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OAC 5160-12-08 — Registered nurse assessment and registered nurse consultation services

OhioregulationOhio Department of Medicaid· effective 2021-11-28

What this rule requires your agency to do

  • 1RN assessments must be verified using an ODM-approved EVV system per rule 5160-1-40 (para. (B)(7)).(OAC 5160-12-08 — Registered nurse assessment and registered nurse consultation services)
  • 2Agency and non-agency providers must maintain clinical records at their place of business and a copy at the individual's residence, in a manner protecting confidentiality (para. (E)(3)-(4)).(OAC 5160-12-08 — Registered nurse assessment and registered nurse consultation services)
  • 3An RN assessment must be performed before the individual first receives the listed services, before any change to the current package of services, and any time the RN is informed of a significant change in condition (para. (B)(1)).(OAC 5160-12-08 — Registered nurse assessment and registered nurse consultation services)
  • 4All RNs providing RN assessment/consultation must maintain a confidential clinical record for each individual containing the enumerated information, including plan-of-care recertification every sixty days and documentation of verbal physician orders (para. (E)(1)-(5)).(OAC 5160-12-08 — Registered nurse assessment and registered nurse consultation services)
  • 5The RN assessment must include a face-to-face interview and observation of the individual in the residence (or by telehealth) capturing the specified physical, social, and emotional health information (para. (B)(3)(b)).(OAC 5160-12-08 — Registered nurse assessment and registered nurse consultation services)
  • 6An LPN must seek the guidance of the directing RN (RN consultation) when the individual experiences a significant change in condition that may necessitate a change in the plan of care and the LPN's interventions (para. (C)(2)).(OAC 5160-12-08 — Registered nurse assessment and registered nurse consultation services)
  • 7An RN may be reimbursed for an RN assessment no more than once every sixty days per individual unless a significant change requires a subsequent assessment (para. (B)(4)(e)).(OAC 5160-12-08 — Registered nurse assessment and registered nurse consultation services)
  • 8An RN performing an RN assessment must hold a current, valid, unrestricted Ohio nursing license, work within RN scope of practice, and be an active Medicaid provider or employed by one (para. (B)(2)(a)-(c)).(OAC 5160-12-08 — Registered nurse assessment and registered nurse consultation services)

Applies to: home health

Requires an RN assessment before home health, PDN, waiver nursing, personal care aide, or HOME choice services begin, before any change, and whenever a significant change occurs, and defines RN consultation between the directing RN and an LPN. It sets detailed clinical-record content, EVV, and supervision requirements. Fills the RN supervision, assessment, and records framework gaps.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.