As Passed by the House                        1            

123rd General Assembly                                             4            

   Regular Session                         Am. Sub. S. B. No. 178  5            

      1999-2000                                                    6            


      SENATORS SCHAFRATH-MUMPER-WHITE-DiDONATO-DRAKE-HAGAN-        8            

    KEARNS-WACHTMANN-WATTS-CARNES-REPRESENTATIVES ASLANIDES-       9            

       TERWILLEGER-VAN VYVEN-OLMAN-HARTNETT-OGG-KRUPINSKI-         10           

    HOLLISTER-WINKLER-O'BRIEN-BRITTON-PERRY-BARRETT-GOODING-       12           

        J. BEATTY-VERICH-REDFERN-CALVERT-AMSTUTZ-METZGER                        


_________________________________________________________________                

                          A   B I L L                                           

             To amend sections 3721.01, 3721.02, 3721.021,         14           

                3721.03, 3721.07, 3721.08, 3721.09, 3721.99,       15           

                4723.02, and 4723.48 and to enact sections                      

                3721.051 and 4723.481 of the Revised Code to       17           

                provide that a county home or district home may                 

                be licensed as a residential care facility and,    18           

                if licensed, the laws and rules governing          19           

                residential care facilities apply to the home, to               

                permit a licensed practical nurse to perform       20           

                certain activities relating to intravenous         21           

                therapy, to make other changes in the law                       

                governing intravenous therapy procedures           22           

                performed by licensed practical nurses, and to     23           

                maintain the provisions of this act on and after   24           

                July 1, 2000, by amending the version of section   25           

                3721.08 of the Revised Code that takes effect on                

                that date.                                                      




BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:        27           

      Section 1.  That sections 3721.01, 3721.02, 3721.021,        29           

3721.03, 3721.07, 3721.08, 3721.09, 3721.99, 4723.02, and 4723.48  30           

be amended and sections 3721.051 and 4723.481 of the Revised Code  31           

be enacted to read as follows:                                     32           

                                                          2      


                                                                 
      Sec. 3721.01.  (A)  As used in sections 3721.01 to 3721.09   41           

and 3721.99 of the Revised Code:                                   42           

      (1)(a)  "Home" means an institution, residence, or facility  44           

that provides, for a period of more than twenty-four hours,        45           

whether for a consideration or not, accommodations to three or     46           

more unrelated individuals who are dependent upon the services of  47           

others, including a nursing home, residential care facility, home  48           

for the aging, and the Ohio veterans' home.                        49           

      (b)  "Home" also means any BOTH OF THE FOLLOWING:            51           

      (i)  ANY facility that a person, as defined in section       53           

3702.51 of the Revised Code, proposes for certification as a       54           

skilled nursing facility or nursing facility under Title XVIII or  55           

XIX of the "Social Security Act," 49 Stat. 620 (1935), 42          56           

U.S.C.A. 301, as amended, and for which a certificate of need,     57           

other than a certificate to recategorize hospital beds as          58           

described in section 3702.522 of the Revised Code or division      59           

(R)(7)(d) of the version of section 3702.51 of the Revised Code    60           

in effect immediately prior to April 20, 1995, has been granted    61           

to the person under sections 3702.51 to 3702.62 of the Revised     62           

Code after August 5, 1989;                                                      

      (ii)  A COUNTY HOME OR DISTRICT HOME THAT IS OR HAS BEEN     64           

LICENSED AS A RESIDENTIAL CARE FACILITY.                           65           

      (c)  "Home" does not mean any of the following:              67           

      (i)  Except as provided in division (A)(1)(b) of this        69           

section, a public hospital or hospital as defined in section       70           

3701.01 or 5122.01 of the Revised Code;                            71           

      (ii)  A residential facility for mentally ill persons as     73           

defined under section 5119.22 of the Revised Code;                 74           

      (iii)  A residential facility as defined in section 5123.19  76           

of the Revised Code;                                               77           

      (iv)  A habilitation center as defined in section 5123.041   79           

of the Revised Code;                                               80           

      (v)  A community alternative home as defined in section      82           

3724.01 of the Revised Code;                                       83           

                                                          3      


                                                                 
      (vi)  An adult care facility as defined in section 3722.01   85           

of the Revised Code;                                               86           

      (vii)  An alcohol or drug addiction program as defined in    88           

section 3793.01 of the Revised Code;                               89           

      (viii)  A facility licensed to provide methadone treatment   91           

under section 3793.11 of the Revised Code;                         92           

      (ix)  A facility providing services under contract with the  94           

department of mental retardation and developmental disabilities    95           

under section 5123.18 of the Revised Code;                         96           

      (x)  A facility operated by a hospice care program licensed  98           

under section 3712.04 of the Revised Code that is used             99           

exclusively for care of hospice patients;                          100          

      (xi)  A facility, infirmary, or other entity that is         103          

operated by a religious order, provides care exclusively to        104          

members of religious orders who take vows of celibacy and live by  105          

virtue of their vows within the orders as if related, and does     106          

not participate in the medicare program established under Title    107          

XVIII of the "Social Security Act" or the medical assistance       108          

program established under Chapter 5111. of the Revised Code and    109          

Title XIX of the "Social Security Act," if on January 1, 1994,     110          

the facility, infirmary, or entity was providing care exclusively  111          

to members of the religious order;                                              

      (xii)  A COUNTY HOME OR DISTRICT HOME THAT HAS NEVER BEEN    113          

LICENSED AS A RESIDENTIAL CARE FACILITY.                           114          

      (2)  "Unrelated individual" means one who is not related to  116          

the owner or operator of a home or to the spouse of the owner or   118          

operator as a parent, grandparent, child, grandchild, brother,                  

sister, niece, nephew, aunt, uncle, or as the child of an aunt or  119          

uncle.                                                                          

      (3)  "Mental impairment" does not mean mental illness as     121          

defined in section 5122.01 of the Revised Code or mental           122          

retardation as defined in section 5123.01 of the Revised Code.     123          

      (4)  "Skilled nursing care" means procedures that require    125          

technical skills and knowledge beyond those the untrained person   126          

                                                          4      


                                                                 
possesses and that are commonly employed in providing for the      127          

physical, mental, and emotional needs of the ill or otherwise      128          

incapacitated.  "Skilled nursing care" includes, but is not        129          

limited to, the following:                                         130          

      (a)  Irrigations, catheterizations, application of           132          

dressings, and supervision of special diets;                       133          

      (b)  Objective observation of changes in the patient's       135          

condition as a means of analyzing and determining the nursing      136          

care required and the need for further medical diagnosis and       137          

treatment;                                                         138          

      (c)  Special procedures contributing to rehabilitation;      140          

      (d)  Administration of medication by any method ordered by   142          

a physician, such as hypodermically, rectally, or orally,          143          

including observation of the patient after receipt of the          144          

medication;                                                        145          

      (e)  Carrying out other treatments prescribed by the         147          

physician that involve a similar level of complexity and skill in  148          

administration.                                                    149          

      (5)(a)  "Personal care services" means services including,   151          

but not limited to, the following:                                 152          

      (i)  Assisting residents with activities of daily living;    154          

      (ii)  Assisting residents with self-administration of        156          

medication, in accordance with rules adopted under section         157          

3721.04 of the Revised Code;                                       158          

      (iii)  Preparing special diets, other than complex           160          

therapeutic diets, for residents pursuant to the instructions of   161          

a physician or a licensed dietitian, in accordance with rules      162          

adopted under section 3721.04 of the Revised Code.                 163          

      (b)  "Personal care services" does not include "skilled      165          

nursing care" as defined in division (A)(4) of this section.  A    166          

facility need not provide more than one of the services listed in  167          

division (A)(5)(a) of this section to be considered to be          168          

providing personal care services.                                  169          

      (6)  "Nursing home" means a home used for the reception and  171          

                                                          5      


                                                                 
care of individuals who by reason of illness or physical or        172          

mental impairment require skilled nursing care and of individuals  173          

who require personal care services but not skilled nursing care.   174          

A nursing home is licensed to provide personal care services and   175          

skilled nursing care.                                              176          

      (7)  "Residential care facility" means a home that provides  178          

either of the following:                                           179          

      (a)  Accommodations for seventeen or more unrelated          181          

individuals and supervision and personal care services for three   182          

or more of those individuals who are dependent on the services of  183          

others by reason of age or physical or mental impairment;          184          

      (b)  Accommodations for three or more unrelated              186          

individuals, supervision and personal care services for at least   187          

three of those individuals who are dependent on the services of    188          

others by reason of age or physical or mental impairment, and, to  189          

at least one of those individuals, any of the skilled nursing      190          

care authorized by section 3721.011 of the Revised Code.           191          

      (8)  "Home for the aging" means a home that provides         193          

services as a residential care facility and a nursing home,        194          

except that the home provides its services only to individuals     195          

who are dependent on the services of others by reason of both age  196          

and physical or mental impairment.                                              

      The part or unit of a home for the aging that provides       198          

services only as a residential care facility is licensed as a      199          

residential care facility.  The part or unit that may provide      200          

skilled nursing care beyond the extent authorized by section       201          

3721.011 of the Revised Code is licensed as a nursing home.        202          

      (9)  "COUNTY HOME" AND "DISTRICT HOME" MEAN A COUNTY HOME    204          

OR DISTRICT HOME OPERATED UNDER CHAPTER 5155. OF THE REVISED       206          

CODE.                                                                           

      (B)  The public health council may further classify homes.   208          

For the purposes of this chapter, any residence, institution,      209          

hotel, congregate housing project, or similar facility that meets  210          

the definition of a home under this section is such a home         211          

                                                          6      


                                                                 
regardless of how the facility holds itself out to the public.     212          

      (C)  For purposes of this chapter, personal care services    214          

or skilled nursing care shall be considered to be provided by a    215          

facility if they are provided by a person employed by or           216          

associated with the facility or by another person pursuant to an   217          

agreement to which neither the resident who receives the services  218          

nor his THE RESIDENT'S sponsor is a party.                         219          

      (D)  Nothing in division (A)(4) of this section shall be     221          

construed to permit skilled nursing care to be imposed on an       222          

individual who does not require skilled nursing care.              223          

      Nothing in division (A)(5) of this section shall be          225          

construed to permit personal care services to be imposed on an     226          

individual who is capable of performing the activity in question   227          

without assistance.                                                228          

      (E)  Division (A)(1)(c)(xi) of this section does not         230          

prohibit a facility, infirmary, or other entity described in that  231          

division from seeking licensure under sections 3721.01 to 3721.09  233          

of the Revised Code or certification under Title XVIII or XIX of   234          

the "Social Security Act."  However, such a facility, infirmary,   235          

or entity that applies for licensure or certification must meet    236          

the requirements of those sections or titles and the rules         237          

adopted under them and obtain a certificate of need from the       238          

director of health under section 3702.52 of the Revised Code.      239          

      (F)  Nothing in this chapter, or rules adopted pursuant to   241          

it, shall be construed as authorizing the supervision,             242          

regulation, or control of the spiritual care or treatment of       243          

residents or patients in any home who rely upon treatment by       244          

prayer or spiritual means in accordance with the creed or tenets   245          

of any recognized church or religious denomination.                246          

      Sec. 3721.02.  The director of health shall license homes    255          

and establish procedures to be followed in inspecting and          256          

licensing homes.  The director may inspect a home at any time.     257          

Each home shall be inspected by the director at least once prior   258          

to the issuance of a license and at least once every fifteen       259          

                                                          7      


                                                                 
months thereafter.  The state fire marshal or a township,          260          

municipal, or other legally constituted fire department approved   261          

by the marshal shall also inspect a home prior to issuance of a    262          

license, at least once every fifteen months thereafter, and at     263          

any other time requested by the director.  A home does not have    264          

to be inspected prior to issuance of a license by the director,    265          

state fire marshal, or a fire department if ownership of the home  266          

is assigned or transferred to a different person and the home was  267          

licensed under this chapter immediately prior to the assignment    268          

or transfer.  The director may enter at any time, for the          269          

purposes of investigation, any institution, residence, facility,   270          

or other structure which has been reported to the director or      271          

that the director has reasonable cause to believe is operating as  272          

a, nursing home, residential care facility, or home for the aging  274          

without a valid license REQUIRED BY SECTION 3721.05 OF THE         275          

REVISED CODE OR, IN THE CASE OF A COUNTY HOME OR DISTRICT HOME,    276          

IS OPERATING DESPITE THE REVOCATION OF ITS RESIDENTIAL CARE        277          

FACILITY LICENSE.  The director may delegate his THE DIRECTOR'S    278          

authority and duties under this chapter to any division, bureau,   281          

agency, or official of the department of health.                   282          

      A single facility may be licensed both as a nursing home     284          

pursuant to this chapter and as an adult care facility pursuant    285          

to Chapter 3722. of the Revised Code if the director determines    286          

that the part or unit to be licensed as a nursing home can be      287          

maintained separate and discrete from the part or unit to be       288          

licensed as an adult care facility.                                289          

      In determining the number of residents in a home for the     291          

purpose of licensing, the director shall consider all the          292          

individuals for whom the home provides accommodations as one       293          

group unless one of the following is the case:                     294          

      (A)  The home is a home for the aging, in which case all     296          

the individuals in the part or unit licensed as a nursing home     297          

shall be considered as one group and all the individuals in the    298          

part or unit licensed as a rest home shall be considered as        299          

                                                          8      


                                                                 
another group;                                                     300          

      (B)  The home is both a nursing home and an adult care       302          

facility.  In that case, all the individuals in the part or unit   303          

licensed as a nursing home shall be considered as one group and    304          

all the individuals in the part or unit licensed as an adult care  305          

facility shall be considered as another group.                     306          

      (C)  The home maintains, in addition to a nursing home or    308          

residential care facility, a separate and discrete part or unit    310          

that provides accommodations to individuals who do not require or               

receive skilled nursing care and do not receive personal care      311          

services from the home, in which case the individuals in the       312          

separate and discrete part or unit shall not be considered in      313          

determining the number of residents in the home if the separate    314          

and discrete part or unit is in compliance with the Ohio basic     315          

building code established by the board of building standards       316          

under Chapters 3781. and 3791. of the Revised Code and the home    317          

permits the director, on request, to inspect the separate and      318          

discrete part or unit and speak with the individuals residing      319          

there, if they consent, to determine whether the separate and      320          

discrete part or unit meets the requirements of this division.     321          

      The director of health shall charge an application fee and   323          

an annual renewal licensing and inspection fee of one hundred      324          

dollars for each fifty persons or part thereof of a home's         325          

licensed capacity.  All fees collected by the director for the     326          

issuance or renewal of licenses shall be deposited into the state  327          

treasury to the credit of the general operations fund created in   328          

section 3701.83 of the Revised Code for use only in administering  329          

and enforcing this chapter and rules adopted under it.             330          

      Sec. 3721.021.  Every person who operates a home, as         339          

defined in section 3721.01 of the Revised Code, AND EACH COUNTY    341          

HOME AND DISTRICT HOME LICENSED AS A RESIDENTIAL CARE FACILITY     342          

shall have available in the home for review by prospective         343          

patients and residents, their guardians, or other persons                       

assisting in their placement, each inspection report completed     344          

                                                          9      


                                                                 
pursuant to section 3721.02 of the Revised Code and each           345          

statement of deficiencies and plan of correction completed and     346          

made available to the public under Titles XVIII and XIX of the     347          

"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as      348          

amended, and any rules promulgated under Titles XVIII and XIX,                  

including such reports that result from life safety code and       349          

health inspections during the preceding three years, and shall     350          

post prominently within the home a notice of this requirement.     351          

      Sec. 3721.03.  The director of health shall enforce the      361          

provisions of sections 3721.01 to 3721.09 and 3721.99 of the       362          

Revised Code and may issue orders to secure compliance with the    363          

provisions of these sections and the rules adopted under them. He  365          

THE DIRECTOR may hold hearings, issue subpoenas, compel                         

testimony, and make adjudications.  In the event the director      367          

finds, upon hearing or opportunity afforded therefor, that any     368          

person, firm, partnership, association, or corporation, COUNTY     369          

HOME, OR DISTRICT HOME licensed under section 3721.07 of the       371          

Revised Code is in violation of any of the provisions of Chapter   372          

3721. of the Revised Code or rules adopted by the public health    373          

council under it; is in violation of any order issued by the       374          

director; is not, or any of its principals are not suitable,       375          

morally or financially to operate such an institution; or is not   376          

furnishing humane, kind, and adequate treatment and care, the      377          

director may issue an order revoking the license previously        378          

issued by him THE DIRECTOR.  Upon the issuance of any order of     380          

revocation, the person whose license is revoked, OR THE COUNTY                  

HOME OR DISTRICT HOME THAT HAS ITS LICENSE REVOKED, may appeal in  381          

accordance with Chapter 119. of the Revised Code.                  382          

      The state fire marshal shall enforce all statutes and rules  384          

pertaining to fire safety in homes and shall adopt rules           385          

pertaining to fire safety in homes as he THE MARSHAL determines    386          

necessary. The rules adopted by the marshal shall be in addition   388          

to those fire safety rules that the board of building standards    389          

and the public health council are empowered to adopt and shall be  390          

                                                          10     


                                                                 
adopted prior to December 31, 1972.  In the event of a dispute     391          

between the marshal and another officer having responsibilities    392          

under sections 3721.01 to 3721.09 of the Revised Code with         393          

respect to the interpretation or application of a specific fire    394          

safety statute or rule, the interpretation of the marshal shall    395          

prevail.                                                                        

      If the ownership of a home is assigned or tranferred         397          

TRANSFERRED to a different person, the new owner is responsible    398          

and liable for compliance with any notice of proposed action or    399          

order issued under this section in accordance with Chapter 119.    400          

of the Revised Code prior to the effective date of the assignment  401          

or transfer.                                                                    

      Sec. 3721.051.  NO COUNTY HOME OR DISTRICT HOME LICENSED     403          

UNDER SECTION 3721.07 OF THE REVISED CODE SHALL DO ANY OF THE      404          

FOLLOWING:                                                         405          

      (A)  VIOLATE ANY OF THE CONDITIONS OR REQUIREMENTS           407          

NECESSARY FOR LICENSING AFTER THE LICENSE HAS BEEN ISSUED;         408          

      (B)  CONTINUE OPERATION AFTER ITS LICENSE HAS BEEN REVOKED   410          

BY THE DIRECTOR OF HEALTH;                                         411          

      (C)  FAIL TO BE OPEN FOR AN INSPECTION, OR INTERFERE WITH    413          

AN INSPECTION, BY A STATE OR LOCAL OFFICIAL PERFORMING INSPECTION  414          

DUTIES UNDER CHAPTER 3721. OF THE REVISED CODE;                    415          

      (D)  VIOLATE ANY OF THE PROVISIONS OF THIS CHAPTER OR ANY    418          

RULES ADOPTED THEREUNDER.                                                       

      Sec. 3721.07.  Every person desiring to operate a home AND   428          

THE SUPERINTENDENT OR ADMINISTRATOR OF EACH COUNTY HOME OR                      

DISTRICT HOME FOR WHICH A LICENSE AS A RESIDENTIAL CARE FACILITY   429          

IS SOUGHT shall apply for a license to the director of health.     430          

The director shall issue a license for the home, if after          431          

investigation of the applicant and, if required by section         432          

3721.02 of the Revised Code, inspection of the home, the           433          

following requirements or conditions are satisfied or complied     434          

with:                                                              435          

      (A)  The applicant has not been convicted of a felony or a   437          

                                                          11     


                                                                 
crime involving moral turpitude;                                   438          

      (B)  The applicant is not violating any of the rules made    440          

by the public health council or any order issued by the director   441          

of health;                                                         442          

      (C)  The buildings in which the home is housed have been     444          

approved by the state fire marshal or a township, municipal, or    445          

other legally constituted fire department approved by the          446          

marshal.  In the approval of a home such agencies shall apply      447          

standards prescribed by the board of building standards, and by    448          

the state fire marshal, and by section 3721.071 of the Revised     449          

Code.                                                              450          

      (D)  The applicant, if it is an individual, or the           452          

principal participants, if it is an association or a corporation,  453          

is or are suitable financially and morally to operate a home;      454          

      (E)  The applicant is equipped to furnish humane, kind, and  456          

adequate treatment and care;                                       457          

      (F)  The home does not maintain or contain:                  459          

      (1)  Facilities for the performance of major surgical        461          

procedures;                                                        462          

      (2)  Facilities for providing therapeutic radiation;         464          

      (3)  An emergency ward;                                      466          

      (4)  A clinical laboratory unless it is under the            468          

supervision of a clinical pathologist who is a licensed physician  469          

in this state;                                                     470          

      (5)  Facilities for radiological examinations unless such    472          

examinations are performed only by a person licensed to practice   473          

medicine, surgery, or dentistry in this state.                     474          

      (G)  The home does not accept or treat outpatients, except   476          

upon the written orders of a physician licensed in this state,     477          

maternity cases, boarding children, and does not house transient   478          

guests, other than participants in an adult day-care program, for  479          

twenty-four hours or less;                                         480          

      (H)  The home is in compliance with sections 3721.28 and     482          

3721.29 of the Revised Code.                                       483          

                                                          12     


                                                                 
      When the director issues a license, the license shall        485          

remain in effect until revoked by the director or voided at the    486          

request of the applicant; provided, there shall be an annual       487          

renewal fee payable during the month of January of each calendar   488          

year.  Any licensed home that does not pay its renewal fee in      489          

January shall pay, beginning the first day of February, a late     491          

fee of one hundred dollars for each week or part thereof that the               

renewal fee is not paid.  If either the renewal fee or the late    492          

fee is not paid by the fifteenth day of February, the director     494          

may, in accordance with Chapter 119. of the Revised Code, revoke                

the home's license.                                                495          

      A person whose license is revoked, AND A COUNTY HOME OR      497          

DISTRICT HOME THAT HAS ITS LICENSE AS A RESIDENTIAL CARE FACILITY  498          

REVOKED, for any reason other than nonpayment of the license       500          

renewal fee or late fees may not apply for a new license under                  

this chapter until a period of one year following the date of      502          

revocation has elapsed.                                            503          

      Any applicant who is denied a license may appeal in          505          

accordance with Chapter 119. of the Revised Code.                  506          

      Sec. 3721.08.  (A)  As used in this section, "real and       515          

present danger" means imminent danger of serious physical or       516          

life-threatening harm to one or more occupants of a home.          517          

      (B)  The director of health may petition the court of        519          

common pleas of the county in which the home is located for an     520          

order enjoining any person from operating a home without a         521          

license OR ENJOINING A COUNTY HOME OR DISTRICT HOME THAT HAS HAD   522          

ITS LICENSE REVOKED FROM CONTINUING TO OPERATE.  The court shall   523          

have jurisdiction to grant such injunctive relief upon a showing   525          

that the respondent named in the petition is operating a home      526          

without a license OR THAT THE COUNTY HOME OR DISTRICT HOME NAMED   527          

IN THE PETITION IS OPERATING DESPITE THE REVOCATION OF ITS                      

LICENSE.  The court shall have jurisdiction to grant such          529          

injunctive relief against the operation of a home without a VALID  530          

license regardless of whether the home meets essential licensing   531          

                                                          13     


                                                                 
requirements.                                                                   

      (C)  Unless the department of human services or contracting  533          

agency has taken action under section 5111.51 of the Revised Code  534          

to appoint a temporary manager or seek injunctive relief, if, in   535          

the judgment of the director of health, real and present danger    536          

exists at any home, the director may petition the court of common  537          

pleas of the county in which the home is located for such          538          

injunctive relief as is necessary to close the home, transfer one  539          

or more occupants to other homes or other appropriate care         540          

settings, or otherwise eliminate the real and present danger. The  542          

court shall have the jurisdiction to grant such injunctive relief  543          

upon a showing that there is real and present danger.                           

      (D)(1)  If the director determines that real and present     545          

danger exists at a home and elects not to immediately seek         546          

injunctive relief under division (C) of this section, he THE       547          

DIRECTOR may give written notice of proposed action to the home.   549          

The notice shall specify all of the following:                     550          

      (a)  The nature of the conditions giving rise to the real    552          

and present danger;                                                553          

      (b)  The measures that the director determines the home      555          

must take to respond to the conditions;                            556          

      (c)  The date on which the director intends to seek          558          

injunctive relief under division (C) of this section if he THE     559          

DIRECTOR determines that real and present danger exists at the     561          

home.                                                                           

      (2)  If the home notifies the director, within the time      563          

specified pursuant to division (D)(1)(c) of this section, that it  564          

believes the conditions giving rise to the real and present        565          

danger have been substantially corrected, the director shall       566          

conduct an inspection to determine whether real and present        567          

danger exists.  If the director determines on the basis of the     568          

inspection that real and present danger exists, he THE DIRECTOR    569          

may petition under division (C) of this section for injunctive     571          

relief.                                                                         

                                                          14     


                                                                 
      (E)(1)  If in the judgment of the director of health         573          

conditions exist at a home that will give rise to real and         574          

present danger if not corrected, the director shall give written   575          

notice of proposed action to the home.  The notice shall specify   576          

all of the following:                                              577          

      (a)  The nature of the conditions giving rise to the         579          

director's judgment;                                               580          

      (b)  The measures that the director determines the home      582          

must take to respond to the conditions;                            583          

      (c)  The date, which shall be no less than ten days after    585          

the notice is delivered, on which the director intends to seek     586          

injunctive relief under division (C) of this section if the        587          

conditions are not substantially corrected and he THE DIRECTOR     588          

determines that a real and present danger exists.                  590          

      (2)  If the home notifies the director, within the period    592          

of time specified pursuant to division (E)(1)(c) of this section,  593          

that the conditions giving rise to the director's determination    594          

have been substantially corrected, the director shall conduct an   595          

inspection.  If the director determines on the basis of the        596          

inspection that the conditions have not been corrected and a real  597          

and present danger exists, he THE DIRECTOR may petition under      598          

division (C) of this section for injunctive relief.                600          

      (F)(1)  A court that grants injunctive relief under          602          

division (C) of this section may also appoint a special master     603          

who, subject to division (F)(2) of this section, shall have such   604          

powers and authority over the home and length of appointment as    605          

the court considers necessary.  Subject to division (F)(2) of      606          

this section, the salary of a special master and any costs         607          

incurred by a special master shall be the obligation of the home.  608          

      (2)  No special master shall enter into any employment       610          

contract on behalf of a home, or purchase with the home's funds    611          

any capital goods totaling more than ten thousand dollars, unless  612          

the special master has obtained approval for the contract or       613          

purchase from the home's operator or the court.                    614          

                                                          15     


                                                                 
      (G)  If the director takes action under division (C), (D),   616          

or (E) of this section, he THE DIRECTOR may also appoint           617          

employees of the department of health to conduct on-site           619          

monitoring of the home. Appointment of monitors is not subject to  620          

appeal under Chapter 119. or any other section of the Revised      621          

Code.  No employee of a home for which monitors are appointed, no  622          

person employed by the home within the previous two years, and no  623          

person who currently has a consulting contract with the            624          

department or a home, shall be appointed under this division.      625          

Every monitor shall have the professional qualifications           626          

necessary to monitor correction of the conditions that give rise   627          

to or, in the director's judgment, will give rise to real and      628          

present danger.  The number of monitors present at a home at any   629          

given time shall not exceed one for every fifty residents, or      630          

fraction thereof.                                                               

      (H)  On finding that the real and present danger for which   632          

injunctive relief was granted under division (C) of this section   633          

has been eliminated and that the home's operator has demonstrated  634          

the capacity to prevent the real and present danger from           635          

recurring, the court shall terminate its jurisdiction over the     636          

home and return control and management of the home to the          637          

operator.  If the real and present danger cannot be eliminated     638          

practicably within a reasonable time following appointment of a    639          

special master, the court may order the special master to close    640          

the home and transfer all residents to other homes or other        641          

appropriate care settings.                                         642          

      (I)  The director of health shall give notice of proposed    644          

action under divisions (D) and (E) of this section to both of the  645          

following:                                                         646          

      (1)  The home's administrator;                               648          

      (2)  If the home is operated by an organization described    650          

in subsection 501(c)(3) and tax exempt under subsection 501(a) of  651          

the "Internal Revenue Code of 1986," 100 Stat. 2085, 26 U.S.C.A.   652          

1, as amended, the board of trustees of the organization; or, if   653          

                                                          16     


                                                                 
the home is not operated by such an organization, the owner of     654          

the home.                                                          655          

      Notices shall be delivered by certified mail or hand         657          

delivery.  If notices are mailed, they shall be addressed to the   658          

persons specified in divisions (I)(1) and (2) of this section, as  659          

indicated in the department of health's records.  If they are      660          

hand delivered, they shall be delivered to persons who would       661          

reasonably appear to the average prudent person to have authority  662          

to accept them.                                                    663          

      (J)  If ownership of a home is assigned or transferred to a  665          

different person, the new owner is responsible and liable for      666          

compliance with any notice of proposed action or order issued      667          

under this section prior to the effective date of the assignment   668          

or transfer.                                                       669          

      THIS IS AN INTERIM SECTION EFFECTIVE UNTIL JULY 1, 2000.     671          

      Sec. 3721.09.  Sections 3721.02, 3721.03, 3721.04, 3721.05,  680          

3721.051, 3721.07, and 3721.08 of the Revised Code and the         682          

regulations adopted pursuant thereto are not applicable in         683          

political subdivisions which the the director of health, by        684          

annual certification, determines have adopted and are enforcing    685          

their own standards which are equal to or greater in their         686          

requirements than those of sections 3721.02, 3721.03, 3721.04,     687          

3721.05, 3721.051, 3721.07, and 3721.08 of the Revised Code and    689          

the regulations adopted pursuant thereto.  Officials of political  690          

subdivisions shall cooperate fully with the director and provide                

him THE DIRECTOR with information which he THE DIRECTOR finds      692          

necessary in order to make a determination.                        693          

      Sec. 3721.99.  (A)  Whoever violates section 3721.021,       702          

division (B), (D), or (E) of section 3721.05, DIVISION (A), (C),   704          

OR (D) OF SECTION 3721.051, section 3721.06, division (A) of       705          

section 3721.22, division (A) or (B) of section 3721.24, or        706          

division (E) or (F) of section 3721.30 of the Revised Code shall   707          

be fined one hundred dollars for a first offense.  For each        708          

subsequent offense, the violator shall be fined five hundred                    

                                                          17     


                                                                 
dollars.                                                           709          

      (B)  Whoever violates division (A) or (C) of section         711          

3721.05 OR DIVISION (B) OF SECTION 3721.051 of the Revised Code    713          

shall be fined five thousand dollars for a first offense.  For     714          

each subsequent offense, the violator shall be fined ten thousand  715          

dollars.                                                                        

      (C)  Whoever violates division (D) of section 3721.031 or    717          

division (E) of section 3721.22 of the Revised Code is guilty of   718          

registering a false complaint, a misdemeanor of the first degree.  719          

      Sec. 4723.02.  As used in this chapter:                      728          

      (A)  "Registered nurse" means an individual who holds a      730          

current, valid license issued under this chapter that authorizes   731          

the practice of nursing as a registered nurse.                     732          

      (B)  "Practice of nursing as a registered nurse" means       734          

providing to individuals and groups nursing care requiring         735          

specialized knowledge, judgment, and skill derived from the        736          

principles of biological, physical, behavioral, social, and        737          

nursing sciences.  Such nursing care includes:                     738          

      (1)  Identifying patterns of human responses to actual or    740          

potential health problems amenable to a nursing regimen;           741          

      (2)  Executing a nursing regimen through the selection,      743          

performance, management, and evaluation of nursing actions;        744          

      (3)  Assessing health status for the purpose of providing    746          

nursing care;                                                      747          

      (4)  Providing health counseling and health teaching;        749          

      (5)  Administering medications, treatments, and executing    751          

regimens prescribed by licensed physicians; dentists;              753          

optometrists; podiatrists; or, until January 1, 2010, advanced     755          

practice nurses authorized to prescribe under section 4723.56 of   756          

the Revised Code;                                                               

      (6)  Teaching, administering, supervising, delegating, and   758          

evaluating nursing practice.                                       759          

      (C)  "Nursing regimen" may include preventative,             761          

restorative, and health promotion activities.                      762          

                                                          18     


                                                                 
      (D)  "Assessing health status" means the collection of data  764          

through nursing assessment techniques, which may include           765          

interviews, observation, and physical evaluations for the purpose  766          

of providing nursing care.                                         767          

      (E)  "Licensed practical nurse" means an individual who      769          

holds a current, valid license issued under this chapter that      770          

authorizes the practice of nursing as a licensed practical nurse.  771          

      (F)  "The practice of nursing as a licensed practical        773          

nurse" means providing to individuals and groups nursing care      774          

requiring the application of basic knowledge of the biological,    775          

physical, behavioral, social, and nursing sciences at the          776          

direction of a licensed physician, dentist, podiatrist,            777          

optometrist, or registered nurse.  Such nursing care includes:     778          

      (1)  Observation, patient teaching, and care in a diversity  780          

of health care settings;                                           781          

      (2)  Contributions to the planning, implementation, and      783          

evaluation of nursing;                                             784          

      (3)  Administration of medications and treatments            786          

prescribed by a licensed physician; dentist; optometrist;          788          

podiatrist; or, until January 1, 2010, an advanced practice nurse  790          

authorized to prescribe under section 4723.56 of the Revised       791          

Code, except that administration of intravenous therapy shall be   792          

performed only in accordance with section 4723.48 OR 4723.481 of   793          

the Revised Code.  Medications may be administered by a licensed   794          

practical nurse upon proof of completion of a course in            795          

medication administration approved by the board of nursing.        796          

      (4)  Administration to an adult of intravenous therapy       798          

prescribed by a licensed physician; dentist; optometrist;          799          

podiatrist; or, until January 1, 2010, an advanced practice nurse  800          

authorized to prescribe under section 4723.56 of the Revised       801          

Code, on the condition that the licensed practical nurse is        803          

authorized by the board of nursing pursuant to UNDER section       804          

4723.48 OR 4723.481 of the Revised Code to perform intravenous     806          

therapy and performs intravenous therapy only in accordance with   808          

                                                          19     


                                                                 
section 4723.48 of the Revised Code THOSE SECTIONS.                809          

      (G)  "Certified registered nurse anesthetist" means a        811          

registered nurse who holds a valid certificate of authority        812          

issued under this chapter that authorizes the practice of nursing  813          

as a certified registered nurse anesthetist in accordance with     814          

section 4723.43 of the Revised Code and rules adopted by the       815          

board of nursing.                                                  816          

      (H)  "Clinical nurse specialist" means a registered nurse    819          

who holds a valid certificate of authority issued under this       820          

chapter that authorizes the practice of nursing as a clinical      821          

nurse specialist in accordance with section 4723.43 of the         822          

Revised Code and rules adopted by the board of nursing.            823          

      (I)  "Certified nurse-midwife" means a registered nurse who  825          

holds a valid certificate of authority issued under this chapter   826          

that authorizes the practice of nursing as a certified             827          

nurse-midwife in accordance with section 4723.43 of the Revised    828          

Code and rules adopted by the board of nursing.                    829          

      (J)  "Certified nurse practitioner" means a registered       831          

nurse who holds a valid certificate of authority issued under      832          

this chapter that authorizes the practice of nursing as a          833          

certified nurse practitioner in accordance with section 4723.43    834          

of the Revised Code and rules adopted by the board of nursing.     836          

      (K)  "Physician" means an individual who holds a             839          

certificate issued under Chapter 4731. of the Revised Code         841          

authorizing the practice of medicine and surgery or osteopathic    843          

medicine and surgery and is practicing in this state.              844          

      (L)  "Dentist" means an individual who is licensed under     847          

Chapter 4715. of the Revised Code to practice dentistry and is     848          

practicing in this state.                                          849          

      (M)  "Podiatrist" means an individual who holds a            852          

certificate issued under Chapter 4731. of the Revised Code         853          

authorizing the practice of podiatry and is practicing in this     854          

state.                                                                          

      (N)  "Collaboration" or "collaborating" means the            856          

                                                          20     


                                                                 
following:                                                         857          

      (1)  In the case of a clinical nurse specialist, except as   860          

provided in division (N)(3) of this section, or a certified nurse               

practitioner, that a podiatrist acting within the podiatrist's     861          

scope of practice in accordance with section 4731.51 of the        862          

Revised Code and with whom the nurse has entered into a standard   864          

care arrangement or physician with whom the nurse has entered                   

into a standard care arrangement is continuously available to      866          

communicate with the clinical nurse specialist or certified nurse  867          

practitioner either in person or by radio, telephone, or other     868          

form of telecommunication;                                                      

      (2)  In the case of a certified nurse-midwife, that a        870          

physician with whom the certified nurse-midwife has entered into   871          

a standard care arrangement is continuously available to           872          

communicate with the certified nurse-midwife either in person or   873          

by radio, telephone, or other form of telecommunication;           874          

      (3)  In the case of a clinical nurse specialist whose        876          

nursing specialty is mental health or psychiatric mental health,   877          

that a physician is continuously available to communicate with     879          

the nurse either in person or by radio, telephone, or other form   880          

of telecommunication.                                                           

      (O)  "Supervision" means that a certified registered nurse   883          

anesthetist is under the direction of a podiatrist acting within   884          

the podiatrist's scope of practice in accordance with section                   

4731.51 of the Revised Code, a dentist acting within the           886          

dentist's scope of practice in accordance with Chapter 4715. of    888          

the Revised Code, or a physician, and, when administering          889          

anesthesia, the certified registered nurse anesthetist is in the   890          

immediate presence of the podiatrist, dentist, or physician.       891          

      (P)  "Standard care arrangement" means a written, formal     894          

guide for planning and evaluating a patient's health care that is  895          

developed by a collaborating physician or podiatrist and a                      

clinical nurse specialist, certified nurse-midwife, or certified   896          

nurse practitioner and meets the requirements of section 4723.431  897          

                                                          21     


                                                                 
of the Revised Code.                                               898          

      Sec. 4723.48.  (A)  The board of nursing may authorize a     908          

licensed practical nurse to administer to an adult intravenous     909          

therapy prescribed by a licensed physician; dentist; optometrist;  911          

podiatrist; or, until January 1, 2010, an advanced practice nurse  912          

authorized to prescribe under section 4723.56 of the Revised       913          

Code, if all of the following are true of the licensed practical                

nurse:                                                             914          

      (1)  The nurse has a current, valid license issued under     916          

this chapter that includes authorization to administer             917          

medications.                                                                    

      (2)  The nurse has successfully completed a course in        919          

intravenous administration approved by the board of nursing that   920          

includes both of the following:                                    921          

      (a)  A minimum of forty hours of training that includes all  923          

of the following:                                                  924          

      (i)  The curriculum established by rules adopted by the      926          

board of nursing and in effect on January 1, 1999;                 928          

      (ii)  Training in the anatomy and physiology of the          930          

cardiovascular system, signs and symptoms of local and systemic    931          

complications in the administration of fluids and antibiotic       933          

additives, and guidelines for management of these complications;   934          

      (iii)  Any other training or instruction the board           936          

considers appropriate.                                             937          

      (b)  A testing component that includes THE SUCCESSFUL        939          

PERFORMANCE OF three venipunctures supervised by a physician or    941          

registered nurse in a health care setting.                         942          

      (B)  A EXCEPT AS PROVIDED IN SECTION 4723.481 OF THE         944          

REVISED CODE, A licensed practical nurse may perform intravenous   945          

therapy only if authorized by the board of nursing pursuant to     948          

division (A) of this section and only if it is performed in        950          

accordance with this section.                                                   

      A licensed practical nurse authorized BY THE BOARD to        952          

perform intravenous therapy may perform an intravenous therapy     953          

                                                          22     


                                                                 
procedure only at the direction of one of the following:           954          

      (1)  A licensed physician, dentist, optometrist, or          956          

podiatrist who, except as provided in division (C)(2) of this      957          

section, is present and readily available at the facility where    959          

the intravenous therapy procedure is performed;                    960          

      (2)  A registered nurse in accordance with division (C) of   963          

this section.                                                                   

      (C)(1)  Except as provided in division (C)(2) of this        966          

section AND SECTION 4723.481 OF THE REVISED CODE, when a licensed  967          

practical nurse authorized BY THE BOARD to perform intravenous     969          

therapy performs an intravenous therapy procedure at the           970          

direction of a registered nurse, the registered nurse or another   972          

registered nurse shall be readily available at the site where the  974          

intravenous therapy is performed, and before the licensed          975          

practical nurse initiates the intravenous therapy, the registered  976          

nurse shall personally perform an on-site assessment of the        977          

individual who is to receive the intravenous therapy.                           

      (2)  When a licensed practical nurse authorized BY THE       979          

BOARD to perform intravenous therapy performs an intravenous       980          

therapy procedure in a home as defined in section 3721.10 of the   981          

Revised Code, or in an intermediate care facility for the          982          

mentally retarded as defined in section 5111.20 of the Revised     983          

Code, at the direction of a registered nurse or licensed           985          

physician, dentist, optometrist, or podiatrist, a registered       986          

nurse shall be on the premises of the home or facility or          987          

accessible by some form of telecommunication.                                   

      (D)  No licensed practical nurse shall perform any of the    989          

following intravenous therapy procedures:                          990          

      (1)  Initiating or maintaining any of the following:         992          

      (a)  Blood or blood components;                              994          

      (b)  Solutions for total parenteral nutrition;               996          

      (c)  Any cancer therapeutic medication including, but not    998          

limited to, cancer chemotherapy or an anti-neoplastic agent;       999          

      (d)  Solutions administered through any central venous line  1,001        

                                                          23     


                                                                 
or arterial line or any other line that does not terminate in a    1,003        

peripheral vein, except that a licensed practical nurse            1,004        

AUTHORIZED BY THE BOARD TO PERFORM INTRAVENOUS THERAPY may         1,005        

maintain the solutions specified in division (D)(6)(a) of this     1,006        

section that are being administered through a central venous line  1,008        

or peripherally inserted central catheter;                         1,009        

      (e)  Any investigational or experimental medication.         1,011        

      (2)  Initiating intravenous therapy in any vein other than,  1,013        

EXCEPT THAT A LICENSED PRACTICAL NURSE AUTHORIZED BY THE BOARD TO  1,015        

PERFORM INTRAVENOUS THERAPY MAY INITIATE INTRAVENOUS THERAPY IN                 

ACCORDANCE WITH THIS SECTION IN a vein of the hand, forearm, or    1,018        

antecubital fossa;                                                              

      (3)  Discontinuing a central venous, arterial, or any other  1,020        

line that does not terminate in a peripheral vein;                 1,021        

      (4)  Initiating or discontinuing a peripherally inserted     1,023        

central catheter;                                                  1,024        

      (5)  Mixing, preparing, or reconstructing RECONSTITUTING     1,026        

any medication for intravenous therapy, except that a licensed     1,028        

practical nurse authorized BY THE BOARD to perform intravenous     1,029        

therapy may prepare or reconstitute an antibiotic additive;        1,031        

      (6)  Administering medication via the intravenous route,     1,033        

including all of the following ACTIVITIES:                         1,034        

      (a)  Adding medication to an intravenous solution or to an   1,036        

existing infusion, except that a licensed practical nurse          1,038        

authorized BY THE BOARD to administer PERFORM intravenous therapy  1,039        

may initiate DO EITHER OF THE FOLLOWING:                           1,040        

      (i)  INITIATE an intravenous infusion containing one or      1,042        

more of the following elements:                                    1,044        

      (i)  Dextrose DEXTROSE 5%;                                   1,046        

      (ii)  Normal NORMAL saline;                                  1,048        

      (iii)  Lactated LACTATED ringers;                            1,050        

      (iv)  Sodium SODIUM chloride .45%;                           1,052        

      (v)  Sodium SODIUM chloride 0.2%;                            1,054        

      (vi)  Water STERILE WATER.                                   1,057        

                                                          24     


                                                                 
      (ii)  HANG SUBSEQUENT CONTAINERS OF THE INTRAVENOUS          1,059        

SOLUTIONS SPECIFIED IN DIVISION (D)(6)(a) OF THIS SECTION THAT     1,062        

CONTAIN VITAMINS OR ELECTROLYTES, IF A REGISTERED NURSE INITIATED  1,063        

THE INFUSION OF THAT SAME INTRAVENOUS SOLUTION.                    1,064        

      (b)  Initiating or maintaining an intravenous piggyback      1,066        

infusion, except that a licensed practical nurse authorized BY     1,067        

THE BOARD to administer PERFORM intravenous therapy may initiate   1,068        

or maintain an intravenous piggyback infusion containing an        1,070        

antibiotic additive;                                                            

      (c)  Injecting medication via a direct intravenous route,    1,072        

except that a licensed practical nurse authorized BY THE BOARD to  1,073        

administer PERFORM intravenous therapy may inject heparin or       1,075        

normal saline to flush an intermittent infusion device or heparin  1,076        

lock including, but not limited to, bolus or push.                 1,077        

      (7)  Aspirating any intravenous line to maintain patency;    1,079        

      (8)  Changing tubing on any line other than one that         1,081        

terminates in a peripheral vein including, but not limited to, an  1,082        

arterial line or a central venous line, EXCEPT THAT A LICENSED     1,083        

PRACTICAL NURSE AUTHORIZED BY THE BOARD TO PERFORM INTRAVENOUS     1,084        

THERAPY MAY CHANGE TUBING ON AN INTRAVENOUS LINE THAT TERMINATES   1,085        

IN A PERIPHERAL VEIN;                                                           

      (9)  Programming or setting any function of a patient        1,087        

controlled infusion pump.                                          1,088        

      (E)  Notwithstanding division (D) of this section, at the    1,091        

direction of a licensed physician or a registered nurse, a         1,092        

licensed practical nurse authorized BY THE BOARD to perform        1,093        

intravenous therapy may perform the following activities for the   1,095        

purpose of performing dialysis;:                                                

      (1)  The routine administration and regulation of saline     1,097        

solution for the purpose of maintaining an established fluid       1,098        

plan;                                                                           

      (2)  The administration of a heparin dose intravenously;     1,100        

      (3)  The administration of a heparin dose peripherally via   1,102        

a fistula needle;                                                  1,103        

                                                          25     


                                                                 
      (4)  The loading and activation of a constant infusion pump  1,105        

or the intermittent injection of a dose of medication prescribed   1,106        

by a licensed physician for dialysis.                              1,107        

      (F)  No person shall employ or direct a licensed practical   1,109        

nurse to perform an intravenous therapy procedure without first    1,111        

verifying that the licensed practical nurse has been approved IS   1,112        

AUTHORIZED by the board of nursing to perform intravenous          1,113        

therapy.                                                                        

      (G)  The board of nursing shall maintain a registry of the   1,116        

names of licensed practical nurses authorized pursuant to          1,117        

division (A) of this section to perform intravenous therapy.       1,118        

      Sec. 4723.481.  (A)  A LICENSED PRACTICAL NURSE MAY PERFORM  1,120        

ON ANY PERSON ANY OF THE INTRAVENOUS THERAPY PROCEDURES SPECIFIED  1,124        

IN DIVISION (B) OF THIS SECTION WITHOUT RECEIVING AUTHORIZATION    1,125        

TO PERFORM INTRAVENOUS THERAPY FROM THE BOARD OF NURSING UNDER     1,126        

SECTION 4723.48 OF THE REVISED CODE, IF BOTH OF THE FOLLOWING      1,127        

APPLY:                                                                          

      (1)  THE LICENSED PRACTICAL NURSE ACTS AT THE DIRECTION OF   1,130        

A REGISTERED NURSE OR A LICENSED PHYSICIAN, DENTIST, OPTOMETRIST,  1,131        

OR PODIATRIST AND THE REGISTERED NURSE, PHYSICIAN, DENTIST,        1,132        

OPTOMETRIST, OR PODIATRIST IS ON THE PREMISES WHERE THE PROCEDURE  1,133        

IS TO BE PERFORMED OR ACCESSIBLE BY SOME FORM OF                                

TELECOMMUNICATION.                                                 1,134        

      (2)  THE LICENSED PRACTICAL NURSE CAN DEMONSTRATE THE        1,137        

KNOWLEDGE, SKILLS, AND ABILITY TO PERFORM THE PROCEDURE SAFELY.    1,138        

      (B)  THE INTRAVENOUS THERAPY PROCEDURES THAT A LICENSED      1,140        

PRACTICAL NURSE MAY PERFORM PURSUANT TO DIVISION (A) OF THIS       1,141        

SECTION ARE LIMITED TO THE FOLLOWING:                              1,142        

      (1)  VERIFICATION OF THE TYPE OF PERIPHERAL INTRAVENOUS      1,144        

SOLUTION BEING ADMINISTERED;                                       1,145        

      (2)  EXAMINATION OF A PERIPHERAL INFUSION SITE AND THE       1,147        

EXTREMITY FOR POSSIBLE INFILTRATION;                               1,148        

      (3)  REGULATION OF A PERIPHERAL INTRAVENOUS INFUSION         1,150        

ACCORDING TO THE PRESCRIBED FLOW RATE;                             1,151        

                                                          26     


                                                                 
      (4)  DISCONTINUATION OF A PERIPHERAL INTRAVENOUS DEVICE AT   1,153        

THE APPROPRIATE TIME;                                              1,154        

      (5)  PERFORMANCE OF ROUTINE DRESSING CHANGES AT THE          1,156        

INSERTION SITE OF A PERIPHERAL VENOUS OR ARTERIAL INFUSION,        1,157        

PERIPHERALLY INSERTED CENTRAL CATHETER INFUSION, OR CENTRAL        1,158        

VENOUS PRESSURE SUBCLAVIAN INFUSION.                               1,159        

      Section 2.  That existing sections 3721.01, 3721.02,         1,161        

3721.021, 3721.03, 3721.07, 3721.08, 3721.09, 3721.99, 4723.02,    1,162        

and 4723.48 of the Revised Code are hereby repealed.               1,163        

      Section 3.  That the version of section 3721.08 of the       1,165        

Revised Code that is scheduled to take effect on July 1, 2000, be  1,166        

amended to read as follows:                                                     

      Sec. 3721.08.  (A)  As used in this section, "real and       1,175        

present danger" means imminent danger of serious physical or       1,176        

life-threatening harm to one or more occupants of a home.          1,177        

      (B)  The director of health may petition the court of        1,179        

common pleas of the county in which the home is located for an     1,180        

order enjoining any person from operating a home without a         1,181        

license OR ENJOINING A COUNTY HOME OR DISTRICT HOME THAT HAS HAD   1,182        

ITS LICENSE REVOKED FROM CONTINUING TO OPERATE.  The court shall   1,183        

have jurisdiction to grant such injunctive relief upon a showing   1,185        

that the respondent named in the petition is operating a home      1,186        

without a license OR THAT THE COUNTY HOME OR DISTRICT HOME NAMED   1,187        

IN THE PETITION IS OPERATING DESPITE THE REVOCATION OF ITS                      

LICENSE.  The court shall have jurisdiction to grant such          1,189        

injunctive relief against the operation of a home without a VALID  1,190        

license regardless of whether the home meets essential licensing   1,191        

requirements.                                                                   

      (C)  Unless the department of job and family services or     1,193        

contracting agency has taken action under section 5111.51 of the   1,194        

Revised Code to appoint a temporary manager or seek injunctive     1,195        

relief, if, in the judgment of the director of health, real and    1,196        

present danger exists at any home, the director may petition the   1,197        

court of common pleas of the county in which the home is located   1,198        

                                                          27     


                                                                 
for such injunctive relief as is necessary to close the home,      1,199        

transfer one or more occupants to other homes or other             1,200        

appropriate care settings, or otherwise eliminate the real and     1,201        

present danger. The court shall have the jurisdiction to grant     1,202        

such injunctive relief upon a showing that there is real and       1,203        

present danger.                                                                 

      (D)(1)  If the director determines that real and present     1,205        

danger exists at a home and elects not to immediately seek         1,206        

injunctive relief under division (C) of this section, the          1,207        

director may give written notice of proposed action to the home.   1,209        

The notice shall specify all of the following:                     1,210        

      (a)  The nature of the conditions giving rise to the real    1,212        

and present danger;                                                1,213        

      (b)  The measures that the director determines the home      1,215        

must take to respond to the conditions;                            1,216        

      (c)  The date on which the director intends to seek          1,218        

injunctive relief under division (C) of this section if the        1,219        

director determines that real and present danger exists at the     1,221        

home.                                                                           

      (2)  If the home notifies the director, within the time      1,223        

specified pursuant to division (D)(1)(c) of this section, that it  1,224        

believes the conditions giving rise to the real and present        1,225        

danger have been substantially corrected, the director shall       1,226        

conduct an inspection to determine whether real and present        1,227        

danger exists.  If the director determines on the basis of the     1,228        

inspection that real and present danger exists, the director may   1,230        

petition under division (C) of this section for injunctive         1,231        

relief.                                                                         

      (E)(1)  If in the judgment of the director of health         1,233        

conditions exist at a home that will give rise to real and         1,234        

present danger if not corrected, the director shall give written   1,235        

notice of proposed action to the home.  The notice shall specify   1,236        

all of the following:                                              1,237        

      (a)  The nature of the conditions giving rise to the         1,239        

                                                          28     


                                                                 
director's judgment;                                               1,240        

      (b)  The measures that the director determines the home      1,242        

must take to respond to the conditions;                            1,243        

      (c)  The date, which shall be no less than ten days after    1,245        

the notice is delivered, on which the director intends to seek     1,246        

injunctive relief under division (C) of this section if the        1,247        

conditions are not substantially corrected and the director        1,248        

determines that a real and present danger exists.                  1,250        

      (2)  If the home notifies the director, within the period    1,252        

of time specified pursuant to division (E)(1)(c) of this section,  1,253        

that the conditions giving rise to the director's determination    1,254        

have been substantially corrected, the director shall conduct an   1,255        

inspection.  If the director determines on the basis of the        1,256        

inspection that the conditions have not been corrected and a real  1,257        

and present danger exists, the director may petition under         1,258        

division (C) of this section for injunctive relief.                1,260        

      (F)(1)  A court that grants injunctive relief under          1,262        

division (C) of this section may also appoint a special master     1,263        

who, subject to division (F)(2) of this section, shall have such   1,264        

powers and authority over the home and length of appointment as    1,265        

the court considers necessary.  Subject to division (F)(2) of      1,266        

this section, the salary of a special master and any costs         1,267        

incurred by a special master shall be the obligation of the home.  1,268        

      (2)  No special master shall enter into any employment       1,270        

contract on behalf of a home, or purchase with the home's funds    1,271        

any capital goods totaling more than ten thousand dollars, unless  1,272        

the special master has obtained approval for the contract or       1,273        

purchase from the home's operator or the court.                    1,274        

      (G)  If the director takes action under division (C), (D),   1,276        

or (E) of this section, the director may also appoint employees    1,278        

of the department of health to conduct on-site monitoring of the   1,279        

home. Appointment of monitors is not subject to appeal under       1,280        

Chapter 119. or any other section of the Revised Code.  No         1,281        

employee of a home for which monitors are appointed, no person     1,282        

                                                          29     


                                                                 
employed by the home within the previous two years, and no person  1,283        

who currently has a consulting contract with the department or a   1,284        

home, shall be appointed under this division.  Every monitor       1,285        

shall have the professional qualifications necessary to monitor    1,286        

correction of the conditions that give rise to or, in the          1,287        

director's judgment, will give rise to real and present danger.    1,288        

The number of monitors present at a home at any given time shall   1,289        

not exceed one for every fifty residents, or fraction thereof.     1,290        

      (H)  On finding that the real and present danger for which   1,292        

injunctive relief was granted under division (C) of this section   1,293        

has been eliminated and that the home's operator has demonstrated  1,294        

the capacity to prevent the real and present danger from           1,295        

recurring, the court shall terminate its jurisdiction over the     1,296        

home and return control and management of the home to the          1,297        

operator.  If the real and present danger cannot be eliminated     1,298        

practicably within a reasonable time following appointment of a    1,299        

special master, the court may order the special master to close    1,300        

the home and transfer all residents to other homes or other        1,301        

appropriate care settings.                                         1,302        

      (I)  The director of health shall give notice of proposed    1,304        

action under divisions (D) and (E) of this section to both of the  1,305        

following:                                                         1,306        

      (1)  The home's administrator;                               1,308        

      (2)  If the home is operated by an organization described    1,310        

in subsection 501(c)(3) and tax exempt under subsection 501(a) of  1,311        

the "Internal Revenue Code of 1986," 100 Stat. 2085, 26 U.S.C.A.   1,312        

1, as amended, the board of trustees of the organization; or, if   1,313        

the home is not operated by such an organization, the owner of     1,314        

the home.                                                          1,315        

      Notices shall be delivered by certified mail or hand         1,317        

delivery.  If notices are mailed, they shall be addressed to the   1,318        

persons specified in divisions (I)(1) and (2) of this section, as  1,319        

indicated in the department of health's records.  If they are      1,320        

hand delivered, they shall be delivered to persons who would       1,321        

                                                          30     


                                                                 
reasonably appear to the average prudent person to have authority  1,322        

to accept them.                                                    1,323        

      (J)  If ownership of a home is assigned or transferred to a  1,325        

different person, the new owner is responsible and liable for      1,326        

compliance with any notice of proposed action or order issued      1,327        

under this section prior to the effective date of the assignment   1,328        

or transfer.                                                       1,329        

      Section 4.  That all existing versions of section 3721.08    1,331        

of the Revised Code are hereby repealed.                           1,332        

      Section 5.  Sections 3 and 4 of this act shall take effect   1,334        

on July 1, 2000.