Chapter 4723-8 Advanced Practice Registered Nurse Certification and Practice

4723-8-01 Definitions.

As used in this chapter:

(A) "Advanced practice registered nurse" means a certified registered nurse anesthetist, clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner as provided in division (O) of section 4723.01 of the Revised Code.

(B) "Certificate of authority" means the certificate issued by the board and held by an advanced practice registered nurse who has fulfilled all requirements of the board set forth in section 4723.41 of the Revised Code and this chapter.

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

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

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

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

(G) "Collaboration" or "collaborating" means:

(1) In the case of a certified nurse practitioner or a clinical nurse specialist, except as provided in paragraph (G)(2) of this rule, that a podiatrist or physician has entered into a standard care arrangement with the nurse and is continuously available to communicate with the clinical nurse specialist or certified nurse practitioner either in person, or by radio, telephone, or other form of telecommunication;

(2) 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; or

(3) In the case of a certified nurse-midwife, that a physician has entered into a standard care arrangement with the nurse and is continuously available to communicate with the nurse either in person, or by radio, telephone, or other form of telecommunication.

(H) "Dentist" means an individual holding a license issued under Chapter 4715. of the Revised Code to practice dentistry, and who is practicing in Ohio.

(I) "Physician" means an individual holding a certificate issued under Chapter 4731. of the Revised Code authorizing the practice of medicine and surgery or osteopathic medicine and surgery, and who is practicing in Ohio.

(J) "Podiatrist" means an individual holding a certificate issued under Chapter 4731. of the Revised Code authorizing the practice of podiatric medicine, and who is practicing in Ohio.

(K) "Standard care arrangement" means a written, formal guide for planning and evaluating a patient's health care that is developed by a collaborating physician or podiatrist and a certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist, and that meets the requirements of section 4723.431 of the Revised Code and this chapter.

(L) "Supervision" means that a certified registered nurse anesthetist is under the direction of a podiatrist, a dentist, or a physician, and, when administering anesthesia, the certified registered nurse anesthetist is in the immediate presence of the podiatrist, dentist, or physician.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/01/2015
Promulgated Under: 119.03
Statutory Authority: 4723.07
Rule Amplifies: 4723.01 , 4723.43
Prior Effective Dates: 04/01/1997, 02/01/2002, 04/01/2006, 11/5/2012

4723-8-02 Standards of practice.

(A) An advanced practice registered nurse shall provide to patients nursing care that requires knowledge and skill obtained from advanced formal education, which includes a clinical practicum, and clinical experience as specified in sections 4723.41 and 4723.43 of the Revised Code and this chapter.

(B) Except as otherwise precluded by law or rule, each advanced practice registered nurse shall practice in accordance with the following:

(1) The advanced practice registered nurse's education and clinical experience;

(2) The advanced practice registered nurse's national certification as provided in section 4723.41 of the Revised Code; and

(3) Chapter 4723. of the Revised Code and rules adopted under that chapter.

(C) Only a certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist authorized under section 4723.48 of the Revised Code may prescribe drugs.

(D) Each certified nurse-midwife, certified nurse practitioner, and clinical nurse specialist shall utilize and incorporate into the nurse's practice, knowledge of Chapter 4731. of the Revised Code and rules adopted under that chapter that govern the practice of the nurse's collaborating physician or podiatrist. Each certified registered nurse anesthetist shall utilize and incorporate into the nurse's practice, knowledge of Chapters 4715. and 4731. of the Revised Code and rules adopted under these chapters that govern the practice of the nurse's supervising podiatrist, dentist, or physician.

(E) Nothing in this rule precludes an advanced practice registered nurse from practicing as a registered nurse in accordance with section 4723.01 of the Revised Code and the rules of the board.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.07
Rule Amplifies: 4723.01 , 4723.43
Prior Effective Dates: 04/01/1997, 04/01/1998, 02/01/2003, 02/01/2004, 04/01/2006, 02/01/2011, 11/05/2012

4723-8-03 Title protection.

(A) Only a person who holds a current valid certificate of authority issued in accordance with section 4723.41 of the Revised Code and this chapter may use the following titles or initials:

(1) Certified nurse-midwife, C.N.M., certified registered nurse-midwife, or C.R.N.M., if the individual is authorized to practice in accordance with division (A) of section 4723.43 of the Revised Code;

(2) Clinical nurse specialist, C.N.S., clinical registered nurse specialist, or C.R.N.S., if the individual is authorized to practice in accordance with division (D) of section 4723.43 of the Revised Code;

(3) Certified nurse practitioner, C.N.P., certified registered nurse practitioner, or C.R.N.P., if the individual is authorized to practice under division (C) of section 4723.43 of the Revised Code;

(4) Certified registered nurse anesthetist or C.R.N.A., if the individual is authorized to practice in accordance with division (B) of section 4723.43 of the Revised Code; or

(5) Advanced practice registered nurse or A.P.R.N. if the individual is authorized to practice under division (A) to division (D) of section 4723.43 of the Revised Code.

(B) Only a person who holds a current valid certificate of authority issued in accordance with section 4723.41 of the Revised Code and this chapter to practice as a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist shall:

(1) Practice in accordance with section 4723.43 of the Revised Code and this chapter as a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist;

(2) Hold themselves out as being a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, clinical nurse specialist, or advanced registered practice nurse;

(3) Use any title or initials implying that the person is a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, clinical nurse specialist, or advanced practice registered nurse authorized to practice in accordance with section 4723.03 of the Revised Code and paragraph (A) of this rule.

(C) At all times when an advanced practice registered nurse is providing direct care to a patient within the nurse's respective scope of practice, each certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist shall display and identify the applicable title as set forth in this rule.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/01/2015
Promulgated Under: 119.03
Statutory Authority: 4723.07
Rule Amplifies: 4723.44
Prior Effective Dates: 04/01/1997, 02/01/2004, 04/01/2006, 11/05/2012

4723-8-04 Standard care arrangement for a certified nurse-midwife, certified nurse practitioner, and clinical nurse specialist.

(A) Prior to engaging in practice, a standard care arrangement shall be entered into with each physician or podiatrist with whom the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist collaborates.

(1) The standard care arrangement shall be revised to reflect the addition or deletion of a physician or podiatrist with whom the nurse collaborates within that employment setting. Under these circumstances, a new standard care arrangement is not necessary.

(2) A new standard care arrangement shall be executed when the nurse is employed at a different setting and engages in practice with a different collaborating physician or podiatrist.

(B) A certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist engaged in the practice of the nurse's specialty, shall enter into a written standard care arrangement with one or more collaborating physicians or podiatrists whose practice is the same or similar to the nurse's practice. In accordance with division (D) of section 4723.431 of the Revised Code, a clinical nurse specialist without a certificate to prescribe whose nursing specialty is mental health or psychiatric mental health is not required to enter into a standard care arrangement.

(C) The standard care arrangement shall include at least:

(1) The signatures of each nurse, and each collaborating physician, or the physician's designated representative, or each podiatrist with whom the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist primarily collaborates indicating review of and agreement to abide by the terms of the standard care arrangement. For purposes of this rule, a physician's designated representative means a physician who serves as the department or unit director or chair, within the same institution, organization or facility department or unit, and within the same practice specialty, that the nurse practices, and with respect to whom the physician has executed a legal authorization to enter collaborating agreements on the physicians' behalf;

(2) The date when the arrangement is initially executed;

(3) The date of the most recent review of the arrangement;

(4) The complete name, specialty and practice area, business address, and business phone number or number at which the individual can be reached at any time for:

(a) Each collaborating physician or podiatrist with whom the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist primarily collaborates and who is a party to the standard care arrangement; and

(b) Each certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist who is a party to the standard care arrangement;

(5) A statement of services offered by the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist consistent with section 4723.43 of the Revised Code and this chapter. For holders of a certificate to prescribe, there shall also be a description of the scope of prescriptive practice.

(6) A plan for incorporation of new technology or procedures consistent with the applicable scope of practice as set forth in section 4723.43 of the Revised Code and this chapter;

(7) Quality assurance provisions, including at least:

(a) A schedule for periodic review and reapproval of the standard care arrangement. The standard care arrangement shall be reviewed at least annually. Each nurse who is a party to the arrangement and at least one collaborating physician or podiatrist shall sign and date the annual review of the standard care arrangement;

(b) Criteria for referral of a patient by the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist to a collaborating physician or podiatrist, including, for the certified nurse-midwife, a plan for referral of breech or face presentation or any other abnormal condition identified as such in the standard care arrangement;

(c) A process for the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist to obtain consultation from the physician or podiatrist;

(d) A procedure for regular review of referrals made by the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist to other health care professionals, and the care outcomes for a representative sample of all patients seen by the nurse; and

(e) A process for chart review in accordance with rule 4723-8-05 of the Administrative Code if the nurse's practice includes any direct patient care, education, or management;

(8) A policy for care of infants up to age one and recommendations for collaborating physician visits for children from birth to age three, if the nurse is providing services to infants;

(9) A plan for coverage of patients in instances of emergency or planned absences of either the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist, or the collaborating physician or podiatrist;

(10) A process for resolution of disagreements regarding matters of patient management; and

(11) An arrangement regarding reimbursement under the medical assistance program as set forth in Chapter 5162. of the Revised Code and in accordance with any rules adopted under division (B) of section 5164.02 of the Revised Code.

(12) For nurses with a current valid certificate to prescribe, the following quality assurance provisions shall include at least:

(a) Provisions to ensure timely direct, personal evaluation of the patient with a collaborating physician or the physician's designee when indicated;

(b) Additional prescribing parameters for those drugs or therapeutic devices established in the formulary, including:

(i) Provisions for use of drugs with non-food and drug administration (FDA) approved indications;

(ii) Provisions for use of drugs approved by the FDA and reviewed by the committee on prescriptive governance subsequent to the date of the standard care arrangement;

(iii) Provisions for use of drugs previously reviewed by the committee on prescriptive governance but approved by the FDA for new indications subsequent to the date of the standard care arrangement; and

(iv) Provisions for the use of schedule II controlled substances.

(c) A procedure for the nurse and the collaborating physician, or a designated member of a quality assurance committee, composed of physicians, of the institution, organization, or agency where the nurse has practiced during the period covered by the review, to conduct a periodic review, at least semiannually, of:

(i) A representative sample of prescriptions written by the nurse;

(ii) A representative sample of schedule II prescriptions written by the nurse; and

(d) Provisions to ensure that the nurse is meeting all the requirements of rule 4723-9-12 of the Administrative Code related to review of a patient's OARRS report, consultation with the collaborating physician prior to prescribing based on the OARRS report and signs of drug abuse or diversion described in paragraph (B) of rule 4723-9-12 of the Administrative Code, and documentation of receipt and assessment of OARRS report information in the patient's record.

(13) Quality assurance standards consistent with rule 4723-8-05 of the Administrative Code.

(D) The most current copy of the standard care arrangement, and any legal authorization signed by a physician according to paragraph (C)(1) of this rule, shall be retained and be available upon request at each site where practice of the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist occurs. Upon request of the board, the certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist shall immediately provide a copy of the standard care arrangement to the board.

(E) When a hospital negotiates a standard care arrangement in accordance with division

(E) of section 4723.431 of the Revised Code and this chapter, the standard care arrangement shall be developed in accordance with paragraph (C) of this rule. Review and approval of the standard care arrangement shall be in accordance with the policies and procedures of the hospital governing body and the bylaws, policies, and procedures of the hospital medical staff.

(F) A certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist shall notify the board of the identity of a collaborating physician or podiatrist not later than thirty days after engaging in practice.

(G) A certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist shall notify the board of any change in the name and business address of a collaborating physician or podiatrist not later than thirty days after the change takes effect.

(H) A clinical nurse specialist who does not hold a certificate to prescribe and whose nursing specialty is mental health or psychiatric mental health is exempt from the requirement of executing a standard care arrangement in accordance with division (D)(1) of section 4723.431 of the Revised Code. The clinical nurse specialist who does not hold a certificate to prescribe and whose nursing specialty is mental health or psychiatric mental health shall identify one or more physicians with whom the nurse collaborates in accordance with division (D)(1) of section 4723.431 of the Revised Code.

(I) A clinical nurse specialist who holds a certificate to prescribe and whose nursing specialty is mental health or psychiatric mental health shall enter into a standard care arrangement in accordance with division (D)(2) of section 4723.431 of the Revised Code.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.07
Rule Amplifies: 4723.431
Prior Effective Dates: 04/01/1997, 02/01/2002, 02/01/2003, 02/01/2006, 02/01/2011, 11/05/2012

4723-8-05 Quality assurance standards.

(A) A holder of a current valid certificate of authority shall comply with all continuing education requirements for registered nurse license renewal set forth in division (C) of section 4723.24 of the Revised Code and national certification requirements set forth in sections 4723.41 and 4723.42 of the Revised Code and this chapter.

(B) The certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist and the collaborating physician or podiatrist shall jointly review each effective standard care arrangement at least once a year. Such review shall be documented with the date and signature of each nurse who is party to the arrangement and at least one collaborating physician or podiatrist.

(C) Each certified nurse-midwife, certified nurse practitioner, and clinical nurse specialist who is a party to a standard care arrangement shall comply with all quality assurance provisions of the standard care arrangement in accordance with this chapter. Failure to provide, enter into, or to practice in accordance with a standard care arrangement may result in disciplinary action in accordance with section 4723.28 of the Revised Code.

(D) Each practicing advanced practice registered nurse shall participate in a quality assurance process and shall immediately provide documentation satisfactory to the board of such participation upon request of the board. The quality assurance process shall include at a minimum:

(1) Periodic random chart review at least annually by a collaborating or supervising physician, podiatrist, dentist, or a designated member of a quality assurance committee, composed of physicians, of the institution, organization, or agency where the nurse has practiced during the period covered by the review. If the nurse holds prescriptive authority, the process shall include a procedure for periodic review, at least semi-annually, of prescriptions written and prescribing patterns for the holder of a certificate to prescribe;

(2) Subsequent to each chart review, a conference shall be held between a collaborating or supervising physician, podiatrist, dentist, or a designated member of a quality assurance committee of the institution, organization, or agency and the advanced practice registered nurse. Such conference shall include, but not be limited to, a discussion of the results of the chart review and identification of any patient care issues, and, where applicable, whether past plans for improving care delivery have been effectively implemented. The results of the chart review and conference shall be incorporated into a plan used to maintain or improve care delivery; and

(3) A process for patient evaluation of care.

(E) Documentation of participation in an ongoing, systematic quality assurance process at an institution, organization, or agency shall satisfy the requirements of paragraph (D) of this rule, provided there is a plan to utilize the results of the quality assurance process to maintain or improve care delivery.

(F) Annually, each certified nurse-midwife, certified nurse practitioner, and clinical nurse specialist shall verify the licensure and, if applicable, certification status of each collaborating physician or podiatrist with whom the nurse has an effective standard care arrangement. Verification of physician or podiatrist licensure and certification status may be obtained from the state medical board or an employing institution, organization, medical group practice, or agency. The certified nurse-midwife, certified nurse practitioner, or clinical nurse specialist shall document that such verification was obtained upon request of the board.

(G) The board may review or investigate, at any time, whether an advanced practice registered nurse has complied with the quality assurance standards set forth in this rule.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.07
Rule Amplifies: 4723.41 , 4723.431
Prior Effective Dates: 04/01/1997, 02/01/2002, 04/01/2006, 02/01/2011, 11/05/2012

4723-8-06 National certifying organizations.

(A) To be approved by the board, a national certifying organization shall meet all of the requirements set forth in division (A) of section 4723.46 of the Revised Code.

(B) Annually at a time specified by the board, the board shall provide to each national nursing certifying organization approved by the board for the prior year a form, located at http://www.nursing.ohio.gov/forms.htm (revised November 2013), for the organization to submit to the board attesting that the organization has met and continues to meet all the requirements contained in section 4723.46 of the Revised Code. The board shall verify compliance of each national nursing certifying organization with the criteria contained in section 4723.46 of the Revised Code. No later than January thirtieth of each year, the board shall publish a list of approved national certifying organizations that meet these requirements. The board may approve additional national nursing certifying organizations or discontinue approval of a national nursing certifying organization based on criteria in section 4723.46 of the Revised Code. At the discretion of the board, it may discontinue approval of a national certifying organization for failure of the organization to return to the board the form indicating compliance with the requirements of section 4723.46 of the Revised Code.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.07
Rule Amplifies: 4723.46
Prior Effective Dates: 04/01/1997, 04/01/1998, 04/01/1999, 02/01/2006, 02/01/2011

4723-8-07 Initial certificate of authority.

(A) To obtain a certificate of authority to practice as a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist, an applicant who meets the qualifications set forth in section 4723.41 of the Revised Code and this chapter shall:

(1) Submit a completed application on the form specified by the board, located athttp://www.nursing.ohio.gov/forms.htm (revised October 2013), that includes the documentation and meets the requirements set forth in section 4723.41 of the Revised Code; and

(2) Submit an application fee of one hundred dollars.

(B) If an applicant for a certificate of authority fails to meet the requirements for certification within one year from the date the application is received, or the application submitted to the board remains incomplete for one year, the application shall be considered void and the fee submitted with the application shall be forfeited. The application shall state the circumstances under which this forfeiture may occur.

(C) A certificate of authority for an advanced practice registered nurse shall be automatically suspended or revoked, in accordance with section 4723.47 of the Revised Code, when a license to practice as a registered nurse is suspended or revoked. If suspended, the certificate of authority shall remain suspended until the license to practice as a registered nurse is reinstated. A certificate of authority shall automatically lapse or become inactive, in accordance with section 4723.47 of the Revised Code, when a license to practice as a registered nurse is lapsed or made inactive. The certificate of authority shall remain lapsed or inactive until the license to practice as a registered nurse is renewed or reactivated.

(D) The board may specify in taking disciplinary action under section 4723.28 of the Revised Code that a restriction placed on a license to practice as a registered nurse is applicable to the status of a certificate of authority.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.07
Rule Amplifies: 4723.41 , 4723.42 , 4723.47
Prior Effective Dates: 04/01/1997, 04/01/1998, 02/01/2000, 02/01/2006, 02/01/2008, 02/01/2011

4723-8-08 Certificate of authority renewal; notification of national recertification.

(A) To renew a certificate of authority to practice as a certified nurse-midwife, certified nurse practitioner, clinical nurse specialist, or certified registered nurse anesthetist, a holder of a current valid certificate of authority who meets the qualifications set forth in section 4723.41 of the Revised Code and this chapter shall:

(1) Submit a completed renewal application on an application specified by the board, located at http://www.nursing.ohio.gov/forms.htm (revised March 2013), that includes:

(a) Except as provided in paragraph (A)(2) of this rule, documentation satisfactory to the board that the holder has maintained certification in the nursing specialty with a national certifying organization as required by division (B) of section 4723.42 of the Revised Code;

(b) A list of the names and business addresses of the holder's current collaborating physicians and podiatrists, if the nurse is a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner; and

(c) The renewal fee set forth in division (A)(10) of section 4723.08 of the Revised Code. If a completed renewal application is not postmarked, renewed on-line, or otherwise received by the board before July first of odd numbered years, in order to renew the applicant shall pay a late processing fee of fifty dollars in accordance with division (A)(13) of section 4723.08 of the Revised Code. The late processing fee is in addition to the renewal fee specified in division (A)(10) of section 4723.08 of the Revised Code, and is in addition to any late processing fee imposed with respect to renewal of the applicant's registered nurse license; and

(2) A clinical nurse specialist, originally issued a certificate of authority on or before December 31, 2000 in accordance with division (C) of section 4723.41 of the Revised Code, as that division existed prior to March 20, 2013, is not required to provide documentation of having maintained certification in the holder's specialty, but shall submit documentation satisfactory to the board of completion of continuing education in compliance with paragraph (B) of rule 4723-8-10 of the Administrative Code.

(B) A renewed certificate of authority shall be current until the next scheduled renewal period for registered nurse licensure. However, when a certificate of authority is issued by the board on or after the first of March of an odd numbered year, that certificate of authority shall be current through the thirty-first of August of the next odd numbered year.

(C) The board shall provide each holder of a current valid certificate of authority an application for renewal of a certificate of authority, except when the board is aware that an individual is ineligible for renewal for any reason, including those reasons specified in division (A) of section 4723.24 of the Revised Code. 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 and this chapter.

(D) Within thirty days of recertification by the applicable national certifying organization, the holder of a certificate of authority shall request that the national certifying organization provide, directly to the board, satisfactory documentation of recertification to the board. This requirement does not apply to a clinical nurse specialist, originally issued a certificate of authority on or before December 31, 2000 in accordance with division (C) of section 4723.41 of the Revised Code, as that division existed prior to March 20, 2013.

(E) A certificate of authority holder who fails to maintain certification or recertification by the applicable national certifying organization listed in the division (A)(3) of section 4723.41 of the Revised Code or approved by the Board according to section 4723.46 of the Revised Code, may be subject to disciplinary action in accordance with section 4723.28 of the Revised Code. This requirement does not apply to a clinical nurse specialist, originally issued a certificate of authority on or before December 31, 2000 in accordance with division (C) of section 4723.41 of the Revised Code, as that division existed prior to March 20, 2013.

(F) A clinical nurse specialist, originally issued a certificate of authority on or before December 31, 2000 in accordance with division (C) of section 4723.41 of the Revised Code, as that division existed prior to March 20, 2013, who fails to complete the continuing nursing education required by division (B) of section 4723.42 of the Revised Code and rule 4723-8-10 of the Administrative Code, may be subject to disciplinary action in accordance with section 4723.28 of the Revised Code.

(G) A holder of a current valid certificate of authority who does not intend to practice as a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist in Ohio may request that the certificate of authority be placed on inactive status:

(1) At time of renewal, by checking the appropriate box on the certificate of authority renewal application that indicates the holder wants to place the certificate on inactive status; or

(2) At any other time, by submitting to the board a written statement requesting inactive status.

(H) While on inactive status a nurse shall not represent or imply to the public that the nurse is authorized to practice as a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist or use the titles established by section 4723.03 of the Revised Code and rule 4723-8-03 of the Administrative Code.

(I) An inactive or lapsed certificate of authority for an advanced practice registered nurse may be reactivated or reinstated by written request which shall be accompanied by:

(1) For reinstatement, a completed certificate of authority renewal application on the form specified by the board, including documentation of continued national certification status throughout the period during which the certificate of authority was lapsed. A clinical nurse specialist, originally issued a certificate of authority on or before December 31, 2000 in accordance with division (C) of section 4723.41 of the Revised Code, as that division existed prior to March 20, 2013, is not required to provided documentation of having maintained certification in the holder's specialty, but shall submit documentation satisfactory to the board, of completion of continuing education in compliance with paragraph (B) of rule 4723-8-10 of the Administrative Code; and

(2) Payment of the applicable fees set forth in section 4723.08 of the Revised Code.

(J) A certificate holder, who submits a renewal application on July first or later, or whose certificate lapsed, due to the holder's service in the armed forces of the United States, or in the national guard or in a reserve component, shall be eligible for renewal and reinstatement without payment of the late application fee required by division (A)(13) of section 4723.08 of the Revised Code, and the reinstatement fee required by division (A)(18) of section 4723.08 of the Revised Code, if the following are met:

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

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

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

(K) A certificate holder, who submits a renewal application on July first or later, or whose certificate lapsed, due to the holder's spouse's service in the armed forces of the United States, or in the national guard or in a reserve component, shall be eligible for renewal and reinstatement without payment of the late application fee required by division (A)(13) of section 4723.08 of the Revised Code, and the reinstatement fee required by division (A)(18) of section 4723.08 of the Revised Code, if the following are met:

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

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

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

R.C. 119.032 review dates: 04/08/2014 and 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.07
Rule Amplifies: 4723.42 , 4723.47
Prior Effective Dates: 04/01/1997, 04/01/1998, 04/01/1999, 02/01/2006, 02/01/2011

4723-8-09 Certificates of authority for a certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist practicing in another jurisdiction.

A certified nurse-midwife, certified nurse practitioner, certified registered nurse anesthetist, or clinical nurse specialist who is practicing in another jurisdiction may apply for a certificate of authority to practice in Ohio if the nurse meets the requirements for approval for a certificate of authority set forth in section 4723.41 of the Revised Code and this chapter. An applicant from another jurisdiction shall:

(A) Submit a completed application on a form specified by the board that includes the requirements of section 4723.41 of the Revised Code; and

(B) Submit the applicable fee.

R.C. 119.032 review dates: 10/08/2010 and 10/01/2015
Promulgated Under: 119.03
Statutory Authority: 4723.07
Rule Amplifies: 4723.41
Prior Effective Dates: 04/01/1997, 02/01/2006

4723-8-10 Continuing education requirements.

(A) Each advanced practice registered nurse who obtains continuing nursing education in the nurse's area of practice for the purpose of obtaining or maintaining a national certification may use those continuing education hours to satisfy the continuing education requirements set forth in section 4723.24 of the Revised Code and Chapter 4723-14 of the Administrative Code if the continuing education meets the requirements of Chapter 4723-14 of the Administrative Code.

(B) A clinical nurse specialist, originally issued a certificate of authority on or before December 31, 2000 in accordance with division (C) of section 4723.41 of the Revised Code, as that division existed prior to March 20, 2013, who is not certified by a national nursing certifying organization approved by the board shall obtain twelve contact hours of continuing nursing education in addition to the twenty-four hours required every two years for renewal of a license to practice nursing as a registered nurse. For the purposes of complying with this rule:

(1) The additional hours shall be in programs that are targeted to advanced practice registered nurses in the nurse's area of practice or in relevant programs from other health care disciplines;

(2) The continuing education activity must meet the requirements of Chapter 4723-14 of the Administrative Code; and

(3) The clinical nurse specialist cannot use the waiver option contained in rule 4723-14-03 of the Administrative Code for the additional twelve contact hours of continuing nursing education required by this paragraph.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.07
Rule Amplifies: 4723.24 , 4723.41 , 4723.42
Prior Effective Dates: 04/01/1997, 04/01/1998, 04/01/1999, 02/01/2006, 02/01/2011, 11/05/2012