other jurisdiction of the United 3,064
States: aggravated murder, murder, voluntary manslaughter, 3,065
felonious assault, kidnapping, rape, sexual battery, GROSS SEXUAL 3,066
IMPOSITION, aggravated arson, AGGRAVATED ROBBERY, or aggravated 3,068
burglary. The suspension shall remain in effect from the date of 3,069
the conviction, plea, or finding until an adjudicatory hearing 3,070
ADJUDICATION is held under Chapter 119. of the Revised Code. If 3,072
the board has knowledge that an automatic suspension has 3,073
occurred, it shall notify the license holder INDIVIDUAL SUBJECT
TO THE SUSPENSION. If the license holder INDIVIDUAL is notified 3,075
and either fails to request an adjudicatory hearing ADJUDICATION 3,077
within the time periods established by Chapter 119. of the 3,079
Revised Code or fails to participate in the hearing ADJUDICATION, 3,080
the board may SHALL enter a final order PERMANENTLY revoking the 3,082
license.
Sec. 4723.32. This chapter does not prohibit ANY OF THE 3,091
FOLLOWING:
(A) The practice of nursing by students as an integral 3,093
69
part of a program of study leading to initial licensure and A 3,094
STUDENT CURRENTLY ENROLLED IN AND ACTIVELY PURSUING COMPLETION OF 3,095
A PRELICENSURE NURSING EDUCATION PROGRAM approved by the board of 3,096
nursing, IF THE STUDENT'S PRACTICE IS UNDER THE AUSPICES OF THE 3,098
PROGRAM AND THE STUDENT ACTS UNDER THE DIRECT SUPERVISION OF A 3,099
REGISTERED NURSE SERVING FOR THE PROGRAM AS A FACULTY MEMBER, 3,100
TEACHING ASSISTANT, OR PRECEPTOR;
(B) The practice of nursing by a person currently licensed 3,103
in another jurisdiction who is employed by the United States 3,104
government or any agency thereof while in the discharge of
official duties; 3,105
(C) The rendering of medical assistance to a licensed 3,107
physician, licensed dentist, or licensed podiatrist by a person 3,108
under the direction, supervision, and control of such licensed 3,109
physician, dentist, or podiatrist ACTIVITIES OF AN INDIVIDUAL WHO 3,110
HOLDS A VALID LICENSE, CERTIFICATE, OR REGISTRATION AUTHORIZING 3,111
THE PRACTICE OF A PROFESSION IN THIS STATE AND IS ACTING WITHIN 3,112
THE SCOPE OF THAT PROFESSION; 3,113
(D)(C) The activities of persons employed as nursing 3,115
aides, attendants, orderlies, or other auxiliary workers in 3,116
patient homes, nurseries, nursing homes, hospitals, home health 3,117
agencies, or other similar institutions, AS LONG AS THE 3,118
ACTIVITIES ARE PERFORMED IN ACCORDANCE WITH RULES ADOPTED BY THE 3,120
BOARD REGARDING DELEGATION OF NURSING TASKS BY REGISTERED NURSES 3,121
TO TRAINED BUT UNLICENSED INDIVIDUALS; 3,122
(E) The practice of nursing by any registered nurse or 3,124
licensed practical nurse currently licensed in another 3,125
jurisdiction who is employed by an individual, agency, or 3,126
corporation located in that jurisdiction and whose employment 3,127
responsibilities include transporting patients into, out of, or 3,128
through this jurisdiction, so long as each trip does not exceed 3,129
forty-eight hours in this state; 3,130
(F)(D) The provision of nursing services to family members 3,132
or in emergency situations; 3,133
70
(G)(E) The care of the sick when done in connection with 3,136
the practice of religious tenets of any church and by OR FOR its 3,137
members;
(H)(F) The practice of nursing as a certified registered 3,139
nurse anesthetist, clinical nurse specialist, certified 3,141
nurse-midwife, or certified nurse practitioner by a student as an 3,142
integral part CURRENTLY ENROLLED IN AND ACTIVELY PURSUING 3,143
COMPLETION of a program of study leading to initial authorization 3,144
by the board to practice nursing in the specialty, if the program 3,145
qualifies the student to sit for the examination of a national 3,146
certifying organization listed in division (A)(3) of section 3,147
4723.41 of the Revised Code or approved by the board under
section 4723.46 of the Revised Code, or prepares the student to 3,149
receive a master's degree in accordance with division (A)(2) of 3,150
section 4723.41 of the Revised Code;
(G) THE ACTIVITIES OF AN INDIVIDUAL CURRENTLY LICENSED TO 3,153
PRACTICE NURSING IN ANOTHER JURISDICTION, IF THE INDIVIDUAL DOES 3,154
NOT REPRESENT THE INDIVIDUAL AS BEING LICENSED UNDER THIS CHAPTER 3,156
AND ONE OF THE FOLLOWING IS THE CASE:
(1) THE INDIVIDUAL IS ENGAGING IN THE PRACTICE OF NURSING 3,158
BY DISCHARGING OFFICIAL DUTIES WHILE EMPLOYED BY OR UNDER 3,159
CONTRACT WITH THE UNITED STATES GOVERNMENT OR ANY AGENCY THEREOF; 3,162
(2) THE INDIVIDUAL IS ENGAGING IN THE PRACTICE OF NURSING 3,164
AS AN EMPLOYEE OF AN INDIVIDUAL, AGENCY, OR CORPORATION LOCATED 3,165
IN THE OTHER JURISDICTION IN A POSITION WITH EMPLOYMENT 3,166
RESPONSIBILITIES THAT INCLUDE TRANSPORTING PATIENTS INTO, OUT OF, 3,167
OR THROUGH THIS STATE, AS LONG AS EACH TRIP IN THIS STATE DOES 3,168
NOT EXCEED SEVENTY-TWO HOURS; 3,169
(3) THE INDIVIDUAL IS CONSULTING WITH AN INDIVIDUAL 3,171
LICENSED IN THIS STATE TO PRACTICE ANY HEALTH-RELATED PROFESSION; 3,172
(4) THE INDIVIDUAL IS ENGAGING IN ACTIVITIES ASSOCIATED 3,174
WITH TEACHING IN THIS STATE AS A GUEST LECTURER AT OR FOR A 3,176
NURSING EDUCATION PROGRAM, CONTINUING NURSING EDUCATION PROGRAM, 3,177
OR IN-SERVICE PRESENTATION; 3,178
71
(5) THE INDIVIDUAL IS CONDUCTING EVALUATIONS OF NURSING 3,180
CARE THAT ARE UNDERTAKEN ON BEHALF OF AN ACCREDITING 3,182
ORGANIZATION, INCLUDING THE NATIONAL LEAGUE FOR NURSING 3,183
ACCREDITING COMMITTEE, THE JOINT COMMISSION ON ACCREDITATION OF 3,184
HEALTHCARE ORGANIZATIONS, OR ANY OTHER NATIONALLY RECOGNIZED 3,185
ACCREDITING ORGANIZATION;
(6) THE INDIVIDUAL IS PROVIDING NURSING CARE TO AN 3,187
INDIVIDUAL WHO IS IN THIS STATE ON A TEMPORARY BASIS, NOT TO 3,188
EXCEED SIX MONTHS IN ANY ONE CALENDAR YEAR, IF THE NURSE IS 3,189
DIRECTLY EMPLOYED BY OR UNDER CONTRACT WITH THE INDIVIDUAL OR A 3,190
GUARDIAN OR OTHER PERSON ACTING ON THE INDIVIDUAL'S BEHALF; 3,191
(7) THE INDIVIDUAL IS PROVIDING NURSING CARE DURING ANY 3,193
DISASTER, NATURAL OR OTHERWISE, THAT HAS BEEN OFFICIALLY DECLARED 3,194
TO BE A DISASTER BY A PUBLIC ANNOUNCEMENT ISSUED BY AN 3,195
APPROPRIATE FEDERAL, STATE, COUNTY, OR MUNICIPAL OFFICIAL. 3,196
Sec. 4723.34. (A) REPORTS TO THE BOARD OF NURSING SHALL 3,205
BE MADE AS FOLLOWS: 3,206
(1) AN INDIVIDUAL LICENSED UNDER THIS CHAPTER SHALL REPORT 3,208
TO THE BOARD ANY OTHER REGISTERED NURSE OR LICENSED PRACTICAL 3,209
NURSE WHOM THE INDIVIDUAL BELIEVES HAS VIOLATED ANY PROVISION OF 3,210
THIS CHAPTER OR THE RULES ADOPTED UNDER IT. 3,211
(2) Every employer of registered nurses or licensed 3,214
practical nurses shall report to the board of nursing the name of 3,215
any person CURRENT OR FORMER EMPLOYEE licensed under this chapter 3,216
whose employment WHO has been terminated voluntarily or 3,217
involuntarily because of ENGAGED IN conduct that would be grounds 3,218
for disciplinary action by the board under division (B) of 3,220
section 4723.28 of the Revised Code. 3,221
(B)(3) Nursing associations shall report to the board the 3,223
name of any registered nurse or licensed practical nurse who has 3,224
been investigated and found to constitute a danger to the public 3,225
health, safety, and welfare because of conduct that would be 3,226
grounds for disciplinary action by the board under section 3,227
4723.28 of the Revised Code, except that a nursing association is 3,228
72
not required to report the name of such a nurse if the nurse is 3,229
maintaining satisfactory participation in a peer support program 3,230
approved by the board under rules adopted under section 4723.07 3,231
of the Revised Code. 3,232
(C)(4) If the prosecutor in a case described in divisions 3,234
(B)(3) to (5) of section 4723.28 of the Revised Code, or in a 3,235
case where the trial court issued an order of dismissal upon 3,236
technical or procedural grounds of a charge of a misdemeanor 3,237
committed in the course of practice, a felony charge, or a charge 3,238
of gross immorality or moral turpitude, knows or has reason to 3,239
believe that the person charged is licensed under this chapter to 3,240
practice nursing as a registered nurse or as a licensed practical 3,241
nurse, the prosecutor shall notify the board of nursing on forms 3,242
prescribed and provided by the board. The report shall include 3,243
the name and address of the license holder, the charge, and the 3,244
certified court documents recording the action. 3,245
(D)(B) If any person fails to provide a report required by 3,247
this section, the board may seek an order from a court of 3,248
competent jurisdiction compelling submission of the report. IF 3,249
THE FAILURE TO REPORT IS A VIOLATION OF DIVISION (A)(2) OF THIS 3,250
SECTION, THE BOARD MAY PUBLISH THE EMPLOYER'S NAME IN ANY OF THE 3,251
BOARD'S PUBLICATIONS, INCLUDING INFORMATION THE BOARD MAINTAINS 3,252
ON THE INTERNET.
Sec. 4723.341. As used in this section, "person" has the 3,261
same meaning as in section 1.59 of the Revised Code and also 3,262
includes the board of nursing and its members and employees; 3,263
health care facilities, associations, and societies; insurers; 3,264
and individuals. 3,265
In the absence of fraud or bad faith, no person reporting 3,267
to the board of nursing or testifying in an adjudication hearing 3,268
conducted under Chapter 119. of the Revised Code with regard to 3,269
alleged incidents of negligence or malpractice, matters subject 3,270
to section 2301.373 or 4723.28 of the Revised Code, violations of 3,271
section 4723.34 of the Revised Code, or the qualifications, 3,272
73
fitness, or character of a person licensed or applying for a 3,273
license to practice nursing as a registered nurse or licensed 3,274
practical nurse shall be subject to any civil action or liable 3,275
for damages as a result of making the report or testifying. 3,276
In the absence of fraud or bad faith, no professional 3,278
association of individuals who are licensed under this chapter 3,279
that sponsors a committee or program to provide peer assistance 3,280
to nurses with substance abuse problems, no representative or 3,281
agent of such a committee or program, and no member of the board 3,282
of nursing shall be liable to any person for damages in a civil 3,283
action by reason of actions taken to refer a nurse to a treatment 3,284
provider designated by the board or actions or omissions of the 3,285
provider in treating a nurse. 3,286
Sec. 4723.35. (A) As used in this section, "chemical 3,295
dependency" means either of the following: 3,296
(1) The chronic and habitual use of alcoholic beverages to 3,298
the extent that the user no longer can control the use of alcohol 3,299
or endangers the user's health, safety, or welfare or that of 3,300
others;
(2) The use of a drug of abuse, CONTROLLED SUBSTANCE as 3,302
defined in section 3719.011 3719.01 of the Revised Code, A 3,304
HARMFUL INTOXICANT AS DEFINED IN SECTION 2925.01 OF THE REVISED 3,305
CODE, OR A DANGEROUS DRUG AS DEFINED IN SECTION 4729.01 OF THE 3,306
REVISED CODE, to the extent that the user becomes physically or 3,308
psychologically dependent on the SUBSTANCE, INTOXICANT, OR drug 3,309
or endangers the user's health, safety, or welfare or that of 3,310
others. 3,311
(B) The board of nursing shall establish a chemical 3,313
dependency treatment MONITORING program, which shall be called 3,314
the alternative program for chemically dependent nurses. The 3,317
progarm PROGRAM shall be MADE available to registered nurses and 3,319
licensed practical nurses ANY INDIVIDUAL UNDER THE BOARD'S 3,320
JURISDICTION who have HAS a chemical dependency and meet MEETS 3,322
THE BOARD'S eligibility requirements FOR ADMISSION TO AND 3,323
74
CONTINUED PARTICIPATION IN THE PROGRAM. The board shall develop 3,324
the program, SELECT THE PROGRAM'S NAME, and designate an 3,325
administrator A COORDINATOR to operate it, and ADMINISTER THE 3,327
PROGRAM.
(C) THE BOARD shall adopt rules in accordance with Chapter 3,330
119. of the Revised Code that establish the following:
(1) Eligibility requirements for ADMISSION TO AND 3,332
CONTINUED participation IN THE MONITORING PROGRAM; 3,333
(2) Terms and conditions a nurse THAT must meet BE MET to 3,336
PARTICIPATE IN AND successfully complete the program; 3,337
(3) Procedures for keeping confidential records regarding 3,339
participants;
(4) Any other requirements or procedures necessary to 3,341
establish and administer the program. 3,342
(C) A registered nurse or licensed practical nurse may 3,344
voluntarily seek treatment for any chemical dependency that may 3,345
be grounds for disciplinary action by the board under division 3,347
(B) of section 4723.28 of the Revised Code. The board of nursing 3,349
may abstain from taking disciplinary action against a nurse who 3,350
voluntarily seeks treatment if it finds that the nurse can be 3,351
treated effectively and that there is no impairment of ability to 3,352
practice according to acceptable and prevailing standards of safe 3,354
nursing care. The board may require, as a condition of its 3,355
abstention, that the nurse participate in the alternative program 3,356
for chemically dependent nurses, comply with the terms and 3,357
conditions of the program, and successfully complete it. 3,358
(D) A nurse who voluntarily participates in the 3,360
alternative program for chemically dependent nurses without being 3,361
referred by the board and complies with the terms and conditions 3,362
of the program and the requirements of this section shall not be 3,363
subject to investigation or disciplinary action by the board for 3,364
chemical dependency. The nurse shall report to the board any
failure to comply with the terms and conditions of the program or 3,366
successfully complete it.
75
(E)(D) Except as provided in division (F)(E) of this 3,369
section, all records OF AN INDIVIDUAL'S PARTICIPATION IN THE 3,370
MONITORING PROGRAM, including medical records, chemical 3,371
dependency records, and mental health records, of a participant 3,372
in the program shall be confidential, are not public records for 3,374
the purposes of section 149.43 of the Revised Code, and are not
subject to discovery by subpoena or admissible as evidence in any 3,376
judicial proceeding. The administrator of the program 3,377
COORDINATOR shall maintain all records in the board's office for 3,379
a period of five years.
(F) On commencement of participation in the program, a 3,382
registered nurse or licensed practical nurse shall sign a waiver
permitting the program administrator to release to the board the 3,383
nurse's records if the nurse fails to comply with the terms and 3,385
conditions of the program, does not successfully complete the 3,386
program, or is unable to practice according to acceptable and 3,387
prevailing standards of safe nursing care due to chemical 3,389
dependency. The administrator shall report to the board any such 3,390
nurse and release the nurse's records to it. The board shall 3,391
then investigate in accordance with division (E) of section 3,392
4723.28 of the Revised Code.
(G)(E) THE MONITORING PROGRAM'S COORDINATOR MAY DISCLOSE 3,394
RECORDS OR INFORMATION REGARDING AN INDIVIDUAL'S PROGRESS AND 3,396
STATUS OF PARTICIPATION IN THE PROGRAM TO THE DISCIPLINARY 3,398
SECTION OF THE BOARD OF NURSING AND TO ANY PERSON OR GOVERNMENT 3,399
ENTITY THAT THE PROGRAM PARTICIPANT AUTHORIZES IN WRITING TO BE 3,400
GIVEN THE RECORDS OR INFORMATION.
IN DISCLOSING RECORDS OR INFORMATION UNDER THIS DIVISION, 3,402
THE COORDINATOR SHALL NOT INCLUDE ANY RECORD OR INFORMATION THAT 3,403
IS PROTECTED UNDER SECTION 3793.13 OF THE REVISED CODE OR ANY 3,404
FEDERAL STATUTE OR REGULATION THAT PROVIDES FOR THE 3,406
CONFIDENTIALITY OF MENTAL HEALTH OR SUBSTANCE ABUSE RECORDS. 3,408
(F) IN THE ABSENCE OF FRAUD OR BAD FAITH, THE MONITORING 3,410
PROGRAM'S COORDINATOR, THE BOARD OF NURSING, AND THE BOARD'S 3,411
76
EMPLOYEES AND REPRESENTATIVES ARE NOT LIABLE FOR DAMAGES IN ANY 3,413
CIVIL ACTION AS A RESULT OF DISCLOSING RECORDS OR INFORMATION IN 3,414
ACCORDANCE WITH DIVISION (E) OF THIS SECTION. In the absence of 3,416
fraud or bad faith, any person reporting to the program with 3,418
regard to a nurse's AN INDIVIDUAL'S chemical dependence 3,419
DEPENDENCY, or the progress or lack of progress of that nurse 3,420
INDIVIDUAL with regard to treatment, shall be immune from any 3,422
civil action and shall IS not be liable for civil damages IN ANY 3,423
CIVIL ACTION as a result of the report. 3,424
(G) THE BOARD OF NURSING MAY ABSTAIN FROM TAKING ACTION 3,426
UNDER SECTION 4723.28 OF THE REVISED CODE AGAINST AN INDIVIDUAL 3,427
BECAUSE OF THE INDIVIDUAL'S CHEMICAL DEPENDENCY, IF THE 3,429
INDIVIDUAL MEETS THE ELIGIBILITY REQUIREMENTS FOR ADMISSION INTO 3,431
THE MONITORING PROGRAM AND ALL OF THE FOLLOWING OCCUR: 3,433
(1) THE INDIVIDUAL ENTERS INTO A MONITORING AGREEMENT WITH 3,435
THE COORDINATOR OF THE PROGRAM; 3,436
(2) THE INDIVIDUAL COMPLIES WITH THE TERMS AND CONDITIONS 3,438
FOR CONTINUED PARTICIPATION IN THE PROGRAM, AS SPECIFIED IN THE 3,439
MONITORING AGREEMENT; 3,440
(3) THE INDIVIDUAL SUCCESSFULLY COMPLETES THE TERMS AND 3,442
CONDITIONS OF THE MONITORING AGREEMENT. 3,443
Sec. 4723.42. (A) If the applicant for authorization to 3,452
practice nursing as a certified registered nurse anesthetist, 3,454
clinical nurse specialist, certified nurse-midwife, or certified 3,457
nurse practitioner has met all the requirements of section 3,459
4723.41 of the Revised Code and has paid the fee required by 3,461
section 4723.08 of the Revised Code, the board of nursing shall 3,462
issue its certificate of authority to practice nursing as a 3,464
certified registered nurse anesthetist, clinical nurse 3,465
specialist, certified nurse-midwife, or certified nurse 3,467
practitioner, which shall designate the nursing specialty the 3,469
nurse is authorized to practice. The certificate entitles its 3,470
holder to practice nursing in the specialty designated on the 3,471
certificate.
77
The board shall issue or deny its certificate not later 3,474
than sixty days after receiving all of the documents required by 3,475
section 4723.41 of the Revised Code. Not later than fifteen days 3,477
after receipt of an application, the board shall provide the 3,478
applicant with written notice, by mail, of any required documents 3,480
that remain to be submitted. 3,481
If an applicant is under investigation for a violation of 3,484
this chapter, the board shall conclude the investigation not 3,485
later than ninety days after receipt of all required documents, 3,486
unless this ninety-day period is extended by written consent of 3,487
the applicant, or unless the board determines that a substantial 3,489
question of such a violation exists and the board has notified 3,490
the applicant in writing of the reasons for the continuation of 3,491
the investigation. If the board determines that the applicant 3,492
has not violated this chapter, it shall issue a certificate not 3,493
later than forty-five days after making that determination. 3,496
(B) Authorization to practice nursing as a certified 3,499
registered nurse anesthetist, clinical nurse specialist, 3,501
certified nurse-midwife, or certified nurse practitioner shall be 3,503
renewed biennially according to rules and a schedule adopted by 3,505
the board. Before a date specified by the board IN PROVIDING 3,506
RENEWAL APPLICATIONS TO CERTIFICATE HOLDERS, the board shall mail 3,508
an application for renewal of a certificate of authority to each
certificate holder at the last known address of the holder FOLLOW 3,511
THE PROCEDURES IT FOLLOWS UNDER SECTION 4723.24 OF THE REVISED 3,512
CODE IN PROVIDING RENEWAL APPLICATIONS TO LICENSE HOLDERS.
Failure of the CERTIFICATE holder to receive an application for 3,514
renewal from the board does not excuse the holder from the 3,515
requirements of section 4723.44 of the Revised Code. Not 3,516
NOT later than the date specified by the board, the holder 3,519
shall complete the renewal form and return it to the board with 3,521
all of the following:
(1) The renewal fee required by section 4723.08 of the 3,523
Revised Code; 3,524
78
(2) Except as provided in division (C) of this section, 3,527
documentation satisfactory to the board that the holder has 3,528
maintained certification in the nursing specialty with a national 3,529
certifying organization listed in division (A)(3) of section 3,531
4723.41 of the Revised Code or approved by the board under 3,532
section 4723.46 of the Revised Code; 3,533
(3) A list of the names and business addresses of the 3,535
holder's current collaborating physicians and podiatrists, if the 3,536
holder is a clinical nurse specialist, certified nurse-midwife, 3,537
or certified nurse practitioner;
(4) If the holder's certificate was issued under division 3,540
(C) of section 4723.41 of the Revised Code, evidence 3,541
DOCUMENTATION SATISFACTORY TO THE BOARD that the holder has 3,542
completed continuing education for a clinical nurse specialist as 3,543
required by rule of the board; 3,544
(5) If the holder's certificate was issued under division 3,547
(D) of section 4723.41 of the Revised Code, verification of 3,548
DOCUMENTATION SATISFACTORY TO THE BOARD THAT THE HOLDER HAS 3,549
continued employment by a public agency or a private, nonprofit 3,550
entity that receives funding under Title X of the "Public Health 3,552
Service Act," 42 U.S.C. 300 and 300a-1 (1991). 3,554
On receipt of the renewal application, fees, and documents, 3,557
the board shall verify that the applicant holds a current license 3,559
to practice nursing as a registered nurse in this state, and, if 3,561
it so verifies, shall renew the certificate. If an applicant 3,562
submits the completed renewal application after the date 3,563
specified in the board's schedule, but before the expiration of 3,564
the certificate, the board shall grant a renewal when the late 3,565
renewal fee required by section 4723.08 of the Revised Code is 3,566
paid.
An applicant for reinstatement of an expired certificate 3,569
shall submit the REINSTATEMENT FEE, renewal fee, and the late 3,572
renewal fee required by section 4723.08 of the Revised Code. Any 3,573
holder of a certificate who desires inactive status shall give 3,574
79
the board written notice to that effect. 3,575
(C) The board shall renew a certificate of authority to 3,578
practice nursing as a clinical nurse specialist issued pursuant 3,579
to division (C) of section 4723.41 of the Revised Code, if the 3,581
certificate holder complies with all renewal requirements of this 3,582
section other than the requirement of having maintained 3,583
certification in the holder's nursing specialty. 3,584
Sec. 4723.43. A certified registered nurse anesthetist, 3,594
clinical nurse specialist, certified nurse-midwife, or certified 3,595
nurse practitioner may provide to individuals and groups nursing 3,597
care that requires knowledge and skill obtained from advanced 3,598
formal education and clinical experience. THE NURSING CARE MAY 3,599
BE PROVIDED THROUGH ELECTRONIC COMMUNICATION.
(A) A nurse authorized to practice as a certified 3,602
nurse-midwife, in collaboration with physicians, may provide the 3,603
management of preventive services and those primary care services 3,604
necessary to provide health care to women antepartally, 3,605
intrapartally, postpartally, and gynecologically, consistent with 3,606
the nurse's education and certification, and in accordance with 3,607
rules adopted by the board.
No certified nurse-midwife may perform version, deliver 3,610
breech or face presentation, use forceps, do any obstetric 3,611
operation, or treat any other abnormal condition, except in 3,612
emergencies. Division (A) of this section does not prohibit a 3,614
certified nurse-midwife from performing episiotomies or normal 3,615
vaginal deliveries, or repairing vaginal tears. 3,616
(B) A nurse authorized to practice as a certified 3,619
registered nurse anesthetist, with the supervision and in the 3,620
immediate presence of a physician, podiatrist, or dentist, may 3,621
administer anesthesia and perform anesthesia induction,
maintenance, and emergence, and may perform with supervision 3,622
preanesthetic preparation and evaluation, postanesthesia care, 3,623
and clinical support functions, consistent with the nurse's 3,625
education and certification, and in accordance with rules adopted 3,626
80
by the board. When a certified registered nurse anesthetist is 3,629
supervised by a podiatrist, the nurse's scope of practice is 3,631
limited to the anesthesia procedures that the podiatrist has the
authority under section 4731.51 of the Revised Code to perform. 3,633
A certified registered nurse anesthetist may not administer 3,634
general anesthesia under the supervision of a podiatrist in a
podiatrist's office. When a certified registered nurse 3,635
anesthetist is supervised by a dentist, the nurse's scope of 3,637
practice is limited to the anesthesia procedures that the dentist
has the authority under Chapter 4715. of the Revised Code to 3,639
perform.
(C) A nurse authorized to practice as a certified nurse 3,641
practitioner, in collaboration with physicians or podiatrists, 3,642
may provide preventive and primary care services and evaluate and 3,644
promote patient wellness within the nurse's nursing specialty,
consistent with the nurse's education and certification, and in 3,645
accordance with rules adopted by the board. When a certified 3,647
nurse practitioner is collaborating with a podiatrist, the 3,648
nurse's scope of practice is limited to the procedures that the 3,649
podiatrist has the authority under section 4731.51 of the Revised 3,650
Code to perform. 3,651
(D) A nurse authorized to practice as a clinical nurse 3,654
specialist, in collaboration with physicians or podiatrists, may 3,655
provide and manage the care of individuals and groups with 3,656
complex health problems and provide health care services that 3,657
promote, improve, and manage health care within the nurse's 3,658
nursing specialty, consistent with the nurse's education and in 3,660
accordance with rules adopted by the board. When a clinical 3,662
nurse specialist is collaborating with a podiatrist, the nurse's 3,663
scope of practice is limited to the procedures that the
podiatrist has the authority under section 4731.51 of the Revised 3,665
Code to perform.
Sec. 4723.431. (A) Except as provided in division (C) of 3,675
this section, a clinical nurse specialist, certified 3,676
81
nurse-midwife, or certified nurse practitioner may practice only 3,677
in accordance with a standard care arrangement entered into with
one or more collaborating physicians or podiatrists. A STANDARD 3,678
CARE ARRANGEMENT MAY BE ENTERED INTO ONLY WITH A PHYSICIAN OR 3,679
PODIATRIST whose practice is the same as or similar to the 3,681
nurse's nursing specialty. The PHYSICIAN OR PODIATRIST MUST HOLD 3,682
A CERTIFICATE ISSUED UNDER CHAPTER 4731. OF THE REVISED CODE TO
PRACTICE IN THIS STATE AND MUST BE ACTIVELY ENGAGED IN PRACTICE 3,683
IN THIS STATE.
EACH standard care arrangement shall be in writing and 3,686
contain all of the following:
(1) Criteria for referral of a patient by the clinical 3,688
nurse specialist, certified nurse-midwife, or certified nurse 3,689
practitioner to a collaborating physician or podiatrist; 3,690
(2) A process for the clinical nurse specialist, certified 3,692
nurse-midwife, or certified nurse practitioner to obtain a 3,693
consultation with the physician or podiatrist; 3,694
(3) A plan for coverage in instances of emergency or 3,696
planned absences of either the clinical nurse specialist, 3,697
certified nurse-midwife, or certified nurse practitioner or the 3,698
collaborating physician or podiatrist that provides the means 3,699
whereby a physician or podiatrist is available for emergency
care; 3,700
(4) The process for resolution of disagreements regarding 3,702
matters of patient management between the clinical nurse 3,703
specialist, certified nurse-midwife, or certified nurse 3,704
practitioner and the collaborating physician or podiatrist; 3,705
(5) A procedure for a regular review of the referrals by 3,707
the clinical nurse specialist, certified nurse-midwife, or 3,708
certified nurse practitioner to other health care professionals 3,709
and the care outcomes for a random sample of all patients seen by 3,710
the nurse;
(6) If the clinical nurse specialist or certified nurse 3,713
practitioner regularly provides services to infants, a policy for 3,714
82
care of infants up to age one and recommendations for
collaborating physician visits for children from birth to age 3,715
three;
(7) Any other criteria required by rule of the board 3,717
adopted pursuant to section 4723.07 of the Revised Code. 3,720
(B) The standard care arrangement shall be retained on 3,723
file at the site where the clinical nurse specialist, certified
nurse-midwife, or certified nurse practitioner practices by the 3,724
nurse and the collaborating physician or podiatrist. Prior 3,725
approval of the standard care arrangement by the board of nursing 3,726
is not required, but the board may periodically review it for 3,727
compliance with this section.
(C) A clinical nurse specialist whose nursing specialty is 3,730
mental health or psychiatric mental health, as determined by the 3,731
board, is not required to enter into a standard care arrangement
with a collaborating physician, but shall practice in 3,732
collaboration with physicians. 3,733
(D) Nothing in this section prohibits a hospital from 3,735
hiring a clinical nurse specialist, certified nurse-midwife, or 3,736
certified nurse practitioner as an employee and negotiating 3,737
standard care arrangements on behalf of the employee as necessary 3,738
to meet the requirements of this section. A standard care 3,739
arrangement between the hospital's employee and the employee's
collaborating physician is subject to approval by the medical 3,740
staff and governing body of the hospital prior to implementation 3,741
of the arrangement at the hospital. 3,742
Sec. 4723.47. If a certified registered nurse 3,751
anesthetist's, clinical nurse specialist's, certified 3,752
nurse-midwife's, or certified nurse practitioner's license to 3,753
practice nursing as a registered nurse expires for failure to 3,754
renew under section 4723.24 of the Revised Code, the nurse's 3,755
certificate of authority to practice nursing as a certified 3,756
registered nurse anesthetist, clinical nurse specialist, 3,757
certified nurse-midwife, or certified nurse practitioner is 3,759
83
automatically suspended until the license is reinstated. If the 3,760
license is revoked under section 4723.28 or 4723.281 of the
Revised Code, the nurse's certificate of authority is 3,761
automatically revoked. If the license is suspended under either 3,762
section, the nurse's certificate of authority is automatically 3,763
suspended while the license remains suspended. IF THE LICENSE IS 3,764
CLASSIFIED AS INACTIVE UNDER SECTION 4723.24 OF THE REVISED CODE, 3,765
THE NURSE'S CERTIFICATE OF AUTHORITY IS AUTOMATICALLY CLASSIFIED 3,766
AS INACTIVE WHILE THE LICENSE REMAINS INACTIVE.
Sec. 4723.48. A REGISTERED NURSE, LICENSED PRACTICAL 3,769
NURSE, OR OTHER INDIVIDUAL WHO FOLLOWS THE ORDERS OF A CERTIFIED 3,770
NURSE-MIDWIFE, CERTIFIED REGISTERED NURSE-ANESTHETIST, CERTIFIED 3,771
NURSE PRACTITIONER, OR CLINICAL NURSE SPECIALIST IS NOT LIABLE IN 3,773
DAMAGES IN A CIVIL ACTION FOR INJURY, DEATH, OR LOSS TO PERSON OR 3,774
PROPERTY RESULTING FROM THE REGISTERED NURSE'S, LICENSED
PRACTICAL NURSE'S, OR OTHER INDIVIDUAL'S ACTS OR OMISSIONS IN 3,776
PERFORMING ANY PROCEDURE, TREATMENT OR OTHER HEALTH CARE SERVICE 3,778
PURSUANT TO THE ORDERS IF THE REGISTERED NURSE, LICENSED 3,779
PRACTICAL NURSE, OR OTHER INDIVIDUAL REASONABLY BELIEVED THAT THE 3,781
CERTIFIED NURSE-MIDWIFE, CERTIFIED REGISTERED NURSE-ANESTHETIST, 3,782
CERTIFIED NURSE PRACTITIONER, OR CLINICAL NURSE SPECIALIST WAS 3,783
ACTING WITHIN THE PROPER SCOPE OF PRACTICE OR WAS RELAYING 3,784
MEDICAL ORDERS OR OTHER INSTRUCTIONS FROM A COLLABORATING OR 3,785
SUPERVISING PHYSICIAN, PODIATRIST, OR DENTIST, UNLESS THE ACT OR 3,787
OMISSION CONSTITUTES WILLFUL OR WANTON MISCONDUCT.
Sec. 4723.55. (A) For purposes of the pilot programs 3,796
established by section 4723.52 of the Revised Code, the board of 3,797
nursing may approve registered nurses as advanced practice 3,798
nurses. The board shall not approve as an advanced practice 3,799
nurse a person who is practicing as a certified registered nurse 3,800
anesthetist. 3,801
Any individual who desires to receive approval shall submit 3,803
a written application to the board of nursing on forms the board 3,804
shall prescribe and furnish. The application shall be 3,805
84
accompanied by the fee established in rules adopted under section 3,806
4723.54 of the Revised Code and shall include any information the 3,807
board requires pursuant to rules adopted under that section. 3,808
(B) The board may approve an applicant as an advanced 3,810
practice nurse if the BOTH OF THE FOLLOWING APPLY: 3,811
(1) THE applicant has completed no less than three years 3,814
of experience in the practice of nursing as a registered nurse 3,815
that meets the criteria specified by the board pursuant to rules 3,816
adopted under section 4723.54 of the Revised Code and either of 3,817
the following applies:;
(1)(2) The applicant is a MEETS THE SAME EDUCATIONAL OR 3,820
NATIONAL CERTIFICATION REQUIREMENTS THAT MUST BE MET UNDER
SECTION 4723.41 OF THE REVISED CODE TO RECEIVE A CERTIFICATE OF 3,821
AUTHORITY TO PRACTICE AS A CERTIFIED nurse-midwife holding a 3,822
current, valid certificate issued under section 4723.42 of the 3,823
Revised Code and is certified by the American college of 3,824
nurse-midwives;
(2) The applicant is a registered nurse certified as a 3,826
clinical nurse specialist, or CERTIFIED nurse practitioner by a 3,828
national certifying organization recognized by the board. 3,829
(C) For purposes of division (B) of this section, the 3,831
board of nursing may recognize a national certifying organization 3,832
if all of the following apply: 3,833
(1) The organization's certification standards prescribe 3,835
minimum educational and professional experience requirements 3,836
beyond those required for licensure as a registered nurse, 3,837
including completion of a course of study in advanced practice 3,838
nursing; 3,839
(2) The organization's certification standards require 3,841
successful completion of an examination acceptable to the board 3,842
of nursing; 3,843
(3) The organization establishes professional titles and 3,845
initials for use by those it certifies that are acceptable to the 3,846
board of nursing. 3,847
85
(C) Approval under this section as an advanced practice 3,849
nurse is valid for two years. The board may renew its approval 3,850
of an advanced practice nurse if the nurse submits a written 3,851
application to the board on forms the board shall prescribe and 3,852
furnish. The application shall be accompanied by the renewal fee 3,853
established in rules adopted under section 4723.54 of the Revised 3,854
Code and shall include any information the board requires 3,855
pursuant to rules adopted under that section. 3,856
Sec. 4723.56. (A) For purposes of the pilot programs 3,865
established by section 4723.52 of the Revised Code, the board of 3,866
nursing may approve an advanced practice nurse to prescribe drugs 3,867
and therapeutic devices if the nurse submits to the board all of 3,868
the following: 3,869
(1) Evidence of having attained at least a master's degree 3,871
in nursing from an accredited institution recognized by the 3,872
board; 3,873
(2) Evidence of completing the pharmacology instruction 3,875
required by division (B) of this section; 3,876
(3) A copy of the protocol STANDARD CARE ARRANGEMENT 3,878
established between the nurse and the nurse's collaborating 3,880
physician that meets the requirements of division (C) of this 3,881
section and receives approval from the formulary committee for 3,882
advanced practice nurses established under section 4723.57 of the 3,883
Revised Code;
(4) Any other information the board requires pursuant to 3,885
rules adopted under section 4723.58 of the Revised Code; 3,886
(5) The fee established in rules adopted under section 3,888
4723.54 of the Revised Code. 3,889
(B) To receive approval under this section to prescribe 3,891
drugs and therapeutic devices, an advanced practice nurse must 3,892
have completed a minimum of thirty hours of instruction in 3,893
pharmacology. The instruction must have been completed within 3,894
three years prior to application for the approval, unless the 3,895
board of nursing establishes by rule adopted under section 3,896
86
4723.58 of the Revised Code another time period within which the 3,897
instruction must have been completed. The instruction may have 3,898
been received through either of the following: 3,899
(1) Planned classroom, clinical, or provider-directed 3,901
independent study in pharmacology from an accredited institution 3,902
recognized by the board of nursing; 3,903
(2) Pharmacology courses determined to be acceptable by 3,905
the board pursuant to rules adopted under section 4723.58 of the 3,906
Revised Code. 3,907
(C) Each advanced practice nurse who desires to receive 3,909
approval under this section to prescribe drugs and therapeutic 3,910
devices shall enter into an A STANDARD CARE arrangement with a 3,911
collaborating physician. The advanced practice nurse and the 3,913
collaborating physician shall develop a written protocol that 3,914
establishes the arrangement between the nurse and the physician 3,915
WITH RESPECT TO THE NURSE'S PRESCRIPTIVE AUTHORITY. The protocol 3,916
PRESCRIPTIVE AUTHORITY PROVISIONS OF THE ARRANGEMENT shall 3,918
include the following:
(1) The drugs that the advanced practice nurse may 3,920
prescribe and the limitations on the authority to prescribe them, 3,922
including any restrictions on dosage units or refills, in
accordance with the formulary established in rules adopted under 3,923
section 4723.58 of the Revised Code; 3,924
(2) The conditions under which the advanced practice nurse 3,926
must refer patients to the collaborating physician or another 3,927
physician; 3,928
(3) The responsibilities of the collaborating physician; 3,930
(4) Procedures for quality assurance reviews of the 3,932
advanced practice nurse by the collaborating physician. 3,933
(D)(1) On receipt of a protocol STANDARD CARE ARRANGEMENT 3,935
under division (A) of this section, the board shall submit the 3,937
protocol STANDARD CARE ARRANGEMENT to the formulary committee for 3,939
advanced practice nurses for the committee's review. An advanced 3,940
practice nurse shall prescribe drugs and therapeutic devices only 3,941
87
in accordance with a protocol STANDARD CARE ARRANGEMENT approved 3,942
by the committee. 3,943
(2) If an advanced practice nurse and collaborating 3,945
physician propose to make a change in an approved protocol, the 3,946
advanced practice nurse shall file the proposed change with the 3,947
board of nursing at least thirty days prior to the date on which 3,948
the proposed change is intended to become effective. The board 3,949
shall submit the proposed change to the formulary committee for 3,950
the committee's review. The advanced practice nurse and 3,951
collaborating physician shall implement the change only if it is 3,952
approved by the committee. 3,953
(E) Notwithstanding any other provision of this chapter or 3,955
Chapter 2925., 3719., 4729., or 4731. of the Revised Code to the 3,956
contrary, an advanced practice nurse approved under this section 3,957
may prescribe drugs and therapeutic devices as specified in the 3,958
protocol STANDARD CARE ARRANGEMENT established between the nurse 3,959
and the collaborating physician and may personally supply drugs 3,961
and therapeutic devices in accordance with section 4723.561 of 3,962
the Revised Code.
(F) Approval under this section to prescribe and 3,964
personally supply drugs and therapeutic devices is valid for two 3,965
years. The board may renew its approval to prescribe drugs and 3,966
therapeutic devices if the nurse submits to the board all of the 3,967
following:
(1) Evidence of completing during the previous two years 3,969
at least twelve hours of continuing education in pharmacology 3,970
from an accredited institution recognized by the board; 3,971
(2) A written recommendation for renewal from the nurse's 3,973
collaborating physician; 3,974
(3) Any other information the board requires pursuant to 3,976
rules adopted under section 4723.58 of the Revised Code; 3,977
(4) The fee established in rules adopted under section 3,979
4723.54 of the Revised Code. 3,980
(G) The continuing education required by this section is 3,982
88
in addition to the continuing education required under section 3,983
4723.24 of the Revised Code. 3,984
(H) Application for approval under this section may be 3,986
made at the same time that application is made for approval under 3,987
section 4723.55 of the Revised Code or at any time subsequent to 3,988
receiving approval under that section. 3,989
Sec. 4723.57. (A) There is hereby created the formulary 3,999
committee for advanced practice nurses. Three members of the 4,000
committee shall be advanced practice nurses appointed by the 4,001
board of nursing, each of whom shall hold at least a master's 4,002
degree in nursing. One of these members shall be a nurse-midwife 4,003
certified by the American college of nurse-midwives, one shall be 4,004
a nurse practitioner certified as such by a national certifying 4,005
organization recognized by the board of nursing in accordance 4,006
with section 4723.55 of the Revised Code, and one shall be a 4,007
clinical nurse specialist certified as such by a national 4,008
certifying organization recognized by the board of nursing in 4,009
accordance with section 4723.55 of the Revised Code. Three 4,010
members shall be physicians appointed by the state medical board 4,011
who have experience working with advanced practice nurses. One 4,012
member shall be a pharmacist appointed by the state board of 4,013
pharmacy. The director of health or his THE DIRECTOR'S designee 4,014
shall serve as a nonvoting member of the formulary committee. 4,016
Initial appointments to the formulary committee shall be 4,018
made within sixty days after the effective date of this section 4,020
JANUARY 14, 1993. Vacancies shall be filled in the manner 4,021
provided for original appointments. 4,022
Annually, the formulary committee shall organize by 4,024
selecting a chairman CHAIRPERSON from its voting members. For 4,025
the committee to take any action, the action must be approved by 4,027
affirmative vote of at least four voting members, of which two 4,028
must be advanced practice nurses and two must be physicians. 4,029
Members shall serve without compensation but shall be reimbursed 4,030
by the board of nursing for their actual and necessary expenses 4,031
89
incurred in carrying out their duties as committee members. 4,032
(B) The formulary committee shall make recommendations to 4,034
the board of nursing regarding the board's adoption of rules 4,035
under section 4723.58 of the Revised Code. It shall review, and 4,036
approve or disapprove, each protocol STANDARD CARE ARRANGEMENT 4,037
and proposed change to a protocol STANDARD CARE ARRANGEMENT it 4,039
receives from the board of nursing pursuant to section 4723.56 of 4,041
the Revised Code.
Sec. 4723.58. (A) In accordance with Chapter 119. of the 4,050
Revised Code, the board of nursing shall adopt rules regarding 4,051
the approval of advanced practice nurses under section 4723.56 of 4,052
the Revised Code to prescribe drugs and therapeutic devices. The 4,053
rules shall be consistent with the recommendations of the 4,054
formulary committee for advanced practice nurses and shall 4,055
establish all of the following: 4,056
(1) A formulary listing the drugs and therapeutic devices, 4,058
including types and classes where appropriate, that may be 4,059
prescribed by advanced practice nurses; 4,060
(2) Requirements pertaining to the protocol STANDARD CARE 4,062
ARRANGEMENT that is required to be established between an 4,064
advanced practice nurse and the nurse's collaborating physician; 4,065
(3) Requirements regarding the pharmacology courses that 4,067
an advanced practice nurse is required to complete to receive 4,068
approval or renewal of approval to prescribe drugs and 4,069
therapeutic devices; 4,070
(4) Standards and procedures for approval and renewal of 4,072
approval of advanced practice nurses to prescribe drugs and 4,073
therapeutic devices; 4,074
(5) Any other requirements with regard to advanced 4,076
practice nurses approved to prescribe drugs and therapeutic 4,077
devices. 4,078
(B) The drugs included in the formulary shall not include 4,080
any drug listed on schedule I or II, as specified in section 4,081
3719.41 of the Revised Code. The formulary may include 4,082
90
restrictions and requirements for prescriptions and shall include 4,083
requirements specific to advanced practice nursing. 4,084
Sec. 4723.59. (A) An advanced practice nurse shall 4,093
practice as an advanced practice nurse only in accordance with 4,094
the standard care arrangement developed under section 4723.52 of 4,095
the Revised Code for the pilot program in which the nurse is 4,096
participating. An advanced practice nurse who does not follow 4,097
the standard care arrangement is guilty of unprofessional conduct 4,098
and is subject to disciplinary action under section 4723.28 of 4,099
the Revised Code for violation of this chapter and the rules 4,100
adopted under it. 4,101
(B) An advanced practice nurse approved under section 4,103
4723.56 of the Revised Code shall prescribe drugs and therapeutic 4,104
devices specified in the protocol STANDARD CARE ARRANGEMENT 4,105
established between the nurse and the collaborating physician 4,106
only in accordance with the protocol STANDARD CARE ARRANGEMENT. 4,107
An advanced practice nurse approved under section 4723.56 of the
Revised Code shall personally supply drugs and therapeutic 4,108
devices in accordance with section 4723.561 of the Revised Code. 4,109
Any advanced practice nurse who does not follow the protocol 4,111
STANDARD CARE ARRANGEMENT or personally supply drugs and devices
in accordance with section 4723.561 of the Revised Code is guilty 4,113
of unprofessional conduct and is subject to disciplinary action 4,114
under section 4723.28 of the Revised Code for violation of this 4,115
chapter and the rules adopted under it.
(C) Any collaborating physician who does not perform the 4,117
responsibilities the physician agreed to perform in the protocol 4,119
STANDARD CARE ARRANGEMENT established between the physician and
an advanced practice nurse in accordance with section 4723.56 of 4,120
the Revised Code is guilty of unprofessional conduct and is 4,121
subject to disciplinary action by the state medical board. Under 4,122
this division, the state medical board may revoke, limit, or 4,123
suspend the physician's certificate to practice, pursuant to an 4,124
adjudicatory hearing under Chapter 119. of the Revised Code and a 4,125
91
vote of not less than six of its members. 4,126
Sec. 4723.591. A REGISTERED NURSE, LICENSED PRACTICAL 4,128
NURSE, OR OTHER INDIVIDUAL WHO FOLLOWS THE ORDERS OF AN ADVANCED 4,129
PRACTICE NURSE IS NOT LIABLE IN DAMAGES IN A CIVIL ACTION FOR 4,130
INJURY, DEATH, OR LOSS TO PERSON OR PROPERTY RESULTING FROM THE 4,131
REGISTERED NURSE'S, LICENSED PRACTICAL NURSE'S, OR OTHER
INDIVIDUAL'S ACTS OR OMISSIONS IN PERFORMING ANY PROCEDURE, 4,132
TREATMENT, OR OTHER HEALTH CARE SERVICE PURSUANT TO THE ORDERS IF 4,134
THE REGISTERED NURSE, ADVANCED PRACTICAL NURSE, OR OTHER 4,135
INDIVIDUAL REASONABLY BELIEVED THAT THE ADVANCED PRACTICE NURSE 4,136
WAS ACTING WITHIN THE PROPER SCOPE OF PRACTICE OR WAS RELAYING
MEDICAL ORDERS OR OTHER INSTRUCTIONS FROM A COLLABORATING 4,137
PHYSICIAN, UNLESS THE ACT OR OMISSION CONSTITUTES WILLFUL OR 4,138
WANTON MISCONDUCT.
Sec. 4731.22. (A) The state medical board, by an 4,148
affirmative vote of not fewer than six of its members, may revoke 4,149
or may refuse to grant a certificate to a person found by the 4,150
board to have committed fraud during the administration of the 4,151
examination for a certificate to practice or to have committed 4,153
fraud, misrepresentation, or deception in applying for or 4,154
securing any certificate to practice or certificate of
registration issued by the board. 4,155
(B) The board, by an affirmative vote of not fewer than 4,158
six members, shall, to the extent permitted by law, limit, 4,159
revoke, or suspend an individual's certificate to practice, 4,161
refuse to register an individual, refuse to reinstate a 4,163
certificate, or reprimand or place on probation the holder of a 4,165
certificate for one or more of the following reasons:
(1) Permitting one's name or one's certificate to practice 4,167
or certificate of registration to be used by a person, group, or 4,169
corporation when the individual concerned is not actually 4,170
directing the treatment given; 4,171
(2) Failure to maintain minimal standards applicable to 4,174
the selection or administration of drugs, or failure to employ 4,175
92
acceptable scientific methods in the selection of drugs or other 4,176
modalities for treatment of disease; 4,177
(3) Selling, giving away, personally furnishing, 4,179
prescribing, or administering drugs for other than legal and 4,180
legitimate therapeutic purposes or a plea of guilty to, a 4,182
judicial finding of guilt of, or a judicial finding of 4,183
eligibility for treatment in lieu of conviction of, a violation 4,185
of any federal or state law regulating the possession,
distribution, or use of any drug; 4,186
(4) Willfully betraying a professional confidence. 4,188
For purposes of this division, "willfully betraying a 4,190
professional confidence" does not include the making of a report 4,191
of an employee's use of a drug of abuse, or a report of a 4,192
condition of an employee other than one involving the use of a 4,193
drug of abuse, to the employer of the employee as described in 4,194
division (B) of section 2305.33 of the Revised Code. Nothing in 4,196
this division affects the immunity from civil liability conferred 4,198
by that section upon a physician who makes either type of report 4,199
in accordance with division (B) of that section. As used in this 4,200
division, "employee," "employer," and "physician" have the same 4,201
meanings as in section 2305.33 of the Revised Code. 4,202
(5) Making a false, fraudulent, deceptive, or misleading 4,205
statement in the solicitation of or advertising for patients; in 4,207
relation to the practice of medicine and surgery, osteopathic 4,208
medicine and surgery, podiatry, or a limited branch of medicine; 4,209
or in securing or attempting to secure any certificate to 4,211
practice or certificate of registration issued by the board.
As used in this division, "false, fraudulent, deceptive, or 4,213
misleading statement" means a statement that includes a 4,214
misrepresentation of fact, is likely to mislead or deceive 4,215
because of a failure to disclose material facts, is intended or 4,216
is likely to create false or unjustified expectations of 4,217
favorable results, or includes representations or implications 4,218
that in reasonable probability will cause an ordinarily prudent 4,219
93
person to misunderstand or be deceived. 4,220
(6) A departure from, or the failure to conform to, 4,222
minimal standards of care of similar practitioners under the same 4,223
or similar circumstances, whether or not actual injury to a 4,224
patient is established; 4,225
(7) Representing, with the purpose of obtaining 4,227
compensation or other advantage as personal gain or for any other 4,229
person, that an incurable disease or injury, or other incurable 4,230
condition, can be permanently cured; 4,231
(8) The obtaining of, or attempting to obtain, money or 4,233
anything of value by fraudulent misrepresentations in the course 4,234
of practice; 4,235
(9) A plea of guilty to, a judicial finding of guilt of, 4,238
or a judicial finding of eligibility for treatment in lieu of
conviction for, a felony; 4,239
(10) Commission of an act that constitutes a felony in 4,241
this state, regardless of the jurisdiction in which the act was 4,242
committed; 4,243
(11) A plea of guilty to, a judicial finding of guilt of, 4,246
or a judicial finding of eligibility for treatment in lieu of
conviction for, a misdemeanor committed in the course of 4,247
practice;
(12) Commission of an act in the course of practice that 4,249
constitutes a misdemeanor in this state, regardless of the 4,251
jurisdiction in which the act was committed; 4,252
(13) A plea of guilty to, a judicial finding of guilt of, 4,255
or a judicial finding of eligibility for treatment in lieu of
conviction for, a misdemeanor involving moral turpitude; 4,256
(14) Commission of an act involving moral turpitude that 4,258
constitutes a misdemeanor in this state, regardless of the 4,260
jurisdiction in which the act was committed; 4,261
(15) Violation of the conditions of limitation placed by 4,263
the board upon a certificate to practice; 4,264
(16) Failure to pay license renewal fees specified in this 4,266
94
chapter; 4,267
(17) Except as authorized in section 4731.31 of the 4,269
Revised Code, engaging in the division of fees for referral of 4,271
patients, or the receiving of a thing of value in return for a 4,272
specific referral of a patient to utilize a particular service or 4,273
business;
(18) Subject to section 4731.226 of the Revised Code, 4,275
violation of any provision of a code of ethics of the American 4,277
medical association, the American osteopathic association, the 4,278
American podiatric medical association, or any other national 4,279
professional organizations that the board specifies by rule. The 4,281
state medical board shall obtain and keep on file current copies 4,282
of the codes of ethics of the various national professional 4,283
organizations. The individual whose certificate is being 4,284
suspended or revoked shall not be found to have violated any 4,286
provision of a code of ethics of an organization not appropriate 4,287
to the individual's profession. 4,288
For purposes of this division, a "provision of a code of 4,291
ethics of a national professional organization" does not include 4,292
any provision that would preclude the making of a report by a 4,293
physician of an employee's use of a drug of abuse, or of a 4,294
condition of an employee other than one involving the use of a 4,295
drug of abuse, to the employer of the employee as described in
division (B) of section 2305.33 of the Revised Code. Nothing in 4,297
this division affects the immunity from civil liability conferred 4,298
by that section upon a physician who makes either type of report 4,299
in accordance with division (B) of that section. As used in this 4,300
division, "employee," "employer," and "physician" have the same 4,301
meanings as in section 2305.33 of the Revised Code. 4,302
(19) Inability to practice according to acceptable and 4,304
prevailing standards of care by reason of mental illness or 4,305
physical illness, including, but not limited to, physical 4,306
deterioration that adversely affects cognitive, motor, or 4,307
perceptive skills. 4,308
95
In enforcing this division, the board, upon a showing of a 4,311
possible violation, may compel any individual authorized to 4,312
practice by this chapter or who has submitted an application 4,314
pursuant to this chapter to submit to a mental examination, 4,316
physical examination, including an HIV test, or both a mental and 4,318
a physical examination. The expense of the examination is the 4,320
responsibility of the individual compelled to be examined. 4,321
Failure to submit to a mental or physical examination or consent 4,322
to an HIV test ordered by the board constitutes an admission of 4,323
the allegations against the individual unless the failure is due 4,325
to circumstances beyond the individual's control, and a default 4,326
and final order may be entered without the taking of testimony or 4,327
presentation of evidence. If the board finds an individual 4,328
unable to practice because of the reasons set forth in this 4,330
division, the board shall require the individual to submit to 4,331
care, counseling, or treatment by physicians approved or 4,332
designated by the board, as a condition for initial, continued, 4,333
reinstated, or renewed authority to practice. An individual 4,335
affected under this division shall be afforded an opportunity to 4,337
demonstrate to the board the ability to resume practice in 4,338
compliance with acceptable and prevailing standards under the 4,339
provisions of the individual's certificate. For the purpose of 4,341
this division, any individual who applies for or receives a 4,342
certificate to practice under this chapter accepts the privilege 4,343
of practicing in this state and, by so doing, shall be deemed to 4,346
have given consent to submit to a mental or physical examination 4,347
when directed to do so in writing by the board, and to have 4,348
waived all objections to the admissibility of testimony or 4,349
examination reports that constitute a privileged communication. 4,350
(20) Except when civil penalties are imposed under section 4,352
4731.225 or 4731.281 of the Revised Code, and subject to section 4,353
4731.226 of the Revised Code, violating or attempting to violate, 4,355
directly or indirectly, or assisting in or abetting the violation 4,356
of, or conspiring to violate, any provisions of this chapter or 4,357
96
any rule promulgated by the board.
This division does not apply to a violation or attempted 4,359
violation of, assisting in or abetting the violation of, or a 4,360
conspiracy to violate, any provision of this chapter or any rule 4,361
adopted by the board that would preclude the making of a report 4,364
by a physician of an employee's use of a drug of abuse, or of a 4,365
condition of an employee other than one involving the use of a 4,366
drug of abuse, to the employer of the employee as described in
division (B) of section 2305.33 of the Revised Code. Nothing in 4,368
this division affects the immunity from civil liability conferred 4,369
by that section upon a physician who makes either type of report 4,370
in accordance with division (B) of that section. As used in this 4,371
division, "employee," "employer," and "physician" have the same 4,372
meanings as in section 2305.33 of the Revised Code. 4,373
(21) The violation of any abortion rule adopted by the 4,375
public health council pursuant to section 3701.341 of the Revised 4,376
Code; 4,377
(22) Any of the following actions taken by the state 4,379
agency responsible for regulating the practice of medicine and 4,380
surgery, osteopathic medicine and surgery, podiatry, or the 4,381
limited branches of medicine in another state, for any reason 4,382
other than the nonpayment of fees: the limitation, revocation, 4,383
or suspension of an individual's license to practice; acceptance 4,384
of an individual's license surrender; denial of a license; 4,385
refusal to renew or reinstate a license; imposition of probation; 4,387
or issuance of an order of censure or other reprimand; 4,388
(23) The violation of section 2919.12 of the Revised Code 4,390
or the performance or inducement of an abortion upon a pregnant 4,391
woman with actual knowledge that the conditions specified in 4,392
division (B) of section 2317.56 of the Revised Code have not been 4,393
satisfied or with a heedless indifference as to whether those 4,394
conditions have been satisfied, unless an affirmative defense as 4,395
specified in division (H)(2) of that section would apply in a 4,396
civil action authorized by division (H)(1) of that section; 4,397
97
(24) The revocation, suspension, restriction, reduction, 4,399
or termination of clinical privileges by the United States 4,401
department of defense or department of veterans affairs or the 4,403
termination or suspension of a certificate of registration to 4,404
prescribe drugs by the drug enforcement administration of the 4,405
United States department of justice; 4,406
(25) Termination or suspension from participation in the 4,408
medicare or medicaid programs by the department of health and 4,410
human services or other responsible agency for any act or acts 4,411
that also would constitute a violation of division (B)(2), (3), 4,412
(6), (8), or (19) of this section; 4,413
(26) Impairment of ability to practice according to 4,415
acceptable and prevailing standards of care because of habitual 4,416
or excessive use or abuse of drugs, alcohol, or other substances 4,417
that impair ability to practice. 4,418
For the purposes of this division, any individual 4,420
authorized to practice by this chapter accepts the privilege of 4,422
practicing in this state subject to supervision by the board. By 4,423
filing an application for or holding a certificate to practice 4,426
under this chapter, an individual shall be deemed to have given 4,428
consent to submit to a mental or physical examination when 4,429
ordered to do so by the board in writing, and to have waived all 4,430
objections to the admissibility of testimony or examination 4,431
reports that constitute privileged communications. 4,432
If it has reason to believe that any individual authorized 4,434
to practice by this chapter or any applicant for certification to 4,436
practice suffers such impairment, the board may compel the 4,437
individual to submit to a mental or physical examination, or 4,438
both. The expense of the examination is the responsibility of 4,440
the individual compelled to be examined. Any mental or physical 4,442
examination required under this division shall be undertaken by a 4,443
treatment provider or physician who is qualified to conduct the 4,444
examination and who is chosen by the board. 4,445
Failure to submit to a mental or physical examination 4,448
98
ordered by the board constitutes an admission of the allegations 4,449
against the individual unless the failure is due to circumstances 4,450
beyond the individual's control, and a default and final order 4,451
may be entered without the taking of testimony or presentation of 4,452
evidence. If the board determines that the individual's ability 4,453
to practice is impaired, the board shall suspend the individual's 4,454
certificate or deny the individual's application and shall 4,455
require the individual, as a condition for initial, continued, 4,456
reinstated, or renewed certification to practice, to submit to 4,458
treatment.
Before being eligible to apply for reinstatement of a 4,460
certificate suspended under this division, the impaired 4,462
practitioner shall demonstrate to the board the ability to resume 4,464
practice in compliance with acceptable and prevailing standards 4,465
of care under the provisions of the practitioner's certificate. 4,466
The demonstration shall include, but shall not be limited to, the 4,468
following:
(a) Certification from a treatment provider approved under 4,470
section 4731.25 of the Revised Code that the individual has 4,472
successfully completed any required inpatient treatment; 4,473
(b) Evidence of continuing full compliance with an 4,475
aftercare contract or consent agreement; 4,476
(c) Two written reports indicating that the individual's 4,478
ability to practice has been assessed and that the individual has 4,479
been found capable of practicing according to acceptable and 4,480
prevailing standards of care. The reports shall be made by 4,481
individuals or providers approved by the board for making the 4,482
assessments and shall describe the basis for their determination. 4,483
The board may reinstate a certificate suspended under this 4,486
division after that demonstration and after the individual has 4,487
entered into a written consent agreement. 4,488
When the impaired practitioner resumes practice, the board 4,490
shall require continued monitoring of the individual. The 4,492
monitoring shall include, but not be limited to, compliance with 4,494
99
the written consent agreement entered into before reinstatement 4,495
or with conditions imposed by board order after a hearing, and, 4,496
upon termination of the consent agreement, submission to the 4,497
board for at least two years of annual written progress reports 4,498
made under penalty of perjury stating whether the individual has 4,499
maintained sobriety. 4,500
(27) A second or subsequent violation of section 4731.66 4,502
or 4731.69 of the Revised Code; 4,503
(28) Except as provided in division (N) of this section: 4,505
(a) Waiving the payment of all or any part of a deductible 4,508
or copayment that a patient, pursuant to a health insurance or 4,509
health care policy, contract, or plan that covers the 4,510
individual's services, otherwise would be required to pay if the 4,512
waiver is used as an enticement to a patient or group of patients 4,513
to receive health care services from that individual; 4,514
(b) Advertising that the individual will waive the payment 4,517
of all or any part of a deductible or copayment that a patient, 4,518
pursuant to a health insurance or health care policy, contract, 4,519
or plan that covers the individual's services, otherwise would be 4,521
required to pay. 4,522
(29) Failure to use universal blood and body fluid 4,524
precautions established by rules adopted under section 4731.051 4,525
of the Revised Code; 4,526
(30) Failure of a collaborating physician to perform the 4,529
responsibilities agreed to by the physician in the protocol 4,530
established between the physician and an advanced practice nurse 4,531
in accordance with section 4723.56 PARTICIPATING IN THE PILOT 4,532
PROJECTS ESTABLISHED UNTIL JANUARY 1, 2010, UNDER SECTION 4723.52 4,534
of the Revised Code;
(31) Failure to provide notice to, and receive 4,536
acknowledgment of the notice from, a patient when required by 4,538
section 4731.143 of the Revised Code prior to providing 4,539
nonemergency professional services, or failure to maintain that 4,540
notice in the patient's file;
100
(32) Failure of a physician supervising a physician 4,542
assistant to maintain supervision in accordance with the 4,543
requirements of Chapter 4730. of the Revised Code and the rules 4,544
adopted under that chapter;
(33) Failure of a physician or podiatrist to maintain a 4,546
standard care arrangement with a clinical nurse specialist, 4,547
certified nurse-midwife, or certified nurse practitioner with 4,548
whom the physician or podiatrist is in collaboration pursuant to 4,549
section 4731.27 of the Revised Code and practice in accordance 4,550
with the arrangement;
(34) Failure to comply with the terms of a consult 4,552
agreement entered into with a pharmacist pursuant to section 4,553
4729.39 of the Revised Code; 4,554
(35) Failure to cooperate in an investigation conducted by 4,556
the board under division (F) of this section, including failure 4,558
to comply with a subpoena or order issued by the board or failure 4,559
to answer truthfully a question presented by the board at a 4,560
deposition or in written interrogatories, except that failure to 4,561
cooperate with an investigation shall not constitute grounds for 4,562
discipline under this section if a court of competent 4,563
jurisdiction has issued an order that either quashes a subpoena 4,564
or permits the individual to withhold the testimony or evidence 4,565
in issue.
(C) Disciplinary actions taken by the board under 4,567
divisions (A) and (B) of this section shall be taken pursuant to 4,568
an adjudication under Chapter 119. of the Revised Code, except 4,569
that in lieu of an adjudication, the board may enter into a 4,570
consent agreement with an individual to resolve an allegation of 4,571
a violation of this chapter or any rule adopted under it. A 4,572
consent agreement, when ratified by an affirmative vote of not 4,573
fewer than six members of the board, shall constitute the 4,574
findings and order of the board with respect to the matter 4,575
addressed in the agreement. If the board refuses to ratify a 4,576
consent agreement, the admissions and findings contained in the 4,577
101
consent agreement shall be of no force or effect. 4,578
(D) For purposes of divisions (B)(10), (12), and (14) of 4,580
this section, the commission of the act may be established by a 4,581
finding by the board, pursuant to an adjudication under Chapter 4,583
119. of the Revised Code, that the individual committed the act.
The board does not have jurisdiction under those divisions if the 4,586
trial court renders a final judgment in the individual's favor
and that judgment is based upon an adjudication on the merits. 4,589
The board has jurisdiction under those divisions if the trial 4,590
court issues an order of dismissal upon technical or procedural 4,591
grounds.
(E) The sealing of conviction records by any court shall 4,593
have no effect upon a prior board order entered under this 4,594
section or upon the board's jurisdiction to take action under 4,595
this section if, based upon a plea of guilty, a judicial finding 4,597
of guilt, or a judicial finding of eligibility for treatment in 4,598
lieu of conviction, the board issued a notice of opportunity for 4,599
a hearing prior to the court's order to seal the records. The 4,600
board shall not be required to seal, destroy, redact, or 4,601
otherwise modify its records to reflect the court's sealing of 4,602
conviction records. 4,603
(F)(1) The board shall investigate evidence that appears 4,605
to show that a person has violated any provision of this chapter 4,607
or any rule adopted under it. Any person may report to the board
in a signed writing any information that the person may have that 4,609
appears to show a violation of any provision of this chapter or 4,610
any rule adopted under it. In the absence of bad faith, any 4,612
person who reports information of that nature or who testifies
before the board in any adjudication conducted under Chapter 119. 4,614
of the Revised Code shall not be liable in damages in a civil 4,615
action as a result of the report or testimony. Each complaint or 4,617
allegation of a violation received by the board shall be assigned 4,618
a case number and shall be recorded by the board. 4,619
(2) Investigations of alleged violations of this chapter 4,621
102
or any rule adopted under it shall be supervised by the 4,623
supervising member elected by the board in accordance with 4,624
section 4731.02 of the Revised Code and by the secretary as 4,625
provided in section 4731.39 of the Revised Code. The president
may designate another member of the board to supervise the 4,627
investigation in place of the supervising member. No member of
the board who supervises the investigation of a case shall 4,629
participate in further adjudication of the case.
(3) In investigating a possible violation of this chapter 4,632
or any rule adopted under this chapter, the board may administer 4,634
oaths, order the taking of depositions, issue subpoenas, and 4,635
compel the attendance of witnesses and production of books, 4,636
accounts, papers, records, documents, and testimony, except that 4,637
a subpoena for patient record information shall not be issued 4,638
without consultation with the attorney general's office and 4,639
approval of the secretary and supervising member of the board. 4,641
Before issuance of a subpoena for patient record information, the 4,642
secretary and supervising member shall determine whether there is 4,645
probable cause to believe that the complaint filed alleges a
violation of this chapter or any rule adopted under it and that 4,646
the records sought are relevant to the alleged violation and 4,648
material to the investigation. The subpoena may apply only to 4,649
records that cover a reasonable period of time surrounding the 4,650
alleged violation. 4,651
On failure to comply with any subpoena issued by the board 4,654
and after reasonable notice to the person being subpoenaed, the 4,655
board may move for an order compelling the production of persons 4,656
or records pursuant to the Rules of Civil Procedure. 4,657
A subpoena issued by the board may be served by a sheriff, 4,659
the sheriff's deputy, or a board employee designated by the 4,660
board. Service of a subpoena issued by the board may be made by 4,662
delivering a copy of the subpoena to the person named therein, 4,663
reading it to the person, or leaving it at the person's usual 4,664
place of residence. When the person being served is a person 4,665
103
whose practice is authorized by this chapter, service of the 4,666
subpoena may be made by certified mail, restricted delivery, 4,667
return receipt requested, and the subpoena shall be deemed served 4,668
on the date delivery is made or the date the person refuses to 4,669
accept delivery.
A sheriff's deputy who serves a subpoena shall receive the 4,671
same fees as a sheriff. Each witness who appears before the 4,673
board in obedience to a subpoena shall receive the fees and 4,675
mileage provided for witnesses in civil cases in the courts of 4,676
common pleas.
(4) All hearings and investigations of the board shall be 4,678
considered civil actions for the purposes of section 2305.251 of 4,679
the Revised Code. 4,680
(5) Information received by the board pursuant to an 4,682
investigation is confidential and not subject to discovery in any 4,683
civil action. 4,684
The board shall conduct all investigations and proceedings 4,686
in a manner that protects the confidentiality of patients and 4,688
persons who file complaints with the board. The board shall not 4,690
make public the names or any other identifying information about 4,691
patients or complainants unless proper consent is given or, in 4,692
the case of a patient, a waiver of the patient privilege exists 4,693
under division (B) of section 2317.02 of the Revised Code, except 4,694
that consent or a waiver of that nature is not required if the 4,695
board possesses reliable and substantial evidence that no bona 4,697
fide physician-patient relationship exists. 4,698
The board may share any information it receives pursuant to 4,701
an investigation, including patient records and patient record 4,702
information, with other licensing boards and governmental 4,703
agencies that are investigating alleged professional misconduct 4,704
and with law enforcement agencies and other governmental agencies 4,706
that are investigating or prosecuting alleged criminal offenses.
A board or agency that receives the information shall comply with 4,707
the same requirements regarding confidentiality as those with 4,708
104
which the state medical board must comply, notwithstanding any 4,709
conflicting provision of the Revised Code or procedure of the 4,711
board or agency that applies when the board or agency is dealing
with other information in its possession. The information may be 4,713
admitted into evidence in a criminal trial in accordance with the 4,714
Rules of Evidence, but the court shall require that appropriate 4,715
measures are taken to ensure that confidentiality is maintained 4,716
with respect to any part of the information that contains names 4,717
or other identifying information about patients or complainants
whose confidentiality was protected by the state medical board 4,718
when the information was in the board's possession. Measures to 4,719
ensure confidentiality that may be taken by the court include 4,720
sealing its records or deleting specific information from its 4,722
records.
(6) On a quarterly basis, the board shall prepare a report 4,724
that documents the disposition of all cases during the preceding 4,725
three months. The report shall contain the following information 4,726
for each case with which the board has completed its activities: 4,727
(a) The case number assigned to the complaint or alleged 4,729
violation; 4,730
(b) The type of certificate to practice, if any, held by 4,733
the individual against whom the complaint is directed; 4,734
(c) A description of the allegations contained in the 4,736
complaint; 4,737
(d) The disposition of the case. 4,739
The report shall state how many cases are still pending and 4,742
shall be prepared in a manner that protects the identity of each 4,744
person involved in each case. The report shall be a public 4,745
record under section 149.43 of the Revised Code.
(G) If the secretary and supervising member determine that 4,747
there is clear and convincing evidence that an individual has 4,749
violated division (B) of this section and that the individual's 4,750
continued practice presents a danger of immediate and serious 4,752
harm to the public, they may recommend that the board suspend the 4,753
105
individual's certificate to practice without a prior hearing. 4,755
Written allegations shall be prepared for consideration by the
board. 4,756
The board, upon review of those allegations and by an 4,758
affirmative vote of not fewer than six of its members, excluding 4,760
the secretary and supervising member, may suspend a certificate 4,761
without a prior hearing. A telephone conference call may be 4,762
utilized for reviewing the allegations and taking the vote on the 4,763
summary suspension. 4,764
The board shall issue a written order of suspension by 4,766
certified mail or in person in accordance with section 119.07 of 4,767
the Revised Code. The order shall not be subject to suspension 4,769
by the court during pendency of any appeal filed under section 4,770
119.12 of the Revised Code. If the individual subject to the 4,772
summary suspension requests an adjudicatory hearing by the board, 4,773
the date set for the hearing shall be within fifteen days, but 4,774
not earlier than seven days, after the individual requests the 4,776
hearing, unless otherwise agreed to by both the board and the 4,777
individual.
Any summary suspension imposed under this division shall 4,779
remain in effect, unless reversed on appeal, until a final 4,780
adjudicative order issued by the board pursuant to this section 4,781
and Chapter 119. of the Revised Code becomes effective. The 4,782
board shall issue its final adjudicative order within sixty days 4,783
after completion of its hearing. A failure to issue the order 4,784
within sixty days shall result in dissolution of the summary 4,785
suspension order but shall not invalidate any subsequent, final 4,786
adjudicative order. 4,787
(H) If the board takes action under division (B)(9), (11), 4,790
or (13) of this section and the judicial finding of guilt, guilty 4,791
plea, or judicial finding of eligibility for treatment in lieu of 4,792
conviction is overturned on appeal, upon exhaustion of the 4,794
criminal appeal, a petition for reconsideration of the order may 4,795
be filed with the board along with appropriate court documents. 4,796
106
Upon receipt of a petition of that nature and supporting court 4,797
documents, the board shall reinstate the individual's certificate 4,798
to practice. The board may then hold an adjudication under 4,799
Chapter 119. of the Revised Code to determine whether the 4,800
individual committed the act in question. Notice of an 4,802
opportunity for a hearing shall be given in accordance with 4,803
Chapter 119. of the Revised Code. If the board finds, pursuant 4,804
to an adjudication held under this division, that the individual 4,805
committed the act or if no hearing is requested, the board may 4,807
order any of the sanctions identified under division (B) of this 4,808
section.
(I) The certificate to practice issued to an individual 4,810
under this chapter and the individual's practice in this state 4,812
are automatically suspended as of the date the individual pleads
guilty to, is found by a judge or jury to be guilty of, or is 4,814
subject to a judicial finding of eligibility for treatment in 4,815
lieu of conviction for any of the following criminal offenses in 4,817
this state or a substantially equivalent criminal offense in 4,818
another jurisdiction: aggravated murder, murder, voluntary 4,819
manslaughter, felonious assault, kidnapping, rape, sexual 4,820
battery, gross sexual imposition, aggravated arson, aggravated 4,821
robbery, or aggravated burglary. Continued practice after 4,823
suspension shall be considered practicing without a certificate. 4,824
The board shall notify the individual subject to the 4,827
suspension by certified mail or in person in accordance with 4,828
section 119.07 of the Revised Code. If an individual whose 4,829
certificate is suspended under this division fails to make a 4,830
timely request for an adjudication under Chapter 119. of the 4,831
Revised Code, the board shall enter a final order permanently 4,832
revoking the individual's certificate to practice. 4,833
(J) If the board is required by Chapter 119. of the 4,836
Revised Code to give notice of an opportunity for a hearing and 4,837
if the individual subject to the notice does not timely request a 4,838
hearing in accordance with section 119.07 of the Revised Code, 4,840
107
the board is not required to hold a hearing, but may adopt, by an 4,841
affirmative vote of not fewer than six of its members, a final 4,843
order that contains the board's findings. In that final order, 4,844
the board may order any of the sanctions identified under 4,845
division (A) or (B) of this section. 4,846
(K) Any action taken by the board under division (B) of 4,848
this section resulting in a suspension from practice shall be 4,849
accompanied by a written statement of the conditions under which 4,850
the individual's certificate to practice may be reinstated. The 4,852
board shall adopt rules governing conditions to be imposed for 4,853
reinstatement. Reinstatement of a certificate suspended pursuant 4,854
to division (B) of this section requires an affirmative vote of 4,855
not fewer than six members of the board. 4,856
(L) When the board refuses to grant a certificate to an 4,859
applicant, revokes an individual's certificate to practice, 4,861
refuses to register an applicant, or refuses to reinstate an 4,862
individual's certificate to practice, the board may specify that 4,863
its action is permanent. An individual subject to a permanent 4,864
action taken by the board is forever thereafter ineligible to 4,865
hold a certificate to practice and the board shall not accept an 4,866
application for reinstatement of the certificate or for issuance 4,867
of a new certificate.
(M) Notwithstanding any other provision of the Revised 4,869
Code, all of the following apply: 4,870
(1) The surrender of a certificate issued under this 4,872
chapter shall not be effective unless or until accepted by the 4,874
board. Reinstatement of a certificate surrendered to the board 4,875
requires an affirmative vote of not fewer than six members of the 4,876
board.
(2) An application for a certificate made under the 4,879
provisions of this chapter may not be withdrawn without approval 4,881
of the board.
(3) Failure by an individual to renew a certificate of 4,884
registration in accordance with this chapter shall not remove or
108
limit the board's jurisdiction to take any disciplinary action 4,886
under this section against the individual. 4,887
(N) Sanctions shall not be imposed under division (B)(28) 4,890
of this section against any person who waives deductibles and 4,891
copayments as follows:
(1) In compliance with the health benefit plan that 4,893
expressly allows such a practice. Waiver of the deductibles or 4,894
copayments shall be made only with the full knowledge and consent 4,895
of the plan purchaser, payer, and third-party administrator. 4,896
Documentation of the consent shall be made available to the board 4,897
upon request.
(2) For professional services rendered to any other person 4,899
authorized to practice pursuant to this chapter, to the extent 4,901
allowed by this chapter and rules adopted by the board. 4,902
(O) Under the board's investigative duties described in 4,904
this section and subject to division (F) of this section, the 4,906
board shall develop and implement a quality intervention program 4,908
designed to improve through remedial education the clinical and 4,910
communication skills of individuals authorized under this chapter 4,911
to practice medicine and surgery, osteopathic medicine and
surgery, and podiatry. In developing and implementing the 4,913
quality intervention program, the board may do all of the 4,914
following:
(1) Offer in appropriate cases as determined by the board 4,916
an educational and assessment program pursuant to an 4,917
investigation the board conducts under this section; 4,918
(2) Select providers of educational and assessment 4,920
services, including a quality intervention program panel of case 4,921
reviewers;
(3) Make referrals to educational and assessment service 4,924
providers and approve individual educational programs recommended 4,925
by those providers. The board shall monitor the progress of each 4,926
individual undertaking a recommended individual educational 4,927
program. 4,928
109
(4) Determine what constitutes successful completion of an 4,930
individual educational program and require further monitoring of 4,931
the individual who completed the program or other action that the 4,933
board determines to be appropriate;
(5) Adopt rules in accordance with Chapter 119. of the 4,935
Revised Code to further implement the quality intervention 4,937
program.
An individual who participates in an individual educational 4,940
program pursuant to this division shall pay the financial 4,941
obligations arising from that educational program. 4,942
Sec. 4731.27. As used in this section, "collaboration" and 4,951
"standard care arrangement" have the same meanings as in section 4,952
4723.02 4723.01 of the Revised Code. 4,954
Except as provided in division (C) of section 4723.431 of 4,956
the Revised Code, a physician or podiatrist shall enter into a 4,957
standard care arrangement with a clinical nurse specialist, 4,958
certified nurse-midwife, or certified nurse practitioner with 4,959
whom the physician or podiatrist is in collaboration and practice 4,960
in accordance with the arrangement. The standard care 4,961
arrangement shall be retained on file by the physician or
podiatrist and nurse at the site where the nurse practices. 4,962
Prior approval of the standard care arrangement by the state 4,963
medical board is not required, but the board may periodically 4,964
review it.
Nothing in this section prohibits a hospital from hiring a 4,966
clinical nurse specialist, certified nurse-midwife, or certified 4,967
nurse practitioner as an employee and negotiating standard care 4,968
arrangements on behalf of the employee as necessary to meet the 4,969
requirements of this section. A standard care arrangement 4,970
between the hospital's employee and the employee's collaborating
physician is subject to approval by the medical staff and 4,971
governing body of the hospital prior to implementation of the 4,972
arrangement at the hospital.
Sec. 4731.281. (A) On or before the deadline established 4,981
110
under division (B) of this section for applying for renewal of a 4,983
certificate of registration, each person holding a certificate 4,984
under this chapter to practice medicine and surgery, osteopathic 4,985
medicine and surgery, or podiatry shall certify to the state 4,986
medical board that in the preceding two years the person has 4,987
completed one hundred hours of continuing medical education. The 4,988
certification shall be made upon the application for biennial 4,989
registration submitted pursuant to division (B) of this section. 4,991
The board shall adopt rules providing for pro rata reductions by 4,992
month of the number of hours of continuing education required for 4,994
persons who are in their first registration period, who have a
registration period of less than two years due to initial 4,995
implementation of the staggered renewal schedule established 4,996
under division (B) of this section, who have been disabled due to 4,998
illness or accident, or who have been absent from the country. 4,999
In determining whether a course, program, or activity 5,001
qualifies for credit as continuing medical education, the board 5,002
shall approve all continuing medical education taken by persons 5,004
holding a certificate to practice medicine and surgery that is 5,005
certified by the Ohio state medical association, all continuing 5,006
medical education taken by persons holding a certificate to 5,007
practice osteopathic medicine and surgery that is certified by 5,008
the Ohio osteopathic association, and all continuing medical 5,009
education taken by persons holding a certificate to practice 5,010
podiatry that is certified by the Ohio podiatric medical 5,011
association. Each person holding a certificate to practice under 5,013
this chapter shall be given sufficient choice of continuing 5,014
education programs to ensure that the person has had a reasonable 5,015
opportunity to participate in continuing education programs that 5,017
are relevant to the person's medical practice in terms of subject 5,019
matter and level.
The board may require a random sample of persons holding a 5,022
certificate to practice under this chapter to submit materials 5,023
documenting completion of the continuing medical education 5,024
111
requirement during the preceding registration period, but this 5,025
provision shall not limit the board's authority to investigate 5,026
pursuant to section 4731.22 of the Revised Code. 5,027
(B)(1) Every person holding a certificate under this 5,029
chapter to practice medicine and surgery, osteopathic medicine 5,030
and surgery, or podiatry wishing to renew that certificate shall 5,031
apply to the board for a certificate of registration upon an 5,033
application furnished by the board, and pay to the board at the 5,034
time of application a fee of three hundred five dollars, 5,035
according to the following schedule: 5,036
(a) Persons whose last name begins with the letters "A" 5,038
through "B," on or before April 1, 2001, and the first day of 5,039
April of every odd-numbered year thereafter; 5,040
(b) Persons whose last name begins with the letters "C" 5,042
through "D," on or before January 1, 2001, and the first day of 5,043
January of every odd-numbered year thereafter; 5,044
(c) Persons whose last name begins with the letters "E" 5,047
through "G," on or before October 1, 2000, and the first day of 5,049
October of every even-numbered year thereafter; 5,050
(d) Persons whose last name begins with the letters "H" 5,053
through "K," on or before July 1, 2000, and the first day of July 5,055
of every even-numbered year thereafter;
(e) Persons whose last name begins with the letters "L" 5,058
through "M," on or before April 1, 2000, and the first day of 5,060
April of every even-numbered year thereafter;
(f) Persons whose last name begins with the letters "N" 5,063
through "R," on or before January 1, 2000, and the first day of 5,066
January of every even-numbered year thereafter; 5,067
(g) Persons whose last name begins with the letter "S," on 5,070
or before October 1, 1999, and the first day of October of every 5,071
odd-numbered year thereafter;
(h) Persons whose last name begins with the letters "T" 5,074
through "Z," on or before July 1, 1999, and the first day of July 5,075
of every odd-numbered year thereafter. 5,076
112
The board shall deposit the fee in accordance with section 5,079
4731.24 of the Revised Code, except that, until July 30, 2001, 5,081
the board shall deposit twenty dollars of the fee into the state 5,082
treasury to the credit of the physician loan repayment fund 5,083
created by section 3702.78 of the Revised Code. 5,084
(2) The board shall mail or cause to be mailed to every 5,086
person registered to practice medicine and surgery, osteopathic 5,087
medicine and surgery, or podiatry, an application for 5,088
registration addressed to the person's last known post-office 5,089
address or may cause the application to be sent to the person 5,091
through the secretary of any recognized medical, osteopathic, or 5,092
podiatric society, according to the following schedule: 5,093
(a) To persons whose last name begins with the letters "A" 5,095
through "B," on or before January 1, 2001, and the first day of 5,097
January of every odd-numbered year thereafter;
(b) To persons whose last name begins with the letters "C" 5,100
through "D," on or before October 1, 2000, and the first day of 5,101
October of every even-numbered year thereafter; 5,102
(c) To persons whose last name begins with the letters "E" 5,105
through "G," on or before July 1, 2000, and the first day of July 5,108
of every even-numbered year thereafter; 5,109
(d) To persons whose last name begins with the letters "H" 5,112
through "K," on or before April 1, 2000, and the first day of 5,115
April of every even-numbered year thereafter; 5,116
(e) To persons whose last name begins with the letters "L" 5,119
through "M," on or before January 1, 2000, and the first day of 5,122
January of every even-numbered year thereafter; 5,123
(f) To persons whose last name begins with the letters "N" 5,126
through "R," on or before October 1, 1999, and the first day of 5,129
October of every odd-numbered year thereafter; 5,130
(g) To persons whose last name begins with the letter "S," 5,133
on or before July 1, 1999, and the first day of July of every 5,135
odd-numbered year thereafter; 5,136
(h) To persons whose last name begins with the letters "T" 5,139
113
through "Z," on or before April 1, 1999, and the first day of 5,142
April of every odd-numbered year thereafter. 5,143
Failure of any person to receive an application from the 5,146
board shall not excuse the person from the requirements contained 5,147
in this section. The application shall contain proper spaces for 5,148
the applicant's signature and the insertion of the required 5,149
information, including a statement that the person has fulfilled 5,151
the continuing education requirements imposed by this section. 5,152
The applicant shall write or cause to be written upon the 5,154
application so furnished the applicant's full name, principal 5,156
practice address and residence address, the number of the 5,158
applicant's certificate to practice, and any other facts for the 5,160
identification of the applicant as a person holding a certificate 5,161
to practice under this chapter as the board considers necessary. 5,162
The applicant shall include with the application a list of the 5,163
names and addresses of any clinical nurse specialists, certified 5,164
nurse-midwives, or certified nurse practitioners with whom the 5,165
applicant is currently collaborating, as defined in section 5,166
4723.02 4723.01 of the Revised Code. The applicant shall execute 5,168
and deliver the application to the board by mail or in person. 5,170
Every person registered under this section shall give written 5,171
notice to the board of any change of principal practice address 5,172
or residence address or in the list within thirty days of the 5,173
change.
The applicant shall report any criminal offense that 5,175
constitutes grounds for refusal of registration under section 5,176
4731.22 of the Revised Code to which the applicant has pleaded 5,177
guilty, of which the applicant has been found guilty, or for 5,180
which the applicant has been found eligible for treatment in lieu 5,181
of conviction, since last signing an application for a 5,183
certificate of registration.
(C) The board shall issue to any person holding a 5,185
certificate under this chapter to practice medicine and surgery, 5,186
osteopathic medicine and surgery, or podiatry, upon application 5,187
114
and qualification therefor in accordance with this section, a 5,188
certificate of registration under the seal of the board. A 5,189
certificate of registration shall be valid for a two-year period, 5,190
commencing on the first day of the third month after the 5,192
registration fee is due and expiring on the last day of the month 5,194
two years thereafter. 5,195
The board shall publish and cause to be mailed to each 5,199
person registered under this section, upon request, a printed 5,200
list of the persons so registered.
(D) Failure of any certificate holder to register and 5,202
comply with this section shall operate automatically to suspend 5,203
the holder's certificate to practice. Continued practice after 5,206
the suspension of the certificate to practice shall be considered 5,207
as practicing in violation of section 4731.41, 4731.43, or 5,209
4731.60 of the Revised Code. Subject to section 4731.222 of the 5,210
Revised Code, the board shall reinstate a certificate to practice 5,211
for failure to register upon an applicant's submission of the 5,212
biennial registration fee, the applicable monetary penalty, and 5,214
certification by signature of the applicant that the applicant 5,215
has completed the requisite continuing medical education. The 5,216
penalty for reinstatement shall be fifty dollars if the 5,218
certificate has been suspended for two years or less and one 5,219
hundred dollars if the certificate has been suspended for more
than two years. The board shall deposit the penalties in 5,220
accordance with section 4731.24 of the Revised Code. 5,222
(E) If an individual certifies completion of the number of 5,224
hours and type of continuing medical education required to 5,226
receive a certificate of registration or reinstatement of a 5,227
certificate to practice, and the board finds through the random 5,228
samples it conducts under this section or through any other means 5,229
that the individual did not complete the requisite continuing 5,230
medical education, the board may impose a civil penalty of not 5,231
more than five thousand dollars. The board's finding shall be 5,232
made pursuant to an adjudication under Chapter 119. of the 5,233
115
Revised Code and by an affirmative vote of not fewer than six 5,235
members.
A civil penalty imposed under this division may be in 5,237
addition to or in lieu of any other action the board may take 5,238
under section 4731.22 of the Revised Code. The board shall 5,240
deposit civil penalties in accordance with section 4731.24 of the 5,241
Revised Code.
(F) The state medical board may obtain information not 5,243
protected by statutory or common law privilege from courts and 5,244
other sources concerning malpractice claims against any person 5,245
holding a certificate to practice under this chapter or 5,246
practicing as provided in section 4731.36 of the Revised Code. 5,247
Sec. 4743.05. Except as otherwise provided in sections 5,256
4701.20, 4723.061, and 4729.65 of the Revised Code, all money 5,257
collected under Chapters 3773., 4701., 4703., 4709., 4713., 5,258
4715., 4717., 4723., 4725., 4729., 4732., 4733., 4734., 4736., 5,259
4741., 4753., 4755., 4757., 4759., and 4761. of the Revised Code 5,260
shall be paid into the state treasury to the credit of the 5,261
occupational licensing and regulatory fund, which is hereby 5,262
created for use in administering such chapters. Money deposited 5,263
to the credit of the fund under section 4731.24 of the Revised 5,264
Code shall be used until July 1, 1998, for administering Chapters 5,265
4730. and 4731. of the Revised Code. 5,266
At the end of each quarter, the director of budget and 5,268
management shall transfer from the occupational licensing and 5,270
regulatory fund to the nurse education assistance fund created in 5,271
section 3333.28 of the Revised Code the amount certified to the 5,272
director under division (B) of section 4723.08 of the Revised 5,273
Code.
At the end of the first quarter of 1995 and at the end of 5,275
each quarter thereafter, the director shall transfer from the 5,276
occupational licensing and regulatory fund to the certified 5,277
public accountant education assistance fund created in section 5,278
4701.26 of the Revised Code the amount certified to the director 5,280
116
under division (D)(2) of section 4701.10 of the Revised Code.
Sec. 4751.05. (A) The board of examiners of nursing home 5,289
administrators shall admit to examination for licensure as a 5,290
nursing home administrator any candidate who: 5,291
(1) Pays the application fee of fifty dollars; 5,293
(2) Submits evidence of good moral character and 5,295
suitability; 5,296
(3) Is at least eighteen years of age; 5,298
(4) Has completed educational requirements and work 5,300
experience satisfactory to the board; 5,301
(5) Submits an application on forms prescribed by the 5,303
board; 5,304
(6) Pays the examination fee of one hundred fifty dollars. 5,306
(B) Nothing in Chapter 4751. of the Revised Code or the 5,308
rules adopted thereunder shall be construed to require an 5,309
applicant for licensure or a temporary license, who is employed 5,310
by an institution for the care and treatment of the sick to 5,312
demonstrate proficiency in any medical techniques or to meet any 5,313
medical educational qualifications or medical standards not in 5,314
accord with the remedial care and treatment provided by the 5,315
institution if the institution is all of the following: 5,316
(1) Operated exclusively for patients who use spiritual 5,318
means for healing and for whom the acceptance of medical care is 5,319
inconsistent with their religious beliefs; 5,320
(2) Accredited by a national accrediting organization; 5,322
(3) Exempt from federal income taxation under section 501 5,324
of the Internal Revenue Code of 1986, 100 Stat. 2085, 26 U.S.C.A. 5,326
1, as amended; 5,327
(4) Providing twenty-four hour nursing care pursuant to 5,329
the exemption in division (G)(E) of section 4723.32 of the 5,330
Revised Code from the licensing requirements of Chapter 4723. of 5,332
the Revised Code.
(C) If a person fails three times to attain a passing 5,334
grade on the examination, said person, before the person may 5,335
117
again be admitted to examination, shall meet such additional 5,336
education or experience requirements, or both, as may be 5,337
prescribed by the board. 5,338
Sec. 5111.04. (A) As used in this section: 5,347
(1) "Outpatient health facility" means a facility that 5,349
provides comprehensive primary health services by or under the 5,350
direction of a physician at least five days per week on a 5,351
forty-hour per week basis to outpatients, is operated by the 5,352
board of health of a city or general health district or another 5,353
public agency or by a nonprofit private agency or organization 5,354
under the direction and control of a governing board that has no 5,355
health-related responsibilities other than the direction and 5,356
control of one or more such outpatient health facilities, and 5,357
receives at least seventy-five per cent of its operating funds 5,358
from public sources, except that it does not include an 5,359
outpatient hospital facility or a federally qualified health 5,360
center as defined in Sec. 1905(l) (2)(B) of the "Social Security 5,361
Act," 103 Stat. 2264 (1989), 42 U.S.C.A. 1396d(l)(2)(B). 5,362
(2) "Comprehensive primary health services" means 5,364
preventive, diagnostic, therapeutic, rehabilitative, or 5,365
palliative items or services that include all of the following: 5,366
(a) Services of physicians, physician assistants, and 5,368
certified nurse practitioners; 5,369
(b) Diagnostic laboratory and radiological services; 5,371
(c) Preventive health services, such as children's eye and 5,373
ear examinations, perinatal services, well child services, and 5,374
family planning services; 5,375
(d) Arrangements for emergency medical services; 5,377
(e) Transportation services. 5,379
(3) "Certified nurse practitioner" has the same meaning as 5,381
in section 4723.02 4723.01 of the Revised Code. 5,382
(B) Outpatient health facilities are a separate category 5,384
of medical care provider under the rules governing the 5,385
administration of the medical assistance program established 5,386
118
under section 5111.01 of the Revised Code. Rates of 5,387
reimbursement for items and services provided by an outpatient 5,388
health facility under this section shall be prospectively 5,389
determined by the department of human services not less often 5,390
than once each year, shall not be subject to retroactive 5,391
adjustment based on actual costs incurred, and shall not exceed 5,392
the maximum fee schedule or rates of payment, limitations based 5,393
on reasonable costs or customary charges, and limitations based 5,394
on combined payments received for furnishing comparable services, 5,395
as are applicable to outpatient hospital facilities under Title 5,396
XVIII of the "Social Security Act." In determining rates of 5,397
reimbursement prospectively, the department shall take into 5,398
account the historic expenses of the facility, the operating 5,399
requirements and services offered by the facility, and the 5,400
geographical location of the facility, shall provide incentives 5,401
for the efficient and economical utilization of the facility's 5,402
resources, and shall ensure that the facility does not 5,403
discriminate between classes of persons for whom or by whom 5,404
payment for items and services is made. 5,405
(C) A facility does not qualify for classification as an 5,407
outpatient health facility under this section unless it: 5,408
(1) Has health and medical care policies developed with 5,410
the advice of and subject to review by an advisory committee of 5,411
professional personnel, including one or more physicians, one or 5,412
more dentists if dental care is provided, and one or more 5,413
registered nurses; 5,414
(2) Has a medical director, a dental director, if dental 5,416
care is provided, and a nursing director responsible for the 5,417
execution of such policies, and has physicians, dentists, 5,418
nursing, and ancillary staff appropriate to the scope of services 5,419
provided; 5,420
(3) Requires that the care of every patient be under the 5,422
supervision of a physician, provides for medical care in case of 5,423
emergency, has in effect a written agreement with one or more 5,424
119
hospitals and one or more other outpatient facilities, and has an 5,425
established system for the referral of patients to other 5,426
resources and a utilization review plan and program; 5,427
(4) Maintains clinical records on all patients; 5,429
(5) Provides nursing services and other therapeutic 5,431
services in compliance with applicable laws and rules and under 5,432
the supervision of a registered nurse, and has a registered nurse 5,434
on duty at all times when the facility is in operation; 5,435
(6) Follows approved methods and procedures for the 5,437
dispensing and administration of drugs and biologicals; 5,438
(7) Maintains the accounting and record-keeping system 5,440
required under federal laws and regulations for the determination 5,441
of reasonable and allowable costs. 5,442
Section 2. That existing sections 121.22, 3313.68, 5,444
3701.85, 3702.51, 3719.13, 3721.34, 3727.01, 4113.51, 4113.52, 5,445
4723.02, 4723.04, 4723.051, 4723.06, 4723.061, 4723.07, 4723.08, 5,448
4723.09, 4723.15, 4723.151, 4723.24, 4723.28, 4723.281, 4723.31,
4723.32, 4723.34, 4723.341, 4723.35, 4723.39, 4723.42, 4723.43, 5,450
4723.431, 4723.47, 4723.48, 4723.55, 4723.56, 4723.57, 4723.58, 5,452
4723.59, 4731.22, 4731.27, 4731.281, 4743.05, 4751.05, and 5,453
5111.04 and sections 4723.342 and 4723.51 of the Revised Code are 5,454
hereby repealed.
Section 3. That Section 3 of Am. Sub. H.B. 478 of the 5,456
119th General Assembly, as amended by Sub. H.B. 391 of the 120th 5,457
General Assembly and Am. Sub. S.B. 154 of the 121st General 5,458
Assembly, be amended to read as follows:
"Sec. 3. Sections 4723.51, 4723.52, 4723.53, 4723.54, 5,460
4723.55, 4723.56, 4723.561, 4723.57, 4723.58, 4723.59, 4723.591, 5,461
and 4723.60 of the Revised Code are hereby repealed, effective 5,462
January 1, 2010." 5,463
Section 4. That existing Section 3 of Am. Sub. H.B. 478 of 5,465
the 119th General Assembly, as amended by Sub. H.B. 391 of the 5,466
120th General Assembly and Am. Sub. S.B. 154 of the 121st General 5,467
Assembly, is hereby repealed.
120
Section 5. The amendment of Section 3 of Am. Sub. H.B. 478 5,469
of the 119th General Assembly, as amended by Sub. H.B. 391 of the 5,471
120th General Assembly and Am Sub. S.B. 154 of the 121st General 5,472
Assembly, is intended to accelerate the repeal of section 4723.51 5,473
of the Revised Code, as scheduled to occur January 1, 2010, in 5,474
accordance with the outright repeal of that section by this act. 5,475
Section 6. The amendment of sections 4723.55, 4723.56, 5,477
4723.57, 4723.58, and 4723.59 of the Revised Code is not intended 5,478
to supersede the earlier repeal, with delayed effective date, of 5,479
those sections. 5,480
Section 7. The amendments made by this act to section 5,482
4723.02 of the Revised Code with respect to the terms of office 5,483
for members of the Board of Nursing do not affect the terms of 5,484
the members holding office on the effective date of this act. 5,485
Section 8. Notwithstanding the amendment made by this act 5,487
to division (A)(7) of section 4723.08 of the Revised Code, until 5,488
July 1, 2001, the fee for biennial renewal of a certificate of 5,489
authority to practice nursing as a certified nurse-midwife, 5,490
certified registered nurse anesthetist, certified nurse 5,491
practitioner, or clinical nurse specialist is one hundred
dollars.