{"ref":"OH-HH-CS-02","title":"Skilled Nursing Services and Ohio Nursing Practice","category":"Clinical tasks","summary":"Sets out who may furnish skilled nursing for the Agency, what registered nurses and licensed practical nurses do, how nursing is supervised, the Ohio nursing practice limits that apply (practice within an Ohio license, the Board of Nursing’s standards of practice, LPN practice at the direction of a registered nurse, and the tasks Ohio Medicaid reserves to registered nurses), and how nurses document visits, report changes, teach, and keep their skills current.","inShort":["Only nurses with a current Ohio license (or a multistate license recognized in Ohio) give nursing care. If your license lapses, stop seeing patients.","LPNs work at the direction of an RN and call the RN about any change not covered by an order.","Only RNs do IV tasks, central line dressing changes, pump programming (except routine insulin) and blood products.","Write a timed, dated clinical note for every visit and submit it by the end of the next business day.","Call the practitioner promptly about any change that means the plan of care may need to change. In an emergency, call 911 first."],"primaryCitation":"42 CFR §484.75","citations":["ORC 4723.03","ORC 4723.34","OAC 4723-4","OAC 4723-13-01","OAC 4723-13-03","OAC 4723-13-05","OAC 5160-12-01(G)","OAC 5160-32-01(D)(3)"],"federalCitations":["42 CFR §484.75","42 CFR §484.75(b)","42 CFR §484.75(c)","42 CFR §484.115(e)","42 CFR §484.115(k)","42 CFR §484.2","42 CFR §484.55","42 CFR §484.60(c)","42 CFR §484.60(d)","42 CFR §484.105(f)","42 CFR §484.110(b)"],"surveyorAsks":["Show me that each nurse holds a current Ohio license and how you verified it.","Who supervises your LPNs, and how do you document that supervision?"],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §484.75)","5. Who May Provide Skilled Nursing","6. Duties of the Registered Nurse","7. Duties of the Licensed Practical Nurse","8. Tasks Reserved to Registered Nurses","9. Supervision of Nursing","10. Practice Standards for Every Nurse","11. Nursing Visits and Clinical Notes","12. Reporting Changes in Condition","13. Teaching and Counseling","14. Responsibilities of Every Skilled Professional","15. Procedures and Competency","16. Responsibilities","17. Records and Compliance Monitoring","18. Staff Training","19. References","20. Related Policies and Forms","21. Approval","22. Revision History"],"version":"1.0","sample":false,"pack":"oh-hha","state":"Ohio","service":"Home health","guides":[{"path":"/guides/home-health-agency-policies/","h1":"What policies and procedures are required for home health agencies?"},{"path":"/guides/home-health-conditions-of-participation/","h1":"Home health Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}