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(123rd General Assembly)(Substitute House Bill Number 511)
AN ACT
To amend sections 2305.24, 2305.25, 2305.251, 3313.68, 3701.07, 3701.85,
3702.51, 3719.13, 3721.031,
3721.34,
3727.01, 4723.02, 4723.03, 4723.04, 4723.051, 4723.06, 4723.061, 4723.07,
4723.08,
4723.09, 4723.15, 4723.171,
4723.24, 4723.25, 4723.28, 4723.281, 4723.282, 4723.31, 4723.32, 4723.34,
4723.341,
4723.35, 4723.40, 4723.42, 4723.43, 4723.47, 4723.48, 4723.62, 4723.74,
4723.76, 4723.79, 4723.99,
4731.27, 4731.281, 4743.05, 4751.05,
5111.04, and 5126.35; to amend, for the purpose of adopting new section
numbers as
indicated in parentheses, sections 4723.02 (4723.01), 4723.04 (4723.02),
4723.051 (4723.10), 4723.31
(4723.082), and 4723.39
(4723.081); to enact sections 3701.91, 4113.512, 4723.021, and 4723.33; to
re-enact section
4723.17, as amended by Am. Sub. H.B. 241 and Am. Sub. S.B. 178 of the 123rd
General Assembly; and
to repeal section 4723.342
of the Revised Code
to revise the laws regarding the practice of nursing and the
licensing and enforcement duties of the Board of Nursing, to establish
the confidentiality of records held by peer review and utilization
review committees of long-term care facilities and immunities from
civil liability related to those committees,
and to amend the
version of 4723.99 of the Revised Code that is scheduled to take effect June
27, 2001, to continue the provisions of this act on and after that effective
date.
Be it enacted by the General Assembly of the State of Ohio:
SECTION 1 . That sections 2305.24, 2305.25, 2305.251, 3313.68, 3701.07,
3701.85, 3702.51, 3719.13,
3721.031, 3721.34,
3727.01, 4723.02, 4723.03, 4723.04, 4723.051, 4723.06, 4723.061,
4723.07, 4723.08, 4723.09, 4723.15, 4723.171, 4723.24, 4723.25, 4723.28,
4723.281, 4723.282,
4723.31, 4723.32, 4723.34, 4723.341, 4723.35, 4723.40, 4723.42, 4723.43,
4723.47, 4723.48, 4723.62, 4723.74, 4723.76, 4723.79, 4723.99,
4731.27, 4731.281, 4743.05, 4751.05, 5111.04, and 5126.35 be
amended; sections 4723.02
(4723.01), 4723.04 (4723.02), 4723.051 (4723.10), 4723.31
(4723.082), and 4723.39 (4723.081)
be amended for the purpose of adopting new section numbers as
indicated in parentheses; and sections 3701.91, 4113.512,
4723.021, and 4723.33 of the Revised Code be enacted to read as follows:
Sec. 2305.24. Any information, data, reports, or records
made available to a quality assurance committee or utilization
committee of a hospital or long-term care facility or of any
not-for-profit health care
corporation that is a member of the hospital or long-term care facility
or of which the hospital or long-term care facility is a member
shall be confidential and shall be used by
the committee and the committee members only in the exercise of
the proper functions of the committee. Any information, data,
reports, or records made available to a utilization committee of
a state or local medical society composed of doctors of medicine
or doctors of osteopathic medicine and surgery shall be
confidential and shall be used by the committee and the committee
members only in the exercise of the proper functions of the
committee. A right of action similar to that a patient may have
against an attending physician for misuse of information, data,
reports, or records arising out of the physician-patient
relationship shall accrue against a member of a quality
assurance committee or utilization committee for misuse of any
information, data, reports, or records furnished to the committee
by an attending physician. No physician, surgeon, institution,
or hospital, or long-term care facility furnishing
information, data, reports, or records to
a committee with respect to any patient examined or treated by
the physician or surgeon or confined in the institution
or, hospital,
or long-term care facility
shall, by reason of the furnishing, be deemed liable in
damages to any person, or be held to answer for betrayal of a
professional confidence within the meaning and intent of section
4731.22 of the Revised Code. Information, data, or reports
furnished to a utilization committee of a state or local medical
society shall contain no name of any person involved therein. As used in this section, "utilization committee" is the
committee established to administer a utilization review plan of
a hospital, of a not-for-profit health care corporation which is
a member of the hospital or of which the hospital is a member, or
of an extended care a skilled nursing facility as provided in
the "Health Insurance
for the Aged Act," 79 Stat. 313 (1965), 42 U.S.C. 1395x(k). Sec. 2305.25. (A) No health care entity and
no individual who is a member of or works on behalf of any of the following
boards or committees of a health care entity or of any of the following
corporations shall be liable in damages to any person for any acts,
omissions, decisions, or other conduct within the scope of the
functions of the board, committee, or corporation: (1) A peer review committee of a hospital or long-term care facility,
a nonprofit
health care corporation which is a member of the hospital or long-term care
facility or of
which the hospital or facility is a member, or a community mental
health
center; (2) A board or committee of a hospital or long-term care facility or
of a nonprofit health care corporation which is a member of the
hospital or long-term care facility or of which the hospital or
long-term care facility is a
member reviewing professional
qualifications or activities of the hospital medical staff of the
hospital or long-term care facility or
applicants for admission to the medical staff; (3) A utilization committee of a state or local society
composed of doctors of medicine, doctors of osteopathic
medicine, or doctors of podiatric medicine; (4) A peer review committee of nursing home providers or
administrators, including a corporation engaged in
performing the functions of a peer review committee of nursing home providers
or administrators, or a corporation engaged in the functions of another type
of peer review or professional standards review
committee; (5) A peer review committee, professional standards review
committee, or arbitration committee of a state or local society
composed of doctors of medicine, doctors of osteopathic medicine, doctors of
dentistry, doctors of optometry, doctors
of podiatric medicine, psychologists, or pharmacists;
(6)(5) A peer review committee of a health insuring
corporation that has at least a two-thirds
majority of member
physicians in active practice and that conducts professional
credentialing and quality review activities involving the
competence or professional conduct of health care providers,
which conduct adversely affects, or could adversely affect, the
health or welfare of any patient. For purposes of this division,
"health insuring corporation" includes
wholly owned
subsidiaries of a health insuring
corporation.
(7)(6) A peer review committee of any insurer authorized
under Title XXXIX of the Revised Code to do the business of
sickness and accident insurance in this state that has at least a
two-thirds majority of physicians in active practice and that
conducts professional credentialing and quality review activities
involving the competence or professional conduct of health care
providers, which conduct adversely affects, or could adversely
affect, the health or welfare of any patient;
(8)(7) A peer review committee of any insurer authorized
under Title XXXIX of the Revised Code to do the business of
sickness and accident insurance in this state that has at least a
two-thirds majority of physicians in active practice and that
conducts professional credentialing and quality review activities
involving the competence or professional conduct of a health care
facility that has contracted with the insurer to provide health
care services to insureds, which conduct adversely affects, or
could adversely affect, the health or welfare of any patient;
(9)(8) A peer review committee of an insurer authorized under
Title XXXIX of the Revised Code to do the business of medical professional
liability insurance in this state and that conducts professional quality
review
activities involving the competence or professional conduct of health care
providers, which conduct adversely affects, or could affect, the health or
welfare of any patient;
(10)(9) A peer review committee of a health care entity.
(B)(1) A hospital shall be presumed to not be negligent in the credentialing
of a qualified person if the hospital proves by a preponderance of the
evidence that at the time of the alleged negligent credentialing of the
qualified person it was accredited by the joint commission on accreditation of
health care organizations, the American osteopathic association, or the
national committee for quality assurance. (2) The presumption that a hospital is not negligent as provided in division
(B)(1) of this section may be rebutted only by proof, by a preponderance of
the evidence, of any of the following: (a) The credentialing and review requirements of the accrediting
organization did not apply to the hospital, the qualified person, or the type
of professional care that is the basis of the claim against the hospital. (b) The hospital failed to comply with all material credentialing and review
requirements of the accrediting organization that applied to the qualified
person. (c) The hospital, through its medical staff executive committee
or its governing body and sufficiently in advance to take appropriate action,
knew that a previously competent qualified person with
staff privileges at the hospital had developed a pattern of
incompetence that indicated that the qualified person's privileges should have
been limited prior to treating the plaintiff at the
hospital. (d) The hospital, through its medical staff executive committee
or its governing body and sufficiently in advance to take appropriate action,
knew that a previously competent qualified person with
staff privileges at the hospital would provide fraudulent
medical treatment but failed to limit the qualified person's
privileges prior to treating the plaintiff at the
hospital. (3) If the plaintiff fails to rebut the presumption provided in division
(B)(1) of this section, upon the motion of the hospital, the court shall enter
judgment in favor of the hospital on the claim of negligent credentialing. (C) Nothing in this section otherwise shall relieve any individual or
health care entity from liability arising from treatment of a
patient or resident. Nothing in this section shall be construed as
creating an exception
to section 2305.251 of the Revised Code. (D) No person who provides information under this section without
malice and in the reasonable
belief that the information is warranted by the facts known
to the person shall be subject to suit for civil
damages as a result of providing the information. (E) As used in this section: (1) "Peer review committee" means a utilization review committee, quality
assurance committee, quality improvement committee, tissue committee,
credentialing committee, or other committee that conducts professional
credentialing and quality review activities involving the competence or
professional conduct of health care practitioners. (2) "Health care entity" means a government entity, a for-profit or
nonprofit corporation, a limited liability company, a partnership, a
professional corporation, a state or local society as described in division
(A)(3) of this section, or other health care organization, including,
but not limited to, health care entities described in division (A) of
this section, whether acting on its own behalf or on behalf of or in
affiliation with other health care entities, that conducts, as part of its
purpose, professional credentialing or quality review activities involving
the competence or professional conduct of health care practitioners or
providers. (3) "Hospital" means either of the following: (a) An institution that has been registered or licensed by the
Ohio department of health as a hospital; (b) An entity, other than an insurance company authorized to
do business in this state, that owns, controls, or is
affiliated with an institution that has been registered
or licensed by the Ohio department of health as a hospital. (4) "Qualified person" means a member of the medical staff of a hospital
or a person who has professional privileges at a hospital pursuant to section
3701.351 of the Revised Code. (F) This section shall be considered to be purely
remedial in its operation and shall be applied in a remedial
manner in any civil action in which this section is relevant,
whether the civil action is pending in court or commenced on or
after the effective date of this section, regardless of when the
cause of action accrued and notwithstanding
any other section
of the Revised Code or prior rule of law of this state. Sec. 2305.251. Proceedings and records within the scope of the peer review
or utilization review functions of all review
boards, committees, or corporations described in section
2305.25 of the Revised Code shall
be held in confidence and shall not be subject to discovery or
introduction in evidence in any civil action against a health
care professional, a hospital, a long-term care facility, a
not-for-profit health care
corporation that is a member of a hospital or long-term care facility
or of which
a hospital or long-term care facility is a member, or another health
care entity
arising
out of matters that are the subject of evaluation and review by
the review board, committee, or corporation. No person in
attendance at a meeting of a review
board, committee, or corporation or serving as a member or
employee of a review board, committee, or corporation shall be
permitted or required to testify in any civil action as to any
evidence or other matters produced or presented during the
proceedings of the review board, committee, or corporation or as
to any finding, recommendation, evaluation, opinion, or other action of the
review board, committee, or corporation or a member or
employee of it. Information, documents, or records
otherwise available from original sources are not to be construed
as being unavailable for discovery or for use in any civil
action merely because they were presented during proceedings of a
review board, committee, or corporation, nor should any person
testifying before a review board, committee, or corporation or
who is a member or employee of the review board, committee, or corporation be
prevented from testifying as
to matters within the person's knowledge, but the witness cannot be
asked about the witness's testimony before the review board,
committee, or corporation or an opinion formed by the witness as a result of
the review board, committee, or corporation hearing. An order by a court to
produce for discovery or for use at trial the
proceedings or records described in this section is a final order. Sec. 3313.68. The board of education of each city,
exempted village, or local school district may appoint one or
more school physicians and one or more school dentists. Two or
more school districts may unite and employ one such physician and
at least one such dentist whose duties shall be such as are
prescribed by law. Said school physician shall hold a license to
practice medicine in Ohio, and each school dentist shall be
licensed to practice in this state. School physicians and
dentists may be discharged at any time by the board of education.
School physicians and dentists shall serve one year and until
their successors are appointed and shall receive such
compensation as the board of education determines. The board of
education may also employ registered nurses, as defined by
section 4723.02 4723.01 and licensed as school nurses
under section 3319.22 of the Revised Code, to aid in such inspection
in such ways as are prescribed by it, and to aid in the conduct and
coordination of the school health service program. The school
dentists shall make such examinations and diagnoses and render
such remedial or corrective treatment for the school children as
is prescribed by the board of education; provided that all such
remedial or corrective treatment shall be limited to the children
whose parents cannot otherwise provide for same, and then only
with the written consent of the parents or guardians of such
children. School dentists may also conduct such oral hygiene
educational work as is authorized by the board of education. The board of education may delegate the duties and powers
provided for in this section to the board of health or officer
performing the functions of a board of health within the school
district, if such board or officer is willing to assume the same.
Boards of education shall co-operate with boards of health in the
prevention and control of epidemics. Sec. 3701.07. (A) The public health council shall adopt
rules in accordance with Chapter 119. of the Revised Code
defining and classifying hospitals and dispensaries and providing
for the reporting of classification information by hospitals and
dispensaries. The rules may require each hospital to report
information in the following categories, shall limit the
information to information necessary to classify hospitals and
dispensaries as general or specialty facilities, and providing for the
reporting of information shall not
include require inclusion of any confidential patient data or
any information
concerning the financial condition, income, expenses, or net
worth of the facilities other than that financial information
already contained in those portions of the medicare or medicaid
cost report that is necessary for the department of health to
certify the per diem cost under section 3701.62 of the Revised
Code. The rules may require the reporting of information in the
following categories: (1) Information needed to identify and classify the
institution; (2) Information on facilities and type and volume of
services provided by the institution; (3) The number of beds listed by category of care
provided; (4) The number of licensed or certified professional
employees by classification; (5) The number of births that occurred at the institution
the previous calendar year; (6) Any other information that the council considers relevant to the
safety of patients served by the institution. Every hospital and dispensary, public or private, annually
shall register with and report to the department of health on
forms. Reports shall be submitted in the manner prescribed
in rules adopted under this division. (B) Every governmental entity or private nonprofit
corporation or association whose employees or representatives are
defined as residents' rights advocates under divisions (E)(1) and
(2) of section 3721.10 or division (A)(10) of section 3722.01 of
the Revised Code shall register with the department of health on
forms furnished by the director of health and shall provide such
reasonable identifying information as the director may prescribe. The department shall compile a list of the governmental
entities, corporations, or associations registering under this
division and shall update the list annually. Copies of the list
shall be made available to nursing home administrators as defined
in division (C) of section 3721.10 of the Revised Code and to
adult care facility managers as defined in section 3722.01 of the
Revised Code. (C) Every governmental entity or private nonprofit
corporation or association whose employees or representatives act
as residents' rights advocates for community alternative homes
pursuant to section 3724.08 of the Revised Code shall register
with the department of health on forms furnished by the director
of health and shall provide such reasonable identifying
information as the director may prescribe. The department shall compile a list of the governmental
entities, corporations, and associations registering under this
division and shall update the list annually. Copies of the list
shall be made available to operators or residence managers of
community alternative homes as defined in section 3724.01 of the
Revised Code. Sec. 3701.85. (A) As used in this section: (1) "Automated external defibrillation" has the same
meaning as in section 2305.235 of the Revised Code. (2) "Emergency medical services organization" has the same meaning
as in section 4765.01 of the Revised Code. (3) "Emergency medical service provider" means a person
who is an "emergency medical technician-basic," "emergency
medical technician-intermediate," "emergency medical
technician-paramedic," or "first responder" as defined in
section 4765.01 of the Revised
Code. (4) "Physician" has the same meaning as in section
4765.01 of the Revised Code. (5) "Registered nurse" and "licensed practical nurse"
have the same meanings as in section 4723.02 4723.01 of the
Revised Code. (B) A person who possesses an automated external defibrillator
shall do all of the following: (1) Require expected users to complete successfully a course in automated
external defibrillation and cardiopulmonary resuscitation that
is offered or approved by the American heart association or
another nationally recognized organization; (2) Maintain and test the defibrillator according to the
manufacturer's guidelines; (3) Consult with a physician regarding compliance with the
requirements of divisions (B)(1) and (2) of this section. (C) A person who possesses an automated external
defibrillator may notify an emergency medical services
organization of the location of the defibrillator. (D) A person who has
obtained appropriate training on how to perform automated
external defibrillation and has successfully completed a course
in cardiopulmonary resuscitation may perform automated external
defibrillation, regardless of whether the person is a physician,
registered nurse, licensed practical nurse, or emergency medical
service provider. When automated external defibrillation is not
performed as part of an emergency medical services system or at
a hospital as defined in section 3727.01 of the Revised Code, an
emergency medical services system shall be activated as soon as
possible. Sec. 3701.91. The department of health shall make available to the public
a toll-free
patient safety telephone line.
The department may make the toll-free patient safety telephone line
available by maintaining a toll-free telephone line specifically for accepting
calls regarding patient safety or by using a
toll-free telephone line that the department maintains for accepting calls
regarding other
matters. The department shall accept calls placed through the toll-free
patient safety telephone line by any person seeking to report an action or
failure to act in the provision of health care that the
person in good faith believes has resulted in or is likely to result in harm
to
a patient. This section shall not
be used by the department to
accept calls pertaining to a home, as defined in section 3721.10
of the Revised Code. A person who makes a report under this section is not
required to provide any information to the department that could reveal the
person's identity. Information provided by a person under this section is not
a public record as defined in section 149.43 of the Revised Code. Sec. 3702.51. As used in sections 3702.51 to 3702.62 of
the Revised Code: (A) "Applicant" means any person that submits an
application for a certificate of need and who is designated in
the application as the applicant. (B) "Person" means any individual, corporation, business
trust, estate, firm, partnership, association, joint stock
company, insurance company, government unit, or other entity. (C) "Certificate of need" means a written approval granted
by the director of health to an applicant to authorize conducting
a reviewable activity. (D) "Health service area" means a geographic region
designated by the director of health under section 3702.58 of the
Revised Code. (E) "Health service" means a clinically related service,
such as a diagnostic, treatment, rehabilitative, or preventive
service. (F) "Health service agency" means an agency designated to
serve a health service area in accordance with section 3702.58 of
the Revised Code. (G) "Health care facility" means: (1) A hospital registered under section 3701.07 of the
Revised Code; (2) A nursing home licensed under section 3721.02 of the
Revised Code, or by a political subdivision certified under
section 3721.09 of the Revised Code; (3) A county home or a county nursing home as defined in
section 5155.31 of the Revised Code that is certified under Title
XVIII or XIX of the "Social Security Act," 49 Stat. 620 (1935),
42 U.S.C.A. 301, as amended; (4) A freestanding dialysis center; (5) A freestanding inpatient rehabilitation facility; (6) An ambulatory surgical facility; (7) A freestanding cardiac catheterization facility; (8) A freestanding birthing center; (9) A freestanding or mobile diagnostic imaging center; (10) A freestanding radiation therapy center. A health care facility does not include the offices of
private physicians and dentists whether for individual or group
practice, residential facilities licensed under section
5123.19 of the Revised Code, or habilitation centers certified by
the director of mental retardation and developmental disabilities
under section 5123.041 of the Revised Code, or an institution for
the sick that is operated exclusively for patients who use spiritual means for
healing and for whom the acceptance of medical care is inconsistent with their
religious beliefs, accredited by a national accrediting organization, exempt
from federal income taxation under section 501 of the Internal
Revenue Code of 1986, 100 Stat. 2085, 26 U.S.C.A. 1, as
amended, and providing twenty-four hour nursing care pursuant to the exemption
in division (G)(E) of section 4723.32 of the Revised Code from
the licensing requirements of Chapter 4723. of the Revised Code. (H) "Medical equipment" means a single unit of medical
equipment or a single system of components with related functions
that is used to provide health services. (I) "Third-party payer" means a health insuring corporation
licensed under Chapter
1751.
of the Revised Code, a health maintenance organization as defined in
division (K) of this section, an
insurance company that issues sickness and accident insurance in
conformity with Chapter 3923. of the Revised Code, a
state-financed health insurance program under Chapter 3701.,
4123., or 5111. of the Revised Code, or any self-insurance plan. (J) "Government unit" means the state and any county,
municipal corporation, township, or other political subdivision
of the state, or any department, division, board, or other agency
of the state or a political subdivision. (K) "Health maintenance organization" means a public or
private organization organized under the law of any state that is
qualified under section 1310(d) of Title XIII of the "Public
Health Service Act," 87 Stat. 931 (1973), 42 U.S.C.
300e-9. (L) "Existing health care facility" means a health care
facility that is licensed or otherwise approved to practice in
this state, in accordance with applicable law, is staffed and
equipped to provide health care services, and actively provides
health services or has not been actively providing health
services for less than twelve consecutive months. (M) "State" means the state of Ohio, including, but not
limited to, the general assembly, the supreme court, the offices
of all elected state officers, and all departments, boards,
offices, commissions, agencies, institutions, and other
instrumentalities of the state of Ohio. "State" does not include
political subdivisions. (N) "Political subdivision" means a municipal corporation,
township, county, school district, and all other bodies corporate
and politic responsible for governmental activities only in
geographic areas smaller than that of the state to which the
sovereign immunity of the state attaches. (O) "Affected person" means: (1) An applicant for a certificate of need, including an
applicant whose application was reviewed comparatively with the
application in question; (2) The person that requested the reviewability ruling in question; (3) Any person that resides or regularly uses health care
facilities within the geographic area served or to be served by
the health care services that would be provided under the
certificate of need or reviewability ruling in question; (4) Any health care facility that is located in the health
service area where the health care services would be provided
under the certificate of need or reviewability ruling in question; (5) Third-party payers that reimburse health care
facilities for services in the health service area where the
health care services would be provided under the certificate of need or
reviewability ruling in question; (6) Any other person who testified at a public hearing
held under division (B) of section 3702.52 of the Revised Code or
submitted written comments in the course of review of the
certificate of need application in question. (P) "Osteopathic hospital" means a hospital registered
under section 3701.07 of the Revised Code that advocates
osteopathic principles and the practice and perpetuation of
osteopathic medicine by doing any of the following: (1) Maintaining a department or service of osteopathic
medicine or a committee on the utilization of osteopathic
principles and methods, under the supervision of an osteopathic
physician; (2) Maintaining an active medical staff, the majority of
which is comprised of osteopathic physicians; (3) Maintaining a medical staff executive committee that
has osteopathic physicians as a majority of its members. (Q) "Ambulatory surgical facility" has the same meaning as in
section 3702.30 of the Revised Code. (R) Except as otherwise provided in division (T) of this section, and until
the termination date specified in section 3702.511 of the Revised Code,
"reviewable activity" means any of the following: (1) The addition
by any person of any of the following health
services, regardless of the amount of operating costs or capital
expenditures: (a) A heart, heart-lung, lung, liver, kidney, bowel,
pancreas, or bone marrow transplantation service, a stem cell harvesting and
reinfusion service, or a service for transplantation
of any other organ unless transplantation of the organ is
designated by public health council rule not to be a reviewable
activity; (b) A cardiac catheterization service; (c) An open-heart surgery service; (d) Any new, experimental medical technology
that is designated by rule of the public health council. (2) The acceptance of high-risk patients, as defined in
rules adopted under section 3702.57 of the Revised Code, by any cardiac
catheterization service that was initiated without a certificate of
need pursuant to division
(R)(3)(b) of the version of this section in effect
immediately prior to April 20,
1995; (3)(a) The establishment, development, or construction of a
new health care facility other than a new long-term care facility or a new
hospital; (b) The establishment, development, or construction of a new hospital or
the relocation of an existing hospital; (c) The relocation of hospital beds, other than long-term care,
perinatal, or pediatric intensive care beds, into or out of a rural
area. (4)(a) The replacement of an existing hospital; (b) The replacement of an existing hospital obstetric or
newborn care unit or freestanding birthing
center. (5)(a) The renovation of a hospital
that involves
a capital expenditure, obligated on or after the effective date of
this amendment, of five million dollars or more,
not including expenditures for equipment, staffing, or operational costs. For
purposes of division (R)(5)(a) of this
section, a capital expenditure is obligated: (i) When a contract enforceable under Ohio law is entered
into for the construction, acquisition, lease, or financing of a capital
asset; (ii) When the governing body of a hospital takes formal action to
commit its own funds for a construction project undertaken by the hospital as
its own contractor; (iii) In the case of donated property, on the date the gift is
completed under applicable Ohio law. (b) The renovation of a hospital obstetric or newborn care
unit
or freestanding birthing center that involves a capital expenditure of five
million dollars or more, not including expenditures for equipment, staffing,
or operational costs. (6) Any change in the health care services, bed capacity,
or site, or any other failure to conduct the reviewable activity
in substantial accordance with the approved application for which
a certificate of need was granted, if the change is made prior to
the date the activity for which the certificate was issued ceases to be a
reviewable activity; (7) Any of the following changes in perinatal bed capacity or pediatric
intensive care bed capacity: (a) An increase in bed capacity; (b) A change in service or service-level
designation of newborn care beds or obstetric beds in a hospital or
freestanding birthing center, other than a change of service that is provided
within the service-level designation of newborn care or obstetric beds as
registered by the department of health; (c) A relocation of perinatal or pediatric
intensive care beds from one physical facility or
site to another, excluding the relocation of beds within a
hospital or freestanding birthing
center or the relocation of beds among buildings of a
hospital or freestanding birthing
center at the same site. (8) The expenditure of more than one hundred ten per cent
of the maximum expenditure specified in a certificate of need; (9) Any transfer of a certificate of need issued prior to April
20, 1995, from the person
to whom it was issued to another person before the project that
constitutes a reviewable activity is completed, any agreement
that contemplates the transfer of a certificate of need issued prior to that
date upon
completion of the project, and any transfer of the controlling
interest in an entity that holds a certificate of need issued prior to that
date. However, the transfer of a certificate of need issued prior to that
date or agreement to
transfer such a certificate of need from the person to whom the
certificate of need was issued to an affiliated or related person
does not constitute a reviewable transfer of a certificate of
need for the purposes of this division, unless the transfer
results in a change in the person that holds the
ultimate controlling interest in the certificate of need. (10)(a) The acquisition by any person of any of the following medical
equipment,
regardless of the amount of operating costs or capital expenditure: (i) A cobalt radiation therapy unit; (ii) A linear accelerator; (iii) A gamma knife unit. (b) The acquisition by any person of medical equipment with a
cost of two million dollars or more. The cost of acquiring medical equipment
includes the sum of the following: (i) The greater of its fair market value or the cost of its lease
or purchase; (ii) The cost of installation and any other activities essential
to the acquisition of the equipment and its placement into service. (11) The addition of another cardiac
catheterization laboratory to an existing cardiac
catheterization service. (S) Except as provided in division
(T) of this section,
"reviewable activity" also means any of the following
activities, none of which are subject to a termination date: (1) The establishment, development, or construction of a
new long-term care facility; (2) The replacement of an existing long-term care
facility; (3) The renovation of a long-term care facility that
involves a capital expenditure of two million dollars or more,
not including expenditures for equipment, staffing, or
operational costs; (4) Any of the following changes in long-term care bed
capacity: (a) An increase in bed capacity; (b) A relocation of beds from one
physical facility or site to another, excluding the relocation
of beds within a long-term care facility or among buildings of a
long-term care facility at the same site; (c) A recategorization of hospital
beds registered under section 3701.07 of the
Revised
Code from another registration
category to skilled nursing beds or long-term care beds. (5) Any change in the health services, bed capacity, or
site, or any other failure to conduct the reviewable activity in
substantial accordance with the approved application for which a
certificate of need concerning long-term care beds was granted,
if the change is made within five years after the implementation
of the reviewable activity for which the certificate was
granted; (6) The expenditure of more than one hundred ten per cent
of the maximum expenditure specified in a certificate of need
concerning long-term care beds; (7) Any transfer of a certificate of need that concerns
long-term care beds and was issued prior to
April 20, 1995, from the person
to whom it was issued to another person before the project that
constitutes a reviewable activity is completed, any agreement
that contemplates the transfer of such a certificate of need
upon completion of the project, and any transfer of the
controlling interest in an entity that holds such a certificate
of need. However, the transfer of a certificate of need that
concerns long-term care beds and was issued prior to
April 20, 1995, or agreement to
transfer such a certificate of need from the person to whom the
certificate was issued to an affiliated or related person does
not constitute a reviewable transfer of a certificate of need
for purposes of this division, unless the transfer results in a
change in the person that holds the ultimate controlling
interest in the certificate of need. (T) "Reviewable activity" does not include any of the
following activities: (1) Acquisition of computer hardware or software; (2) Acquisition of a telephone system; (3) Construction or acquisition of parking facilities; (4) Correction of cited deficiencies that are in violation
of federal, state, or local fire, building, or safety laws and
rules and that constitute an imminent threat to public health or
safety; (5) Acquisition of an existing health care facility that
does not involve a change in the number of the beds, by service,
or in the number or type of health services; (6) Correction of cited deficiencies identified by
accreditation surveys of the joint commission on accreditation of
healthcare organizations or of the American osteopathic
association; (7) Acquisition of medical equipment to replace the same
or similar equipment for which a certificate of need has been
issued if the replaced equipment is removed from service; (8) Mergers, consolidations, or other corporate
reorganizations of health care facilities that do not involve a
change in the number of beds, by service, or in the number or
type of health services; (9) Construction, repair, or renovation of bathroom
facilities; (10) Construction of laundry facilities, waste disposal
facilities, dietary department projects, heating and air
conditioning projects, administrative offices, and portions of
medical office buildings used exclusively for physician services; (11) Acquisition of medical equipment to conduct research
required by the United States food and drug administration or
clinical trials sponsored by the national institute of health.
Use of medical equipment that was acquired without a certificate
of need under division (T)(11) of this section and for
which
premarket approval has been granted by the United States food and
drug administration to provide services for which patients or
reimbursement entities will be charged shall be a reviewable
activity. (12) Removal of asbestos from a health care facility. Only that portion of a project that meets the requirements
of division (T) of this section is not a reviewable
activity. (U) "Small rural hospital" means a hospital that is
located within a rural area, has fewer than
one hundred beds, and to which fewer than four thousand persons
were admitted during the most recent calendar year. (V) "Children's hospital" means any of the following: (1) A hospital registered under section 3701.07 of the
Revised Code that provides general pediatric medical and surgical
care, and in which at least seventy-five per cent of annual
inpatient discharges for the preceding two calendar years were
individuals less than eighteen years of age; (2) A distinct portion of a hospital registered under
section 3701.07 of the Revised Code that provides general
pediatric medical and surgical care, has a total of at least one
hundred fifty registered pediatric special care and pediatric
acute care beds, and in which at least seventy-five per cent of
annual inpatient discharges for the preceding two calendar years
were individuals less than eighteen years of age; (3) A distinct portion of a hospital, if the hospital is
registered under section 3701.07 of the Revised Code as a
children's hospital and the children's hospital meets all the
requirements of division (V)(1) of this section. (W) "Long-term care facility" means any of the following: (1) A nursing home licensed under section 3721.02 of the
Revised Code or by a political subdivision certified under section 3721.09 of
the Revised Code; (2) The portion of any facility, including a county home or county
nursing home, that is certified as a skilled nursing facility or a nursing
facility under Title XVIII or XIX of the "Social Security Act"; (3) The portion of any hospital that contains beds registered under
section 3701.07 of the Revised Code as skilled nursing beds or long-term care
beds. (X) "Long-term care bed" means a bed in a long-term care facility. (Y) "Perinatal bed" means a bed in a hospital that is registered under
section 3701.07 of the Revised Code as a newborn care bed or obstetric bed, or
a bed in a freestanding birthing center. (Z) "Freestanding birthing center" means any facility in which
deliveries routinely occur, regardless of whether
the facility is located on the campus of another health care facility, and
which is not licensed under Chapter 3711. of
the Revised
Code as a level one, two, or three maternity
unit or a limited maternity unit. (AA)(1) "Reviewability ruling" means a ruling issued by the
director of health under division (A) of section 3702.52 of the Revised Code
as to whether a particular proposed project is or is not a
reviewable activity. (2) "Nonreviewability ruling" means a ruling issued under
that division that a particular proposed project is not a reviewable
activity. (BB)(1) "Metropolitan
statistical area" means an area of this state designated a
metropolitan statistical area or primary metropolitan
statistical area in United
States office of management and
budget bulletin No. 93-17,
June 30, 1993, and its
attachments. (2) "Rural area" means any area of this state not located
within a metropolitan statistical area. Sec. 3719.13. Prescriptions, orders, and records, required
by Chapter 3719. of the Revised Code, and stocks of dangerous
drugs and controlled substances, shall be open for inspection
only to federal, state, county, and municipal officers, and
employees of the state board of pharmacy whose duty it is to
enforce the laws of this state or of the United States relating
to controlled substances. Such prescriptions, orders, records,
and stocks shall be open for inspection by employees of the state
medical board for purposes of enforcing Chapter 4731. of the
Revised Code and employees of the board of nursing for purposes of
enforcing Chapter 4723. of the Revised Code. No person having knowledge of any
such prescription, order, or record shall divulge such knowledge,
except in connection with a prosecution or proceeding in court or
before a licensing or registration board or officer, to which
prosecution or proceeding the person to whom such prescriptions,
orders, or records relate is a party. Sec. 3721.031. (A) The director of health may investigate
any complaint he the director receives concerning a home. (1) Except as required by court order, as necessary for
the administration or enforcement of any statute relating to
homes, or as provided in division (C) of this section, the
director and any employee of the department of health shall not
release any of the following information without the permission
of the individual or of his the individual's legal
representative: (a) The identity of any patient or resident; (b) The identity of any individual who submits a complaint
about a home; (c) The identity of any individual who provides the
director with information about a home and has requested
confidentiality; (d) Any information that reasonably would tend to disclose
the identity of any individual described in division (A)(1)(a) to
(c) of this section. (2) An agency or individual to whom the director is
required, by court order or for the administration or enforcement
of a statute relating to homes, to release information described
in division (A)(1) of this section shall not release the
information without the permission of the individual who would be
or would reasonably tend to be identified, or of his the
individual's legal
representative, unless the agency or individual is required to
release it by division (C) of this section, by court order, or
for the administration or enforcement of a statute relating to
homes. (B) Except as provided in division (C) of this section,
any record that identifies an individual described in division
(A)(1)(a) to (c) of this section or that reasonably would tend to
identify such an individual is not a public record for the
purposes of section 149.43 of the Revised Code, and is not
subject to inspection and copying under section 1347.08 of the
Revised Code. (C) If the director, or an agency or individual to whom
the director is required by court order or for administration or
enforcement of a statute relating to homes to release information
described in division (A)(1) of this section, uses information in
any administrative or judicial proceeding against a home that
reasonably would tend to identify an individual described in
division (A)(1)(a) to (c) of this section, the director, agency,
or individual shall disclose that information to the home.
However, the director, agency, or individual shall not disclose
information that directly identifies an individual described in
divisions (A)(1)(a) to (c) of this section, unless the individual
is to testify in the proceedings. (D) No person shall knowingly register a false complaint
about a home with the director, or knowingly swear or affirm the
truth of a false complaint, when the complaint is made for the
purpose of incriminating another. (E) An individual who in good faith submits a complaint under
this section or any other provision of the Revised Code
regarding
a violation of this chapter, or participates in any investigation,
administrative proceeding, or judicial proceeding resulting from
the complaint, has the full protection against retaliatory action
provided by sections 4113.51 to 4113.53 of the Revised
Code. Sec. 3721.34. For purposes of implementing sections
3721.28 to 3721.33 of the Revised Code, the director of health
may advise, consult or cooperate with, or enter into agreements
with the board of nursing, other state agencies and,
political
subdivisions, the federal government, or any person.
The
director may enter into agreements that provide for the board of
nursing or another a state agency to do any of the following: (A) Approve or reapprove, in accordance with division (A)
of section 3721.31 of the Revised Code and the rules adopted by
the director under section 3721.30 of the Revised Code,
competency evaluation programs and training and competency
evaluation programs, or, in accordance with rules adopted by the
director under section 3721.30 of the Revised Code, programs to
train instructors and coordinators for training and competency
evaluation programs and evaluators for competency evaluation
programs, and to perform any functions related to approval and
reapproval of those programs including any of the following: (1) Conduct adjudications under Chapter 119. of the
Revised Code; (2) Conduct the inspections and examinations described in
division (A)(5) or (D) of section 3721.31 of the Revised Code; (3) Deny, suspend, or revoke approval or reapproval, in
accordance with Chapter 119. of the Revised Code, of programs
that are not in compliance with sections 3721.30 and 3721.31 of
the Revised Code and the rules adopted thereunder; (4) Collect the fees described in division (G) of section
3721.31 of the Revised Code in the amounts prescribed in rules
adopted by the director of health under section 3721.30 of the
Revised Code and deposit them into the nurse aide training fund
created by section 3721.33 of the Revised Code. (B) Approve or deny, in accordance with Chapter 119. of
the Revised Code, the requests described in division (B)(2) of
section 3721.31 of the Revised Code. Sec. 3727.01. As used in this section, "health maintenance
organization" means a public or private organization organized
under the law of any state that is qualified under section
1310(d) of Title XIII of the "Public Health Service Act," 87
Stat. 931 (1973), 42 U.S.C. 300e-9, or that does all of the
following: (A) Provides or otherwise makes available to enrolled
participants health care services including at least the
following basic health care services: usual physician services,
hospitalization, laboratory, x-ray, emergency and preventive
service, and out-of-area coverage; (B) Is compensated, except for copayments, for the
provision of basic health care services to enrolled participants
by a payment that is paid on a periodic basis without regard to
the date the health care services are provided and that is fixed
without regard to the frequency, extent, or kind of health
service actually provided; (C) Provides physician services primarily in either of the
following ways: (1) Directly through physicians who are either employees
or partners of the organization; (2) Through arrangements with individual physicians or one
or more groups of physicians organized on a group-practice or
individual-practice basis. As used in this chapter, "hospital" means an institution
classified as a hospital under section 3701.07 of the Revised
Code in which are provided to inpatients diagnostic, medical,
surgical, obstetrical, psychiatric, or rehabilitation care for a
continuous period longer than twenty-four hours or a hospital operated by a
health maintenance
organization. "Hospital" does not include a facility licensed
under Chapter 3721. of the Revised Code, a health care facility
operated by the department of mental health or the department of
mental retardation and developmental disabilities, a health
maintenance organization that does not operate a hospital, the
office of any private licensed health care professional, whether
organized for individual or group practice, or a clinic that
provides ambulatory patient services and where patients are not
regularly admitted as inpatients. "Hospital" also does not include an
institution for
the sick that is operated exclusively for patients who use spiritual means for
healing and for whom the acceptance of medical care is inconsistent with their
religious beliefs, accredited by a national accrediting organization, exempt
from federal income taxation under section 501 of the Internal
Revenue Code of 1986, 100 Stat. 2085, 26 U.S.C.A. 1,
as
amended, and providing twenty-four hour nursing care pursuant to the exemption
in division (G)(E) of section 4723.32 of the Revised Code from
the licensing
requirements of Chapter 4723. of the Revised Code. Sec. 4113.512. The employer of an employee whose duties include
providing health care or supervising an individual who provides
health care
may make information available to the
employee explaining the employee's duty to make reports pursuant to section
4113.52 of the Revised Code,
as well as the employee's opportunity to make reports
regarding patient safety pursuant to section 3701.91 of the
Revised Code. Sec. 4723.02 4723.01. As used in this chapter: (A) "Registered nurse" means an individual who holds a
current, valid license issued under this chapter that authorizes
the practice of nursing as a registered nurse. (B) "Practice of nursing as a registered nurse" means
providing to individuals and groups nursing care requiring
specialized knowledge, judgment, and skill derived from the
principles of biological, physical, behavioral, social, and
nursing sciences. Such nursing care includes: (1) Identifying patterns of human responses to actual or
potential health problems amenable to a nursing regimen; (2) Executing a nursing regimen through the selection,
performance, management, and evaluation of nursing actions; (3) Assessing health status for the purpose of providing
nursing care; (4) Providing health counseling and health teaching; (5) Administering medications, treatments, and executing
regimens authorized by an individual who is
authorized to practice in this state and is acting within the course of the
individual's professional practice; (6) Teaching, administering, supervising, delegating, and
evaluating nursing practice. (C) "Nursing regimen" may include preventative,
restorative, and health-promotion activities. (D) "Assessing health status" means the collection of data
through nursing assessment techniques, which may include
interviews, observation, and physical evaluations for the purpose
of providing nursing care. (E) "Licensed practical nurse" means an individual who
holds a current, valid license issued under this chapter that
authorizes the practice of nursing as a licensed practical nurse. (F) "The practice of nursing as a licensed practical
nurse" means providing to individuals and groups nursing care
requiring the application of basic knowledge of the biological,
physical, behavioral, social, and nursing sciences at the
direction of a licensed physician, dentist, podiatrist,
optometrist, chiropractor, or registered nurse. Such nursing
care includes: (1) Observation, patient teaching, and care in a diversity
of health care settings; (2) Contributions to the planning, implementation, and
evaluation of nursing; (3) Administration of medications and treatments
authorized by an individual who is
authorized to practice in this state and is acting within the course of the
individual's professional practice, except that administration of
intravenous therapy shall be performed only in accordance with section
4723.17 or 4723.171
of the Revised Code. Medications may be administered by a licensed
practical nurse upon proof of completion of a course in
medication administration approved by the board of nursing. (4) Administration to an adult of intravenous therapy
authorized by an individual who is authorized to practice in this
state and is acting within the course of the individual's professional
practice, on the condition that the licensed practical nurse is authorized
under section 4723.17 or 4723.171 of
the Revised Code to perform intravenous therapy
and performs intravenous
therapy only in accordance with 4723.17 those sections. (G) "Certified registered
nurse anesthetist" means a registered nurse who holds a valid
certificate of authority issued under this chapter that
authorizes the practice of nursing as a certified registered
nurse anesthetist in accordance with section 4723.43 of the
Revised Code and rules adopted by the board of
nursing. (H) "Clinical nurse specialist" means a registered
nurse who holds a valid certificate of authority issued under
this chapter that authorizes the practice of nursing as a
clinical nurse specialist in accordance with section 4723.43 of
the Revised Code and rules adopted by the board
of nursing. (I) "Certified nurse-midwife" means a registered nurse who
holds a valid certificate of authority issued under this chapter
that authorizes the practice of nursing as a certified nurse-midwife in
accordance with section 4723.43 of the Revised
Code and rules adopted by the board of nursing. (J) "Certified nurse practitioner" means a registered nurse
who holds a valid certificate of authority issued under this
chapter that authorizes the practice of nursing as a certified nurse
practitioner in accordance with section 4723.43 of the
Revised Code and rules adopted by the board of
nursing. (K) "Physician" means an individual
authorized under Chapter 4731. of
the Revised Code to practice
medicine and surgery or osteopathic medicine and surgery. (L) "Collaboration" or "collaborating" means the
following: (1) In the case of a clinical nurse specialist, except
as provided in division (L)(3) of this section, or a
certified nurse
practitioner, that one or more podiatrists acting
within the scope of
practice of podiatry in accordance with section 4731.51 of the
Revised Code and with whom the nurse has entered into a
standard care arrangement or one or more physicians
with whom the nurse has entered into a
standard care arrangement are continuously
available to communicate with the clinical nurse specialist or
certified nurse practitioner either in person or by radio, telephone, or
other form of telecommunication; (2) In the case of a certified nurse-midwife, that one
or more physicians with whom the certified nurse-midwife has entered into
a standard care arrangement are
continuously available to communicate with the certified nurse-midwife
either in person or by radio, telephone, or other form of
telecommunication; (3) In the case of a clinical nurse specialist who practices
the nursing specialty of mental health or psychiatric
mental health without being authorized to prescribe drugs and therapeutic
devices, that one or more physicians are
continuously
available to communicate with the nurse either in person or by radio,
telephone, or other form of telecommunication. (M) "Supervision," as it pertains to a certified
registered nurse
anesthetist, means that a the certified
registered nurse anesthetist is under the direction of a podiatrist acting
within the podiatrist's scope of practice in accordance with section 4731.51
of the Revised
Code, a dentist acting within the dentist's
scope of practice in accordance with Chapter
4715. of the Revised
Code, or a physician, and, when administering
anesthesia, the certified registered nurse anesthetist is in the immediate
presence of the podiatrist, dentist, or physician. (N) "Standard care arrangement," except as it
pertains to an advanced practice nurse, means a
written, formal guide for planning and evaluating a patient's health care that
is developed by one or more collaborating
physicians or podiatrists and a clinical nurse
specialist, certified nurse-midwife, or certified nurse practitioner and meets
the requirements of section 4723.431 of the
Revised Code. (O) "Advanced practice nurse," until three years and eight months
after this amendment May 17, 2000, means a
registered nurse who is approved by the
board of nursing under section 4723.55 of the Revised Code
to practice as an advanced practice nurse. (Q)(P) "Dialysis care" means the care and procedures that a
dialysis technician is authorized to provide and perform, as specified in
section 4723.72 of the Revised Code.
(R)(Q) "Dialysis technician" means an individual who holds a
current, valid certificate or temporary certificate issued under this chapter
that authorizes the individual to practice as a dialysis technician in
accordance with section 4723.72 of the Revised Code.
Sec. 4723.04 4723.02. The state nurses' board shall be
known
as
the board of nursing. The board shall assume and exercise all
the powers and perform all the duties conferred and imposed on it
by this chapter. The The board shall consist of thirteen members who shall
be citizens of the United States and residents of Ohio. Eight
members shall be registered nurses, each of whom shall be a
graduate of an approved program of nursing education that
prepares persons for licensure as a registered nurse, shall hold
a currently active license issued under this chapter to practice
nursing as a registered nurse, and shall have been actively
engaged in the practice of nursing as a registered nurse for the
five years immediately preceding the member's initial appointment
to the board. Of the eight members who are registered nurses, at least one
shall hold a valid certificate of authority issued under this chapter that
authorizes the practice of nursing as a certified registered nurse
anesthetist, clinical nurse specialist, certified
nurse-midwife, or certified nurse
practitioner. Four members shall be
licensed practical nurses,
each of whom shall be a graduate of an approved program of
nursing education that prepares persons for licensure as a
practical nurse, shall hold a currently active license issued
under this chapter to practice nursing as a licensed practical
nurse, and shall have been actively engaged in the practice of
nursing as a licensed practical nurse for the five years
immediately preceding the member's initial appointment to the
board. One member shall represent the interests of consumers of
health care. Neither this member nor any person in the member's
immediate family shall be a member of or associated with a health
care provider or profession or shall have a financial interest in
the delivery or financing of health care. Representation of
nursing service and nursing education and of the various
geographical areas of the state shall be considered in making
appointments. As As the term of any member of the board expires, a
successor shall be appointed who has the qualifications the
vacancy requires. Terms of office shall be for five four years,
commencing on the first day of January and ending on the
thirty-first day of December. Each A current or former board member who has served not more than one full term
or one full term and not more than thirty months of another term may be
reappointed for one additional term. Each member shall hold office from
the date of appointment until the end of the term for which the
member was appointed. The term of a member shall expire if the
member ceases to meet any requirement of this section for the
member's position on the board. Any member appointed to fill a
vacancy occurring prior to the expiration of the term for which
the member's predecessor was appointed shall hold office for
the remainder
of such term. A person who has served a full term on the board
or more than thirty months of the remainder of the term of a
predecessor shall not be eligible for a subsequent appointment to
the board. Any member shall continue in office subsequent to the
expiration date of the member's term until the
member's successor takes office, or
until a period of sixty days has elapsed, whichever occurs first.
Nursing Nursing organizations of this state may each submit to the
governor the names of not more than five nominees for each
position to be filled on the board. From the names so submitted
or from others, at the governor's discretion, the governor
with the advice
and consent of the senate shall make such appointments. Any member of the board may be removed by the governor for
neglect of any duty required by law or for incompetency or
unprofessional or dishonorable conduct, after a hearing as
provided in Chapter 119. of the Revised Code. Seven Seven members of
the board including at least four registered nurses and at least
one licensed practical nurse shall at all times constitute a
quorum. Each member of the board shall receive an amount fixed
pursuant to division (J) of section 124.15 of the Revised Code
for each day in attendance at board meetings and in discharge of
official duties, and in addition thereto, necessary expense
incurred in the performance of such duties. The board shall elect one of its nurse members as president
and one as vice-president. The board shall elect one of its registered
nurse members to serve as the supervising member for disciplinary matters. The board may establish advisory groups to serve in
consultation with the board or the executive director. Each
advisory group shall be given a specific charge in writing and
shall report to the board. Members of advisory groups shall
serve without compensation but shall receive their actual and
necessary expenses incurred in the performance of their official
duties. Sec. 4723.021. In the absence of fraud or bad faith,
the board of nursing, a current or former board member, an agent of
the board, a representative of the board,
an employee of the board, or an entity that provides services related to
remediation under the board's practice intervention and improvement program
shall not be held liable in
damages to any person as the result of any act, omission,
proceeding, conduct, or decision related to official duties
undertaken or performed pursuant to this chapter. If
a member, agent, representative, employee, or entity asks to be defended by
the
state against any claim or action arising out of
any act, omission, proceeding, conduct, or decision related to
the requestor's official duties, and the request is made in
writing at a reasonable time before trial and the requestor
cooperates in good faith in the defense of the
claim or action, the state shall provide and pay for the requestor's defense
and shall pay any resulting judgment, compromise, or
settlement. At no time shall the state pay any part of a claim
or judgment that is for punitive or exemplary damages. Sec. 4723.03. (A) No person shall engage in the practice
of nursing as a registered nurse, hold herself or himself
out represent the person as
being a registered nurse, or use the title "registered nurse," the
initials "R.N.," or any other title implying that the person is a
registered nurse, for a fee, salary, or other consideration, or
as a volunteer, without holding a current, valid license as a
registered nurse under this chapter. (B) No person shall engage in the practice of nursing as a
licensed practical nurse, hold herself or himself out represent the
person as
being a
licensed
practical nurse, or use the title "licensed practical nurse," the
initials "L.P.N.," or any other title implying that the person is
a licensed practical nurse, for a fee, salary, or other
consideration, or as a volunteer, without holding a current,
valid license as a practical nurse under this chapter. (C) No person shall use the titles or initials "graduate
nurse," "G.N.," "professional nurse," "P.N.," "graduate practical
nurse," "G.P.N.," "practical nurse," "P.N.," "trained nurse,"
"T.N.," or any other statement, title, or initials that would
imply or represent to the public that the person is authorized to
practice nursing in this state, except as follows: (1) A person licensed under this chapter to practice nursing as a registered
nurse may use that title and the initials "R.N."; (2) A person licensed
under this chapter to practice nursing as a licensed practical
nurse may use that title and the initials
"L.P.N."; (3) A person authorized under this chapter to practice
nursing as a certified registered nurse anesthetist may use that
title, the initials "C.R.N.A." or "N.A.," and
any other title or initials approved by the board of nursing; (4) A person authorized under this chapter to practice
nursing as a clinical nurse specialist may use that title, the
initials "C.N.S.," and any other title or
initials approved by the board; (5) A person authorized under this chapter to practice
nursing as a certified nurse-midwife may use that title, the initials
"C.N.M.," and any other title
or initials approved by the board; (6) A person authorized under this chapter to practice
nursing as a certified nurse practitioner may use that title, the initials
"C.N.P.," and any other
title or initials approved by the board. (D) No person shall employ a person not licensed as a
registered nurse under this chapter to engage in the practice of
nursing as a registered nurse. No person shall employ a person
not licensed as a practical nurse under this chapter to engage in
the practice of nursing as a licensed practical nurse. (E) No person shall sell or fraudulently
obtain or furnish
any nursing diploma, license, certificate, renewal, or record, or
aid or abet such acts. Sec. 4723.06. (A) The board of nursing shall: (1) Administer and enforce the provisions of this chapter,
including the taking of disciplinary action for violations of
section 4723.28 of the Revised Code, any other provisions of this
chapter, or rules promulgated adopted under Chapter 119. of
the Revised
Code this chapter; (2) Examine applicants develop criteria that an applicant must meet
to be eligible to sit for the examination for licensure to practice as a
registered nurse or as a licensed practical nurse; (3) Issue and renew nursing licenses and dialysis technician certificates, as
provided in this chapter; (4) Define the minimum curricula and standards for
educational programs of the schools of professional nursing and
schools of practical nursing in this state; (5) Survey, inspect, and grant full approval to
prelicensure nursing education programs that
meet the standards established by rules adopted under section
4723.07 of the Revised Code. Prelicensure nursing education
programs include, but are not limited to, associate degree,
baccalaureate degree, diploma, and doctor of nursing programs
leading to initial licensure to practice nursing as a registered
nurse and practical nurse programs leading to initial licensure
to practice nursing as a licensed practical nurse. (6) Grant conditional approval, by a vote of a quorum of
the board, to a new prelicensure nursing education program or a
program that is being
reestablished after having ceased to operate, if the program meets and
maintains
the minimum standards of the
board established by rules adopted under section 4723.07 of the
Revised Code. If the board does not grant conditional approval,
it shall hold a hearing an adjudication under Chapter 119. of
the Revised Code to
consider conditional approval of the program. If
the board grants conditional approval, at its first meeting after
the first class has completed the program, the board shall
determine whether to grant full approval to the program. If the board
does not
grant full approval or if it
appears that the program has failed to meet and maintain
standards established by rules adopted under section 4723.07 of
the Revised Code, the board shall hold a hearing an adjudication
under Chapter
119. of the Revised Code to consider the program. Based on
results of the hearing adjudication, the board may continue or
withdraw
conditional approval, or grant full approval. (7) Place on provisional approval, for a period of time
specified by the board, a program that has ceased
to meet and maintain the minimum standards of the board
established by rules adopted under section 4723.07 of the Revised
Code. At the end of the period, the board shall reconsider
whether the program meets the standards and
shall
grant full approval if it does. If it does not, the board may
withdraw approval, pursuant to a hearing an adjudication under
Chapter 119. of
the Revised Code. (8) Approve continuing nursing education programs and
courses under standards established in rules adopted under
section 4723.07 of the Revised Code; (9) Approve peer support programs, under rules
adopted under section 4723.07 of the Revised Code, for nurses and for dialysis
technicians; (10) Establish the alternative a program for monitoring
chemical dependency in
accordance with section 4723.35 of the Revised Code; (11) Establish the practice intervention and improvement program in
accordance with section 4723.282 of the Revised Code; (12) Issue and renew certificates of authority to practice nursing
as a
certified registered nurse anesthetist, clinical nurse specialist, certified
nurse-midwife, or certified nurse practitioner; (13) Approve under section 4723.46 of the
Revised Code
national certifying organizations for examination and certification of
certified registered nurse anesthetists, clinical nurse specialists, certified
nurse-midwives, or certified nurse practitioners; (14) Issue and renew certificates to prescribe in accordance with
sections 4723.48 and 4723.484 4723.485 of the Revised Code; (15) Grant approval to the planned classroom and clinical
study required by section 4723.483 of the Revised Code to be
eligible for a certificate to prescribe; (16) Make an annual edition of
the formulary established in rules adopted under section
4723.50 of the Revised Code available to the public either
in printed form or by electronic means and, as soon as possible after
any revision of the formulary becomes effective, make the
revision available to the public in printed form or by
electronic means; (17) Provide guidance and make recommendations to the general assembly,
the governor, state agencies, and the federal government with respect to the
regulation of the practice of nursing and the enforcement of this chapter; (18) Make an annual report to the governor, which shall be
open for public inspection; (18)(19) Maintain and have open for public inspection the
following records:
(a) A record of all its meetings and proceedings; (b) A file of applicants for and holders of nursing licenses,
registrations, and certificates granted under this chapter and dialysis
technician certificates granted under this chapter. The file shall be
maintained in the form prescribed by rule of the board. (c) A list of prelicensure nursing education programs
approved by the board; (d) A list of approved peer support programs for nurses and dialysis
technicians. (B) The board may fulfill the requirement of division
(A)(8) of this section by authorizing persons who meet the
standards established in rules adopted under division (F) of
section 4723.07 of the Revised Code to approve continuing nursing
education programs and courses. Persons so authorized shall
approve continuing nursing education programs and courses in
accordance with standards established in rules adopted under
division (E) of section 4723.07 of the Revised Code. Persons seeking authorization to approve continuing nursing
education programs and courses shall apply to the board and pay
the appropriate fee established under section 4723.08 of the
Revised Code. Authorizations to approve continuing nursing
education programs and courses shall expire at the end of the two-year
period
beginning the date of issuance, and may be renewed by the
board according to the schedule established in rules adopted under
section 4732.07 of the Revised Code. Sec. 4723.061. The This chapter does not require the board of
nursing may enter into agreements with the
director of health under section 3721.34 of the Revised Code to assist the
director in implementing sections 3721.28 to 3721.34 of the Revised Code. Any
money received by the board from the department of health pursuant to such
agreements shall be deposited in the nurse aide fund, which is hereby created
in the state treasury. The board shall use the fund to pay the costs it
incurs
in carrying out such agreements to act on minor violations of this
chapter or the rules adopted under it, if the violations are committed by
individuals licensed under this chapter and the board determines that the
public is adequately protected by issuing a notice or warning to the
alleged offender. Sec. 4723.07. In accordance with Chapter 119. of the
Revised Code, the board of nursing shall adopt and may amend and
rescind rules that establish all of the following: (A) Providing Provisions for its the board's
government and control of its
actions and business affairs; (B) Establishing minimum minimum curricula and standards for
nursing education programs that prepare graduates to take
licensing examinations, be licensed under this chapter and
establishing procedures for granting,
renewing,
and withdrawing approval of those programs; (C) Establishing requirements Criteria that applicants for
licensure must meet to be permitted eligible to take
licensing
examinations; (D) Governing the administration and conduct of
examinations for licensure to practice nursing as a registered
nurse or as a licensed practical nurse;
(D) Standards and procedures for renewal of the licenses and
certificates issued by the board; (E) Establishing standards Standards for approval of continuing
nursing education programs and courses for registered nurses,
licensed practical nurses, certified registered nurse anesthetists,
clinical nurse specialists, certified nurse-midwives, and certified nurse
practitioners. The standards may provide for
approval of continuing nursing education programs and courses that have
been approved by other state boards of nursing or by national
accreditation systems for nursing, including, but not limited to,
the American nurses' credentialing center and the national
association for practical nurse education and service. (F) Establishing standards Standards that persons must meet to
be
authorized by the board to approve continuing nursing education
programs and courses and a schedule to have by which that
authorization expires and may be renewed; (G) Establishing requirements requirements, including
continuing
education requirements, for restoring inactive nursing licenses and dialysis
technician certificates issued under this chapter and nursing licenses
and
dialysis technician certificates that have lapsed through failure to renew; (H) Establishing requirements for issuing endorsements of nursing licenses
and dialysis technician certificates issued by another state; (I) Governing conditions Conditions that may be imposed for
reinstatement of a nursing license or dialysis technician certificate
issued
under this chapter following action taken under sections 2301.373,
4723.28, and 4723.281 of the Revised Code resulting in a
suspension from
practice;
(J) Establishing standards (I) Standards for approval
of peer support
programs for persons who hold a nursing license or dialysis technician
certificate issued under this chapter;
(K) Establishing requirements (J) Requirements for
board
approval of courses in medication administration by licensed
practical nurses;
(L) Establishing criteria for specialty certification of
registered nurses;
(M) Establishing criteria (K) Criteria for evaluating
the qualifications of an
applicant
who is applying for a
license by endorsement to practice nursing as a registered nurse or
licensed
practical nurse or for, a certificate of authority issued under
division
(E) of section 4723.41 of the Revised Code, or a dialysis technician
certificate by the board's endorsement of the applicant's authority to
practice issued by the licensing agency of another state;
(N) Establishing universal (L) Universal blood and
body fluid
precautions that shall be used by each person holding a nursing license or
dialysis technician certificate issued under this
chapter who performs exposure-prone invasive procedures. The
rules shall define and establish requirements for universal blood
and body fluid precautions that include the following:
(1) Appropriate use of hand washing; (2) Disinfection and sterilization of equipment; (3) Handling and disposal of needles and other sharp
instruments; (4) Wearing and disposal of gloves and other protective
garments and devices. (O) Establishing standards (M) Standards and
procedures for
approving certificates of authority to practice nursing as a certified
registered nurse anesthetist, clinical nurse specialist, certified
nurse-midwife, or certified nurse practitioner, and for renewal of those
certificates;
(P) Establishing quality (N) Quality assurance
standards for certified registered nurse anesthetists, clinical nurse
specialists, certified nurse-midwives, or certified nurse practitioners;
(Q) Establishing additional (O) Additional criteria
for the standard care arrangement required by section 4723.431 of the
Revised Code
entered into by a clinical nurse specialist, certified nurse-midwife, or
certified nurse practitioner and the nurse's collaborating physician or
podiatrist;
(R) Establishing continuing (P) Continuing education
standards for clinical nurse specialists who are exempt under division
(C) of section 4723.41 of the
Revised Code
from the requirement of having passed a certification examination;
(Q) For purposes of division (B)(31) of section 4723.28
of the Revised Code, the actions, omissions, or other circumstances that constitute failure
to establish and maintain professional boundaries with a patient. Subject to Chapter 119. of the Revised Code, the The board may
adopt other rules necessary to carry out the provisions of this
chapter. The rules shall be adopted in accordance with Chapter
119. of the Revised Code.
Sec. 4723.08. (A) The board of nursing may impose fees
not to exceed the following limits: (1) For application for licensure by examination to
practice nursing as a registered nurse or as a licensed practical
nurse, fifty dollars; (2) For application for licensure by endorsement to
practice nursing as a registered nurse or as a licensed practical
nurse, fifty dollars; (3) For application for a certificate of authority to practice nursing
as a certified registered nurse anesthetist, clinical nurse specialist,
certified nurse-midwife, or certified nurse practitioner, one hundred
dollars; (4) For application for a temporary dialysis technician certificate, the
amount specified in rules adopted under section 4723.79 of the Revised Code; (5) For application for a full dialysis technician certificate, the amount
specified in rules adopted under section 4723.79 of the Revised Code; (6) For application for a certificate to prescribe, fifty dollars; (5)(7) For verification of a nursing license, certificate of
authority, or dialysis technician certificate to another
jurisdiction, fifteen dollars;
(6)(7)(8) For providing a replacement copy of a nursing
license,
certificate of authority, or dialysis technician certificate, fifteen dollars;
(7)(8)(9) For biennial renewal of a nursing license,
thirty-five
dollars;
(8)(9) For (10) Except as provided in division
(C) of this section, for biennial renewal of a certificate of
authority
to
practice
nursing as a certified registered nurse anesthetist, clinical nurse
specialist,
certified nurse-midwife, or certified nurse practitioner, one hundred
eighty-five dollars;
(9)(11) For renewal of a certificate to prescribe,
fifty dollars;
(10)(10)(12) For biennial renewal of a dialysis technician
certificate, the amount specified in rules adopted under section 4723.79 of
the Revised Code;
(11)(13) For processing a late application for renewal of a
nursing
license, certificate of authority, or dialysis technician certificate, fifty
dollars;
(11)(12)(14) For application for authorization to approve
continuing nursing education programs and courses from an
applicant accredited by a national accreditation system for
nursing, five hundred dollars;
(12)(13)(15) For application for authorization to approve
continuing nursing education programs and courses from an
applicant not accredited by a national accreditation system for
nursing, one thousand dollars;
(13)(14)(16) For each year for
which authorization to approve
continuing nursing education programs and courses is renewed,
one hundred fifty dollars;
(15)(17) For application for approval to operate a dialysis
training program, the amount specified in rules adopted under section 4723.79
of the Revised Code;
(16)(14)(18) For reinstatement of a lapsed license or
certificate of authority, one hundred dollars;
(19) For written verification of a nursing license,
certificate of authority, or dialysis technician certificate, other than
verification to another jurisdiction, five dollars. The board may contract
for services pertaining to this
verification process and the collection of the fee, and may
permit the contractor to retain a portion of the fees as
compensation, before any amounts are deposited into the state
treasury. (B) Each quarter, for purposes of transferring funds under section 4743.05
of the Revised Code to the nurse education assistance fund created in section 3333.28
of the Revised Code, the board of nursing shall certify to
the director of budget and management the number of biennial
licenses renewed under this chapter during the preceding quarter
and the amount equal to that number times five dollars. (C) The fee for biennial renewal of a certificate of authority to
practice nursing as a certified nurse-midwife, certified registered nurse
anesthetist, certified nurse practitioner, or clinical nurse specialist that
expires on or before August 31, 2005, is one hundred dollars. Sec. 4723.39 4723.081. The board of nursing, subject to the
approval of the
controlling
board, may establish fees in excess of the amounts provided by section 4723.08
of the Revised Code, provided that such fees do not exceed those amounts by
more than fifty per cent. Sec. 4723.31 4723.082. Except as provided in division
(A)(4) of section 3721.34 and
section 4723.061 of the Revised Code, all All receipts of the board
of nursing,
from any source, shall be deposited in the state treasury to the credit of the
occupational licensing and regulatory fund. All vouchers of the board shall
be approved by the board president or executive director, or
both, as authorized by the board. Sec. 4723.09. (A) An application for licensure by examination
to practice as a registered nurse or as a licensed practical
nurse shall be submitted to the board of nursing in the form
prescribed by rules of the board. The application shall include
evidence that the applicant has completed requirements of a
nursing education program approved by the board or approved by
another jurisdiction's board that regulates nurse licensure. The
application also shall include
any other information required by
rules of the board. The application shall be accompanied by the
application fee required by section 4723.08 of the Revised Code.
If the board determines that the applicant meets the requirements
to take the examination, it shall admit the applicant to the
examination. The board shall grant a license to practice nursing as a
registered nurse or as a licensed practical nurse if the
applicant passes the examination accepted by the board under section
4723.10 of the Revised Code and the board determines that
the applicant has not committed any act that is grounds for
disciplinary action under section 2301.373 or 4723.28 of the Revised
Code, or determines that an applicant who has committed such acts has made
restitution or has been rehabilitated, or both. The board is not
required to afford a hearing an adjudication to an individual to
whom
it has refused
to grant a license because of that individual's failure
to pass the
examination. (B) An application for license by endorsement to practice
nursing as a registered nurse or as a licensed practical nurse
shall be submitted to the board in the form prescribed by rules
of the board and shall be accompanied by the application fee
required by section 4723.08 of the Revised Code. The application
shall include evidence that the applicant holds a license in good
standing in another jurisdiction granted after passing an
examination approved by the board of that jurisdiction that is equivalent
to the examination requirements under this chapter for a license to practice
nursing as a registered nurse or licensed practical nurse, and
shall
include other information required by rules of the board of
nursing. The board shall grant a license by endorsement if the
applicant is licensed or certified by another jurisdiction and
the board determines, pursuant to rules established under section
4723.07 of the Revised Code, that all of the following apply: (1) The educational preparation of the applicant is substantially similar
to the minimum curricula and standards for nursing education programs
established by the board under section 4723.07 of the Revised Code; (2) The examination, at the time it is successfully completed, is
equivalent to the examination requirements in effect at that time for
applicants who successfully completed the were licensed by
examination in this state; (3) The applicant has not committed any act that is grounds for
disciplinary action under section 2301.373, 4723.28,
or 4723.281 of the
Revised Code, or determines that an applicant who has committed
such acts has made restitution or has been rehabilitated, or both. The board may grant a nonrenewable temporary permit to
practice nursing as a registered nurse or as a licensed practical
nurse to an applicant for license by endorsement if the board is
satisfied by the evidence that the applicant holds a current, active
license in
good standing in another jurisdiction. The temporary permit
shall expire at the earlier of one hundred twenty days after
issuance or upon the issuance of a license by endorsement. Sec. 4723.051 4723.10. The With respect to
individuals applying
for licensure by examination, the board of nursing, in administering
examinations for
licensure under this chapter, may make use of shall accept all or
any part of the licensure
examination of the national council of state boards of nursing or any other
national standardized nursing examination that determines the board
considers to be an appropriate measure of whether a person is
competent to commence practicing nursing as a registered nurse or as a
licensed
practical nurse. The If the board incurs any cost in its acceptance
of an examination under this section or in making the accepted examination
available to applicants, the board may require applicants for licensure by
examination
to practice nursing as a registered nurse or as a licensed practical nurse
to
pay the application fee required by section 4723.08 of the Revised Code
and to
pay for any related materials from the organization
providing the examination pay an amount sufficient to cover the cost
incurred. Sec. 4723.15. (A) A certificate of registration to
practice professional nursing as a registered nurse issued by the
state nurses board or the board of nursing education and nurse
registration under former provisions of this chapter or by the
nurses' examining committee of the state medical board as
provided in former sections 1295-01 to 1295-20 and 1347 et seq.
of the General Code shall remain valid and shall confer the same
privileges and impose the same responsibilities and requirements
as a license issued by the board of nursing under this chapter on
or after the effective date of this section June
14, 1988. (B) A license to practice practical nursing as a licensed
practical nurse issued by the board of nursing education and
nurse registration under former provisions of this chapter shall
remain valid and shall confer the same privileges and impose the
same responsibilities and requirements as a license issued by the
board of nursing under this chapter on or after the effective
date of this section June 14, 1988. (C) Any person who on the effective date of this section
June 14, 1988,
holds a current, valid certificate or license to practice nursing
as a registered nurse or as a licensed practical nurse in this
state shall, for the purposes of this chapter, be deemed to hold
a license. (D) Any licensed practical nurse who on the effective date
of this section June 14, 1988, holds proof of
successful completion of a course
in medication administration approved by the board of nursing
shall be considered to be qualified to administer medication as
defined in division (F)(3) of section 4723.02
4723.01 of the Revised Code. Sec. 4723.171. (A) A licensed practical nurse may perform on
any person any of the intravenous
therapy procedures specified in division (B) of this section
without receiving authorization to perform intravenous therapy
from the board of nursing under section 4723.48 4723.17 of the
Revised Code, if both of the following apply: (1) The licensed practical
nurse acts at the direction of a registered nurse or a licensed
physician, dentist, optometrist, or podiatrist and the registered
nurse, physician, dentist, optometrist, or podiatrist is on the premises where
the procedure is to be performed or accessible by some form of
telecommunication. (2) The
licensed practical nurse can demonstrate the knowledge, skills, and
ability to perform the procedure safely. (B) The intravenous therapy procedures that a licensed practical
nurse may perform pursuant to division (A) of this section are
limited to the following: (1) Verification of the type of peripheral intravenous solution
being administered; (2) Examination of a peripheral infusion site and the extremity
for possible infiltration; (3) Regulation of a peripheral intravenous infusion according to
the prescribed flow rate; (4) Discontinuation of a peripheral intravenous device at the
appropriate time; (5) Performance of routine dressing changes at the insertion site
of a peripheral venous or arterial infusion, peripherally inserted central
catheter infusion, or central venous pressure
subclavian infusion. Sec. 4723.24. (A) All active licenses issued under this
chapter shall be renewed biennially according to a schedule
established by the board of nursing. The board shall mail
provide an
application for renewal to every holder of an active license, except
when the board is aware that an individual is ineligible for license renewal
for any reason, including pending criminal charges in this state or another
jurisdiction, failure to comply with a disciplinary order from the board or
the terms 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 board's request
documentation of having completed the continuing nursing education
requirements specified in division (C) of this section. If the board provides a renewal application by mail, the application shall
be
addressed to the last known post-office address of the holder
and mailed before the date specified in the board's schedule. Failure
of
the holder to receive an application for renewal from the board
shall not excuse the holder from the requirements contained in
this section. The The license holder shall complete the renewal form and
return it to the treasurer of state with the renewal fee required
by section 4723.08 of the Revised Code on or before the date
specified by the board. The license holder shall report any
conviction, plea, or judicial finding regarding a criminal
offense that constitutes grounds for denial of a
license the board to impose sanctions under
section 4723.28 of the Revised Code of which the holder has been
found guilty or to which the holder has entered a plea of guilty
or no contest since the submission of the holder's holder
last preceding submitted an
application to the board. The The treasurer shall immediately forward the renewal
application to the board, and on. On receipt of the
renewal
application, the board shall verify that the applicant meets the
renewal requirements and shall renew the license for the
following two-year period. If If a renewal application that
meets
the renewal requirements is submitted after the date specified in
the board's schedule, but before expiration of the license, the
board shall grant a renewal upon payment of the late renewal fee
authorized under section 4723.08 of the Revised Code. (B) Every license holder shall give written notice to the
board of any
change of name or address within thirty days of the change. The
board shall require the holder to document a change of name in a
manner acceptable to the board. (C)(1) Except in the case of a first renewal after licensure by
examination, effective January 1, 1992, to be eligible for
renewal of an active license to practice nursing as a registered
nurse or licensed practical nurse, each individual who holds an
active license must shall, in each two-year period specified by
the
board, complete continuing nursing education as follows: (A)(a) For renewal of a license that was issued for a
two-year renewal period, twenty-four hours of continuing nursing
education;
(B)(b) For renewal of a license that was issued for less than
a two-year renewal period, the number of hours of
continuing nursing
education specified by the board in rules adopted in
accordance with Chapter 119. of the Revised Code;
(c) Of the hours of continuing nursing education completed in any
renewal period, at least one hour of the education must be directly related to
the statutes and rules pertaining to the practice of nursing in this state. (2) The board shall adopt rules establishing the procedure for
an applicant a license holder to certify to the board completion
of the required continuing
nursing education. Continuing nursing education
The board may conduct a random sample of license holders and require that
the license holders included in the sample submit satisfactory documentation
of having completed the requirements for continuing nursing education. On the
board's request, a license holder included in the sample shall submit the
required documentation. (3) An educational activity
may be applied
to meet this toward meeting the continuing nursing education
requirement only if it is obtained through a program or
course approved by the board or a person authorized by the board
has authorized to approve continuing nursing education programs and
courses.
On request of the board, an applicant or license holder shall
submit satisfactory documentation of completion of the required
continuing nursing education. The (4) The continuing education required
of a certified registered nurse anesthetist, clinical nurse
specialist, certified nurse-midwife, or certified nurse practitioner to
obtain or maintain
certification by a national certifying organization shall be
applied toward the applicant's
continuing education requirements for renewal of the applicant's
a license to practice nursing as a registered nurse. (D) Except as otherwise provided in section 4723.28 of the
Revised Code, a license holder of a license who does not intend
to
practice in Ohio may send to the board written notice to that
effect on or before the renewal date, and the board shall
classify the license as inactive. During the period that the
license is classified as inactive, the holder may not
engage in the practice of nursing in Ohio and is not required to pay the
renewal fee. The holder of an inactive license or an individual who has
failed to renew the individual's license may have the license
restored or
renewed upon meeting the requirements for restoring and renewing
licenses established in rules adopted under section 4723.07 of
the Revised Code. Sec. 4723.25. Not later than ninety days after the effective date of this
section, the The board of nursing
shall approve one or more continuing education
courses of study that comply with divisions (E) and (F) of section 4723.07 of
the Revised Code and that assist registered nurses and licensed practical
nurses in recognizing the signs of domestic violence and its relationship to
child abuse. Nurses are not required to take the courses. Sec. 4723.28. As used in this section, "dangerous drug"
and "prescription" have the same meanings as in section
4729.01 of the Revised Code. (A) The board of nursing, pursuant to an adjudication
conducted under Chapter 119. of the Revised Code and by a vote of
a quorum, may revoke or may refuse to grant a nursing license,
certificate of authority, or dialysis technician
certificate
to a person
found by the board to have committed fraud in passing an
examination required to obtain the license, certificate of authority, or
dialysis technician certificate or to have committed fraud,
misrepresentation, or
deception in applying for or securing any nursing license,
certificate of authority, or dialysis technician
certificate
issued by the
board. (B) The board of nursing, pursuant to an adjudication conducted
under Chapter 119. of the Revised Code and by a vote of a
quorum, may impose one or more of the following sanctions: deny,
revoke permanently, suspend, or place restrictions on any nursing
license,
certificate of authority, or dialysis technician
certificate issued by
the board; reprimand or otherwise discipline a holder of a
nursing
license, certificate of authority, or dialysis technician
certificate; or impose a fine of not more than five hundred
dollars
per violation. The sanctions may be imposed for any of the
following: (1) Denial, revocation, suspension, or restriction of authority to
practice a
health
care
occupation, including nursing or practice
as a dialysis technician, for any reason other than a
failure to renew, in Ohio or another state or jurisdiction; (2) Engaging in the practice of nursing or engaging in practice as a
dialysis technician, having failed to
renew a nursing license or dialysis technician certificate
issued under this chapter, or while a nursing license or dialysis
technician certificate is under
suspension; (3) Conviction of, a plea of guilty to, or a judicial
finding of guilt of, a judicial finding of guilt resulting from a
plea of no contest to, or a judicial finding of eligibility for intervention
in lieu of conviction for, a misdemeanor committed in the course of
practice; (4) Conviction of, a plea of guilty to, or a judicial
finding of guilt of, a judicial finding of guilt resulting from a
plea of no contest to, or a judicial finding of eligibility for intervention
in
lieu of conviction for, any felony or of any crime involving gross
immorality or moral turpitude; (5) Selling, giving away, or administering drugs or therapeutic devices for
other than legal and legitimate therapeutic purposes; or conviction of,
a plea of guilty to, or a judicial finding of guilt of, a
judicial finding of guilt resulting from a plea of no contest to, or a
judicial finding of eligibility for intervention in lieu of conviction
for, violating
any municipal, state, county, or federal drug law; (6) Conviction of, a plea of guilty to, or a judicial
finding of guilt of, a judicial finding of guilt resulting from a
plea of no contest to, or a judicial finding of eligibility for intervention
in lieu of conviction for, an act in another jurisdiction that
would
constitute a felony or a crime of moral turpitude in Ohio; (7) Conviction of, a plea of guilty to, or a judicial
finding of guilt of, a judicial finding of guilt resulting from a
plea of no contest to, or a judicial finding of eligibility for intervention
in lieu of conviction for, an act in the course of practice in
another
jurisdiction that would constitute a misdemeanor in Ohio; (8) Self-administering or otherwise taking into the body
any dangerous drug, as defined in section 4729.01 of the Revised Code,
in any way not in accordance with a legal,
valid prescription issued for that individual; (9) Habitual indulgence in the use of controlled
substances, other habit-forming drugs, or alcohol or other
chemical substances to an extent that impairs ability to
practice; (10) Impairment of the ability to practice according to
acceptable and prevailing standards of safe nursing care because
of habitual or excessive use
of
drugs, alcohol, or other chemical
substances that impair the ability to practice; (11) Impairment of the ability to practice according to acceptable and
prevailing standards of safe nursing care because of a physical or mental
disability; (12) Assaulting or causing harm to a patient or depriving
a patient of the means to summon assistance; (13) Obtaining or attempting to obtain money or anything
of value by intentional misrepresentation or material deception
in the course of practice; (14) Adjudication by a probate court of being mentally ill or mentally
incompetent. The board may restore the person's nursing license or
dialysis technician certificate upon adjudication
by a probate court of the person's restoration to competency or
upon submission to the board of other proof of competency. (15) The suspension or termination of employment by the
department of defense or the veterans administration of the
United States for any act that violates or would violate this
chapter; (16) Violation of this chapter or any rules adopted under
it; (17) Violation of any restrictions placed on a nursing license or
dialysis technician certificate by
the board; (18) Failure to use universal blood and body fluid
precautions established by rules adopted under section 4723.07 of
the Revised Code; (19) Failure to practice in accordance with acceptable
and
prevailing standards of safe nursing care or safe dialysis care; (20) In the case of a registered nurse, engaging in
activities that exceed the practice of nursing as a registered
nurse under section 4723.02 of the Revised Code; (21) In the case of a licensed practical nurse, engaging
in activities that exceed the practice of nursing as a licensed
practical nurse under section 4723.02 of the Revised Code; (22) In the case of a dialysis technician, engaging in activities that
exceed those permitted under section 4723.72 of the Revised Code; (23) Aiding and abetting a person in
that person's practice of
nursing without a license or practice as a dialysis technician without a
certificate issued under this chapter; (24) In the case of a certified registered nurse
anesthetist,
clinical nurse specialist,
certified nurse-midwife, or certified nurse practitioner,
or a registered nurse approved as an
advanced practice nurse under section 4723.55 of the Revised
Code, except as provided in division (M) of this
section, either of the following: (a) Waiving the payment of all or any part of a deductible
or copayment that a patient, pursuant to a health insurance or
health care policy, contract, or plan that covers such nursing
services, would otherwise be required to pay if the waiver is
used as an enticement to a patient or group of patients to
receive health care services from that provider; (b) Advertising that the nurse will waive the payment of all or
any part of a deductible or copayment that a patient, pursuant to
a health insurance or health care policy, contract, or plan that
covers such nursing services, would otherwise be required to
pay. (25) Failure to comply with the terms and conditions of
participation in
the alternative chemical dependency monitoring program for
chemical
dependency created by established under section
4723.35 of the Revised Code; (26) Failure to comply with the terms and conditions
required under the
practice intervention and improvement program established under section
4723.282 of the Revised Code; (27) In the case of a certified registered nurse
anesthetist,
clinical
nurse specialist, certified nurse-midwife, or certified nurse
practitioner: (a) Engaging in activities that exceed those
permitted for the nurse's nursing specialty under section 4723.43 of the
Revised Code; (b) Failure to meet the quality assurance standards
established under section 4723.07 of the
Revised Code. (28) In the case of a clinical nurse specialist,
certified
nurse-midwife, or certified nurse practitioner, failure to maintain a standard
care arrangement in accordance with section 4723.431 of the
Revised Code or to practice in accordance with the standard
care arrangement; (28)(29) In the case of a
clinical nurse specialist, certified nurse-midwife,
or certified nurse practitioner who holds a certificate to
prescribe issued under section 4723.48 of the
Revised Code, failure to prescribe drugs and
therapeutic devices in accordance with section 4723.481 of the
Revised Code;
(29)(30) Prescribing any drug or device
to perform or induce an abortion, or otherwise performing or inducing an
abortion;
(30) Failure to return to the board a license or
certificate
issued under this chapter that has lapsed or been suspended or
revoked.
(29)(31) Failure to establish and maintain professional
boundaries with a patient, as specified in rules adopted under section 4723.07
of the Revised Code;
(32) Regardless of whether the contact or verbal behavior
is consensual, engaging with a patient other than the spouse of the registered
nurse, licensed practical nurse, or dialysis technician
in any of the following: (a) Sexual contact, as defined in section 2907.01 of the Revised Code; (b) Verbal behavior that is sexually demeaning to the patient or
may be reasonably interpreted by the patient as sexually demeaning. (C) Disciplinary actions taken by the board under divisions (A)
and (B) of this section shall be taken pursuant to an adjudication
conducted under Chapter 119. of the Revised Code, except that in lieu of a hearing,
the board may enter into a consent agreement with an individual to resolve an
allegation of a violation of this chapter or any rule adopted under it. A
consent agreement, when ratified by a vote of a quorum, shall constitute the
findings and order of the board with respect to the matter addressed in the
agreement. If the board refuses to ratify a consent agreement, the admissions
and findings contained in the agreement shall be of no effect. (D) The hearings of the board shall be conducted in accordance
with Chapter 119. of the Revised Code. The board may appoint a hearing examiner, as
provided in section 119.09 of the Revised Code, to conduct any hearing the board is
authorized
to hold under Chapter 119. of the Revised Code. In any instance in which the board is required under Chapter 119.
of the Revised Code to give notice of an opportunity for a hearing and the applicant or
license holder does not make a timely request for a hearing in accordance with
section 119.07 of 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 the board's
findings. In the final order, the board may order any of the sanctions listed
in division (A) or (B) of this section. (E) If a criminal action is brought against a registered nurse,
licensed
practical nurse, or dialysis
technician for an
act or crime described in divisions (B)(3) to (7)
of this section and the action is dismissed by the trial court
other than on the merits, the board shall hold conduct an
adjudication hearing to determine whether the
registered nurse, licensed practical nurse, or dialysis technician
committed the act
on which the action was based. If the board determines on the
basis of the hearing adjudication that the registered nurse,
licensed practical nurse, or dialysis technician committed the act,
or if the registered nurse, licensed practical nurse,
or dialysis technician fails to participate in the hearing
adjudication, the
board may take action as though the registered nurse,
licensed practical nurse, or dialysis technician had been
convicted of the act. If the board takes action on the basis of a conviction,
plea of guilty, or a judicial determination of guilt
finding as described
in divisions (B)(3) to (7) of this section that is overturned on
appeal, the registered nurse, licensed practical
nurse, or dialysis technician may, on exhaustion of the appeal
process, petition the board for reconsideration of its action.
On receipt of the petition and supporting court documents, the
board shall temporarily rescind its action. If the board
determines that the decision on appeal was a decision on the
merits, it shall permanently rescind its action. If the board
determines that the decision on appeal was not a decision on the
merits, it shall hold conduct an adjudicatory hearing
adjudication to determine
whether the registered nurse, licensed practical
nurse, or dialysis technician committed the act on which the
original conviction, plea, or judicial determination finding was
based.
If the board determines on the basis of the hearing adjudication
that the
registered nurse, licensed practical nurse, or
dialysis technician committed such act, or if the
registered nurse, licensed practical nurse, or dialysis technician does
not request a hearing an adjudication, the board shall reinstate
its action;
otherwise, the board shall permanently rescind its action. Notwithstanding the provision of division (C)(2) of section
2953.32 of the Revised Code specifying that if records pertaining
to a criminal case are sealed under that section the proceedings
in the case shall be deemed not to have occurred, sealing of the
records of a conviction on which the board has based an action
under this section shall have no effect on the board's action or
any sanction imposed by the board under this section. (D) In enforcing division (B) of
The board shall not be required to
seal, destroy, redact, or otherwise modify its records to reflect the court's
sealing of conviction records.
(F) The board may investigate an individual's criminal background
in performing its duties under this section. (G) During the course of an investigation conducted under
this section, the board
may compel any registered nurse,
licensed practical nurse, or dialysis technician or applicant under this
chapter to submit to a
mental or physical
examination, or both, as required by the board and at the expense
of the individual, if the board finds reason to believe that the
individual under investigation may have a physical or mental impairment that
may affect the individual's ability to provide safe nursing care Failure
of any individual to submit to a
mental or physical examination when directed constitutes an
admission of the allegations, unless the failure is due to
circumstances beyond the individual's control, and a default and
final order may be entered without the taking of testimony or
presentation of evidence. If If the board finds that an individual
is impaired, the board shall require the individual to submit to
care, counseling, or treatment approved or designated by the
board, as a condition for initial, continued, reinstated, or
renewed authority to practice. The individual shall
be afforded
an opportunity to demonstrate to the board that the individual can
begin or resume
the individual's occupation in compliance with acceptable and
prevailing
standards of care under the provisions of the individual's authority
to practice. For
the purpose For purposes
of this section division, any
registered nurse, licensed practical nurse, or dialysis technician or
applicant under this chapter
shall be deemed to have given
consent to submit to a mental or physical examination when
directed to do so in writing by the board, and to have waived all
objections to the admissibility of testimony or examination
reports that constitute a privileged communication. (E)(H) The board shall investigate evidence that appears to
show that any person has violated any provision of this chapter
or any rule of the board. Any person may report to the board any
information the person may have that appears to show a violation
of any provision of this chapter or rule of the board. In the
absence of bad faith, any person who reports such information or
who testifies before the board in any adjudication
conducted under Chapter 119. of the Revised Code shall not be
liable for civil damages as a result of the report or testimony.
(I) All of the following apply under this chapter with respect to
the confidentiality of information: (1) Information received by the board pursuant to an
investigation is confidential and not subject to discovery in any
civil action, except that the board may disclose information to law
enforcement officers and government entities investigating a registered
nurse, licensed practical nurse, or dialysis
technician or a person who may have engaged in the unauthorized practice of
nursing No law enforcement officer or government entity with
knowledge of any information disclosed by the board pursuant to this division
shall divulge the information to any other person or government entity except
for the purpose of an adjudication by a court or licensing or registration
board or officer to which the person to whom the information relates is a
party. (2) If the an investigation requires a review of
patient records,
the investigation and proceeding shall be conducted in such a
manner as to protect patient confidentiality. (3) All hearings adjudications and investigations of
the board shall be
considered civil actions for the purposes of section 2305.251 of
the Revised Code. The hearings of the board shall be conducted in accordance
with Chapter 119. of the Revised Code. The board may appoint a
hearing examiner as provided in section 119.09 to conduct any
hearing the board is empowered to hold under Chapter 119. of the
Revised Code.
In the absence of fraud or bad faith, neither the board nor
any current or former members, agents, representatives, or
employees of the board shall be held liable in damages to any
person as the result of any act, omission, proceeding, conduct,
or decision related to their official duties undertaken or
performed pursuant to this chapter. If a current or former
member, agent, representative, or employee requests the state to
defend the individual against any claim or action arising out of
any act,
omission, proceeding, conduct, or decision related to the
individual's
official duties, if the request is made in writing at a
reasonable time before trial, and if the individual requesting
defense cooperates in good faith in the defense of the claim or
action, the state shall provide and pay for such defense and
shall pay any resulting judgment, compromise, or settlement. At
no time shall the state pay that part of a claim or judgment that
is for punitive or exemplary damages.
(F)(4) Any board activity that involves continued
monitoring of an individual as part of or following any disciplinary action
taken under this section shall be conducted in a manner that maintains the
individual's confidentiality. Information received or maintained by the board
with respect to the board's monitoring activities is confidential and not
subject to discovery in any civil action.
(J) Any action taken by the board under this section
resulting in a suspension from practice shall be accompanied by a
written statement of the conditions under which the person may be
reinstated to practice. (G)(K) When the board refuses to grant a license or
certificate to an applicant, revokes a license or
certificate, or refuses to reinstate a license or certificate, the board may
specify that its action is permanent. An individual subject to permanent
action taken by the board is forever ineligible to hold a license or
certificate of the type that was refused or revoked and the board shall not
accept from the individual an application for reinstatement of the license or
certificate or for a new license or certificate.
(L) No unilateral surrender of a nursing license,
certificate of authority, or dialysis technician certificate issued
under this
chapter shall be effective unless accepted by majority vote of
the board. No application for a nursing license, certificate
of authority, or dialysis technician certificate issued under this
chapter may be withdrawn without a majority vote of the board. The board's
jurisdiction to take disciplinary action under this section is not removed or
limited when an individual has a license or certificate
classified as inactive or fails to renew a license or certificate. (H) Notwithstanding division (B)(24) of this section,
sanctions (M) Sanctions shall not be imposed under
division (B)(24) of this section against any licensee who waives
deductibles and copayments as follows:
(1) In compliance with the health benefit plan that
expressly allows such a practice. Waiver of the deductibles or
copayments shall be made only with the full knowledge and consent of
the plan purchaser, payer, and third-party administrator. The
Documentation of the consent shall
be made available to the board upon request. (2) For professional services rendered to any other person
licensed pursuant to this chapter to the extent allowed by this
chapter and the rules of the board. (I) The holder of a license or certificate issued under this
chapter shall return to the board a license or certificate that has
lapsed or been suspended or revoked.
Sec. 4723.281. (A) As used in this section, with regard
to offenses committed in Ohio, "aggravated murder," "murder,"
"voluntary manslaughter," "felonious assault," "kidnapping,"
"rape," "sexual battery," "gross sexual imposition,"
"aggravated arson," "aggravated robbery," and "aggravated
burglary" mean such offenses as defined in Title XXIX of the
Revised Code; with regard to offenses committed in other
jurisdictions, the terms mean offenses comparable to offenses
defined in Title XXIX of the Revised Code. (B) The board of nursing may impose a summary suspension
without a hearing on a person who holds a nursing license
or
dialysis technician certificate issued under this chapter if it
determines that there is evidence that the license or certificate
holder is
subject to actions under division (B) of section 4723.28 of the
Revised Code and that when there is clear and convincing evidence
that
continued practice by the license or certificate holder an
individual licensed under this chapter presents a
danger of
immediate and serious harm to the public. The, as determined
on consideration of the evidence by the president and the
executive director of the board of nursing, the president and director
shall make a preliminary
determination and describe the evidence on which they made their
determination to the other members of the board. The board may
by resolution designate another board member to act in place of
the president of the board and another employee to act in the
place of the executive director, in the event that the board
president or executive director is unavailable or unable to act.
On consideration of the evidence, the board may by an affirmative
vote of seven members, not including the president of the board
or the person named to act in place of the president, impose on the
individual a summary suspension without a hearing. The
description of the evidence and
information may be given and the vote taken by telephone
conference call An individual serving as president or executive
director in the absence of the president or executive director may take any
action that this section requires or authorizes the president or executive
director to take. Immediately following the decision to impose a summary
suspension under this division, the board shall issue a written
order of suspension and cause it to be delivered by certified
mail or in person in accordance with section 119.07 of the
Revised Code. The order shall not be subject to suspension by
the court during the pendency of any appeal filed under section
119.12 of the Revised Code. If the license or certificate holder
individual subject to the suspension requests an
adjudication hearing, the date set for the hearing
adjudication shall be
within fifteen days but not earlier than seven days after the
license or certificate holder has requested a hearing individual
makes the request, unless another
date is
agreed to by both the license or certificate holder individual
and the board. The
summary
suspension shall remain in effect, unless reversed by the board,
until a final adjudication order issued by the board pursuant to
this section and Chapter 119. of the Revised Code becomes
effective. The board shall issue its final adjudication order within
ninety days after completion of the hearing adjudication. If
the board does
not issue such a final order within the ninety-day period, the
summary
suspension shall be void, but any final adjudication order issued
subsequent to the ninety-day period shall not be affected. (C) The license or certificate of a registered nurse, licensed
practical nurse, or
dialysis technician issued to an individual under this chapter is
automatically suspended on that person's individual's conviction
of, plea of
guilty to, or judicial determination of guilt of finding with
regard to any of the
following in Ohio or any other jurisdiction of the United States:
aggravated murder, murder, voluntary manslaughter, felonious
assault, kidnapping, rape, sexual battery, gross sexual
imposition, aggravated arson, aggravated robbery, or
aggravated burglary. The suspension shall remain in effect from
the date of the conviction, plea, or finding until an
adjudicatory hearing adjudication is held under Chapter 119. of
the Revised
Code. If the board has knowledge that an automatic suspension
has occurred, it shall notify the registered nurse,
licensed practical nurse, or dialysis technician individual subject to
the suspension. If
the registered nurse, licensed practical nurse, or dialysis
technician individual is notified and either fails to request an
adjudicatory
hearing adjudication within the time periods established by Chapter
119. of
the Revised Code or fails to participate in the hearing
adjudication, the
board may shall enter a final order permanently revoking
the person's license or
certificate. Sec. 4723.282. (A) As used in this section,
"practice deficiency" means any activity that does not meet
acceptable and prevailing standards of safe and effective
nursing care or dialysis care. (B) The board of nursing may abstain from taking
disciplinary action under section 4723.28 of the Revised
Code against the holder of a license or certificate
issued under this chapter who has a practice deficiency
that has been identified by the board through an investigation conducted under
section 4723.28 of the Revised Code. The board
may abstain from taking action only if the board has reason to believe
that the individual's practice deficiency can be corrected
through remediation, and if the individual
enters into an agreement with the board to seek remediation
as prescribed by the board, complies with the terms and conditions
of the remediation, and successfully completes the remediation.
If an individual fails to complete the remediation or the board
determines that remediation cannot correct the individual's
practice deficiency, the board shall proceed with disciplinary
action in accordance with section 4723.28 of the Revised
Code. (C) To implement its authority under this section to
abstain from taking disciplinary action, the board shall
establish a practice intervention and improvement program. The
board shall designate an administrator to operate the program
and, in accordance with Chapter 119. of the
Revised Code, adopt rules for the program that
establish the following: (1) Criteria for use in identifying an individual's practice
deficiency; (2) Requirements that an individual must meet to be eligible
for remediation and the board's abstention from disciplinary
action; (3) Standards and procedures for prescribing remediation
that is appropriate for an individual's identified practice
deficiency; (4) Terms and conditions that an individual must meet to be
successful in completing the remediation prescribed; (5) Procedures for the board's monitoring of the
individual's remediation; (6) Procedures for maintaining confidential records
regarding individuals who participate in remediation; (7) Any other requirements or procedures necessary to
develop and administer the program. (D) All records held by the board for purposes of the
program shall be confidential, are not public records for
purposes of section 149.43 of the Revised Code,
and are not subject to discovery by subpoena or admissible as
evidence in any judicial proceeding. The administrator of the
program shall maintain all records in the board's office in
accordance with the board's record retention schedule. (E) When an individual begins the remediation
prescribed by the board, the individual shall sign a waiver
permitting any entity that provides services related to the
remediation to release to the board information regarding the
individual's progress. An entity that provides services related
to remediation shall report to the board if the individual fails
to complete the remediation or does not make satisfactory progress in
remediation. In the absence of fraud or bad faith, an entity that reports
to the board regarding an individual's practice deficiency, or
progress or lack of progress in remediation, is not liable in
damages to any person as a result of making the report. (F) An individual participating in remediation
prescribed under this section is responsible for all financial
obligations that may arise from obtaining or completing the
remediation. Sec. 4723.32. This chapter does not prohibit any of the following: (A) The practice of nursing by students as an integral
part of a program of study leading to initial licensure and a student
currently enrolled in and actively pursuing completion of a prelicensure
nursing education program approved by the board of nursing, if
the student's practice is under
the auspices of the program and the student acts under the
supervision of a registered nurse serving for the program
as a faculty member, teaching assistant, or preceptor; (B) The practice of nursing by a person currently
licensed in another jurisdiction who is employed by the United
States government or any agency thereof while in the discharge of
official duties; (C) The rendering of medical assistance to a licensed
physician, licensed dentist, or licensed podiatrist by a person
under the direction, supervision, and control of such licensed
physician, dentist, or podiatrist;
(D)(C) The activities of persons employed as nursing aides,
attendants, orderlies, or other auxiliary workers in patient
homes, nurseries, nursing homes, hospitals, home health agencies,
or other similar institutions;
(E) The practice of nursing by any registered nurse or
licensed practical nurse currently licensed in another
jurisdiction who is employed by an individual, agency, or
corporation located in that jurisdiction and whose employment
responsibilities include transporting patients into, out of, or
through this jurisdiction, so long as each trip does not exceed
forty-eight hours in this state;
(F)(D) The provision of nursing services to family members or
in emergency situations;
(G)(E) The care of the sick when
done in connection with the
practice of religious tenets of any church and by or for its members;
(H)(F) The practice of nursing as a certified registered
nurse
anesthetist, clinical nurse specialist, certified nurse-midwife, or certified
nurse practitioner by a student as an integral part currently
enrolled in and actively pursuing completion of a program of study
leading to initial authorization by the board to practice nursing in the
specialty, if the program qualifies the student to sit for the examination of
a national certifying organization listed in division (A)(3) of
section 4723.41 of the Revised Code or approved by the board under section
4723.46 of the Revised Code, or
prepares the student to receive a master's degree in accordance with division
(A)(2) of section 4723.41 of the Revised Code;
(G) The
activities of an individual who currently holds a license to practice
nursing in another jurisdiction, if the individual's license has not been
revoked, the individual is not currently under suspension or on probation, the
individual does
not represent the individual as being licensed under this
chapter, and one of the following is the case: (1) The individual is engaging in the practice of nursing by discharging
official duties while employed by or under contract with the
United
States government or any agency
thereof; (2) The individual is engaging in the practice of nursing as an employee
of an individual, agency, or corporation located in the other
jurisdiction in a position with employment responsibilities
that include transporting patients into, out of, or through this
state, as long as each trip in this state does not exceed seventy-two
hours; (3) The individual is consulting with an individual licensed in this
state to practice any health-related profession; (4) The individual is engaging in activities associated with teaching in
this state
as a guest lecturer at or for a nursing education
program, continuing nursing education program, or in-service
presentation; (5) The individual is conducting evaluations of nursing care that are
undertaken on
behalf of an accrediting organization, including the national
league for nursing accrediting committee, the joint commission
on accreditation of healthcare organizations, or any other nationally
recognized accrediting organization; (6) The individual is providing nursing care to an individual who is in
this state on a temporary basis, not to exceed six months in any
one calendar year, if the nurse is directly employed by or under
contract with the individual or a guardian or other person
acting on the individual's behalf; (7) The individual is providing nursing care during any disaster, natural
or otherwise, that has been officially declared to be a disaster
by a public announcement issued by an appropriate federal,
state, county, or municipal official. Sec. 4723.33. A registered nurse, licensed practical nurse, or dialysis
technician who in good faith makes a report under this chapter or any other
provision of the Revised Code regarding a violation of this chapter or any other provision
of the Revised Code, or participates in any investigation, administrative
proceeding, or judicial proceeding resulting from the report, has the
full protection against retaliatory action provided by sections 4113.51 to
4113.53 of the Revised Code. Sec. 4723.34. (A) Reports to the board of nursing shall be made as
follows: (1) Every employer of registered nurses,
licensed practical nurses, or dialysis technicians shall report
to the board of nursing
the name of any person current or former employee who holds a
nursing license or
dialysis technician certificate
issued under this chapter whose
employment who has been terminated voluntarily or involuntarily
because of engaged in conduct that would be grounds for
disciplinary action
by the board under division (B) of section 4723.28 of the Revised
Code. (B)(2) Nursing associations shall report to the board the
name of any registered nurse or licensed practical nurse and dialysis
technician associations shall report to the board the name of any dialysis
technician who has
been investigated and found to constitute a danger to the public
health, safety, and welfare because of conduct that would be
grounds for disciplinary action by the board under section
4723.28 of the Revised Code, except that a nursing an
association is
not required to report the individual's name of such a nurse if
the nurse individual is
maintaining satisfactory participation in a peer support program
approved by the board under rules adopted under section 4723.07
of the Revised Code.
(C)(3) If the prosecutor in a case described in divisions
(B)(3) to (5) of section 4723.28 of the Revised Code, or in a
case where the trial court issued an order of dismissal upon
technical or procedural grounds of a charge of a misdemeanor
committed in the course of practice, a felony charge, or a charge
of gross immorality or moral turpitude, knows or has reason to
believe that the person charged is licensed under this chapter to
practice nursing as a registered nurse or as a licensed practical
nurse or holds a certificate issued under this chapter
to practice as a dialysis technician, the prosecutor shall notify
the board of nursing on forms
prescribed and provided by the board. The report shall include
the name and address of the license or certificate holder, the charge,
and the
certified court documents recording the action.
(D)(B) If any person fails to provide a report required by
this section, the board may seek an order from a court of
competent jurisdiction compelling submission of the report.
Sec. 4723.341. (A) As used in this section, "person" has the
same meaning as in section 1.59 of the Revised Code and also
includes the board of nursing and its members and employees;
health care facilities, associations, and societies; insurers;
and individuals. (B) In the absence of fraud or bad faith, no person reporting
to the board of nursing or testifying in an adjudication hearing
conducted under Chapter 119. of the Revised Code with regard to
alleged incidents of negligence or malpractice, or matters
subject
to this chapter or section 2301.373 or 4723.28 of the Revised
Code, violations of
section 4723.34 of the Revised Code, or the qualifications, fitness, or
character of a person licensed or applying for a license to
practice nursing as a registered nurse or licensed practical
nurse, or holding or applying for a certificate to practice as a
dialysis technician, shall be subject to any civil action or liable
for damages
as a result either of the following based on making the
report or testifying: (1) Liability in damages in a civil action for injury, death, or loss to
person or property; (2) Discipline or dismissal by an employer. (C) An individual who is disciplined or dismissed in
violation of division (B)(2) of this section has the same rights and
duties accorded an employee under sections 4113.52 and 4113.53 of the Revised Code. (D) In the absence of fraud or bad faith, no professional
association of
registered nurses or, licensed practical nurses, or
dialysis technicians that sponsors a committee or program to provide peer
assistance
to nurses individuals with substance abuse problems, no
representative or
agent of such a committee or program, and no member of the board
of nursing shall be liable to any person for damages in a civil
action by reason of actions taken to refer a nurse or dialysis
technician to a treatment
provider designated by the board or actions or omissions of the
provider in treating a nurse or dialysis technician. Sec. 4723.35. (A) As used in this section, "chemical dependency"
means either of the following: (1) The chronic and habitual use of alcoholic beverages to the extent that
the user no longer can control the use of alcohol or endangers the user's
health, safety, or welfare or that of others; (2) The use of a drug of abuse, controlled substance
as defined in section 3719.011 3719.01 of the Revised Code,
a harmful intoxicant as defined in section 2925.01 of the Revised
Code, or a dangerous drug as defined in section 4729.01 of the
Revised Code,
to the extent that the user becomes physically or psychologically dependent on
the substance, intoxicant, or drug or endangers the user's health,
safety, or welfare or that of
others. (B) The board of nursing
may abstain from taking disciplinary action under section 4723.28
of the Revised Code against an individual with a chemical
dependency if it finds that the individual can be treated effectively and
there is no impairment of the individual's ability to practice according to
acceptable and prevailing standards of SAFE care. The board
shall establish a chemical dependency
monitoring program, which shall be called the
alternative program for
chemical dependency. The
program shall be available to persons who hold
a nursing license or
dialysis technician certificate issued under this chapter, have a
chemical dependency, and meet eligibility
requirements
to monitor the registered nurses, licensed practical nurses, and
dialysis technicians against whom the board has abstained from taking
action.
The board shall develop the program, select the
program's name, and designate an
administrator a coordinator to operate it, and administer
the program. (C) The board shall adopt rules in accordance with
Chapter 119. of the Revised Code that establish the following: (1) Eligibility requirements for admission to and continued
participation in the monitoring program; (2) Terms and conditions a participant that must meet
be met to participate in and successfully complete the
program; (3) Procedures for keeping confidential records regarding participants; (4) Any other requirements or procedures necessary to establish and
administer the program. (C) A person who holds
a nursing license or dialysis technician certificate issued under this
chapter may voluntarily
seek treatment for any chemical dependency that may be grounds for
disciplinary
action by the board under division (B) of section 4723.28 of the Revised Code.
The board of nursing may abstain from
taking disciplinary action against a person who
voluntarily seeks treatment if
it finds that the person can be treated
effectively and that there is no impairment of ability to practice according
to acceptable and prevailing standards of safe nursing or dialysis care.
The board may
require, as a condition of its abstention, that the person
participate in the
alternative program for chemical dependency, comply with the terms and
conditions of the program, and successfully
complete it.
(D) A person who voluntarily participates in the
alternative
program for chemical dependency
without being referred by the board
and complies with the terms and conditions of the program and the requirements
of this section shall not be subject to investigation or disciplinary action
by the board for chemical dependency. The person shall
report to the board any
failure to comply with the terms and conditions of the
program or successfully complete it.
(D)(1) As a condition of being admitted to the monitoring
program, an individual shall surrender to the program coordinator the license
or certificate
that the individual holds. While the surrender is in effect, the
individual is prohibited from engaging in the practice of nursing
or the provision of dialysis care. If the program coordinator determines that a participant is
capable of resuming practice according to acceptable and
prevailing standards of safe care, the coordinator shall return
the participant's license or certificate. If the participant
violates the terms and conditions of resumed practice, the program
coordinator shall require the participant to surrender the license
or certificate as a condition of continued participation in the
program. The coordinator may require the surrender only on the
approval of the board's supervising member for disciplinary
matters. The surrender of a license or certificate on admission to the
monitoring program or while participating in the program does not
constitute an action by the board under section 4723.28 of the
Revised Code. The participant may
rescind the surrender at any time and the board may proceed by taking
action under section 4723.28 of the Revised Code. (2) If the program coordinator determines that a participant is
significantly out of compliance with the terms and conditions for
participation, the coordinator shall notify the board's
supervising member for disciplinary matters and the supervising
member shall temporarily suspend the participant's license or
certificate. The program coordinator shall notify the participant
of the suspension by certified mail sent to the participant's last known
address
and shall refer the matter to the board for formal action under
section 4723.28 of the Revised Code. (E)
All of the following apply with respect to the receipt, release,
and maintenance of records and information by the monitoring
program: (1) The program coordinator shall maintain all records in the
board's office for a period of five years. (2) When applying to participate in the monitoring program, the
applicant shall sign a waiver permitting the program coordinator to
receive and release information necessary for the coordinator to determine
whether the individual is eligible for admission. After being
admitted, the participant shall sign a waiver permitting the
program coordinator to receive and release information necessary
to determine whether the individual is eligible for continued
participation in the program. Information that may be necessary
for the program coordinator to determine eligibility for admission
or continued participation in the monitoring program includes, but
is not limited to, information provided to and by employers,
probation officers, law enforcement agencies, peer assistance
programs, health professionals, and treatment providers. No
entity with knowledge that the information has been provided to the
monitoring program shall divulge that knowledge to any other
person. (3)
Except as provided in division (F)(E)(4)
of this section,
all records pertaining to an individual's application for or participation
in the monitoring
program,
including medical records, chemical dependency treatment
records, and mental health
records, of a participant in the program shall be
confidential,. The records are not
public
records for the purposes of section 149.43 of the Revised Code, and are
not
subject to
discovery by subpoena or admissible as evidence in any judicial proceeding.
The administrator of the program shall maintain all
records in the board's
office for a period of five years. (F) On commencement of participation in the program,
a person shall sign
a waiver permitting
the program administrator to release to the board the
person's records if the
person fails to
comply with the terms and conditions of the program, does not successfully
complete the
program, or is unable to practice according to acceptable and
prevailing
standards of safe nursing care or dialysis care due to chemical
dependency.
The administrator
shall report to the board any such person and
release the person's records to it. The board shall
then investigate in
accordance with division (E) of section 4723.28 of the Revised Code.
(G)(4) The program coordinator may disclose
information regarding a participant's progress in
the program to
any person or
government entity that the participant authorizes in
writing to be given the information.
In disclosing information under this division, the
coordinator shall not include any information that is
protected under section 3793.13 of the Revised Code or any
federal
statute or regulation that provides for the confidentiality of medical, mental
health,
or substance abuse
records.
(F) In the absence of fraud or bad faith, the
program coordinator, the board of nursing, and the board's employees and
representatives are not
liable for damages in any civil action as a result of disclosing
information in
accordance with division (E)(4) of this section.
In the absence of fraud or bad faith, any person
reporting to the program with regard to an individual's chemical
dependence of a person
who holds a nursing license or dialysis technician certificate issued under
this chapter, or the
progress or lack of progress of that person individual with
regard to
treatment, shall be
immune from any civil action and shall is not be liable for
civil damages in any civil action as a
result of the report. Sec. 4723.40. In addition to any other remedies provided by law
(A) Through the attorney general or an appropriate prosecuting
attorney, the board of
nursing may apply to an appropriate court for an order enjoining the
unauthorized practice of nursing or any other violation
of any provision of this chapter, and, upon. On the
filing of a verified petition, the court shall conduct a hearing
on the petition and give the same preference to the proceeding as is given all
proceedings under Chapter 119. of the Revised Code, irrespective of the position of
the proceeding on the court's calendar. On
a showing that any a person has
violated or is about to violate any provision of this chapter, the court shall
grant an order enjoining such the violation. (B)(1) If the board's supervising member for disciplinary matters
obtains information sufficient to determine that a person may have engaged in
the unauthorized practice of nursing or any other violation of this chapter,
the supervising member shall notify the alleged offender by registered mail
that information has been obtained regarding the alleged violation. The
notice may be sent either before or after a petition has been filed under
division (A) of this section. (2) To be considered
sufficient, the information must include all of the following: (a) A description of the alleged violation; (b) If a particular individual can be identified, the name of the
individual involved in the violation; (c) The name and address of the facility, institution, or other
place
where the violation occurred; (d) The approximate dates that the violation
occurred. (3) Not later than thirty days after receiving notice from the
supervising member, the
alleged offender shall respond to the supervising member with respect to the
allegations. If the person fails to give a timely and sufficient response,
the supervising member shall investigate. Based on the findings of the
investigation, the supervising member may request that the board
proceed as authorized by division (A) of this section. (C) The injunction proceedings and notice requirements provided
for by this section are
in addition to all penalties and other remedies provided in this chapter. Sec. 4723.42. (A) If the applicant for authorization to
practice
nursing as a certified registered nurse anesthetist,
clinical nurse
specialist, certified
nurse-midwife, or certified nurse practitioner has met all the
requirements of
section 4723.41 of the Revised Code and has paid the
fee required
by section
4723.08 of the Revised Code, the board of nursing shall issue its
certificate of authority to practice
nursing as a
certified registered nurse anesthetist, clinical nurse
specialist,
certified nurse-midwife, or certified nurse practitioner, which shall
designate the nursing
specialty the nurse is authorized to practice. The certificate entitles
its holder to practice nursing in
the specialty designated on the certificate. The board shall issue or deny its
certificate not later than sixty days after receiving all of the
documents required by section
4723.41 of the Revised Code. If an applicant is under investigation for a violation
of this chapter, the board shall conclude the investigation
not later than ninety days after receipt
of all required documents, unless
this ninety-day period is extended by written consent of
the applicant, or unless the board
determines that a substantial question of such a violation exists
and the board has notified the applicant in writing of the
reasons for the continuation of the investigation. If the board
determines that the applicant has not violated this chapter, it
shall issue a certificate not later than
forty-five days
after making that
determination. (B) Authorization to practice nursing as a
certified
registered
nurse anesthetist, clinical nurse specialist, certified nurse-midwife, or
certified nurse
practitioner shall be renewed biennially according to rules and a
schedule
adopted by the board. Before a date specified by the
board In providing renewal applications to certificate holders,
the board shall
mail an application for renewal of a certificate of authority to each
certificate holder
at the last known
address of the holder follow the procedures it follows under section
4723.24 of the Revised Code in providing renewal
applications to license holders. Failure of the certificate holder
to receive an
application for renewal from the board does not excuse the holder
from the requirements of section 4723.44 of the Revised Code.
Not Not later than the date specified by the board,
the holder
shall complete the renewal form and return it to the
board with all of the following: (1) The renewal fee required by section 4723.08 of the
Revised Code; (2) Except as provided in division (C) of this
section, documentation satisfactory to the board that the holder
has
maintained certification in the nursing specialty with a national
certifying organization listed in division (A)(3) of
section 4723.41 of the Revised Code or approved
by the board under section 4723.46 of the Revised
Code; (3) A list of the names and business addresses of the holder's current
collaborating physicians and podiatrists, if the holder is a clinical nurse
specialist, certified nurse-midwife, or certified nurse practitioner; (4) If the holder's certificate was issued under
division (C) of section 4723.41 of the Revised
Code, evidence documentation satisfactory to the board that the
holder has completed continuing
education for a clinical nurse specialist as required by rule of
the board; (5) If the holder's certificate was issued under
division (D) of section 4723.41 of the Revised
Code, verification of documentation satisfactory to the board that
the holder has continued employment by a public
agency or a private, nonprofit entity that receives funding under
Title X of the "Public
Health Service Act," 42
U.S.C. 300 and 300a-1
(1991). On receipt of the renewal application, fees, and
documents, the board shall
verify that
the applicant holds a current license to
practice nursing as a registered nurse in this state, and,
if it so verifies, shall renew the
certificate. If an applicant submits the
completed renewal application after the date specified in the
board's schedule, but before the expiration of the certificate,
the board shall grant a renewal when the late renewal fee
required by section 4723.08 of the Revised Code is paid. An applicant for reinstatement of an expired certificate
shall submit the reinstatement fee, renewal fee, and
the
late renewal fee
required by section 4723.08 of the Revised Code. Any holder of a
certificate who desires inactive status shall give the board
written notice to that effect. (C) The board shall renew a certificate of
authority to practice nursing as a clinical nurse specialist
issued pursuant to division (C) of section 4723.41 of
the
Revised Code, if the certificate holder
complies with all renewal requirements of this section other than
the requirement of having maintained certification in the holder's nursing
specialty. Sec. 4723.43. A certified
registered nurse anesthetist, clinical nurse specialist,
certified nurse-midwife, or certified nurse practitioner may provide to
individuals
and groups nursing care that requires knowledge and skill
obtained from advanced formal education and clinical experience. (A) A nurse authorized to practice as a
certified nurse-midwife,
in collaboration with one or more physicians, may provide the
management of preventive services and those primary care services necessary to
provide health care to women antepartally, intrapartally,
postpartally, and gynecologically, consistent with the nurse's education and
certification, and in accordance with rules adopted by the board. No certified nurse-midwife may perform version,
deliver breech or face
presentation, use forceps, do any obstetric operation, or treat any
other abnormal condition, except in
emergencies. Division
(A) of this section does not prohibit a certified nurse-midwife from
performing episiotomies or normal vaginal deliveries, or repairing vaginal
tears. A certified nurse-midwife
who holds a certificate to
prescribe issued under section 4723.48 of the
Revised
Code may, in collaboration with
one or more physicians, prescribe drugs and therapeutic devices in
accordance with section 4723.481 of the Revised Code. (B) A nurse authorized to practice as a
certified registered nurse anesthetist, with the supervision and
in the immediate presence of a physician, podiatrist, or dentist,
may administer anesthesia and perform anesthesia induction,
maintenance, and emergence, and may perform with supervision
preanesthetic preparation and evaluation, postanesthesia care,
and clinical support functions,
consistent with the nurse's education and
certification, and in accordance with rules adopted by the
board. A certified registered nurse anesthetist
is not required to obtain
a certificate to prescribe in order to provide the anesthesia
care described in this division. The physician, podiatrist, or dentist supervising a certified
registered
nurse anesthetist must be actively engaged in practice in
this state. When
a certified registered nurse anesthetist is
supervised by a podiatrist, the nurse's scope of
practice is limited to the anesthesia procedures that the podiatrist has the
authority under section 4731.51 of the Revised
Code to perform. A certified registered nurse anesthetist may not
administer general anesthesia under the supervision of a podiatrist in a
podiatrist's office. When a certified registered nurse
anesthetist is supervised by a dentist, the nurse's
scope of practice is limited to the anesthesia procedures that the dentist
has the authority under Chapter 4715. of the
Revised Code to perform. (C) A nurse authorized to practice as a certified nurse
practitioner, in collaboration with one or more physicians or
podiatrists,
may provide preventive and primary care services and evaluate
and promote patient wellness within the nurse's nursing specialty,
consistent with the nurse's education and certification, and in
accordance with rules adopted by the board.
A certified nurse practitioner who holds a certificate to
prescribe issued under section 4723.48 of the
Revised
Code may, in collaboration with
one or more physicians or podiatrists, prescribe drugs and therapeutic
devices in accordance with section 4723.481 of the Revised Code. When a certified nurse
practitioner is collaborating with a podiatrist, the nurse's
scope of practice is limited to the procedures that the podiatrist has the
authority under section 4731.51 of the Revised
Code to perform. (D) A nurse authorized to practice as a
clinical nurse specialist, in collaboration with one or more physicians
or podiatrists, may provide and manage the care of individuals and
groups with complex health problems and provide health care
services that promote, improve, and manage health
care within the nurse's nursing specialty, consistent with the nurse's
education and in accordance with rules adopted by the board.
A clinical nurse specialist who holds a certificate to
prescribe issued under section 4723.48 of the
Revised
Code may, in collaboration with
one or more physicians or podiatrists, prescribe drugs and therapeutic
devices in accordance with section 4731.481 4723.481 of the
Revised Code. When a clinical nurse specialist is collaborating with a podiatrist,
the nurse's scope of practice is limited to the procedures that the
podiatrist has the authority under section 4731.51 of the
Revised Code to perform. Sec. 4723.47. (A) If a certified registered nurse
anesthetist's, clinical nurse specialist's, certified nurse-midwife's, or
certified nurse practitioner's license to practice nursing as a registered
nurse expires for failure to renew under section 4723.24 of the
Revised Code, the nurse's certificate of authority to
practice nursing as a certified registered nurse anesthetist,
clinical nurse specialist, certified nurse-midwife, or certified nurse
practitioner
is lapsed until the license is
reinstated. If
the license is revoked under section 4723.28 or 4723.281 of the
Revised Code, the nurse's certificate of authority is
automatically revoked. If the license is suspended under either
section, the nurse's certificate of authority is automatically suspended
while the license remains suspended.
If the license is classified as
inactive under section 4723.24 of the Revised Code, the nurse's certificate of authority is
automatically classified as inactive while the license remains inactive. (B) If a clinical nurse specialist, certified
nurse-midwife, or certified nurse practitioner holds a certificate to
prescribe issued under section 4723.48 of the Revised Code and the nurse's
certificate of authority to practice as a
clinical nurse specialist, certified nurse-midwife,
or certified nurse practitioner expires for failure to renew
under section 4723.41 of the
Revised Code, the nurse's certificate to prescribe is lapsed
until the certificate of authority is reinstated. If the
certificate of authority becomes inactive in
accordance with section 4723.42 of the
Revised
Code, the nurse's certificate
to prescribe is lapsed
until the certificate of authority becomes active. If
the certificate of authority is revoked under section 4723.28 or
4723.281 of the Revised
Code, the nurse's certificate
to prescribe is automatically revoked. If the certificate of
authority is suspended under either section, the nurse's
certificate to prescribe is automatically suspended while the
certificate of authority remains suspended. If a restriction is placed
on the certificate of authority under section 4723.28 of the
Revised Code, the same restriction is
placed on the nurse's certificate to prescribe while the
certificate of authority remains restricted. Sec. 4723.48. (A) A clinical nurse specialist, certified
nurse-midwife, or certified nurse practitioner seeking authority to prescribe
drugs and
therapeutic devices shall file with the board of nursing a written
application for a certificate to prescribe. The board of nursing
shall issue a certificate to prescribe to each applicant who meets
the requirements specified in section 4723.482 or 4723.484 of the
Revised Code. Except as provided in division (B) of this section, the
initial
certificate to prescribe that the board issues to an applicant shall be issued
as an externship certificate. Under an externship certificate,
the nurse may obtain
experience in prescribing drugs and therapeutic devices by
participating in an externship that evaluates the nurse's
competence, knowledge, and skill in pharmacokinetic principles and
their clinical application to the specialty being practiced.
During the externship, the nurse may prescribe drugs and
therapeutic devices only when one or more physicians are providing
supervision in accordance with rules adopted under section 4723.50
of the Revised Code. After completing the
externship, the holder of an externship certificate may apply for a new
certificate
to prescribe. On receipt of the new certificate, the nurse may
prescribe drugs and therapeutic devices in collaboration with one
or more physicians or podiatrists. (B) In the case of an advanced practice nurse who
on the effective date of this section May 17,
2000, is approved
under section 4723.56 of the Revised Code to
prescribe
drugs and therapeutic devices, the initial certificate to prescribe that the
board issues to the nurse under this section shall not be an externship
certificate.
The nurse shall be issued a certificate to prescribe that permits
the nurse to prescribe drugs and therapeutic devices in
collaboration with one or more physicians or podiatrists. Sec. 4723.62. (A) As used in this section,
"county board client," "county board worker," "delegated nursing
task," "health care professional," "nurse," and "prescribed
medication" have the same meanings as in section 5126.35 of the
Revised Code. (B)(1) Not later than ninety days after the
effective date of this section, the The board of nursing shall
adopt
rules that, within the programs and services offered by county
boards of mental retardation and developmental disabilities,
govern the delegation by nurses to county board workers of
authority to give or apply prescribed medication to and perform
delegated nursing tasks on county board clients pursuant to a
policy adopted under section 5126.351 of the Revised
Code. The rules shall be adopted in accordance with
Chapter 119. of the Revised Code and establish all
of the following: (a) Standards for the training of nurses to
train county board workers to give or apply prescribed medication
or perform delegated nursing tasks; (b) Standards for training modules and programs
of instruction to be conducted for county board workers to train
them to give or apply prescribed medication or perform delegated
nursing tasks; (c) Criteria to be used and standards to be
followed by nurses when delegating authority to county board
workers to give or apply prescribed medication or perform
delegated nursing tasks; (d) Conditions and limitations on the authority
of a nurse to delegate to a county board worker authority to give
or apply prescribed medication or perform delegated nursing
tasks; (e) Standards for supervision by a nurse of a
county board worker who is giving or applying prescribed
medication or performing a delegated nursing task, including
standards for on-site supervision and off-site supervision
through some means of telecommunication; (f) Procedures for accepting and referring to
the department of mental retardation and developmental
disabilities complaints regarding delegation of authority to
county board workers and actions by county board workers in
giving or applying prescribed medication and performing delegated
nursing tasks; (g) Actions that a county board worker may take
to assist a county board client in the self-administration of
prescribed medication pursuant to section 5126.355 of the
Revised Code; (h) Any other standards, procedures, or
requirements the board considers appropriate with regard to
delegation to county board workers of authority to give or apply
prescribed medication or perform delegated nursing tasks. (2) Training modules and courses of instruction for
training county board workers to give or apply prescribed
medication or perform delegated nursing tasks shall be conducted
by registered nurses and by licensed practical nurses under the
direction of a registered nurse, except that the rules adopted by
the board of nursing under this section may provide for the use
of health care professionals other than nurses to provide
instruction within the scope of their practices. Sec. 4723.74. A person who seeks to operate a dialysis
training program shall apply to the board of nursing for approval of the
program. Applications shall be submitted in
accordance with rules adopted under section 4723.79 of the
Revised Code.
The person shall include with the application the
fee prescribed in those rules. If the program meets the
requirements for approval as specified in the rules, the board
shall approve the program. The board may withdraw the approval of a
program
that ceases to meet the requirements for approval. A program shall apply
for
reapproval and may be reapproved in accordance with rules adopted under
section 4723.79 of the Revised Code. The board may withdraw the approval of a program that ceases to meet the
requirements for approval. Any action to withdraw the approval shall be taken
in accordance with Chapter 119. of the Revised Code. Sec. 4723.76. (A) The board of nursing shall issue a temporary
certificate to practice as a dialysis technician to a person who
meets all of the following requirements: (1) The person applies to the board in accordance with rules
adopted under section 4723.79 of the Revised Code
and includes with the application the fee established in those
rules. (2) The person provides documentation from the person's employer
that demonstrates that the person is competent to perform
dialysis care. (3) One of the following applies: (a) The person has successfully completed a dialysis
training program approved by the board of nursing under section
4723.74 of the Revised Code. (b) The person is, on the effective date of this section
December 24, 2000,
employed as a dialysis technician but has been so employed for less than
twelve months. (c) The person has experience as a dialysis technician in a
jurisdiction that does not license or certify dialysis technicians and
has successfully completed a training program that is substantially similar to
a program approved by the board. (B) A temporary certificate issued to a person who meets
the requirement in division (A)(3)(a) of this
section is valid for eighteen months from the date on which the
holder entered a dialysis training program approved by the board
under section 4723.74 of the Revised Code. A temporary certificate
issued to a person who meets the requirement in division
(A)(3)(b) of this section
is valid for
the number of months equal to eighteen months minus the number of
months the person has been employed as a dialysis technician. A temporary
certificate issued to a person who meets the requirement in division
(A)(3)(c) of this section and has been working as a
dialysis technician for twelve months or longer is valid for six months. A
temporary certificate issued to a person who meets the requirement in division
(A)(3)(c) of this section and has been employed as a
dialysis technician for less than twelve months is valid for the number of
months equal to eighteen months minus the number of months the person has been
employed as a dialysis technician. (C) A temporary certificate issued under this section
may be renewed once if the holder enrolls or re-enrolls in a
dialysis training program approved by the board. A temporary
certificate that has been renewed is not renewable. A person
holding a temporary certificate shall provide a copy of the
temporary certificate to the dialysis provider who employs the
person. The person shall not act as a trainer or preceptor in
any dialysis training program. Sec. 4723.79. The board of nursing shall adopt rules to
administer and enforce sections 4723.71 to 4723.79 of the
Revised Code. The board shall adopt
the rules in accordance with
Chapter 119. of the
Revised Code. The rules shall
establish or specify all of the following: (A) The application
process, fee, and requirements for approval, reapproval, and withdrawing the
approval of a dialysis training
program under section 4723.74 of the
Revised Code. The requirements shall
include standards that must be satisfied regarding curriculum,
length of training, and instructions in
patient care. (B) The application
process, fee, and requirements for issuance of a certificate
under section 4723.75 of the
Revised
Code, except that the amount of the fee shall be no greater than the
fee charged under division (A)(1) of section 4723.08 of the
Revised Code; (C) The application
process, fee, and requirements for issuance of a temporary certificate under
section 4723.76 of the Revised Code; (D) The process for
approval of testing organizations under
section 4723.751 of the Revised Code; (E) Subjects to be
included in a certification examination provided for in division
(B)(1) of section 4723.75 of the
Revised Code; (F) The schedule, fees,
and continuing education requirements for renewal of a certificate
under section 4723.77 of the
Revised Code, except that the fee for the renewal of a
certificate shall be no greater than the fee charged under division
(A)(8)(9) of section 4723.08 of the Revised Code; (G) Standards and procedures for establishing and maintaining
the dialysis registry
required by section 4723.78 of the
Revised
Code, including standards and procedures that persons must follow in
providing the information to be included in the registry; (H) Standards for the
administration of medication by dialysis technicians under
section 4723.72 of the Revised
Code; (I) The information a dialysis provider is to provide to the
board when attesting to a person's competence to perform dialysis; (J) Standards and procedures for the supervision of dialysis
technicians who provide dialysis care in a patient's home, including monthly
home visits by a
registered nurse to monitor the quality of the dialysis care; (K) Any other procedures
or requirements necessary for the administration and enforcement
of sections 4723.71 to 4723.79 of the
Revised
Code. Sec. 4723.99. Whoever (A) Except as provided in
division (B) of this section, whoever violates section 4723.03 or
4723.44 of the Revised Code shall be fined five hundred dollars or
imprisoned not more than ninety days or both is guilty of a felony of
the fifth degree on a first offense and a felony of the fourth degree on each
subsequent offense. (B) A registered nurse or licensed practical nurse who violates
division (A) or (B) of section 4723.03 of the Revised Code by reason of a
license to practice nursing that has lapsed for failure to renew or by
practicing nursing after a license has been classified as inactive is guilty
of a minor misdemeanor. Sec. 4731.27. (A) As used in this section, "collaboration,"
"physician," "standard
care arrangement," and "supervision" have the same
meanings as in section 4723.02 4723.01 of the
Revised Code. (B) Except as provided in division (C)(1) of section
4723.431 of the Revised Code, a
physician or podiatrist shall enter into a standard care arrangement
with each clinical nurse specialist, certified nurse-midwife,
or certified nurse
practitioner with whom the physician or podiatrist is in collaboration.
The collaborating physician or podiatrist shall
fulfill the responsibilities of collaboration, as specified in the arrangement
and in accordance with division (A) of
scetion section 4723.431 of the Revised Code. A copy of the
standard care
arrangement shall be retained on file at each site where the
nurse practices. Prior approval of
the standard care arrangement by the state medical board is not required, but
the board may periodically review it. Nothing in this division
prohibits a hospital from hiring a
clinical nurse
specialist, certified nurse-midwife, or certified nurse practitioner as an
employee and negotiating standard care arrangements on behalf of the employee
as necessary to meet the requirements of this section. A standard care
arrangement between the hospital's employee and the employee's collaborating
physician is subject to approval by the medical staff and governing body of
the hospital prior to implementation of the arrangement at the hospital. (D)(C) With respect to a clinical nurse
specialist, certified nurse-midwife, or certified nurse practitioner
participating in an
externship pursuant to an initial certificate to prescribe issued under
section 4723.48 of the Revised
Code, the physician responsible for evaluating the externship
shall provide the state medical board with the name of the nurse. If the
externship is terminated for any reason, the
physician shall notify the board.
(D) A physician or podiatrist shall cooperate with the
board
of nursing in any investigation the board conducts with respect to
a clinical nurse
specialist, certified nurse-midwife, or certified nurse
practitioner who collaborates with the physician or podiatrist
or with
respect to a certified registered nurse anesthetist who practices
with the supervision of the physician or podiatrist. Sec. 4731.281. (A) On or before the deadline established under division
(B) of this section for applying for renewal
of a certificate of registration, each person
holding a certificate under this chapter to practice medicine and
surgery, osteopathic medicine and surgery, or podiatry shall
certify to the state medical board that in the preceding two years the person
has completed one
hundred hours of continuing medical education. The
certification shall be made upon the application for biennial
registration submitted pursuant to division
(B) of this section. The board shall adopt rules providing for pro rata
reductions by
month of the number of hours of continuing education required
for persons who are in their first registration period, who have a
registration period of less than two years due to initial implementation of
the staggered renewal schedule established under division (B) of this
section, who have
been disabled due to illness or accident, or who have been
absent from the country. In determining whether a course, program, or activity
qualifies for credit as continuing medical education, the board
shall approve all continuing medical education taken
by persons holding a certificate to practice medicine and surgery
that is certified by the Ohio state medical association,
all continuing medical education taken by
persons holding a certificate to practice osteopathic medicine
and surgery that is certified by the Ohio osteopathic
association, and all continuing medical
education taken by persons holding a certificate to practice
podiatry that is certified by the Ohio podiatric medical
association. Each person holding a certificate
to practice under this chapter
shall be given sufficient choice of continuing education programs
to ensure that the person has had a reasonable opportunity to
participate
in continuing education programs that are relevant to the person's
medical
practice in terms of subject matter and level. The board may
require a random sample of persons holding a certificate to
practice under this chapter to submit materials documenting
completion of the continuing medical education requirement during
the preceding registration period, but this provision shall not
limit the board's authority to investigate pursuant to section
4731.22 of the Revised Code. (B)(1) Every person holding a certificate under this chapter to
practice medicine and surgery, osteopathic medicine and surgery,
or podiatry wishing to renew that certificate shall
apply to the board for a certificate of
registration upon an application furnished by the board, and pay to the
board at the time of application a fee of three
hundred five dollars, according to the following
schedule: (a) Persons whose last name begins with the letters "A" through
"B," on or before April 1, 2001, and the first day of April of
every odd-numbered year thereafter; (b) Persons whose last name begins with the letters "C" through
"D," on or before January 1, 2001, and the first day of January
of every odd-numbered year thereafter; (c) Persons whose last name begins with the
letters "E" through "G," on or before October 1,
2000, and the first
day of October of every
even-numbered year thereafter; (d) Persons whose last name begins
with the letters "H" through
"K," on or before July 1, 2000, and the first day
of July of every even-numbered year thereafter; (e) Persons whose last name begins with the
letters "L" through
"M," on or before April 1, 2000, and the first
day of April of every even-numbered year thereafter; (f) Persons whose last name begins with the
letters "N" through
"R," on or before
January 1, 2000, and the first
day of January of every
even-numbered year thereafter; (g) Persons whose last name begins
with the letters "S," on or before October 1, 1999, and the
first day of October of every odd-numbered year thereafter; (h) Persons whose last name begins
with the letters "T" through "Z," on or before
July 1, 1999, and the first day of July of every
odd-numbered year thereafter. The board shall deposit the
fee in accordance with section 4731.24 of
the Revised Code, except that,
until July 30, 2001, the
board shall deposit twenty dollars of the fee into the state treasury
to the credit of the physician loan repayment fund created by
section 3702.78 of the Revised Code. (2) The board shall mail or cause to be mailed to every person
registered to practice medicine and surgery, osteopathic medicine
and surgery, or podiatry, an application for registration
addressed to the person's last known post-office address or
may cause the application to be sent to
the person through the
secretary of any recognized medical, osteopathic, or podiatric
society, according to the following schedule: (a) To persons whose last name begins with the letters "A"
through "B," on or before January 1, 2001, and the first
day of January of every odd-numbered year thereafter; (b) To persons whose last name begins with the
letters "C" through "D," on or before
October 1, 2000, and the first day of October of every
even-numbered year thereafter; (c) To persons whose last name begins with the
letters "E" through
"G," on or before
July 1, 2000, and the first day
of July of every even-numbered
year thereafter; (d) To persons whose last name begins
with the letters "H" through
"K," on or before
April 1, 2000, and the first
day of April of every
even-numbered year thereafter; (e) To persons whose last name begins with the
letters "L" through
"M," on or before
January 1, 2000, and the first
day of January of every
even-numbered year thereafter; (f) To persons whose last name begins with the
letters "N" through
"R," on or before
October 1, 1999, and the first
day of October of every
odd-numbered year thereafter; (g) To persons whose last name begins
with the letters "S," on or
before July 1, 1999, and the
first day of July of every
odd-numbered year thereafter; (h) To persons whose last name begins
with the letters "T" through
"Z," on or before
April 1, 1999, and the first
day of April of every
odd-numbered year thereafter; Failure of any person to receive an application from
the board shall not excuse the person from the requirements
contained in
this section. The application shall contain proper spaces for the
applicant's signature and the insertion of the required
information, including a statement that the person has
fulfilled the
continuing education requirements imposed by this section. The applicant shall write or cause to be written upon the
application so furnished the applicant's full name,
principal
practice
address and residence address, the number of the applicant's
certificate to
practice, and any other facts for the identification of the
applicant as a person holding a certificate to practice under
this chapter as the board considers necessary. The
applicant shall include with the application a list of the names and addresses
of any clinical nurse specialists, certified nurse-midwives, or certified
nurse practitioners with whom the applicant is currently collaborating,
as defined in section 4723.02 4723.01 of the Revised Code.
The applicant shall
execute
and deliver the application to the board by mail or in
person. Every person
registered under this section shall give written notice to the
board of any change of principal practice address or residence
address or in the list within thirty days of the change. The applicant shall report any criminal offense that
constitutes grounds for refusal of registration under section
4731.22 of the Revised Code to which the applicant has pleaded
guilty, of which the applicant has been
found guilty, or
for which the applicant has been found eligible for
intervention
in lieu of conviction, since last
signing an application for
a certificate of registration. (C) The board shall issue to any person holding a certificate
under this chapter to practice medicine and surgery, osteopathic
medicine and surgery, or podiatry, upon application and
qualification therefor in accordance with this section, a
certificate of registration under the seal of the board. A
certificate of registration shall be valid for a two-year period,
commencing on
the first day of the third month after the registration fee
is due and expiring on the last day of
the month two years
thereafter. The board shall publish
and
cause to be mailed to each person registered under this section,
upon request, a printed list of the persons so registered. (D) Failure of any certificate holder to register and comply
with this section shall operate automatically to suspend the
holder's
certificate to practice. Continued
practice after the
suspension of the certificate to practice shall be considered as
practicing in violation of section 4731.41,
4731.43, or 4731.60 of the Revised Code.
Subject to section 4731.222 of the Revised Code, the
board shall reinstate a certificate to practice
for failure to register upon an applicant's submission of the
biennial registration fee, the
applicable monetary penalty, and certification by signature of the
applicant that the applicant has completed the requisite
continuing medical education. The penalty for reinstatement shall be
fifty dollars if
the certificate has been suspended for two years or less and
one hundred dollars if the certificate has been suspended for more
than two years. The board shall deposit the penalties in
accordance with section 4731.24 of the Revised
Code. (E) If an individual certifies completion of the number of hours
and
type of continuing medical education required to receive a
certificate of registration or reinstatement of a certificate to
practice, and the board finds through the random samples it
conducts under this section or through any other means that the
individual did not complete the requisite continuing medical
education, the board may impose a civil penalty of not more than
five thousand dollars. The board's finding shall be made
pursuant to an adjudication under Chapter 119. of the
Revised Code and by an affirmative vote of not
fewer than six members. A civil penalty imposed under this division may be in
addition to or in lieu of any other action the board may take
under section 4731.22 of the Revised Code. The
board shall deposit civil penalties in accordance with section
4731.24 of the Revised Code. (F) The state medical board may obtain information not
protected by statutory or common law privilege from courts and
other sources concerning malpractice claims against any person
holding a certificate to practice under this chapter or
practicing as provided in section 4731.36 of the Revised Code. Sec. 4743.05. Except as otherwise provided in sections
4701.20, 4723.061, and 4729.65 of the Revised Code, all money
collected under Chapters 3773., 4701., 4703., 4709., 4713., 4715.,
4717., 4723., 4725., 4729., 4732., 4733., 4734., 4736., 4741.,
4753., 4755., 4757., 4759., and 4761.
of the Revised Code, and until December 31, 2004, money
collected under Chapter 4779. of the Revised
Code, shall
be paid into the state treasury to the credit of the occupational
licensing and regulatory fund, which is hereby created for use in
administering such chapters. Money deposited to
the credit of the fund under section 4731.24 of the Revised Code shall be used
until July 1, 1998, for administering Chapters 4730. and 4731.
of the Revised Code. At the end of each quarter, the director of budget and management shall
transfer
from the occupational licensing and regulatory fund to the nurse
education assistance fund created in section 3333.28
of the Revised Code the amount certified to the director
under division (B) of section 4723.08 of the Revised Code. At the end of the first quarter of 1995 and at the end of
each quarter thereafter, the director shall transfer from the
occupational licensing and regulatory fund to the certified
public accountant education assistance fund created in section
4701.26 of the Revised Code the amount certified to the
director under division (D)(2) of section 4701.10 of the Revised Code. Sec. 4751.05. (A) The board of examiners of nursing home
administrators, or a government or private entity under contract
with the board to administer examinations for licensure as a nursing home
administrator, shall admit to an examination any candidate
who: (1) Pays the application fee of fifty dollars; (2) Submits evidence of good moral character and
suitability; (3) Is at least eighteen years of age; (4) Has completed educational requirements and work
experience satisfactory to the board; (5) Submits an application on forms prescribed by the
board; (6) Pays the examination fee charged
by the board or government or private entity. (B) Nothing in Chapter 4751. of the Revised Code or the rules
adopted thereunder shall be construed to require an applicant for
licensure or a temporary license, who is employed by
an institution for the care and treatment of the sick
to demonstrate proficiency in any medical
techniques or to meet any medical educational qualifications or
medical standards not in accord with the remedial care and
treatment provided by the institution if the
institution is all of the following: (1) Operated exclusively for patients who use spiritual means for
healing and for whom the acceptance of medical care is inconsistent with their
religious beliefs; (2) Accredited by a national accrediting organization; (3) Exempt from federal income taxation under section 501 of the
Internal
Revenue Code of 1986, 100 Stat. 2085, 26 U.S.C.A. 1,
as amended; (4) Providing twenty-four hour nursing care pursuant to the exemption
in division (G)(E) of section 4723.32 of the Revised Code from
the licensing
requirements of Chapter 4723. of the Revised Code. (C) If a person fails three times to attain a passing
grade on the examination, said person, before the person may
again be admitted to examination, shall meet such additional education or
experience requirements, or both, as may be prescribed by the
board. Sec. 5111.04. (A) As used in this section: (1) "Outpatient health facility" means a facility that
provides comprehensive primary health services by or under the
direction of a physician at least five days per week on a
forty-hour per week basis to outpatients, is operated by the
board of health of a city or general health district or another
public agency or by a nonprofit private agency or organization
under the direction and control of a governing board that has no
health-related responsibilities other than the direction and
control of one or more such outpatient health facilities, and
receives at least seventy-five per cent of its operating funds
from public sources, except that it does not include an
outpatient hospital facility or a federally qualified health
center as defined in Sec. 1905(l) (2)(B) of the "Social Security
Act," 103 Stat. 2264 (1989), 42 U.S.C.A. 1396d(l)(2)(B). (2) "Comprehensive primary health services" means
preventive, diagnostic, therapeutic, rehabilitative, or
palliative items or services that include all of the following: (a) Services of physicians, physician assistants, and
certified nurse practitioners; (b) Diagnostic laboratory and radiological services; (c) Preventive health services, such as children's eye and
ear examinations, perinatal services, well child services, and
family planning services; (d) Arrangements for emergency medical services; (e) Transportation services. (3) "Certified nurse practitioner" has the same meaning as in section
4723.02 4723.01 of the Revised Code. (B) Outpatient health facilities are a separate category
of medical care provider under the rules governing the
administration of the medical assistance program established
under section 5111.01 of the Revised Code. Rates of
reimbursement for items and services provided by an outpatient
health facility under this section shall be prospectively
determined by the department of job and family services not less often
than once each year, shall not be subject to retroactive
adjustment based on actual costs incurred, and shall not exceed
the maximum fee schedule or rates of payment, limitations based
on reasonable costs or customary charges, and limitations based
on combined payments received for furnishing comparable services,
as are applicable to outpatient hospital facilities under Title
XVIII of the "Social Security Act." In determining rates of
reimbursement prospectively, the department shall take into
account the historic expenses of the facility, the operating
requirements and services offered by the facility, and the
geographical location of the facility, shall provide incentives
for the efficient and economical utilization of the facility's
resources, and shall ensure that the facility does not
discriminate between classes of persons for whom or by whom
payment for items and services is made. (C) A facility does not qualify for classification as an
outpatient health facility under this section unless it: (1) Has health and medical care policies developed with
the advice of and subject to review by an advisory committee of
professional personnel, including one or more physicians, one or
more dentists if dental care is provided, and one or more
registered nurses; (2) Has a medical director, a dental director, if dental
care is provided, and a nursing director responsible for the
execution of such policies, and has physicians, dentists,
nursing, and ancillary staff appropriate to the scope of services
provided; (3) Requires that the care of every patient be under the
supervision of a physician, provides for medical care in case of
emergency, has in effect a written agreement with one or more
hospitals and one or more other outpatient facilities, and has an
established system for the referral of patients to other
resources and a utilization review plan and program; (4) Maintains clinical records on all patients; (5) Provides nursing services and other therapeutic
services in compliance with applicable laws and rules and under
the supervision of a registered nurse, and has a
registered nurse on duty at all times when the
facility is in operation; (6) Follows approved methods and procedures for the
dispensing and administration of drugs and biologicals; (7) Maintains the accounting and record-keeping system
required under federal laws and regulations for the determination
of reasonable and allowable costs. Sec. 5126.35. As used in this section and in sections
5126.351 to 5126.357 of the Revised Code: (A) "County board client" means a person
enrolled in a program offered by a county board of mental
retardation and developmental disabilities or receiving services
from a county board. (B) "County board worker" means a person who is
employed by a county board of mental retardation and
developmental disabilities or provides services to county board
clients either as a volunteer or pursuant to a contract with the
board, except that "county board worker" does not include a
health care professional acting within the scope of practice authorized by
the professional's license
or certificate. (C) "Delegated nursing task" means a task that
is within the scope of practice of a nurse as determined pursuant
to Chapter 4723. of the Revised Code and
is delegated by a nurse to a county board worker pursuant to a
policy adopted by a county board under section 5126.351 of the
Revised Code. (D) "Health care professional" means any of the
following: (1) A dentist who holds a valid license issued under
Chapter 4715. of the Revised Code; (2) A registered or licensed practical nurse who holds
a valid license issued under Chapter 4723. of the
Revised Code; (3) An optometrist who holds a valid license issued
under Chapter 4725. of the Revised Code; (4) A pharmacist who holds a valid license issued under
Chapter 4729. of the Revised Code; (5) A doctor of medicine or osteopathic medicine,
podiatrist, or a practitioner of a limited branch of medicine who
holds a valid certificate issued under Chapter 4731. of
the Revised Code; (6) A physician's physician assistant for whom a
physician who holds
a valid certificate of registration issued under section 4730.04
Chapter 4730. of the Revised Code; (7) An occupational therapist or occupational therapy
assistant or a physical therapist or physical therapy assistant
who holds a valid license issued under Chapter 4755. of
the Revised Code; (8) A respiratory care professional who holds a valid
license issued under Chapter 4761. of the Revised
Code. (E) "Nurse" means a registered nurse or
licensed practical nurse who holds a valid license issued under
Chapter 4723. of the Revised Code. (F) "Prescribed medication" means a drug
described in section 4729.01 of the Revised Code
that is to be taken orally or applied topically pursuant to the
instructions of a licensed health care professional who
is authorized by law to prescribe drugs, as defined in
section 4729.01 of the Revised Code. SECTION 2 . That existing sections 2305.24, 2305.25, 2305.251, 3313.68,
3701.07, 3701.85, 3702.51, 3719.13,
3721.031, 3721.34, 3727.01, 4723.02, 4723.03, 4723.04, 4723.051, 4723.06,
4723.061,
4723.07,
4723.08, 4723.09, 4723.15, 4723.171, 4723.24, 4723.25, 4723.28, 4723.281,
4723.282, 4723.31,
4723.32,
4723.34, 4723.341, 4723.35, 4723.39, 4723.40, 4723.42, 4723.43, 4723.47,
4723.48, 4723.62, 4723.74, 4723.76, 4723.79, 4723.99, 4731.27, 4731.281,
4743.05, 4751.05, 5111.04, and 5126.35 and section 4723.342 of the
Revised Code are hereby repealed.
SECTION 3 . The amendment made by this act to section 4723.02 of the Revised
Code providing for a four-year term of office for members of the Board of
Nursing
does not affect the terms of the members holding office on the effective date
of
this act.
SECTION 4 . The authority this act grants to the Board of Nursing
to take disciplinary action under section 4723.28 of the Revised
Code against a person who has been found eligible for intervention
in lieu of conviction extends to a person who, prior to the
effective date of Am. Sub. S.B. 107 of the 123rd General Assembly,
was found eligible for treatment in lieu of conviction.
SECTION 5 . Section 4723.02 of the Revised Code is presented in this act
as a composite of the section as amended by Am. Sub. H.B. 241,
Sub. S.B. 111, and Am. Sub. S.B. 178 of the 123rd General Assembly,
with the new language of none of the acts shown in capital letters.
This is in recognition of the principle stated in division (B) of section
1.52 of the Revised Code that such amendments are to be
harmonized where not substantively irreconcilable and constitutes
a legislative finding that such is the resulting version in
effect on December 24, 2000.
SECTION 6 . Sections 4723.04, 4723.06, 4723.08, and 4723.28 of the Revised Code
are presented in this act
as composites of those sections as amended by both
Am. Sub. H.B. 241 and Sub. S.B. 111 of the 123rd General Assembly,
with the new language of neither of the acts shown in capital letters.
This is in recognition of the principle stated in division (B) of section
1.52 of the Revised Code that such amendments are to be
harmonized where not substantively irreconcilable and constitutes
a legislative finding that such are the resulting versions in
effect prior to the effective date of this act.
SECTION 7 . That section 4723.17 of the Revised Code be re-enacted to read as
follows:
Sec. 4723.17. (A) The board of nursing may
authorize a licensed practical nurse to
administer to an adult intravenous therapy authorized by an individual who is
authorized to practice in this state and is acting within the course of the
individual's professional practice, if all of the following are true of the
licensed practical nurse: (1) The nurse has a current, valid license issued under this
chapter that includes authorization to administer medications. (2) The nurse has successfully completed a course in intravenous
administration approved by the board that includes both of
the following: (a) A minimum of forty hours of training that includes all of the
following: (i) The curriculum established by rules adopted by the board and in effect
on January 1, 1999; (ii) Training in the anatomy and physiology of the cardiovascular
system, signs and symptoms of local and systemic complications in the
administration of fluids and
antibiotic additives, and guidelines for management of these
complications; (iii) Any other training or instruction the board considers
appropriate. (b) A testing component that includes the successful performance of
three venipunctures
supervised by a physician or registered nurse in a health care
setting. (B) Except as provided in section 4723.171 of the Revised Code, a licensed
practical nurse may perform intravenous
therapy
only if authorized by the board
pursuant to division (A) of this section and only if it is
performed
in accordance with this section. A licensed practical nurse authorized by the board to perform
intravenous therapy may perform an intravenous therapy procedure only at the
direction of one of the following: (1) A licensed physician, dentist, optometrist, or podiatrist who,
except as provided in division (C)(2) of this section, is
present
and readily available at the facility where the intravenous therapy procedure
is performed; (2) A registered nurse in accordance with
division (C) of this section. (C)(1) Except as provided in division
(C)(2) of this
section and section 4723.171 of the Revised Code, when a licensed practical nurse
authorized by the board to
perform intravenous
therapy performs an intravenous therapy procedure at the direction of a
registered
nurse, the registered nurse or another registered nurse shall be readily
available at the site
where the intravenous therapy is performed, and before the
licensed practical nurse initiates the intravenous therapy, the
registered nurse shall personally perform an on-site assessment of
the individual who is to receive the intravenous therapy. (2) When a licensed practical nurse authorized by the board to perform
intravenous therapy performs an intravenous therapy procedure in a home
as defined in section 3721.10 of the Revised Code, or in an
intermediate care facility for the mentally retarded as defined in
section 5111.20 of the Revised Code,
at the direction of a registered
nurse or licensed physician, dentist, optometrist, or
podiatrist, a registered nurse shall be on the premises of the
home or facility or accessible by some form of telecommunication. (D) No licensed practical nurse shall perform any of the
following intravenous therapy procedures: (1) Initiating or maintaining any of the following: (a) Blood or blood components; (b) Solutions for total parenteral nutrition; (c) Any cancer therapeutic medication including, but not limited
to, cancer chemotherapy or an anti-neoplastic agent; (d) Solutions administered through any central venous line or
arterial line or any other line that
does not terminate in a peripheral vein, except that a licensed
practical nurse authorized by the board to perform intravenous therapy
may maintain the solutions specified in division
(D)(6)(a) of this
section that are being administered
through a central venous line or peripherally inserted central
catheter; (e) Any investigational or experimental medication. (2) Initiating intravenous therapy in any vein,
except that a licensed practical nurse authorized by the board
to perform intravenous therapy may initiate intravenous therapy in
accordance with this section in
a vein
of the hand, forearm, or antecubital fossa; (3) Discontinuing a central venous, arterial, or any other line
that does not terminate in a peripheral vein; (4) Initiating or discontinuing a peripherally inserted central
catheter; (5) Mixing, preparing, or reconstituting any
medication for
intravenous therapy, except that a licensed practical nurse authorized
by the board to perform intravenous therapy may prepare or reconstitute
an antibiotic
additive; (6) Administering medication via the intravenous route, including
all of the following activities: (a) Adding medication to an intravenous solution or to an
existing infusion, except that a licensed practical
nurse authorized by the board to perform
intravenous therapy
may do either of the following: (i) Initiate an intravenous infusion containing one or more
of the
following elements: dextrose 5%; normal saline; lactated ringers; sodium
chloride .45%; sodium chloride 0.2%; sterile water. (ii) Hang subsequent containers of the intravenous
solutions
specified in division (D)(6)(a) of this
section that contain
vitamins or electrolytes, if a registered nurse initiated the infusion of
that same intravenous solution. (b) Initiating or maintaining an intravenous piggyback infusion,
except that a licensed practical nurse authorized by the board to
perform intravenous therapy may initiate or maintain
an intravenous
piggyback infusion containing an antibiotic additive; (c) Injecting medication via a direct intravenous route, except
that a licensed practical nurse authorized by the board to
perform intravenous therapy
may inject heparin or
normal saline to flush an intermittent infusion device or heparin
lock including, but not limited to, bolus or push. (7) Aspirating any intravenous line to maintain patency; (8) Changing tubing on any line including, but not limited to,
an arterial line
or a
central venous line, except that a licensed practical nurse
authorized by the board to perform intravenous therapy may change tubing on an
intravenous line that terminates in a peripheral vein; (9) Programming or setting any function of a patient controlled
infusion pump. (E) Notwithstanding division (D) of
this section, at the
direction of a physician or a registered nurse, a licensed practical
nurse authorized by the board to perform intravenous therapy may
perform the following
activities for the purpose of performing dialysis: (1) The routine administration and regulation of saline solution for the
purpose of maintaining an established fluid plan; (2) The administration of a heparin dose intravenously; (3) The administration of a heparin dose peripherally via a fistula
needle; (4) The loading and activation of a constant infusion pump or the
intermittent injection of a dose of medication prescribed by a licensed
physician for dialysis. (F) No person shall employ or direct a licensed practical
nurse
to perform an intravenous therapy procedure without first verifying that the
licensed practical nurse is authorized by the
board to perform intravenous therapy. (G) The board shall maintain a registry
of the
names of licensed practical nurses authorized pursuant to
division (A) of this section to perform intravenous therapy. SECTION 8 . That existing section 4723.17 of the Revised Code is hereby
repealed.
SECTION 9 . The re-enactment and repeal of existing section 4723.17 of the
Revised Code is intended to confirm the resulting version of the section in
effect prior to the effective date of this act. The re-enacted section,
previously numbered as section 4723.48 of the Revised Code, is not presented
in capital letters because it is a composite of the section as previously
amended by Am. Sub. H.B. 241 and Am. Sub. S.B. 178 of the 123rd General
Assembly. Under division (B) of section 1.52 of the Revised Code, because
these amendments can be put into simultaneous operation, they were harmonized
prior to the effective date of this act to give effect to each.
SECTION 10 . That the version of section 4723.99 of the Revised Code that is
scheduled to take effect June 27, 2001, be amended to read as follows:
Sec. 4723.99. Whoever (A) Except as provided in division
(B) of this section, whoever violates section 4723.03, 4723.44,
or 4723.73 of the Revised Code shall be fined five hundred dollars or
imprisoned not more than ninety days or both is guilty of a felony of
the fifth degree on a first offense and a felony of the fourth degree on each
subsequent offense. (B) A registered nurse or licensed practical nurse who violates
division (A) or (B) of section 4723.03 of the Revised Code by reason of a
license to practice nursing that has lapsed for failure to renew or by
practicing nursing after a license has been classified as inactive is guilty
of a minor misdemeanor. SECTION 11 . That the existing version of section 4723.99 of the Revised Code
that is scheduled to take effect June 27, 2001, is hereby repealed.
SECTION 12 . Sections 10 and 11 of this act take effect June 27, 2001.
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