This is a reproduction of the original law, as enacted by the Ohio legislature, which is maintained by the Legislative Services Commission. Variances may occur in this reproduction.
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Section 4723.02 Definitions
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 prescribed by licensed physicians; dentists; optometrists; podiatrists; or, until January 1, 2010, advanced practice nurses authorized to prescribe under Section 4723.56 of the Revised Code; (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, 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
prescribed by a licensed physician; dentist; optometrist; podiatrist; or, until January 1, 2010, an advanced practice nurse authorized to prescribe under Section 4723.56 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. (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 who holds a certificate
issued under Chapter 4731. of the Revised Code authorizing the practice of medicine and surgery or osteopathic medicine and surgery and is practicing in this state. (L) “Dentist” means an individual who is licensed under
Chapter 4715. of the Revised Code to practice dentistry and is practicing in this state. (M) “Podiatrist” means an individual who holds a certificate
issued under Chapter 4731. of the Revised Code authorizing the practice of podiatry and is practicing in this state. (N) “Collaboration” or “collaborating” means the following:
(1) In the case of a clinical nurse specialist, except as provided in Division (N)( 3) of this section, or a certified nurse practitioner, that a podiatrist acting within the podiatrist’s scope of practice in accordance with Section 4731.51 of the Revised Code and with whom the nurse has entered into a standard care arrangement or physician with whom the nurse has entered into a standard care arrangement is 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 a
physician with whom the certified nurse- midwife has entered into a standard care arrangement is 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 whose
nursing specialty is mental health or psychiatric mental health, that a physician is continuously available to communicate with the nurse either in person or by radio, telephone, or other form of telecommunication.
2 (O) “Supervision” means that a 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. (P) “Standard care arrangement” means a written, formal
guide for planning and evaluating a patient’s health care that is developed by a collaborating physician or podiatrist and a clinical nurse specialist, certified nursemidwife, or certified nurse practitioner and meets the requirements of Section 4723.431 of the Revised Code.
Section 4723.03 Prohibitions
(A) No person shall engage in the practice of nursing as a registered nurse, hold herself or himself out 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 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; (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.
Section 4723.04 Board of Nursing; Composition; Advisory Groups
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 concerning nurses and nursing and the regulation thereof. 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. 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 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 years, commencing on the first day of January and ending on the thirty- first day of December. 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 her 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 her term until her successor takes office, or until a period of sixty days has elapsed, whichever occurs first. Nursing organizations of this state may each
3 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 his 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 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 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.
Section 4723.05 Executive Director; Appointing Authority
The Board of Nursing shall appoint an executive director, who shall be a registered nurse of this state with at least five years experience in the practice of nursing as a registered nurse, shall be a resident of this state during the term of appointment, and shall not be a member of the Board at the time of appointment or during the term of appointment. The Board shall meet at such times and places as it may direct and provide in its rules. The president may call special meetings, and the executive director shall call special meetings upon the written request of two or more Board members. The Board shall provide itself with a seal. The president and executive director may administer oaths. The executive director is the chief administrative officer of the Board and shall serve as a full time employee of the Board and shall be entitled to attend all meetings of the Board except meetings concerning the appointment and terms of employment of the executive director.
The term of the executive director shall be one year commencing on the first day of January. The executive director shall receive necessary expenses in addition to salary. The executive director shall give a surety bond to the state in such sum as the Board requires, and conditioned upon the faithful performance of the duties of executive director.
The executive director is an appointing authority as defined in Section 124.01 of the Revised Code, and may appoint such nursing education consultants, nursing practice consultants, investigative personnel, and any additional employees for professional, clerical, and special work
necessary to carry out the Board’s functions and with the Board’s approval, may establish standards for the conduct of employees.
Section 4723.051 Use of National Examinations
The Board of Nursing, in administering examinations for licensure under this chapter, may make use of 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 whether a person is competent to commence practicing nursing as a registered nurse or as a licensed practical nurse. 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.
Section 4723.06 Powers and Duties of the Board
(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 under Chapter 119. of the Revised Code; (2) Examine applicants for licensure to practice as a
registered nurse or as a licensed practical nurse; (3) Issue and renew licenses 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 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
4 Revised Code, the Board shall hold a hearing
under Chapter 119. of the Revised Code to consider the program. Based on results of the hearing, 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 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 for nurses under
rules adopted under Section 4723.07 of the Revised Code; (10) Establish the alternative program for chemically
dependent nurses in accordance with Section 4723.35 of the Revised Code; (11) 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; (12) 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; (13) Make an annual report to the governor, which
shall be open for public inspection; (14) 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
licenses, registrations, and 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. (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 twoyear period beginning the date of issuance and may be renewed by the Board.
Section 4723.061 Agreements With Director of the Ohio Department of Health
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.
Section 4723.07 Board Rule Making Authority
In accordance with Chapter 119. of the Revised Code, the Board of Nursing shall adopt and may amend and rescind rules: (A) Providing for its government and control of its actions
and business affairs; (B) Establishing minimum curricula and standards for
nursing education programs that prepare graduates to take licensing examinations, and establishing procedures for granting, renewing, and withdrawing approval of those programs; (C) Establishing requirements that applicants for licensure
must meet to be permitted 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; (E) Establishing standards for approval of continuing nursing
education programs and courses for registered nurses, licensed practical nurses, certified registered nurse anesthetists, clinical nurse specialists, certified nursemidwives, 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 that persons must meet to be
authorized by the Board to approve continuing nursing education programs and courses and a schedule to have that authorization renewed; (G) Establishing requirements, including continuing
education requirements, for restoring inactive licenses and licenses that have lapsed through failure to renew; (H) Governing conditions that may be imposed for
reinstatement following action taken under Sections 2301.373, 4723.28, and 4723.281 of the Revised Code resulting in a suspension from practice;
5 (I) Establishing standards for approval of peer support
programs for nurses; (J) Establishing requirements for Board approval of courses
in medication administration by licensed practical nurses; (K) Establishing criteria for specialty certification of
registered nurses; (L) Establishing 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; (M) Establishing universal blood and body fluid precautions
that shall be used by each person licensed 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 handwashing; (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. (N) Establishing 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; (O) Establishing quality assurance standards for certified
registered nurse anesthetists, clinical nurse specialists, certified nurse- midwives, or certified nurse practitioners; (P) Establishing 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; (Q) Establishing 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.
Subject to Chapter 119. of the Revised Code, the Board may adopt other rules necessary to carry out the provisions of this chapter.
Section 4723.08 Fees
(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 verification of a license or certificate to
another jurisdiction, fifteen dollars; (5) For providing a replacement copy of a license or
certificate, fifteen dollars; (6) For biennial renewal of any license, thirty- five
dollars; (7) 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 dollars; (8) For processing a late application for renewal of
any license or certificate, fifty dollars; (9) 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; (10) 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; (11) For biennial renewal of authorization to approve
continuing nursing education programs and courses, three hundred dollars; (12) For written verification of a license or certificate,
other than verification to another jurisdiction, five dollars. The Board may contract for services pertaining to this verification process and the collection of such 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, 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.
Section 4723.09 Licensure; Temporary Permit
(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 and the Board determines that the applicant has not committed any act
6 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 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 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.
Section 4723.15 Grandfathering Provisions
(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. (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. (C) Any person who on the effective date of this section
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 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 of the Revised Code.
Section 4723.151 Prohibited Practices
Medical diagnosis, prescription of medical measures, and the practice of medicine or surgery or any of its branches by a nurse are prohibited.
Nothing in this section prohibits a certified registered nurse anesthetist, clinical nurse specialist, certified nursemidwife, or certified nurse practitioner from practicing within the nurse’s scope of practice in accordance with Section 4723.43 of the Revised Code.
Section 4723.24 Renewal of License
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 an application for renewal to every holder of an active license addressed to the last known post office address of the holder 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 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 holder shall report any criminal offense that constitutes grounds for denial of a license 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 last preceding application. The treasurer shall immediately forward the renewal application to the Board, and 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 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.
Every holder shall give written notice to the Board of any change of name or address within thirty days of the change.
7 The Board shall require the holder to document a change of
name in a manner acceptable to the Board. 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, in each two- year period specified by the Board, complete continuing nursing education as follows: (A) For renewal of a license that was issued for a two- year
renewal period, twenty- four hours of continuing nursing education; (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. The Board shall adopt rules establishing the procedure for an applicant to certify to the Board completion of the continuing nursing education. Continuing nursing education may be applied to meet this requirement if it is obtained through a program or course approved by the Board or person authorized by the Board. On request of the Board, an applicant or license holder shall submit satisfactory documentation of completion of the required continuing nursing education. 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 license to practice nursing as a registered nurse.
Except as otherwise provided in Section 4723.28 of the Revised Code, a 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.
Section 4723.25 Approval of Courses Concern- ing Domestic Violence
Not later than ninety days after the effective date of this section, 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.
Section 4723.271 Replacement of License; Veri- fication
The Board of Nursing shall provide a replacement copy of a license or certificate issued under this chapter upon request of the holder accompanied by proper identification as prescribed in rules adopted by the Board and payment of the fee authorized under Section 4723.08 of the Revised Code.
Upon request of the holder of a license issued under this chapter and payment of the fee authorized under Section 4723.08 of the Revised Code, the Board shall verify to an agency of another jurisdiction or foreign country the fact that the person holds such license.
Section 4723.28 Denial of Licensure; Disci- pline of License Holder; Mental or Physical Examinations; Immunity
As used in this section, “dangerous drug” and “prescription” have the same meanings as in Section 4729.02 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 license or certificate to a person found by the Board to have committed fraud in passing the examination or to have committed fraud, misrepresentation, or deception in applying for or securing any license or 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 license or certificate issued by the Board; reprimand or otherwise discipline a holder of a license or 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 a
license to practice nursing, for any reason other than failure to renew, in another state or jurisdiction; or denial, revocation, suspension, or restriction of a license to practice a health care occupation other than nursing, for any reason other than a failure to renew, in Ohio or another state or jurisdiction; (2) Engaging in the practice of nursing, having failed
to renew a license issued under this chapter, or while a license is under suspension; (3) Conviction of, a plea of guilty to, or a judicial
finding of guilt of a misdemeanor committed in the course of practice; (4) Conviction of, a plea of guilty to, or a judicial
finding of guilt of any felony or of any crime involving gross immorality or moral turpitude; (5) Selling, giving away, or administering drugs for
other than legal and legitimate therapeutic purposes; or conviction of, a plea of guilty to, or a judicial finding of guilt of violating any municipal, state, county, or federal drug law; (6) Conviction of, a plea of guilty to, or a judicial
finding of guilt of 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 an act in the course of practice in another jurisdiction that would constitute a misdemeanor in Ohio;
8 (8) Self- administering or otherwise taking into the
body any dangerous drug in any way not in accordance with a legal, valid prescription; (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 that the license
applicant or license holder is mentally ill or mentally incompetent. The Board may restore the license 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 license
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; (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) Aiding and abetting in the unlicensed practice of
nursing; (23) 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, 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. (24) Failure to comply with the terms and conditions
of participation in the alternative program for chemically dependent nurses created by Section 4723.35 of the Revised Code; (25) 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. (26) 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. (C) If a criminal action is brought against a license holder
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 an adjudication hearing to determine whether the license holder committed the act on which the action was based. If the Board determines on the basis of the hearing that the license holder committed the act, or if the license holder fails to participate in the hearing, the Board may take action as though the license holder 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 as described in Divisions (B)( 3) to (7) of this section that is overturned on appeal, the license holder 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 an adjudicatory hearing to determine whether the license holder committed the act on which the original conviction, plea, or judicial determination was based. If the Board determines on the basis of the hearing that the license holder committed such act, or if the license holder does not request a
9 hearing, 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 this section, the Board may
compel any individual licensed by this chapter or who has applied for licensure to submit to a mental or physical examination, or both, as required by the Board and at the expense of the individual. 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 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 licensure to practice. The individual shall be afforded an opportunity to demonstrate to the Board that the individual can resume the individual’s occupation in compliance with acceptable and prevailing standards under the provisions of the individual’s license. For the purpose of this section, any individual who is licensed by this chapter or makes application for licensure shall be deemed to have given the individual’s 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) 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.
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 person licensed by the Board. 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.
If the investigation requires a review of patient records, the investigation and proceeding shall be
conducted in such a manner as to protect patient confidentiality.
All hearings 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) 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) No unilateral surrender of a license issued under this
chapter shall be effective unless accepted by majority vote of the Board. No application for a license issued under this chapter may be withdrawn without a majority vote of the Board. (H) Notwithstanding Division (B)( 23) of this section,
sanctions shall not be imposed against any licensee who waives deductibles and copayments: (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 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.
Section 4723.281 Summary Suspension of Li- cense
(A) As used in this section, with regard to offenses committed in Ohio, “aggravated murder,” “murder,” “voluntary manslaughter,” “felonious assault,” “kidnapping,” “rape,” “sexual battery,” “aggravated arson,” 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
10 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 licensed under this chapter if it determines that there is evidence that the license holder is subject to actions under Division (B) of Section 4723.28 of the Revised Code and that there is clear and convincing evidence that continued practice by the license holder presents a danger of immediate and serious harm to the public. The president and the executive director of the Board 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 the summary suspension. The description of the evidence and information may be given and the vote taken by telephone conference call.
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 holder requests an adjudication hearing, the date set for the hearing shall be within fifteen days but not earlier than seven days after the license holder has requested a hearing, unless another date is agreed to by both the license holder 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. If the Board does not issue such 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 of a person licensed under this chapter is
automatically suspended on that person’s conviction, plea of guilty, or judicial determination of guilt of 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, aggravated arson, or aggravated burglary. The suspension shall remain in effect from the date of the conviction, plea, or finding until an adjudicatory hearing is held under Chapter 119. of the Revised Code. If the Board has knowledge that an automatic suspension has occurred, it shall notify the license holder. If the license holder is notified and either fails to request an adjudicatory hearing within the time periods established by Chapter 119. of the Revised Code or fails to
participate in the hearing, the Board may enter a final order revoking the license.
Section 4723.29 Subpoena Powers
In addition to the powers conferred upon the Board of Nursing by Chapter 119. of the Revised Code, the Board may subpoena witnesses and require their attendance, require the testimony of witnesses and require the production by witnesses of books, papers, public records, and other documentary evidence, and examine them as it may require in relation to any matter which it has authority to investigate, inquire into, or hear.
A subpoena for patient record information shall be issued only upon approval of the executive director of the Board, and the president or another member of the Board designated by the president, in consultation with the Office of the Attorney General. Before issuance of any such subpoena, the executive director and the Office of the Attorney General shall determine whether there is probable cause to believe that the complaint filed alleges a violation of this chapter or any rule of the Board, that the records sought are relevant to the alleged violation and material to the investigation, and that the records cover a reasonable period of time surrounding the alleged violation.
Upon failure to comply with any subpoena issued by the Board and after reasonable notice to the person being subpoenaed, the Board may move for an order compelling the production of persons or records pursuant to Ohio Rules of Civil Procedure.
Each officer who serves such subpoena shall receive the same fees as a sheriff, and each witness who appears, in obedience to a subpoena, before the Board, shall receive the fees and mileage provided for witnesses in civil cases in courts of common pleas.
Section 4723.31 Deposit of Fees; Rotary Fund
Except as provided in Division (A)( 4) of Section 3721.34 and Section 4723.061 of the Revised Code, 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.
Section 4723.32 Exemptions From Licensing Requirement
This chapter does not prohibit: (A) The practice of nursing by students as an integral part of
a program of study leading to initial licensure and approved by the Board of Nursing; (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) The activities of persons employed as nursing aides,
attendants, orderlies, or other auxiliary workers in
11 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) The provision of nursing services to family members or
in emergency situations; (G) The care of the sick when done in connection with the
practice of religious tenets of any church and by its members; (H) The practice of nursing as a certified registered nurse
anesthetist, clinical nurse specialist, certified nursemidwife, or certified nurse practitioner by a student as an integral part 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.
Section 4723.34 Mandatory Reporting
(A) Every employer of registered nurses or licensed practical nurses shall report to the Board of Nursing the name of any person licensed under this chapter whose employment has been terminated voluntarily or involuntarily because of conduct that would be grounds for disciplinary action by the Board under Division (B) of Section 4723.28 of the Revised Code. (B) Nursing associations shall report to the Board the name
of any registered nurse or licensed practical nurse 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 association is not required to report the name of such a nurse if the nurse 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) 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, 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 holder, the charge, and the certified court documents recording the action.
(D) 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.
Section 4723.341 Immunity for Reporting
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.
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, matters subject to 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 shall be subject to any civil action or liable for damages as a result of making the report or testifying.
In the absence of fraud or bad faith, no professional association of individuals who are licensed under this chapter that sponsors a committee or program to provide peer assistance to nurses 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 to a treatment provider designated by the Board or actions or omissions of the provider in treating a nurse.
Section 4723.342 Treatment Provider
The Board of Nursing shall adopt rules in accordance with Chapter 119. of the Revised Code establishing standards for approving and designating treatment providers for impaired nurses and shall approve and designate treatment providers in accordance with the rules. The rules shall include standards for both inpatient and outpatient treatment. The rules shall provide that to be approved, a treatment provider must be capable of making an initial examination to determine the type of treatment required for a nurse with a substance abuse problem. Subject to the rules, the Board shall review and approve treatment providers on a regular basis and may, at its discretion, withdraw or deny approval.
An approved treatment provider shall: (A) Report to the Board the name of any nurse engaging in
or showing evidence of engaging in the conduct described in Division (B)( 8) of Section 4723.28 of the Revised Code, or suffering or showing evidence of suffering impairment as described in Division (B)( 9) or (10) of that section, who fails to comply within one week with a referral for examination; (B) Report to the Board the name of any impaired nurse who
fails to enter treatment within forty- eight hours following the provider’s determination that the nurse needs treatment; (C) Require every nurse who enters treatment to agree to a
treatment contract establishing the terms of treatment and aftercare, including any required supervision or restrictions of practice during treatment or aftercare; (D) Require a nurse to suspend practice on entering any
required inpatient treatment;
12 (E) Report to the Board any failure by an impaired nurse to
comply with the terms of the treatment contract during inpatient or outpatient treatment or aftercare; (F) Report to the Board the resumption of practice of any
impaired nurse before the treatment provider has made a clear determination that the nurse is capable of practicing according to acceptable and prevailing standards of safe nursing care; (G) Require a nurse who resumes practice after completion
of treatment to comply with an aftercare contract that meets the requirements of rules adopted by the Board for approval of treatment providers; (H) Report to the Board any nurse who suffers a relapse at
any time during or following aftercare. Any nurse who enters into treatment by an approved treatment provider shall be deemed to have waived any confidentiality requirements that would otherwise prevent the treatment provider from making reports required under this section.
Section 4723.35 Alternative Program for Chemically Dependent Nurses
(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, as defined in Section
3719.011 of the Revised Code, to the extent that the user becomes physically or psychologically dependent on the drug or endangers the user’s health, safety, or welfare or that of others. (B) The Board of Nursing shall establish a chemical
dependency treatment program, which shall be called the alternative program for chemically dependent nurses. The program shall be available to registered nurses and licensed practical nurses who have a chemical dependency and meet eligibility requirements. The Board shall develop the program and designate an administrator to operate it, and shall adopt rules in accordance with Chapter 119. of the Revised Code that establish the following: (1) Eligibility requirements for participation; (2) Terms and conditions a nurse must meet to
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 registered nurse or licensed practical nurse 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 nurse who voluntarily seeks treatment if it finds that the nurse can be treated effectively and that there is no impairment of ability to practice according to acceptable and prevailing standards of safe nursing care. The Board may require, as a condition of its abstention, that the nurse participate in
the alternative program for chemically dependent nurses, comply with the terms and conditions of the program, and successfully complete it. (D) A nurse who voluntarily participates in the alternative
program for chemically dependent nurses 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 nurse shall report to the Board any failure to comply with the terms and conditions of the program or successfully complete it. (E) Except as provided in Division (F) of this section, all
records, including medical records, chemical dependency records, and mental health records, of a participant in the program shall be confidential, 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
registered nurse or licensed practical nurse shall sign a waiver permitting the program administrator to release to the Board the nurse’s records if the nurse 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 due to chemical dependency. The administrator shall report to the Board any such nurse and release the nurse’s records to it. The Board shall then investigate in accordance with Division (E) of Section 4723.28 of the Revised Code. (G) In the absence of fraud or bad faith, any person reporting
to the program with regard to a nurse’s chemical dependence, or the progress or lack of progress of that nurse with regard to treatment, shall be immune from any civil action and shall not be liable for civil damages as a result of the report.
Section 4723.39 Fees in Excess of Statutory Limits
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.
Section 4723.40 Authority to Request Court Order
In addition to any other remedies provided by law, the Board of Nursing may apply to an appropriate court for an order enjoining the violation of any provision of this chapter, and, upon a showing that any person has violated or is about to violate any provision of this chapter, the court shall grant an order enjoining such violation.
Section 4723.41 Application for a Certificate of Authority
(A) Each person who desires to practice nursing as a certified nurse- midwife and has not been authorized to practice midwifery prior to December 1, 1967, and each person who desires to practice nursing as a certified registered
13 nurse anesthetist, clinical nurse specialist, or certified
nurse practitioner shall file with the Board of Nursing a written application for authorization to practice nursing in the desired specialty, under oath, on a form prescribed by the Board.
At the time of making application, the applicant shall meet all of the following requirements: (1) Be a registered nurse; (2) Except as provided in Divisions (B) and (D) of
this section, submit documentation satisfactory to the Board that the applicant has earned at least a
master’s degree with a major in a nursing specialty or in a related field that qualifies the applicant to sit for the certification examination of a national certifying organization listed in Division (A)( 3) of this section or approved by the Board under Section 4723.46 of the Revised Code; (3) Except as provided in Division (C) of this section,
submit documentation satisfactory to the Board of having passed the certification examination of one of the following: (a) If the applicant is applying to practice
nursing as a certified nurse- midwife, the American College of Nurse- Midwives or another national certifying organization approved by the Board under Section 4723.46 of the Revised Code to examine and certify nurse- midwives; (b) If the applicant is applying to practice
nursing as a certified registered nurse anesthetist, the National Council on Certification of Nurse Anesthetists, of the National Council on Recertification of Nurse Anesthetists of the American Association of Nurse Anesthetists, or another national certifying organization approved by the Board under Section 4723.46 of the Revised Code to examine and certify registered nurse anesthetists; (c) If the applicant is applying to practice
nursing as a clinical nurse specialist, the American Nurses Credentialing Center or another national certifying organization approved by the Board under Section 4723.46 of the Revised Code to examine and certify clinical nurse specialists; (d) If the applicant is applying to practice
nursing as a certified nurse practitioner, the American Nurses Credentialing Center, the National Certification Corporation, the National Board of Pediatric Nurse Practitioners and Associates, or another national certifying organization approved by the Board under Section 4723.46 of the Revised Code to examine and certify nurse practitioners. (4) Submit an affidavit with the application that states
all of the following: (a) That the applicant is the person named in
the documents submitted under Divisions (A)( 2) and (3) of this section and is the
lawful possessor thereof; (b) The applicant’s age, residence, the school
at which the applicant obtained education in the applicant’s nursing specialty, and any other facts that the Board requires; (c) If the applicant is already engaged in the
practice of nursing as a certified registered nurse anesthetist, clinical nurse specialist, certified nurse- midwife, or certified nurse practitioner, the period during which and the place where the applicant is engaged; (d) If the applicant is already engaged in the
practice of nursing as a clinical nurse specialist, certified nurse- midwife, or certified nurse practitioner, the names and business addresses of the applicant’s current collaborating physicians and podiatrists. If the applicant is not yet engaged in the practice of nursing as a clinical nurse specialist, certified nursemidwife, or certified nurse practitioner, the applicant shall submit the names and business addresses of the applicant’s collaborating physicians or podiatrists not later than thirty days after first engaging in the practice. The applicant shall give written notice to the Board of any additions or deletions to the affidavit of collaborating physicians or podiatrists not later than thirty days after the change takes effect. (B) On or before December 31, 2000, the Board shall issue
to an applicant a certificate of authority to practice nursing as a certified registered nurse anesthetist, certified nurse- midwife, or certified nurse practitioner if the applicant complies with all requirements of this section, other than the requirement that the applicant has earned at least a master’s degree with a major in a nursing specialty or in a related field that qualifies the applicant to sit for the certification examination of a national certifying organization listed in Division (A)( 3) of this section or approved by the Board under Section 4723.46 of the Revised Code. (C) On or before December 31, 2000, the Board shall issue
to an applicant a certificate of authority to practice nursing as a clinical nurse specialist if the applicant complies with all requirements of this section, other than the requirement of having passed a certification examination. (D) On or before December 31, 2008, the Board shall issue
to an applicant a certificate of authority to practice nursing as a certified nurse practitioner if the applicant has successfully completed a nurse practitioner certificate program that receives funding under and is employed by a public agency or a private, nonprofit entity that receives funding under Title X of the Pubic Health Service Act, 42 U. S. C. 300 and 300a- 1 (1991), and complies with all requirements of this section, other than the requirement that the applicant has earned at least a master’s degree with a major in a nursing specialty or in a related field that qualifies the applicant
14 to sit for the certification examination of a national
certifying organization listed in Division (A)( 3) of this section or approved by the Board under Section 4723.46 of the Revised Code. (E) A certified registered nurse anesthetist, clinical nurse
specialist, certified nurse- midwife, or certified nurse practitioner who is practicing as such in another jurisdiction may apply for a certificate of authority to practice nursing as a certified registered nurse anesthetist, clinical nurse specialist, certified nursemidwife, or certified nurse practitioner in this state if the nurse meets the requirements for a certificate of authority set forth in this section. The application shall be submitted to the Board in the form prescribed by rules of the Board and be accompanied by the application fee required by Section 4723.08 of the Revised Code. The application shall include evidence that the applicant meets the requirements of this section, holds a license or certificate to practice nursing as a certified registered nurse anesthetist, clinical nurse specialist, certified nurse- midwife, or certified nurse practitioner in good standing in another jurisdiction granted after meeting requirements approved by the entity of that jurisdiction that licenses nurses, and other information required by rules of the Board of Nursing.
If the applicant is a certified registered nurse anesthetist, certified nurse- midwife, or certified nurse practitioner who, on or before December 31, 2000, met the requirements of this section to practice as such and
has maintained certification in the applicant’s 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, Division (B) of this section shall apply.
If the applicant is a clinical nurse specialist who, on or before December 31, 2000, met the requirements of this section to practice as such and has earned at least a master’s degree with a major in a nursing specialty or in a related field that qualifies the applicant to sit for the certification examination of a national certifying organization listed in Division (A)( 3) of this section or approved by the Board under Section 4723.46 of the Revised Code, Division (C) of this section shall apply.
Section 4723.42 Authorization to Practice
(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 nursemidwife, 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. Not
later than fifteen days after receipt of an application, the Board shall provide the applicant with written notice, by mail, of any required documents that remain to be submitted.
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, 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. Failure of the 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 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 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 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
15 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 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.
Section 4723.43 Scope of Practice
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 nursemidwife, in collaboration with 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. (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. 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 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. 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 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. 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.
Section 4723.431 Standard Care Arrangement
(A) Except as provided in Division (C) of this section, a clinical nurse specialist, certified nurse- midwife, or certified nurse practitioner may practice only in accordance with a standard care arrangement entered into with one or more collaborating physicians or podiatrists whose practice is the same as or similar to the nurse’s nursing specialty. The standard care arrangement shall be in writing and contain all of the following: (1) Criteria for referral of a patient by the clinical
nurse specialist, certified nurse- midwife, or certified nurse practitioner to a collaborating physician or podiatrist; (2) A process for the clinical nurse specialist, certified
nurse- midwife, or certified nurse practitioner to obtain a consultation with the physician or podiatrist; (3) A plan for coverage in instances of emergency or
planned absences of either the clinical nurse specialist, certified nurse- midwife, or certified nurse practitioner or the collaborating physician or podiatrist that provides the means whereby a physician or podiatrist is available for emergency care; (4) The process for resolution of disagreements
regarding matters of patient management between the clinical nurse specialist, certified nursemidwife, or certified nurse practitioner and the collaborating physician or podiatrist; (5) A procedure for a regular review of the referrals
by the clinical nurse specialist, certified nursemidwife, or certified nurse practitioner to other health care professionals and the care outcomes for a random sample of all patients seen by the nurse; (6) If the clinical nurse specialist or certified nurse
practitioner regularly provides services to infants,
16 a policy for care of infants up to age one and
recommendations for collaborating physician visits for children from birth to age three; (7) Any other criteria required by rule of the Board
adopted pursuant to Section 4723.07 of the Revised Code. (B) The standard care arrangement shall be retained on file
at the site where the clinical nurse specialist, certified nurse- midwife, or certified nurse practitioner practices by the nurse and the collaborating physician or podiatrist. Prior approval of the standard care arrangement by the Board of Nursing is not required, but the Board may periodically review it for compliance with this section. (C) A clinical nurse specialist whose nursing specialty is
mental health or psychiatric mental health, as determined by the Board, is not required to enter into a standard care arrangement with a collaborating physician, but shall practice in collaboration with physicians. (D) Nothing in this section 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 implementaion of the arrangement at the hospital.
Section 4723.44 Prohibited Practice
(A) No person shall do any of the following unless the person holds a current, valid certificate of authority to practice nursing as a certified registered nurse anesthetist, clinical nurse specialist, certified nursemidwife, or certified nurse practitioner issued by the Board of Nursing under this chapter: (1) Engage in the practice of nursing as a certified
registered nurse anesthetist, clinical nurse specialist, certified nurse- midwife, or certified nurse practitioner for a fee, salary, or other consideration, or as a volunteer; (2) Hold herself or himself out as being a certified
registered nurse anesthetist, clinical nurse specialist, certified nurse- midwife, or certified nurse practitioner; (3) Use any title or initials implying that the person is
a certified registered nurse anesthetist, clinical nurse specialist, certified nurse- midwife, or certified nurse practitioner. (B) No person who is not certified by the National Council
on Certification of Nurse Anesthetists of the American Association of Nurse Anesthetists, the National Council on Recertification of Nurse Anesthetists of the American Association of Nurse Anesthetists, or another national certifying organization approved by the Board under Section 4723.46 of the Revised Code shall use the title “Certified Registered Nurse Anesthetist” or the initials “C. R. N. A.”, or any other title or initial implying that the person has been certified by the council or organization.
(C) No certified registered nurse anesthetist, clinical nurse specialist, certified nurse- midwife, or certified nurse practitioner shall do any of the following: (1) Engage, for a fee, salary, or other consideration,
or as a volunteer, in the practice of a nursing specialty other than the specialty designated on the nurse’s current, valid certificate of authority issued by the Board under this chapter; (2) Hold herself or himself out as being authorized to
practice any nursing specialty other than the specialty designated on the current, valid certificate; (3) Use the title “Certified Registered Nurse
Anesthetist” or the initials “N. A.” or “C. R. N. A.,” the title “Clinical Nurse Specialist” or the initials “C. N. S.,” the title “Certified Nurse- Midwife” or the initials “C. N. M.,” the title “Certified Nurse Practitioner” or the initials “C. N. P.,” or any other title or initials implying that the nurse is authorized to practice any nursing specialty other than the specialty designated on the nurse’s current, valid certificate; (4) Enter into a standard care arrangement with a
physician or podiatrist whose practice is not the same or similar to the nurse’s nursing specialty. (D) No person shall knowingly employ a person to engage in
the practice of nursing as a certified registered nurse anesthetist, clinical nurse specialist, certified nursemidwife, or certified nurse practitioner unless the person so employed holds a current, valid certificate of authority to engage in that nursing specialty issued by the Board under this chapter. (E) A certificate certified by the executive director of the
Board, under the official seal of the Board, to the effect that it appears from the records that no certificate of authority to practice nursing as a certified registered nurse anesthetist, clinical nurse specialist, certified nurse- midwife, or certified nurse practitioner has been issued to any person specified therein, or that a certificate, if issued, has been revoked or suspended, shall be received as prima- facie evidence of the record in any court or before any officer of the state.
Section 4723.45 Board of Nursing Successor for Nurse- Midwifery; Transfer of Functions and Responsibilities From the Medical Board
The Board of Nursing is hereby deemed to be the successor to the state medical board with regard to all matters related to the practice of nurse- midwifery that were the responsibility of the medical board under former Sections 4731.30, 4731.32, 4731.33, 4731.341, and 4731.42 of the Revised Code. The Board of Nursing shall assume all of the functions and responsibilities of the medical board with regard to such matters. Any matters related to the practice of nurse- midwifery pending under such sections on the effective date of this section shall be immediately transferred by the medical board to the Board of Nursing accompanied by any records necessary for the Board of Nursing to act.
No legal action pending on the effective date of this section shall be affected by the transfer of functions and
17 responsibilities made by this section. Any such action shall be
prosecuted or defended in the name of the Board of Nursing and, on application of the Board of Nursing, the court shall substitute the Board of Nursing as a party.
Any person who holds a certificate to practice nurse- midwifery issued by the state medical board under Chapter 4731. of the Revised Code is hereby deemed to be certified under this chapter to practice as a nurse- midwife. No right, privilege, or remedy shall be lost or impaired by reason of the transfer of functions and responsibilities under this section from the medical board to the Board of Nursing. All of the rules, orders, actions, and determinations of the medical board with regard to matters related to the practice of nurse- midwifery that were the responsibility of the medical board under former Sections 4731.30, 4731.32, 4731.33, 4731.341, and 4731.42 of the Revised Code shall continue in effect as the rules, orders, determinations, and actions of the Board of Nursing until modified or rescinded by the Board of Nursing.
Within thirty days after the effective date of this section, the medical board shall transfer to the Board of Nursing all records regarding matters related to the practice of nurse- midwifery that were the responsibility of the medical board under former Sections 4731.30, 4731.32, 4731.33, 4731.341, and 4731.42 of the Revised Code.
Section 4723.46 Requirement for Approval of National Certifying Organizations
(A) The Board of Nursing shall establish a list of national certifying organizations approved by the Board to examine and certify registered nurses to practice nursing specialties. To be approved by the Board, a national certifying organization must meet all of the following requirements: (1) Be national in the scope of its credentialing; (2) have an educational requirement beyond that
required for registered nurse licensure; (3) Have practice requirements beyond those required
for registered nurse licensure; (4) Have testing requirements beyond those required
for registered nurse licensure that measure the theoretical and clinical content of a nursing specialty, are developed in accordance with accepted standards of validity and reliability, and are open to registered nurses who have successfully completed the educational program required by the organization; (5) Issue certificates to certified registered nurse
anesthetists, clinical nurse specialists, certified nurse- midwives, or certified nurse practitioners; (6) Periodically review the qualifications of certified
registered nurse anesthetists, clinical nurse specialists, certified nurse- midwives, or certified nurse practitioners. (B) Not later than the thirtieth day of January of each year,
the Board shall publish the list of national certifying organizations that have met the requirements of Division (A) of this section within the previous year and remove from the list organizations that no longer meet the requirements.
Section 4723.47 Automatic Suspension or Re- vocation of Certificate of Authority
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 automatically suspended 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.
Section 4723.51 Advanced Practice Definitions
As used in Sections 4723.52 to 4723.59 of the Revised Code: (1) “Advanced practice nurse” 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. (2) “Physician” means an individual who holds a certificate
issued under Chapter 4731. of the Revised Code authorizing him to practice medicine and surgery or osteopathic medicine and surgery.
Section 4723.52 Pilot Programs Utilizing Ad- vanced Practice Nurses
(A) The school of nursing of Case Western Reserve University, the school of nursing of Wright State University, and the University of Cincinnati College of Nursing and Health shall each establish a pilot program to provide access to health care in underserved areas through the use of advanced practice nurses. Each pilot program shall be operated by the nursing faculty of the university at which it is established. Each pilot program shall cease to exist on January 1, 2010.
An advisory committee shall be established for each of the pilot programs. The dean of the medical school at Case Western Reserve University shall appoint two physicians to serve on the advisory committee of the university’s pilot program. The dean of the medical school at Wright State University shall appoint two physicians to serve on the advisory committee of the university’s pilot program. The dean of the medical school at the University of Cincinnati shall appoint two physicians to serve on the advisory committee of the university’s pilot program. To be appointed, a physician must have experience working with registered nurses who are approved as advanced practice nurses under Section 4723.55 of the Revised Code or, until one year after the Board of Nursing begins approving nurses under that section, nurses who are qualified to be approved under that section. (B) The advisory committee of each pilot program shall
develop a standard care arrangement in accordance with rules adopted by the Board of Nursing under Section
18 4723.54 of the Revised Code. The standard care
arrangement applies only to the advanced practice nurses included in the pilot program for which it is developed. Each advisory committee shall submit a copy of its standard care arrangement to the Board of Nursing for review within thirty days after the Board adopts final rules under Division (A) of Section 4723.54 of the Revised Code. (C) Each standard care arrangement shall establish
conditions under which an advanced practice nurse must refer a patient to a physician and procedures for quality assurance reviews of advanced practice nurses by the advisory committee, and shall comply with any other requirements established by the Board of Nursing in rules adopted under Section 4723.54 of the Revised Code. (D) Biennially, each pilot program shall submit a written
report of its operation to the governor, the speaker of the House of Representatives, the president of the Senate, the Board of Nursing, the state medical board, the state board of pharmacy, the department of health, and the Formulary Committee for Advanced Practice Nurses established under Section 4723.57 of the Revised Code. The first report shall be submitted no later than July 1, 1994.
Section 4723.53 Reimbursement Under Medical Assistance Program
Subject to the availability of federal funds, services provided by advanced practice nurses under the pilot programs established by Section 4723.52 of the Revised Code are eligible for reimbursement under the medical assistance program established under Chapter 5111. of the Revised Code and shall be reimbursed in accordance with rules adopted under Division (B) of Section 5111.02 of the Revised Code.
Section 4723.54 Board Rule Making Authority Regarding Advanced Practice Nurses
In accordance with Chapter 119. of the Revised Code, the Board of Nursing shall adopt rules that establish the following: (A) Requirements for standard care arrangements developed
under Section 4723.52 of the Revised Code; (B) Standards and procedures for the approval and renewal
of approval of registered nurses as advanced practice nurses under Section 4723.55 of the Revised Code; (C) Criteria specifying the types of experience necessary
under Division (B) of Section 4723.55 of the Revised Code to receive approval as an advanced practice nurse; (D) Application fees, not to exceed fifty dollars, for approval
and renewal of approval of advanced practice nurses; (E) Application fees, not to exceed fifty dollars, for approval
and renewal of approval to prescribe drugs and therapeutic devices; (F) Any other procedures, standards, and requirements
necessary to conduct its duties with regard to the pilot programs established by Section 4723.52 of the Revised Code.
Section 4723.55 Approval of Advanced Practice Nurses
(A) For purposes of the pilot programs established by Section 4723.52 of the Revised Code, the Board of Nursing may approve registered nurses as advanced practice nurses. The Board shall not approve as an advanced practice nurse a person who is practicing as a Certified Registered Nurse Anesthetist.
Any individual who desires to receive approval shall submit a written application to the Board of Nursing on forms the Board shall prescribe and furnish. The application shall be accompanied by the fee established in rules adopted under Section 4723.54 of the Revised Code and shall include any information the Board requires pursuant to rules adopted under that section. (B) The Board may approve an applicant as an advanced
practice nurse if the applicant has completed no less than three years of experience in the practice of nursing as a registered nurse that meets the criteria specified by the Board pursuant to rules adopted under Section 4723.54 of the Revised Code and either of the following applies: (1) The applicant is a nurse- midwife holding a
current, valid certificate issued under Section 4723.42 of the Revised Code and is certified by the American College of Nurse- Midwives; (2) The applicant is a registered nurse certified as a
clinical nurse specialist or nurse practitioner by a national certifying organization recognized by the Board. (C) For purposes of Division (B) of this section, the Board of
Nursing may recognize a national certifying organization if all of the following apply: (1) The organization’s certification standards
prescribe minimum educational and professional experience requirements beyond those required for licensure as a registered nurse, including completion of a course of study in advanced practice nursing; (2) The organization’s certification standards require
successful completion of an examination acceptable to the Board of Nursing; (3) The organization establishes professional titles
and initials for use by those it certifies that are acceptable to the Board of Nursing. (C) Approval under this section as a advanced practice nurse
is valid for two years. The Board may renew its approval of an advanced practice nurse if the nurse submits a written application to the Board on forms the Board shall prescribe and furnish. The application shall be accompanied by the renewal fee established in rules adopted under Section 4723.54 of the Revised Code and shall include any information the Board requires pursuant to rules adopted under that section.
Section 4723.56 Requirements for Authority to Prescribe Drugs and Therapeutic Devices; Collaborating Physician; Protocols; Continuing Education
(A) For purposes of the pilot programs established by Section 4723.52 of the Revised Code, the Board of Nursing may approve an advanced practice nurse to
19 prescribe drugs and therapeutic devices if the nurse
submits to the Board all of the following: (1) Evidence of having attained at least a master’s
degree in nursing from an accredited institution recognized by the Board; (2) Evidence of completing the pharmacology
instruction required by Division (B) of this section; (3) A copy of the protocol established between the
nurse and the nurse’s collaborating physician that meets the requirements of Division (C) of this section and receives approval from the Formulary Committee for Advanced Practice Nurses established under Section 4723.57 of the Revised Code; (4) Any other information the Board requires
pursuant to rules adopted under Section 4723.58 of the Revised Code; (5) The fee established in rules adopted under Section
4723.54 of the Revised Code. (B) To receive approval under this section to prescribe drugs
and therapeutic devices, an advanced practice nurse must have completed a minimum of thirty hours of instruction in pharmacology. The instruction must have been completed within three years prior to application for the approval, unless the Board of Nursing established by rules adopted under Section 4723.58 of the Revised Code another time period within which the instruction must have been completed. The instruction may have been received through either of the following: (1) Planned classroom, clinical, or provider- directed
independent study in pharmacology from an accredited institution recognized by the Board of Nursing; (2) Pharmacology courses determined to be
acceptable by the Board pursuant to rules adopted under Section 4723.58 of the Revised Code. (C) Each advanced practice nurse who desires to receive
approval under this section to prescribe drugs and therapeutic devices shall enter into an arrangement with a collaborating physician. The advanced practice nurse and the collaborating physician shall develop a written protocol that establishes the arrangement between the nurse and the physician. The protocol shall include the following: (1) The drugs that the advanced practice nurse may
prescribe and the limitations on the authority to prescribe them, including any restrictions on dosage units or refills, in accordance with the formulary established in rules adopted under Section 4723.58 of the Revised Code; (2) The conditions under which the advanced practice
nurse must refer patients to the collaborating physician or another physician; (3) The responsibilities of the collaborating
physician; (4) Procedures for quality assurance reviews of the
advanced practice nurse by the collaborating physician. (D) (1) On receipt of a protocol under Division (A) of this
section, the Board shall submit the protocol to the Formulary Committee for Advanced Practice
Nurses for the committee’s review. An advanced practice nurse shall prescribe drugs and therapeutic devices only in accordance with a protocol approved by the committee. (2) If an advanced practice nurse and collaborating
physician propose to make a change in an approved protocol, the advanced practice nurse shall file the proposed change with the Board of Nursing at least thirty days prior to the date on which the proposed change is intended to become effective. The Board shall submit the proposed change to the Formulary Committee for the committee’s review. The advanced practice nurse and collaborating physician shall implement the change only if it is approved by the committee. (E) Notwithstanding any other provision of this chapter or
Chapter 2925., 3719., 4729., or 4731. of the Revised Code to the contrary, an advanced practice nurse approved under this section may prescribe drugs and therapeutic devices as specified in the protocol established between the nurse and the collaborating physician and may personally supply drugs and therapeutic devices in accordance with Section 4723.561 of the Revised Code. (F) Approval under this section to prescribe and personally
supply drugs and therapeutic devices is valid for two years. The Board may renew its approval to prescribe drugs and therapeutic devices if the nurse submits to the Board all of the following: (1) Evidence of completing during the previous two
years at least twelve hours of continuing education in pharmacology from an accredited institution recognized by the Board; (2) A written recommendation for renewal from the
nurse’s collaborating physician; (3) Any other information the Board requires
pursuant to rules adopted under Section 4723.58 of the Revised Code; (4) The fee established in rules adopted under Section
4723.50 of the Revised Code. (G) The continuing education required by this section is in
addition to the continuing education required under Section 4723.24 of the Revised Code. (H) Application for approval under this section may be made
at the same time that application is made for approval under Section 4723.55 of the Revised Code or at any time subsequent to receiving approval under that section.
Section 4723.561 Advanced Practice Nurses Personally Supplying Certain Drugs to Patients
An advanced practice nurse approved by the Board of Nursing under Section 4723.56 of the Revised Code to prescribe drugs and therapeutic devices as part of a pilot program established under Section 4723.52 of the Revised Code may personally supply to patients the following drugs and devices that are within the advanced practice nurse’s authority to prescribe: antibiotics, antifungals, scabicides, contraceptives, and prenatal vitamins.
20 The advanced practice nurse shall maintain a written
record of drugs and devices personally supplied under this section. For each drug or device supplied, the collaborating physician shall review the record within seventy- two hours after the drug or device is supplied.
Section 4723.57 Composition of the Formulary Committee; Duties
(A) There is hereby created the Formulary Committee for Advanced Practice Nurses. Three members of the committee shall be advanced practice nurses appointed by the Board of Nursing, each of whom shall hold at
least a master’s degree in nursing. One of these members shall be a nurse- midwife certified by the American College of Nurse- Midwives, one shall be a nurse practitioner certified as such by a national certifying organization recognized by the Board of Nursing in accordance with Section 4723.55 of the Revised Code, and one shall be a clinical nurse specialist certified as such by a national certifying organization recognized by the Board of Nursing in accordance with Section 4723.55 of the Revised Code. Three members shall be physicians appointed by the state medical board who have experience working with advanced practice nurses. One member shall be a pharmacist appointed by the state board of pharmacy. The director of health or his designee shall serve as a nonvoting member of the Formulary Committee.
Initial appointments to the Formulary Committee shall be made within sixty days after the effective date of this section. Vacancies shall be filled in the manner provided for original appointments.
Annually, the Formulary Committee shall organize by selecting a chairman from its voting members. For the committee to take any action, the action must be approved by affirmative vote of at least four voting members, of which two must be advanced practice nurses and two must be physicians. Members shall serve without compensation but shall be reimbursed by the Board of Nursing for their actual and necessary expenses incurred in carrying out their duties as committee members. (B) The Formulary Committee shall make recommendations
to the Board of Nursing regarding the Board’s adoption of rules under Section 4723.58 of the Revised Code. It shall review, and approve or disapprove, each protocol and proposed change to a protocol it receives from the Board of Nursing pursuant to Section 4723.56 of the Revised Code.
Section 4723.58 Board Rule Making Authority Regarding Prescribing Drugs and Therapeutic De- vices
(A) In accordance with Chapter 119. of the Revised Code, the Board of Nursing shall adopt rules regarding the approval of advanced practice nurses under Section 4723.56 of the Revised Code to prescribe drugs and therapeutic devices. The rules shall be consistent with the recommendations of the Formulary Committee for Advanced Practice Nurses and shall establish all of the following:
(1) A formulary listing the drugs and therapeutic devices, including types and classes where appropriate, that may be prescribed by advanced practice nurses; (2) Requirements pertaining to the protocol that is
required to be established between an advanced practice nurse and the nurse’s collaborating physician; (3) Requirements regarding the pharmacology
courses that an advanced practice nurse is required to complete to receive approval or renewal of approval to prescribe drugs and therapeutic devices; (4) Standards and procedures for approval and
renewal of approval of advanced practice nurses to prescribe drugs and therapeutic devices; (5) Any other requirements with regard to advanced
practice nurses approved to prescribe drugs and therapeutic devices. (B) The drugs included in the formulary shall not include
any drug listed on Schedule I or II, as specified in Section 3719.41 of the Revised Code. The formulary may include restrictions and requirements for prescriptions and shall include requirements specific to advanced practice nursing.
Section 4723.59 Practice of Advanced Practice Nurses; Unprofessional Conduct
(A) An advanced practice nurse shall practice as an advanced practice nurse only in accordance with the standard care arrangement developed under Section 4723.52 of the Revised Code for the pilot program in which the nurse is participating. An advanced practice nurse who does not follow the standard care arrangement is guilty of unprofessional conduct and is subject to disciplinary action under Section 4723.28 of the Revised Code for violation of this chapter and the rules adopted under it. (B) An advanced practice nurse approved under Section
4723.56 of the Revised Code shall prescribe drugs and therapeutic devices specified in the protocol established between the nurse and the collaborating physician only in accordance with the protocol. An advanced practice nurse approved under Section 4723.56 of the Revised Code shall personally supply drugs and therapeutic devices in accordance with Section 4723.561 of the Revised Code. Any advanced practice nurse who does not follow the protocol or personally supply drugs and devices in accordance with Section 4723.561 of the Revised Code is guilty of unprofessional conduct and is subject to disciplinary action under Section 4723.28 of the Revised Code for violation of this chapter and the rules adopted under it. (C) Any collaborating physician who does not perform the
responsibilities the physician agreed to perform in the protocol established between the physician and an advanced practice nurse in accordance with Section 4723.56 of the Revised Code is guilty of unprofessional conduct and is subject to disciplinary action by the state medical board. Under this division, the state medical board may revoke, limit, or suspend the physician’s
21 certificate to practice, pursuant to an adjudicatory
hearing under Chapter 119. of the Revised Code and vote of not less than six of its members.
Section 4723.60 Deposit of Application Fees; Rotary
All application fees for approval and renewal of approval of advanced practice nurses collected under Section 4723.55 of the Revised Code shall be deposited in the state treasury to the credit of the occupational licensing and regulatory fund.
Section 4723.61 Rule Making Authority for Delegation to ICF/ MR Workers
(A) As used in this section, “ICF/ MR” and “ICF/ MR worker” have the same meanings as in Section 5123.193 of the Revised Code. (B) The Board of Nursing shall adopt rules as necessary to
govern the delegation specified in Section 5123.193 of the Revised Code. The Board shall adopt initial rules not later than ninety days after the effective date of this section. The rules shall be adopted in accordance with Chapter 119. of the Revised Code and establish the following: (1) Standards that an instructional program must meet
to be approved as a program that trains registered nurses to instruct ICF/ MR workers to give oral and apply topical medications, including the minimum types of information that must be covered in the program and the minimum qualifications the instructional personnel must possess. To qualify for approval, a program must be at least a one- day program and have been approved as a faculty- directed continuing nursing education activity pursuant to rules adopted under Section 4723.07 of the Revised Code. (2) Standards that a unit of instruction must meet to
be approved as an independent study module for nurses on the instruction of medication courses for ICF/ MR workers and the statutes and rules applicable to those workers. To qualify for approval, an independent study module must have been approved as a continuing nursing education activity pursuant to rules adopted under Section 4723.07 of the Revised Code. (3) Standards that a registered nurse must meet to be
eligible to teach ICF/ MR workers to give oral or apply topical medications. With regard to training, the nurse must successfully complete one of the following: (a) An approved training program that trains
registered nurses to instruct ICF/ MR workers in giving oral and applying topical medications; (b) An approved training program given by the
department of mental retardation and developmental disabilities that trains nurses to be instructors of the training program described in the “Program Manual for Implementation of the Medication Administration by Unlicensed Personnel in ICF/ MR Group Homes of 15 Beds or Less,”
as developed by the departments of health and mental retardation and developmental disabilities, a well as an independent study module for nurses on the instruction of medication courses for ICF/ MR workers and the statutes and rules applicable to those workers. (4) Standards that a nurse must meet to remain
eligible to instruct ICF/ MR workers in giving oral and applying topical medications; (5) Standards that a course of instruction must meet to
be approved as a medication course for ICF/ MR workers, including the minimum types of information that must be covered in the course. The course must be conducted by a registered nurse, except that the Board’s standards may allow the use of other health care professionals listed in Division (A) of Section 5123.193 of the Revised Code to provide instruction within the scope of their professions, including licensed practical nurses acting under the direction of registered nurses. (6) Standards an ICF/ MR worker must meet to be
eligible to take the medication course for ICF/ MR workers and to demonstrate successful completion of the course; (7) Standards for the annual training an ICF/ MR
worker must complete to remain eligible to give oral and apply topical medications; (8) Standards nurses must follow in delegating
authority to give oral or apply topical medications in an ICF/ MR, including any conditions or limits pertaining to the delegation; (9) Standards nurses must follow in providing on- site
or off- site direction and supervision of ICF/ MR workers who have been authorized to give oral or apply topical medications; (10) Standards ICF/ MR workers must follow when
giving oral or applying topical medications to ICF/ MR residents. (C) The approval of programs, courses, and training modules
pertaining to delegation of authority to give oral or apply topical medications may be made by the Board of Nursing or by an entity the Board recognizes as an approver of instructional programs. (D) The Board of Nursing may accept complaints from any
person or entity regarding the performance or qualifications of an ICF/ MR worker to give oral or apply topical medications under Section 5123.193 of the Revised Code. The Board shall refer all complaints received to the department of mental retardation and developmental disabilities. The Board may participate in an investigation of a complaint being conducted by the department under Section 5123.193 of the Revised Code.
Section 4723.62 Delegation in MR/ DD County Board Facilities
(A) As used in this section, “county board client,” “county board worker,” “delegated nursing task,” “health care professional,” “nurse,” and “prescribed medication” have
22 the same meanings as in Section 5126.35 of the Revised
Code. (B) (1) Not later than ninety days a