OAC 5160-12-02.3 — Private duty nursing: procedures for service authorization

What this rule requires your agency to do

• 1For emergency PDN delivered outside normal office hours, the provider must have an existing PDN authorization, the services must be medically necessary and necessary to protect health and welfare, and a new authorization must be obtained after delivery (para. (F)(1)).(OAC 5160-12-02.3 — Private duty nursing: procedures for service authorization)
• 2The provider must maintain all written records related to PDN and its authorization for six years following the request, or until an initiated audit is resolved, whichever is longer (para. (G)).(OAC 5160-12-02.3 — Private duty nursing: procedures for service authorization)
• 3The provider must notify ODM (and the ODA case manager or county board SSA as applicable) in writing using the ODM 02374 whenever there is a change in the individual's condition that may warrant a change in the amount, scope, or duration of PDN (para. (B)(3), (C)(3), (D)(3)).(OAC 5160-12-02.3 — Private duty nursing: procedures for service authorization)
• 4The provider must notify ODM/ODA/county board SSA of emergency PDN immediately or no later than the first business day following the emergency provision (para. (F)(2)).(OAC 5160-12-02.3 — Private duty nursing: procedures for service authorization)
• 5As a prerequisite to PDN, the individual must receive PDN authorization from ODM or its designee, and the PDN provider must submit a referral using the ODM 02374 with supporting documentation (para. (A), (B)(1)).(OAC 5160-12-02.3 — Private duty nursing: procedures for service authorization)
• 6The PDN provider may begin furnishing PDN only upon receipt of written PDN authorization and in accordance with all requirements of rule 5160-12-02 (para. (B)(2)(a)(i)).(OAC 5160-12-02.3 — Private duty nursing: procedures for service authorization)