FALL 2021 • Volume 19 Issue 4

Official Publication of the Ohio Board of Nursing

CONGRATULATIONS ON YOUR RETIREMENT

Executive Director, Betsy Houchen

Ohio Board of Nursing 3

From the President

From the Executive Director

Meet New Board Members

2020 Award Nomination – Patricia Sharpnack

—Quick Tips

APRN Notes

Use Of Light-Based Medical Devices For The Purpose Of Hair Removal

Licensing, Process Improvements, and Efficiencies in Ohio eLicense

Occupational License Review for the Ohio Board of Nursing

Advisory Groups and Committees

How Do I Change My Name with the Board? How Do I Change My Address? If You Forgot Your Password Or Your Password has Expired

Board Disciplinary Actions

468

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Ohio Board of Nursing 3

Momentum is the official journal of the Ohio Board of Nursing. Momentum’s traditional journal & interactive digital companion serve over 294,000 nurses, administrators, faculty and nursing students, 4 times a year all across Ohio. Momentum is a timely, widely read and respected voice in Ohio nursing regulation.

8

1

Momentum is published by the

Ohio Board of Nursing17 South High St., Suite 660

Columbus, Ohio 43215-3466

Phone: 614-466-3947

Fax: 614-466-0388

www.nursing.ohio.gov

Vice PresidentJoanna Ridgeway, LPN

Executive DirectorBetsy J. Houchen, JD, MS, RN

The mission of the Ohio Board

of Nursing is to actively safeguard

the health of the public through the

effective regulation of nursing care.

Information published in Momentum is

not copyrighted and may be reproduced.

The Board would appreciate credit for

the material used.

Advertisements contained herein

are not necessarily endorsed

by the Ohio Board of Nursing.

The publisher reserves the

right to accept or reject

advertisements for Momentum.

The Ohio Board of Nursing is an

equal opportunity employer.

MOMENTUM is produced at no cost to Ohio taxpayers.

CONTENTS FALL 2021 I Volume 19 Issue 4

10

4 MOMENTUM

FROM THE PRESIDENT

Joanna RidgewayVice President/Acting President

As we reflect on 2021, we continue to mourn the loss of

our Board President Lauralee Krabill on June 29. In her

absence and in accordance with Board Policy, I have

assumed the role of Board President for the remainder of this

calendar year. I am honored to serve in this role and to be the

first LPN to serve as Board President.

In July, the Board was pleased to welcome new member Donna

Hanly, RN. We encourage you to read Donna’s profile in this

issue of Momentum.

We were also very pleased to congratulate Board member

Patricia Sharpnack, RN. During a National Council of State

Boards of Nursing (NCSBN) virtual awards ceremony in July,

Patricia was presented the Elaine Ellibee Award for outstanding

leadership as past Board President. In addition, we learned

Patricia was unanimously selected to receive the National League

for Nursing Mary Adelaide Nutting Award for Outstanding

Teaching or Leadership in Nursing Education. The Board

congratulates her and the Ursuline nursing education program

for this exceptional recognition and achievement!

The Board also congratulates Director Houchen on her

retirement! As we reflect on her tenure, we are proud of her

leadership that reflects on the innovative changes and the

successful work of the Board in fulfilling our mission of public

protection and increasing operational efficiencies over the last

sixteen years.

• For patient safety, the Board initiated Board Committees for

practice, issued Interpretive Guidelines to provide practice

guidance, implemented the Patient Safety Initiative,

participated in the Ohio Action Coalition, and collaborated

with other boards and state agencies.

• For greater success in treatment and recovery, the Board

initiated changes to expand the Alternative Program, a

confidential non-disciplinary program, which enables

individuals with substance use disorder to participate in the

program earlier in the disease process.

• The Board streamlined processes for investigation of

complaints and timely resolution of disciplinary cases,

including establishing a Board Hearing Committee,

notifying the public about unsafe practitioners, reporting

data to national databanks, and alerting other states through

Nursys and the federal National Practitioners Data Bank

(NPDB) for which the Board has maintained continued

compliance with the reporting requirements.

• Collaboration was critical as the Board participated in

statewide initiatives: preventing human trafficking;

promoting cultural competency; fighting the opioid

epidemic and prescription drug abuse; increasing the

nursing workforce; collecting state workforce data for policy

and planning purposes; promoting nursing/APRNs in

Primary Care Medical Homes (PCMH); expediting and

creating pathways for licensure for military personnel,

veterans, and spouses; and promoting patient safety by

collaborating with state agencies and the private health care

systems.

• The Board moved from paper license applications to a fully

automated online system for all aspects of licensing and

related processes.

• We transformed various APRN certifications into one

license with prescriptive authority for certain APRNs,

adopted an Exclusionary Formulary, and established the

Advisory Committee for Advanced Practice Registered

Nursing.

• The Board amended education program rules for pre-

licensure nursing education innovation, hosted regional

NCLEX conferences, and extended the timeline to provide

grant funding that supports the increased enrollment of

nursing students in Ohio.

• We increased communications and messaging with licensees

and applicants through a redesign and renovation of the

Board website.

We are proud of the Board’s track record and accomplishments

during Director Houchen’s tenure with the Board. A further

detailing of Board operations and accomplishments under

Director Houchen is included in this issue of Momentum, in an

article that summarizes a response to the Ohio legislature’s

review of Board licenses in accordance with SB 255 (132nd

General Assembly) which requires all occupational licensing

boards in the state to be reviewed every six years.

Ohio Board of Nursing 5

6 MOMENTUM

It is with mixed emotions that I retire on September 30, 2021. I’ve worked at the Board for 19 years,

16 of which have been as the Executive Director. I am as proud now as I was all those years ago when

I was appointed by the Board!

When I started as Executive Director in 2005, the Board regulated 207,815 licenses and certificates – for

FY 2021, the number is 318,693! There were 6,692 APRN Certificates of Authority in 2005 – now the

number of APRN licenses is 23,183.

In 2005, we receive 3,701 complaints, had 644 disciplinary cases to monitor for compliance with the

terms and conditions of Consent Agreements or Board Orders, and approved 117 nursing education

programs. Now we annually receive over 8,000 complaints; actively monitor about 1,300 licensees; and

approve 193 education programs and 54 training programs.

At that time, we convened an Advisory Committee to establish certification for Medication Aides and

training programs, and now we have 371 Medication Aides in Ohio.

Certified Community Health Workers (CHWs) were relatively new in 2005 – we certified 73 in 2010 and

now there are 967 certified CHWs in Ohio. The Board recently voted to establish an Advisory Group on

Certified Community Health Workers which is expected to convene for the first time in November.

We have always had a strong partnership with the Board members and that has enabled the Board to

transform as a regulatory agency and realize significant achievements. The Board’s managers,

supervisors and staff are committed to the Board’s work and were key in achieving so many

accomplishments.

Board operations are designed to meet the public expectations that nurses obtain an adequate level of

educational preparation, follow established practice standards, and provide competent nursing care.

They also expect the Board to address unsafe practitioners so vulnerable populations, who nurses serve,

are protected. The Board licenses qualified, competent nurses and removes dangerous practitioners from

practice in a timely manner to protect Ohio patients.

The Board has a proven track record of public protection, participating in initiatives to combat the

nursing shortage, and regulating the largest number of licensed professionals of any agency in the State

of Ohio, while at the same time, implementing numerous cost reductions and operational efficiencies.

I am so proud that the Board’s regulatory excellence has been recognized nationally through numerous

awards – the Board received the NCSBN Regulatory Achievement Award; Patricia Sharpnack, current

Board member and Past President, received the Elaine Ellibee Award; Past Board President Lisa Klenke

received the Exceptional Leadership Award; Lisa Emrich, Board staff, the Exceptional Contribution

Award; and I received the R. Louise McManus Award.

My career has been a remarkable journey and I thank so many who supported and encouraged me along

the way. I leave the Board with fond memories and great pride. Thank you -- I wish you success in your

nursing careers and wish the Board continued success in fulfilling their vital mission of public

protection. And always be clear about the Board’s role of public protection and safe patient care -- it is

critical to all of us, as nursing touches virtually every citizen of Ohio.

FROM THEEXECUTIVE DIRECTOR

Betsy J. Houchen, RN, MS, JD

Executive Director

We have always had

a strong partnership

with the Board

members and that

has enabled the

Board to transform

as a regulatory

agency and realize

significant

achievements. The

Board’s managers,

supervisors and staff

are committed to the

Board’s work and

were key in

achieving so many

accomplishments.

Ohio Board of Nursing 7

8 MOMENTUM

MEET NEW BOARD MEMBER

NAME: Donna L. Hanly, RN

Donna Hanly was appointed to serve as a

RN member of the Ohio Board of Nursing

by Governor Mike DeWine on July 8,

2021. She attended her first Board meeting

in July 2021. We welcome her to the Board

and share her background and thoughts

about being a Board member with you.

WHY DID YOU WANT TO BECOME A BOARD MEMBER?I believe that becoming a Board member

is an incredible opportunity to support

something that I have been passionate

about since becoming an RN many years

ago, and that is to safeguard the public

through the effective regulation of nursing

care. Serving on the Board is a great way to

give back to the profession that has given

me so much, and I’m honored to have

been appointed to be in this role.

WHAT IS YOUR NURSING BACKGROUND?Most of my nursing career was spent as a

bedside nurse specializing in Neuroscience.

I loved both the intuitive nature of the

specialty, and the opportunities inherent

in the field for innovative care. I also spent

several years working in an ambulatory

setting in Family Medicine and found

that caring for individuals and families

throughout the entire lifespan to be very

rewarding.

My passion to impact nursing broadly

led me to a variety of leadership roles at

OhioHealth Riverside Methodist Hospital,

including roles as manager for Neuroscience

and director for Neuroscience and Critical

Care. I became the Chief Nursing Officer

for OhioHealth Grant Medical Center in

2006, and advanced to the role of Senior

Vice President and Chief Nursing Executive

for the OhioHealth system in 2013. I retired

from that role in 2018, and since, have

been adjunct faculty for Ohio University

and I also provide leadership coaching as a

certified professional coach.

WHAT DO YOU BELIEVE YOU CAN BRING TO THE BOARD OF NURSING?I believe that my broad range of

experience, both as a bedside nurse and as

an administrative and operational leader

will serve well to provide insight into the

complexities that guide our profession.

WHAT IS ONE OF THE GREATEST CHALLENGES OF BEING A BOARD MEMBER?I am very early in being a Board

member, but I can already see how

complex it is to provide the structure

and processes to regulate over 300,000

licenses and certificates. One new

challenge, with the recent signing by

the Governor of the Nurse Licensure

Compact, will be to ensure smooth

processes are in place to maximize the

benefit of nurses crossing state borders

to practice safely and effectively.

HOW WOULD YOU DESCRIBE YOUR EXPERIENCE AS A BOARD MEMBER?The Board members and staff have

been extremely gracious, helpful, and

informational as I learn about the duties

and responsibilities inherent in the role.

I find that serving is gratifying both

professionally and personally.

WHAT WOULD YOU SAY TO SOMEONE WHO IS CONSIDERING BECOMING A BOARD MEMBER?It is a great opportunity to serve your

profession and the community! In

addition, having a more thorough

understanding of everything that goes into

ensuring safe practice, and participating in

the process, provides a wonderful growth

opportunity for nurse leaders and I believe

that every nurse is a leader.

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10 MOMENTUM

QUICK TIPAPRN License Applicants: Beginning in September 2021, APRN licensure applicants must be able to answer “yes” to the following questions in order to proceed with the application for APRN licensure: (1) Do you currently hold a master’s or doctoral degree with a major in a nursing specialty that qualified you to take an APRN national certification examination of a national certification organization approved by the Board; and (2) Do you currently hold APRN national certification from a Board approved national certification organization? There are certain exceptions for reciprocity applicants who were licensed as APRNs prior to January 1, 2001 in another state.

For an APRN license application checklist see https://nursing.ohio.gov/wp-content/uploads/2021/08/APRN-Applicants-Aug2021.pdf.

For Board approved national certification organizations, seehttps://nursing.ohio.gov/wp-content/uploads/2021/07/2021-BOARD-APPROVED-NATIONAL-CERTIFYING-ORGANIZATIONS.pdf

BOARD MEMBER AND PAST PRESIDENT PATRICIA SHARPNACK PRESENTED NCSBN AWARD

P atricia A. Sharpnack, DNP,

RN, CNE, NEA-BC, ANEF,

FAAN, Board Member and Past

President recently received one of the

highest awards from the National Council

of State Boards of Nursing (NCSBN),

the Elaine Ellibee Award. The award

is designated for a current or recent

president of a state board of nursing who

has demonstrated leadership as a state

board president and leadership in making

significant contributions to the NCSBN.

She was selected from a pool of nominees

from all 50 states, Washington D.C. and

international boards.

Dr. Sharpnack was appointed to the Ohio

Board of Nursing (Board) by Gov. John

Kasich in 2014 and is now serving a second

appointed term. She was elected president

by fellow Board members for three terms,

the last ending in December 2019. She is

now the Board Supervisory Member and

Chair of the Nursing Education Advisory

Committee. Her current term ends in

December 2021.

In her letter of support for the nomination

on behalf of the Board, Betsy J. Houchen,

JD, MS, RN, executive director of the Board,

wrote that “The Governor recognized (Dr.

Sharpnack’s) leadership in the fight against

the opioid epidemic; the State Action

Coalition called on her leadership skills

to collaborate with others to implement

the recommendations of the (Institute of

Medicine) Future of Nursing Report; and

she developed seamless nursing education,

dual enrollment programs, and nurse

competency models in this state and other

state boards of nursing.”

Dr. Sharpnack was appointed by

Governor Kasich to participate on the

Governor’s Cabinet Opiate Action Team

and collaborate with the governor’s

office, state agencies, and other regulatory

boards to fight the opioid epidemic.

During her tenure as Board President,

Ohio Board of Nursing 11

she also created a pathway for military

personnel and service members to

become licensed practical nurses and

advocated for regulatory approaches

that are responsive to changes in nursing

practice and education.

“Patricia Sharpnack has an exceptional

and outstanding track record of stellar

leadership as a board president in

advancing public protection, regulatory

excellence, and making significant

contributions to NCSBN and its members,”

wrote Houchen. “Her leadership inspires

others locally, statewide and nationally.

She embodies the contributions of Elaine

Ellibee, who strongly believed in the

importance of public protection, superior

patient care and continuing education for

nursing leaders.”

The late Ellibee was the first president

of the NCSBN, serving from 1978-1979.

“I am extremely touched, humbled and

thrilled to have been selected for this

award. It is truly an honor,” said Dr.

Sharpnack. “I have greatly appreciated

my work with the Board and NCSBN

and am blessed to have had the

opportunity to learn so much from both

organizations.”

Dr. Sharpnack explained that the mission

of the Board, and all state boards of

nursing, is to protect the public through

effective regulation. “This means that

those serving on boards of nursing must

place public welfare at the forefront

while helping to guide the board

with new educational models, a just

culture for discipline, clear methods

for renewals and implementation of

rules, guidelines for practice and, more

generally, guidelines for what the public

considers important for nurses to be

accountable for.”

Dr. Sharpnack was inducted as a 2019

fellow of the American Academy of

Nursing, one of the highest honors for

nursing internationally, in recognition

of her extraordinary commitment to

the promotion of public health. The

Academy comprises some 2,600 nurse

leaders in education, management,

practice, policy, and research chosen

from some 4 million registered nurses

in the United States. Recently, Dr.

Sharpnack was unanimously selected to

receive the National League for Nursing

Mary Adelaide Nutting Award for

Outstanding Teaching or Leadership in

Nursing Education.

The Board congratulates Dr. Sharpnack

and is proud she is being recognized and

honored for her many accomplishments

and contributions to nursing and public

safety.

12 MOMENTUM

APRN NOTES

The Ohio Revised Code (ORC) prohibits use of any

statement, title or initials implying or representing

that an individual is licensed as an APRN, unless the

individual is licensed by the Board to practice as an APRN.

Individuals who are not licensed to practice nursing, including

those who have submitted license applications, cannot use any

statement, title, or initials that would imply or represent that

they are licensed. Section 4723.03(E), ORC. For example, an

individual who completed a RN or LPN nursing education

program and passed the NCLEX but is not yet licensed by

the Board of Nursing, cannot practice nursing, and must not

identify themselves as a nurse, a “nurse graduate,” or “graduate

nurse,” etc. in any role. Also, the individual who is not yet

licensed as a RN or LPN may only work as an unlicensed person

through delegation of nursing care as specified under Chapter

4723-13, Ohio Administrative Code (OAC), and must not hold

themselves out as an RN or LPN prior to receiving their license

to practice.

Section 4723.03, ORC, also applies to a RN who has completed

an APRN program and obtained national certification from

a national certifying organization, but who is not yet licensed

by the Board to practice as an APRN. Section 4723.44, ORC,

prohibits individuals who are not licensed as APRNs from using

“any title or initials implying that the person is an advanced

practice registered nurse, including using any title or initials

implying the person is a certified registered nurse anesthetist,

clinical nurse specialist, certified nurse-midwife, or certified

nurse practitioner.”

Some license applicants use their educational degree,

or national certification as a title while waiting on their

licensure and this is not allowed under Ohio law. Please see

the article on title protection at https://nursing.ohio.gov/wp-

content/uploads/2019/08/OhioBoard2016FallMOM4.2.pdf.

Additional information can be found as follows: https://

codes.ohio.gov/ohio-revised-code/section-4723.44; http://

codes.ohio.gov/orc/4723.03

APRNs providing medication-assisted treatment (MAT),

including office-based opioid treatment (OBOT), must meet

all requirements of Rule 4723-9-13, OAC.

Medication-assisted treatment (MAT) means alcohol or drug

addiction services accompanied by medication that has been

approved by the FDA for the treatment of substance use

disorder, prevention of a substance use disorder relapse, or

both. Rule 4723-9-13(A)(6), OAC.

Office-based opioid treatment (OBOT) means medication-

assisted treatment of opioid dependence or addiction utilizing

controlled substances, in a private office or public sector clinic that

is not otherwise regulated, by practitioners who are authorized

to prescribe outpatient supplies of medications approved by

the FDA for the treatment of opioid addiction or prevention of

relapse. OBOT includes treatment with all controlled substance

medications approved by the FDA for such treatment, except for

treatment that occurs in certain specified settings. Rule 4723-9-

13(A)(7), OAC.

Only qualified practitioners, including APRNs, who have

obtained a DATA waiver from the U.S. Substance Abuse and

Mental Health Services Administration (SAMHSA) can offer

buprenorphine for the treatment of opioid use disorders. The

Drug Addiction Treatment Act of 2000 (DATA 2000) and

subsequent legislation (2018 SUPPORT Act) expanded the

use of MAT using buprenorphine to additional practitioners,

including APRNs, in various settings, so long as the practitioner

has obtained a “DATA waiver” prior to engaging in the practice.

The DATA waiver is obtained directly through SAMHSA. All

APRN prescribing is governed by the APRN’s scope (Sections

4723.43, and 4723.481, ORC), standards of care and Chapter 4723-

9, OAC, and the terms of the standard care arrangement (SCA) the

APRN entered into with their collaborating physician. In addition

to the general requirements that govern APRN prescribing, when

an APRN is providing MAT, additional requirements required by

Rule 4723-9-13, OAC, also apply. Some of the requirements of Rule

4723-9-13, OAC, are summarized below. The entire rule is available

through the links provided below.

Qualified CNSs, CNMs, or CNPs may provide MAT, including

prescribing controlled substances in schedule III, IV or V, if they:

• Comply with Section 3719.064, ORC, and all federal and

state laws and regulations governing the prescribing of the

medication, including but not limited to incorporating into

the APRN’s practice knowledge of Chapter 4729, ORC,

and Chapter 4731, ORC, and rules adopted under that

Chapter 4731, ORC, that govern the practice of the APRN’s

collaborating physician.

• Complete at least eight (8) hours of continuing education in

each renewal period related to substance abuse and addiction.

Ohio Board of Nursing 13

• Provide MAT if the treatment is within the collaborating

physician’s normal course of practice and expertise.

In addition to meeting the requirements for

CNPs may provide OBOT under the following circumstances:• The SCA statement of services includes OBOT.

• The CNS, CNM, and CNP performs, or confirms the

completion of, and documents a patient assessment

including but not limited to, a comprehensive medical

and psychiatric history; a brief

mental status history; substance

abuse history; family history and

psychosocial supports; appropriate

physical examination; urine drug

screen or oral fluid drug testing;

pregnancy test for women of

childbearing age and ability;

review of the patient’s prescription

information in OARRS; testing for

various specified conditions.

• The CNS, CNM, and CNP

establishes and documents a

treatment plan that includes all of

required components, including

but not limited to, the rationale

for selection of the specific drug

to be used, patient education;

the patient’s written, informed

consent; random urine-drug

screens or oral fluid drug testing;

a signed treatment agreement

with the patient outlining the

responsibilities of the patient

and the APRN; a plan for

psychosocial treatment that meets

the requirements. Section 4723-9-

13(C)(3), OAC.

• The CNS, CNM, and CNP provides

OBOT only in accordance with

an acceptable treatment protocol

for assessment, induction,

stabilization, maintenance, and

tapering. Acceptable protocols are

specified in Rule 4723-9-13(C)(4),

OAC.

• Except if the CNS, CNM, and CNP

is a qualified behavior healthcare

provider, they must refer and work

jointly with a qualified behavioral

healthcare provider, community mental health services

provider, or community addiction services provider to

determine the optimal type and intensity of psychosocial

treatment for the patient and document the treatment

plan in the patient record.

• If the CNS, CNM, and CNP refers the patient to a

qualified behavioral health service provider, community

addiction services provider, or community mental health

services provider, the APRN shall document the referral

and the APRN’s interactions with the provider in the

patient record.

continued on page 14

14 MOMENTUM

continued from page 13

• The CNS, CNM, and CNP must offer the patient a

prescription for a naloxone kit; ensure that the patient

receives instruction on the kit’s use including, but

not limited to, recognizing the signs and symptoms of

overdose and calling 911 in an overdose situation; offer

a new prescription for naloxone upon expiration or use

of the old kit; and, if the patient refuses the prescription,

the patient must be provided the information on where

to obtain a kit without a prescription.

• If the CNS, CNM, and CNP provides OBOT using

buprenorphine products, they must meet all the additional

requirements specified in Rule 4723-9-13(C)(9), OAC.

If naltrexone is used to treat opioid use disorder, all the

additional requirements specified in Rule 4723-9-13(C)(10),

OAC, must be met.

Links to cited law and rule and additional related resources:

http://codes.ohio.gov/oac/4723-9 (Prescribing standards, generally)

http://codes.ohio.gov/oac/4723-9-13v1 (Medication Assisted

Treatment)

https://codes.ohio.gov/ohio-administrative-code/rule-4723-9-14

(Standards and procedures for withdrawal management for drug

or alcohol addiction)

For information on buprenorphine waiver processing, contact

the SAMHSA Center for Substance Abuse Treatment (CSAT)

at 866-BUP-CSAT (866-287-2728) or infobuprenorphine@

samhsa.hhs.gov

https://www.samhsa.gov/medication-assisted-treatment/

become-buprenorphine-waivered-practitioner

https://nursing.ohio.gov/wp-content/uploads/2020/03/APRN-

PRESCRIBING-PROCESS.pdf

Practice resources, including prescribing resources, are on the on

the Practice Resources page on Board website at www.nursing.

ohio.gov. Please email practice questions to practiceaprn@

nursing.ohio.gov.

Ohio Board of Nursing 15

16 MOMENTUM

USE OF LIGHT-BASED MEDICAL DEVICES FOR THE PURPOSE OF HAIR REMOVAL

T he legislature recently enacted Section 4731.33, Ohio

Revised Code (ORC), effective September 30, 2021,

regarding physician delegation of the application of

light-based medical devices for the purpose of hair removal to

various individuals including RNs and LPNs. Section 4731.33,

ORC, establishes requirements including physician evaluation

and re-evaluation of the patient and on-site supervision of the

RN or LPN, as discussed below.

A physician may only delegate the application of a light-based

medical device for the purpose of hair removal if:

• the light-based medical device has been specifically cleared

or approved by the FDA for the removal of hair from the

human body;

• the use of the light-based medical device for the purpose of

hair removal is within the physician’s normal course of

practice and expertise;

• the physician has seen and evaluated the patient to determine

whether the proposed application of the specific light-based

medical device is appropriate; and,

• the physician has seen and evaluated the patient following the

initial application of the specific light-based medical device,

but prior to any continuation of treatment, to determine that

the patient responded well to that initial application of the

specific light-based medical device. Section 4731.33(B), ORC.

In addition, when delegating to a RN or LPN, the physician must

provide on-site supervision at all times that the RN or LPN is

applying the light-based medical device.

And the physician may supervise no more than two (2) delegates

(whether nurses or other delegates) at the same time. Section

4731.33(F), ORC.

Finally, the RN or LPN is required to immediately report to the

supervising physician any clinically significant side effect

following the application of the light-based medical device or

any failure of the treatment to progress as was expected at the

time the delegation was made. The physician must see and

personally evaluate the patient who has experienced the clinically

significant side effect or whose treatment is not progressing as

expected as soon as practicable. Section 4731.33(H), ORC.

All nurses are required to engage in practice consistent with the

Nurse Practice Act, Chapter 4723, ORC, and standards of

practice in Chapter 4723, Ohio Administrative Code (OAC).

RNs and LPNs may utilize the RN and LPN Decision Making

Model as a guide when determining whether a specific procedure,

task or activity is within the RN’s or LPN’s scope of practice and,

if so, whether the specific procedure, task or activity is consistent

with standards of practice, appropriate to perform based on the

individual nurse’s knowledge and skills, and appropriate based

on the clinical setting. The Model can be accessed on the Board

website under Practice Resources or through the link below.

“Light-based medical device” means any device that can be made to produce or amplify electromagnetic radiation at wavelengths

equal to or greater that one hundred eighty nm but less than or equal to 1.0 x 106 nm and that is manufactured, designed, intended,

or promoted for irradiation of any part of the human body for the purpose of affecting the structure or funtion of the body. Section

4731.33(A)(1), ORC.

“On-site supervision” means the supervising physician is physically in the same location as the delegate during the use of the light-

based medical device, but does not require the physician to be in the same office suite as the delegate during the use of the device.

Section 4731.33 (A)(2), ORC

Ohio Board of Nursing 17

APRNs

Qualified CNPs, CNSs, CNMs may also use or delegate to an RN

or LPN the use of a light-based medical device by observing the

same conditions for physician delegation as established in the

Medical Practice Act. Qualified CNPs, CNSs, CNMs would

include those whose use of light-based medical devices is consistent

with the CNP’s, CNS’s, CNM’s education and training, and scope

and national certification, as defined in Section 4723.43, ORC.

Any CNP, CNS, or CNM who utilizes light-based medical devices

in their practice, must do so according to the terms of the standard

care arrangement (SCA) they enter into with a qualified

collaborating physician. The SCA may include use of light-based

medical devices within the statement of services provided by the

ARPN and include a plan for incorporation of new light-based

medical device technology or related procedures into their practice

consistent with the applicable scope of practice. Rule 4723-8-

04(D)(5) and (6), OAC.

As with any practice or procedure, the CNP, CNS, or CNM must

use or delegate the use of light-based medical devices consistent

with acceptable and prevailing standards of practice and the

applicable law enumerating those standards so as not to exceed the

authority of the collaborating physician and to comply with Rule

4723-8-02(D), OAC, which specifies that the CNP, CNS, or CNM

must, for their practice, apply knowledge of Chapter 4731, ORC,

and the rules adopted under that Chapter.

Links to law and rule and practice resources:

https://codes.ohio.gov/ohio-revised-code/section-4731.33

http://nursing.ohio.gov/wp-content/uploads/2019/10/decision-

making-model20191007_14055357.pdf

https://codes.ohio.gov/ohio-administrative-code/rule-4723-4-03

https://codes.ohio.gov/ohio-administrative-code/rule-4723-4-06

https://codes.ohio.gov/ohio-administrative-code/rule-4723-8-02

https://codes.ohio.gov/ohio-administrative-code/rule-4723-8-04

https://codes.ohio.gov/ohio-administrative-code/chapter-4731-18

Questions may be directed to the Board at practicernandlpn@

nursing.ohio.gov or practiceaprn@nursing.ohio.gov

18 MOMENTUM

During the COVID-19 pandemic, we reported that temporary

licenses, authorized by HB 197, HB 6, and HB 404,

significantly increased the licensure workload. By January

4, 2021, the Board received nearly 17,000 applications, a 35% increase

over 2019. The emergency nature of the pandemic affected everyone

and created unprecedented challenges not only for the State of Ohio and

the Board, but other parties outside the Board’s control like the State’s

online license system, nursing programs, employers, law enforcement’s

criminal background checks, and the national testing centers. As a result,

the requirement to issue temporary licenses required new processes: more

applications to review, manual processes, less time to complete licensing

functions, including individual communications, and the issuance of

other types of licenses. The inability of the licensing platform to integrate

the new license into existing processes further required the Board to

respond separately to employers who needed Board confirmation when

the licensees passed the NCLEX. The temporary license requirements

impacted many aspects of licensure and health care providers, including

patient safety and public protection.

While we all continue to share a common desire to work together to

meet these challenges, nursing workforce needs today in all fifty states

and including internationally educated applicants remain dependent

on successfully completing a standardized, national examination, a

core aspect of the licensing process that assures employers and the

public that an individual is competent for entry-level practice.

The Board will continue to initiate, fund and implement

improvements and efficiencies in the Ohio eLicense system to

continuously improve licensing and related processes for applicants.

The following highlights changes that have been implemented

for fiscal year 2021.

1. IDENTIFIED NEW PROCESS IMPROVEMENT FEATURES a. Installed remote phone software (Jabber), to enable staff to

handle calls from remote work locations.

b. Implemented report components to track ‘last visit’ on an

application which enables supervisors to assign work to staff

based on when an application was last reviewed and monitor

the aging of applications when the Board is waiting to receive

additional documentation.

2. ELIMINATED MANUAL WORK FOR COST AND TIME SAVINGS

a. Disabled withdrawal of application option to be consistent with

administrative rules and eliminate manual processing.

b. Enabled bulk assignment of applications to facilitate multiple

reviews by staff members.

c. Implemented the electronic wall certificate feature which

reduced the time for mailing individual wall certificates and

resulted in cost savings by eliminating mailing, printing, and

envelope expenses.

d. Implemented automation to indicate certain Service Requests

were completed daily which eliminated the need for staff to

manually close these individually.

3. ADDRESSED DATA CONSISTENCY/SECURITY/PRIVACYa. Developed internal reporting systems so Board staff could

respond to public record requests upon the elimination of

this service for Boards and Commissions by the Department of

Administrative Services.

b. Resolved certain ongoing data issues with PearsonVue and

NURSYS integrations to improve data quality that was received

and transmitted to these entities.

4. IMPROVED QUALITY OF SERVICE TO APPLICANTS/ LICENSEES

a. Updated all Initial and Renewal Applications to ensure

consistency of language, questions, and attestations to enhance

ease of use for applicants.

b. Updated all notifications and emails to applicants and licensees

to ensure that additional, helpful information was readily

available in the messages.

c. Implemented the electronic wall certificate feature to enable

licensees to print wall certificates at any time free of charge.

5. REDUCED TIME TO PROCESS LICENSESa. Developed alternate processes to support licensing changes

mandated by HB 197, HB 404 and HB 6 during the declared

emergency. Without implementing these processes, the Board

could not have started immediate processing of these licenses

as was required by law. Additionally, if the Board had to wait for

permanent processes to be implemented in eLicense, it would

have cost time and money.

b. Funded and implemented the automation of matching Program

Completion Letters (PCLs) with applications, previously

completed manually by staff. Manually, once a PCL was located

(10-20 mins), it took about 2-3 minutes per application to upload

the PCL and update the record, while the automated process

uploads about 100 PCLs in 30-60 seconds after the file is placed

in the folder.

LICENSING, PROCESS IMPROVEMENTS, AND EFFICIENCIES IN OHIO eLICENSE

Ohio Board of Nursing 19

20 MOMENTUM20 MOMENTUM

OCCUPATIONAL LICENSE REVIEW FOR THE OHIO BOARD OF NURSING

SB 255 (132nd General Assembly) requires

all occupational licensing boards to be

renewed at least once every six years by the

General Assembly. Ohio Revised Code Section

101.63 (https://codes.ohio.gov/ohio-revised-code/

section-101.63) specifies that standing committees

review approximately 33% of the boards each

biennium, and to review all boards at least once

every six years. Boards must submit a report

containing information about the board’s purpose,

workload, budget, and staffing to demonstrate the

need for its continued existence.

Below are some of the questions and responses

the Board submitted to the Ohio House State and

Local Government Committee in June 2021 for

consideration. Please note the statistics cited are

for FY20, the available data at that time. Data for

FY21 is included in the Board Annual Report for

FY21 which will be posted on the website by

October 1, 2021.

1. DESCRIBE THE BOARD’S PRIMARY PURPOSE, GOALS AND OBJECTIVES, AND LICENSES ISSUED. The mission of the Board is to actively safeguard

the health of the public through the effective

regulation of nursing care. The Board administers

and enforces the provisions of Ohio Revised

Code Chapter 4723.

The Board’s Strategic Initiatives are as follows:

• Compliance/Discipline: To efficiently

handle complaints, investigations, and

adjudications to safeguard the health of

the public and, in cases involving

substance use disorder or practice issues,

provide alternatives to discipline

programs, if determined appropriate.

• Licensure: To assure applicants meet

requirements to practice in Ohio while

maintaining an efficient and effective

system to license applicants as quickly as

possible to enter or remain in the

workforce; and to assure licensees

maintain competency based on

continuing education requirements.

• Education: To approve pre-licensure

education programs to assure the

programs maintain academic and clinical

standards for the preparation of entry-

level nurses.

• Practice: To address pertinent regulatory

issues for licensees and provide greater

clarity about the requirements to those

regulated by the Board and to the public.

• Administration: To maintain operational

support, legislative and regulatory matters,

information technology, communications,

and innovative regulatory programs.

The Board licenses Registered Nurses (RNs);

Licensed Practical Nurses (LPNs); Advanced

Practice Registered Nurses (APRNs) which

includes the designations of Certified Nurse

Practitioners (CNPs), Clinical Nurse Specialists

(CNSs), Certified Nurse Midwives (CNMs), and

Certified Registered Nurse Anesthetists (CRNAs);

Dialysis Technician Interns (DTIs); Dialysis

Technicians (DTs); Community Health Workers

(CHWs); Medication Aides (MA-C); Volunteers;

nursing education programs; and training

programs. The Board expedites licensure for

military personnel, veterans, and spouses. In

FY20, a total of 2,579 licenses were expedited for

military personnel, veterans, and spouses.

2. DESCRIBE THE BOARD’S ANNUAL WORKLOAD. HOW MANY STAFF ARE EMPLOYED?At full capacity, 13 Board members and 71 full-

time equivalent staff are responsible for regulating

about 303,000 licenses, 189 nursing education

programs, and 52 training programs, and

investigating over 8,000 complaints a year.

Education: Competent and safe nursing

practice begins with education programs that

prepare individuals for nursing practice. The

Board determines that 189 pre-licensure

nursing programs meet and/or maintain

educational regulatory standards to assure

entry-level nurses have completed the

educational requirements that prepare them

for nursing practice. In addition, the Board

regulates 52 training programs for dialysis

technicians, community health workers, and

medication aides.

Licensure: The Board determines applicants’

eligibility to be licensed or certified. In FY20, the

Board processed 23,221 applications for licensure

and 25,082 service requests related to licensure;

and issued 21,738 new nursing licenses. The last

RN and APRN renewal cycle, 223,911 RN and

APRN licenses were renewed. In addition, in

FY20, the Board regulated 20,734 APRN licenses

and 2,308 dialysis technicians/dialysis technician

interns; 772 community health workers; and 346

medication aides.

Practice: The Board adopts administrative rules

and monitors legislative proposals to establish

regulatory requirements for safe nursing care.

The Board responds to about 475 practice

questions monthly through individual responses

and develops “Interpretive Guidelines” for

frequently asked questions. The Board convenes

three external advisory groups related to practice

and is in the process of establishing a new

advisory group for CHWs.

Compliance: The Compliance Unit triages and

investigates complaints regarding criminal

offenses including drug diversion, impairment/

substance use disorder, sub-standard practice,

patient abuse and neglect, and other violations of

the Nurse Practice Act and administrative rules.

The Compliance Unit prepares investigative and

hearing subpoenas, Notices of Opportunity for

Hearing, evidentiary materials for no-hearing

requested cases, settlement agreements, legal

publication notices, and assists in preparing

adjudication hearings according to Chapter 119

ORC. For FY20, the Board received 8,350

complaints and all investigative and disciplinary

processes were completed in a timely manner;

and prepared, processed and/or mailed 2,649

Board actions. Staff responded individually to

hundreds of requests from former or current

licensees regarding disciplinary actions and due

Ohio Board of Nursing 21

to COVID-19, conducted investigative interviews,

meetings, and hearings virtually. The Board

reports 100% of all Board disciplinary actions to

the National Practitioners Data Bank (NPDB)

with zero actions missing according to the NPDB

biennial compliance audit. Disciplinary actions are

also reported to Nursys, a national nursing

database.

Staff monitored over 1,200 licensees with

Board action including reviewing employer/

practice reports and drug/alcohol screen

results. In addition, the Board administers two

alternative-to-discipline programs: Alternative

Program for Substance Use Disorder, a

confidential program offered for licensees with

substance use disorder and the Practice

Intervention and Improvement Program, a

confidential practice remediation program

offered for licensees with practice deficiencies.

Administration: The Board uses multiple

venues to inform the public and interested parties

about the Board’s disciplinary actions, proposals

for rule making, practice guidance, new

regulatory requirements, statewide initiatives,

and Board activities and processes. Staff respond

to an average of 800-1,000 public records request

per year with more than 90% completed within a

three-business day turnaround.

Nursing Workforce: The Board (1) assists

the Ohio Department of Higher Education

with the administration of the Nurse

Education Assistance Loan Program, a

tuition assistance program that addresses the

nursing shortage by encouraging graduates

to remain in Ohio as they enter the nursing

profession or become nursing faculty; (2)

administers the Nurse Education Grant

Program that funds education programs to

increase their student capacity; (3)

administers the Nursing Special Issues fund

used to address patient safety and health care

issues related to supply and demand issues

for nurses; and (4) participates in coalitions

or committees such as the Ohio Action

Coalition established to promote nursing

collaboration throughout Ohio and the

recommendations of the Institute of

Medicine (IOM) report, The Future of

Nursing: Leading Change, Advancing Health.

New Licenses: For FY20, there were 302,823

active licenses as of June 30, 2020:

• RNs – 222,635

• LPNs – 56,028

• APRNs – 20,734

• Dialysis Technicians and Interns – 2,308

• Community Health Workers – 772

• Medication Aides - 346

3. HOW MANY NEW LICENSES DOES THE BOARD ISSUE ANNUALLY? HOW MANY RENEWED LICENSES ARE ISSUED ANNUALLY? HOW MUCH DOES A NEW LICENSE COST? HOW MUCH DOES A RENEWAL COST?

Renewal Licenses: The Board renews over

220,000 RN and APRN licenses in odd-numbered

calendar years. For LPNs, about 58,000 licenses

are renewed in even-numbered calendar years.

DT, CHW, and Medication Aide certificates are

also renewed every two years.

New Licenses: For FY20, a total of 21,358 initial

licenses were issued:

• RNs – 14,895

• LPNs – 3,556

• APRNs – 2,192

• Dialysis Technicians and Interns – 484

• Community Health Workers – 162

• Medication Aides – 69

Costs of New and Renewed Licenses: Fees

range from $35 to $150.

4. IN THE PAST 5 YEARS, HAS THERE BEEN ANY CONSIDERATION TO LOWER THE LICENSURE COST? HOW MUCH REVENUE IS PROCURED FROM THE LICENSURE FEES? WHAT DOES THIS REVENUE FUND?The Board receives no General Revenue

funds. The Board is totally funded by licensure

fees and the Board has not requested an

increase in fees. There has been no

consideration to lower or increase the

licensure fee in the past five years. We are

proud that the Board has absorbed an

escalating workload without seeking any fee

increases in over 17 years (since 2004).

In comparing Ohio licensure fees with

nurse license fees in other states: 4 states

charge under $51; 21 states charge $51-

$100 per license; and 33 states charge $101

to over $200.

License revenue funds all Board operations:

• Regulating about 303,000 licenses,

including issuing over 20,000 new

licenses annually.

• Processing over 8,000 complaints and

taking disciplinary actions for violations

including theft of drugs, substance use

disorder, drug diversion, patient abuse

and neglect.

• Oversight of 189 nursing education

programs.

• Oversight of 52 training programs for

DTs, CHWs, and Medication Aides.

• Responding to an average of 454 practice

questions per month.

• Administrative matters including fiscal

management, human resources, payroll,

legal, legislative, operations, information

technology, grant programs, and

communications.

The Board has a demonstrated track record of

fiscal responsibility achieved by streamlining

internal processes and implementing operational

efficiencies. The Board plays an important role in

positively impacting safe nursing care and public

protection while achieving lean and efficient

government with common sense approaches to

meeting regulatory challenges.

5. HAS THE OPERATION OF THE BOARD INHIBITED ECONOMIC GROWTH, REDUCED EFFICIENCY, OR INCREASED THE COST OF GOVERNMENT?The operation of the Board has not inhibited

economic growth, reduced efficiency, or

increased the cost of government.

The Board receives no General Revenue

funds. It is totally funded by license fees paid

continued on page 22

22 MOMENTUM

by those regulated by the Board and those

fees are moderate and not been expanded for

17 years, since 2004.

The public and employers are benefitted from

having a strong regulatory system for nursing in

place to help promote public safety. Public safety

should spur economic growth both directly and

indirectly. Healthy Ohioans lead to prosperity.

6. ARE THERE ANY LICENSES THAT ARE NO LONGER ISSUED BY THE BOARD? HB 216 (131st GA) eliminated Certificates of

Authority (COA) and Certificates to Prescribe

(CTP) as of December 31, 2017. The legislation

replaced both certificates with one license for

APRNs that designates them as CRNAs, CNPs,

CNSs, or CNMs and authorizes certain APRNs

to prescribe.

House Bill 303 (129th GA) streamlined the

dialysis technician certification process. The

Board no longer issues Temporary Certificates 1,

2, and 3, but instead issues a dialysis technician

intern certificate leading to full certification.

7. HAS THE BOARD RECOMMENDED STATUTORY CHANGES TO THE GENERAL ASSEMBLY THAT WOULD BENEFIT THE PUBLIC AS OPPOSED TO THE PERSONS REGULATED BY THE BOARD, IF ANY, AND HAVE THOSE RECOMMENDATIONS AND OTHER POLICIES BEEN ADOPTED AND IMPLEMENTED?

The Board worked with the General Assembly

regarding bills that benefited the public.

• The Board secured an amendment in Am

Sub HB 49 (132nd GA) to authorize LPN

licensure for military personnel who

complete Level 5 military training and the

Community College of the Air Force

education program. This was a result of

collaboration with representatives of the

Ohio National Guard, the Office of

Workforce Transformation, the Ohio

Department of Veteran Affairs, and NCSBN

to establish a pathway for medics to become

licensed practical nurses (LPNs) in Ohio.

• Am Sub HB 49 (132nd GA) authorized,

among other provisions, the provision of

nursing care at a free camp accredited by the

SeriousFun Children’s Network for

individuals with chronic diseases. It also

authorized APRNs to provide medication-

assisted treatment for substance use

disorders.

• House Bill 170 (130th GA) authorized

certain health care professionals, including

APRNs with prescriptive authority, to

personally furnish or issue a prescription for

naloxone to a friend, family member, or

other individual in a position to assist an

individual at risk of experiencing an opioid-

related overdose.

• The Board adopted, in conjunction with

other health care boards, a “Joint Regulatory

Statement on Prescription of Naloxone to

High-Risk Individuals.”

• House Bill 198 (128th GA) created the

Patient Centered Medical Homes (PCMH)

pilot program to provide comprehensive

care at lower costs. A Board member was

appointed to the PCMH Education

Advisory Group. Nursing was a component

of PCMH development in Ohio: five

APRN practices were converted into

PCMH practices as part of the pilot

program, numerous nursing education

programs have successfully implemented

PCMH training and clinical experience in

their curriculums, and thirty nursing

scholarships have been awarded.

To advance/promote PCMH, the Board

adopted rules to establish that PCMHs are

eligible to partner with nursing education

programs for NEGP funding.

• Senate Bill 7, (133rd GA) authorized

licensing boards to issue six-year temporary

licenses to members of the military and

spouses who are licensed in another

jurisdiction and have moved to Ohio for

active duty. The Board participated in the

legislative discussion and promoted its

implementation by including the required

changes as part of the Board’s current

system for issuing temporary permits.

• Am Sub HB 197 (133rd GA), effective on

March 27, 2020, and HB 6 (134th GA),

effective May 14, 2021) suspended, for the

period of the COVID-19 emergency, the

requirement that an applicant for licensure

by examination have passed the NCLEX

examination and authorized the Board to

issue a temporary license.

• Am Sub HB 197 (133rd GA), revised the

practice of CRNAs.

• SB 331 (133rd GA), consistent with the

Board’s testimony in the sunset review

process, abolished the Committee on

Prescriptive Governance (CPG) and

renewed the Advisory Committee on

Advanced Practice Registered Nursing until

December 31, 2022.

8. IS THE PRESERVATION OF THE BOARD AND THE BOARD’S LICENSES NECESSARY TO PROTECT THE PUBLIC’S HEALTH, SAFETY, OR WELFARE? The Board is vital for public protection. Public

protection and safe patient care are critical, as

nursing touches virtually every citizen of Ohio.

The public expects nurses to obtain an adequate

level of educational preparation, follow

established practice standards, and provide

competent nursing care. They also expect the

Board to address unsafe practitioners so

vulnerable populations, who nurses serve, are

protected. Board operations are designed to

meet these public expectations. Board

operations are set up to license only qualified,

competent nurses and remove dangerous

practitioners from practice in a timely manner

to protect Ohio patients.

The Board investigates complaints and takes

disciplinary actions to notify the public about

unsafe practitioners. Further, to protect the

public’s health, the Board reports data to

national databanks to alert other states about

Ohio nurses with disciplinary action. All Board

disciplinary actions are reported to the Nursys

nursing database, and to the federal National

Practitioners Data Bank (NPDB).

Ohio was one of three states that participated in

a three-year NCSBN Transition to Practice

continued from page 21

Ohio Board of Nursing 23

Study, designed to examine the effect of a

Transition to Practice model on patient safety

and quality outcomes based on the practice of

newly licensed nurses transitioning to practice.

Ohio was one of originally eighteen state nursing

boards participating and submitting TERCAP

data to establish a national database regarding

patient safety and practice breakdown. TERCAP

(Taxonomy of Error, Root Cause Analysis and

Practice-Responsibility) is the tool used to gather

data regarding nursing practice breakdown.

The Board routinely works with other state

boards, commissions, and agencies to promote

patient safety and public protection. For

example, a Program Manager participates in

meetings of the Ohio Medicaid Program

Integrity Group, convened by the Attorney

General’s office; patient safety-based projects

in which Board staff contribute include, e.g.,

work with The Ohio State University/the Ohio

Organization of Nurse Leaders (OONL),

addressing the issue of 12-hour shifts on

nurses’ physical and mental health,

RecoveryOhio initiatives, and the State

Working Group convened to address health

care provider sexual impropriety complaints.

9. COULD THE PUBLIC BE PROTECTED OR SERVED IN AN ALTERNATE OR LESS RESTRICTIVE MANNER? IF APPLICABLE, PLEASE IDENTIFY ANY LICENSES OR FUNCTIONS OF THE BOARD THAT COULD BE ELIMINATED OR CONSOLIDATED. There are no licenses or functions of the Board

recommended for elimination or consolidation

at this time. The Board has worked diligently to

balance public protection and regulate in the

least restrictive manner. The Board continuously

identifies and implements changes to address

regulatory efficiency and effectiveness. The Board

was awarded the national NCSBN Board

Regulatory Achievement Award for regulatory

excellence and innovation.

Examples of Board implementation of less

restrictive regulatory and policy changes are

as follows:

• Since 2005, and on a continuing basis, the

Board conducts a “plain English” review

of its rules and amends or rescinds rule

language that is obsolete, ineffective,

contradictory, or redundant.

• Amended administrative rules requiring

education programs to consider requests

for academic credit for military training;

waived renewal fees and/or provided an

extension for continuing education based

on active duty; established a dedicated

Military and Veterans web page; and

assured that licensure examinations are

on the Department of Veterans Affairs

qualified list of non-federal government

examinations allowing eligible veterans

and their dependents to be reimbursed for

the cost of the test.

• Implemented a new policy to decrease the

processing time for veterans, service

members and spouses licensed in other

states seeking reciprocity by “endorsing”

their out-of-state licenses into Ohio.

Applicants no longer need to submit

transcripts and photographs prior to the

issuance of temporary permits and licenses.

The Board determined that educational

preparation could be verified, and the

identity of the applicant could be established

using the Nursys national database and

other methods.

• The Board joined in the fight against human

trafficking by encouraging nurses to become

informed and understand human trafficking

issues; creating a permanent home for

human trafficking materials on the Board

web site; disseminating information through

email and social media; providing a link to

the Ohio Department of Health’s materials

for School Nurses; and assuring that all

Board Investigators attended training.

• Revised administrative rules to specify

that instruction in nursing education

programs or the various training programs

may be online rather than in the

classroom, if appropriate.

• Adopted, for prescribing APRNs, an

exclusionary Formulary to replace the

inclusive Formulary which APRNs had to

consult frequently to determine if certain

drugs were approved.

• Implemented Interpretive Guidelines to

provide nursing practice guidance based

on the Nurse Practice Act and

administrative rules.

• Eliminated the need for APRNs to apply

for two certificates and replaced both

certificates with one license for APRNs.

• Testified before the Legislative Sunset

Review Committee in 2020 to recommend

elimination of the Committee on

Prescriptive Governance (CPG) and

subsequently the CPG was eliminated.

• Removed a regulatory requirement that

applicants submit all their CE

documentation with license applications

thereby streamlining the ease of applying

and decreasing processing time.

• Initiated statutory and administrative rule

changes for the Alternative Program (AP)

to enable individuals with substance use

disorder (SUD) to participate in AP earlier

in their disease process for greater success

in treatment and recovery.

• Permitted LPNs, RNs, and APRNs to

satisfy a portion of their CE requirements

by providing health care services

without compensation to indigent and

uninsured persons.

• Extended the Nurse Education Grant

Program (NEGP), which was scheduled

to end in 2013, to extend 10 more years

until 2023.

• Implemented the collection of nursing

workforce data and provided the raw data

and summary reports on the website for use

by researchers and policy makers to address

supply and demand issues. Data collection is

a vital component of workforce planning and

policymaking. The Board has been collecting

comprehensive nursing workforce data each

year since 2013.

• Participated as a member of the Ohio

Department of Higher Education (ODHE)

Ohio Physician and Allied Health Care

Workforce Preparation Task Force.

• Participated in the Provider Staffing and

Patient Safety Advisory Committee to

identify provider workforce staffing

practices and state-level policies that

contribute to improved patient safety in

clinical care settings.

continued on page 24

24 MOMENTUM

• Implemented the Patient Safety Initiative, a

joint collaborative between the Board and

nursing employers, to implement as more

comprehensive approach to practice issues

with a goal to increase patient safety through

effective reporting, remediation, modification

of systems, and accountability.

• Participated in the Ohio Action Coalition

was established for nursing collaboration

throughout Ohio for the advancement of

the IOM recommendations. The Institute

of Medicine (IOM) report, The Future of

Nursing: Leading Change, Advancing

Health set forth eight recommendations

for nursing.

• Established a new Advisory Group on

Certified Community Health Workers to

examine CHW roles to address access to

health care for underserved populations.

• The Board has implemented and maintained

numerous quality control and efficiency

measures, consistent with its continuous

improvement philosophy:

• Converted all types of applications to

mandatory online submission in 2016 to make

licensing more efficient.

• Implemented the new Ohio eLicense system

3.0 system in conjunction with DAS/OIT.

• Reduced the number of public records

requests by nearly 100% by making documents

available to the public through a national

online nursing database.

• Established an online system for submission of

education program completion letters, rather

than hardcopies, to expedite licensure by

examination.

• Established an electronic means to obtain

other state licensure verification documents

rather than mailed hardcopies, to expedite

licensure by reciprocity.

• Updated the disciplinary databases for

electronic logging of personal confidential

information and eliminated hundreds of staff

hours of manual logging.

• Increased the number of paralegal employees

to assist staff attorneys for increased efficiencies.

• Obtained funding for temporary staffing

through the National Council of State Boards

of Nursing to update the data in Nursys, the

national online nursing database.

• Eliminated the use of paper wallet cards to

reduce costs and eliminate the possibility of

the wallet card being altered, forged, or

misappropriated.

• Reduced the average processing time for

discipline cases, known as “no request

for hearing cases,” from 2.5 years to six

months, by the discontinuation of

outsourcing this function.

• Established a Board Hearing Committee to

expedite cases for Chapter 119. hearings and

for cost savings.

• Hired staff Hearing Examiners for cost savings

and to expedite disciplinary hearing cases.

• Used electronic methods to streamline the

disciplinary complaint intake process by

reducing repetitive data entry.

• Eliminated verification delays so employers

could immediately verify APRN certification

and eliminated the manual processes

previously required for Board staff to update

verification data.

• Used social media and increased use of email

to provide updated information to applicants

and licensees about licensure.

• Hosted an annual NCLEX Regional

Conference for nursing education

programs to increase understanding about

the development of the NCLEX and

provide updates about the Next Generation

NCLEX (NGN).

• Instituted Post-Notice Settlement

Conferences to resolve disciplinary cases

and reduce hearing costs.

• Implemented a complete redesign and

renovation of the Board website for easier

access to information.

• Reconfigured the telephone system for a more

user-friendly system and better navigation.

• Added the capability to issue temporary

permits for APRNs, DTs, and MA-Cs as was

already in place for RNs and LPNs.

• Updated all license applications to ensure

consistency of instructions, compliance

questions, and attestations.

• Automated notifications to licensees about the

expiration of temporary permits.

• Implemented the cloning of information for

temporary permits to eliminate manual

entry, ensure data accuracy, and enable

faster issuance.

• Implemented a feature to allow the automatic

refund of fees and eliminate the need to file

service tickets.

• Implemented visual Compliance

Indicators and Enforcement flags to

provide a direct view of the compliance

status of the current application.

• Created a new Service Request category

through which an applicant can request an

address change to ensure that the request is

automatically connected with the license for

future reference.

• Added an auto-generated email to the

applicant when a license is inactivated to

eliminate the need to email applicants.

• Reduced costs for applicants in obtaining

money orders or cashier’s checks and

expedited Board deposits by using credit or

debit cards for all financial transactions.

• Developed an Applicant Checklist as a tool

to inform applicants of the required

documents and processes and reduce the

need to contact the Board.

• Maintained the Ohio Center for Nursing

website to promote nursing as a career and

provide information about the nursing

workforce in Ohio.

10. ANY ADDITIONAL NOTES OR COMMENTS THE BOARD BELIEVES THE COMMITTEE SHOULD BE AWARE OF? The global COVID-19 pandemic impacted nurses

and the practice of nursing in Ohio and around

the world. The Board recognized the vital role of

nurses providing care on the front lines under

difficult circumstances and immediately worked

to increase the nursing workforce in Ohio.

Highlights of actions to address the COVID-19

declared emergency are as follows:

• Notified states that under Ohio law, out-of-

state nurses can work in Ohio during a

declared emergency without obtaining a

license in Ohio. ORC Section 4723.32(G)(7)

authorizes nurses who hold an active, valid

license in another state to practice in Ohio

without an Ohio license for the duration of

any declared disaster including the current

COVID-19 declared emergency.

• Issued RN, LPN, and APRN temporary

permits within one (1) business day for out-

of-state nurses seeking licensure in Ohio.

continued from page 23

Ohio Board of Nursing 25

MembersOhio Board of Nursing City Term Expires

Joanna Ridgeway, LPN, Vice President Hilliard 2022

Sandra Beidelschies, RNUpper Sandusky 2021

Matthew Carle, Consumer MemberBlacklick 2023

Donna L. Hanly, RN 2025Galena

MembersOhio Board of Nursing City Term Expires

Erin Keels, RN, APRN-CNPColumbus 2022

Deborah Knueve, LPNColumbus Grove 2021

Daniel Lehmann, RN, LPN Dayton 2021

MembersOhio Board of Nursing City Term Expires

Nancymarie Phillips, RNWilloughby 2023

Sandra A. Ranck, RNAshtabula 2022

Patricia A. Sharpnack, DNP, RN Supervising MemberChardon 2021

Advisory Groups and CommitteesAll meetings of the advisory

groups are held in the Board office. If you wish

to attend one of these meetings, please contact

the Board office at 614-466-6940 or board@nursing.ohio.gov to confirm the location, date or time.

Advisory Committee on Advanced Practice Registered Nursing – Chair: Erin Keels, RN, APRN-CNP November 9, 2021Advisory Group on Continuing Education – Chair: Daniel Lehmann, RN, LPN September 24, 2021Advisory Group on Dialysis – Chair: Deborah Knueve, LPN September 21, 2021 (Meeting starts at 1:00 p.m.).Advisory Group on Nursing Education – Chair: Patricia Sharpnack, DNP, RN October 7, 2021

Board Meeting Schedule 2021 September 22-23, 2021, November 17-18, 2021

• Expedited new licenses for those entering

the workforce and license reinstatements or

reactivations for large numbers of nurses

re-entering the workforce.

• Increased Ohio’s nursing workforce

for the pandemic by issuing 16,628

licenses between March 1, 2020, and

June 30, 2020, which was an increase

of 4,546 over the same time in 2019.

• Issued 5,468 temporary licenses through

June 30, 2020, based on provisions in

HB 197 that authorize licensure prior to

passing the NCLEX.

• Extended 1,500 license deadlines in

accordance with HB 197, as of June 30, 2020.

• Worked with the State, NCSBN, and

Pearson VUE to re-open the NCLEX

examination testing centers and restore

full testing capacity in Ohio by July 20,

2020, after the March 2020 closure of

the centers.

• Assured that all investigative and

disciplinary processes remained in place

and were completed in a timely manner.

• Developed, distributed, and posted

numerous practice and education guidance

documents and links to COVID-19

resources to keep licensees and educators

informed and updated during the

pandemic.

• Assisted the Ohio Department of Health

(ODH) with surge planning workforce

efforts. ODH reported that 7,495 of

those responding to a workforce survey

indicated having a nursing license, and

the Board compiled the identifying

information for the records.

The Open Meetings Act was amended during

the declared emergency to authorize holding

meetings virtually. While the Board’s

preference is to hold public meetings in

person, our experience was that meeting

virtually was a benefit to all parties. The Board

believes that this option would be beneficial,

especially for committee and advisory group

meetings, and would increase public access to

Board meetings for those who do not wish to

travel or are unable to travel to Columbus.

The Board has a proven track record of public

protection, participating in initiatives to

combat the nursing shortage, and regulating

the largest number of licensed professionals of

any agency in the State of Ohio, while at the

same time, implementing numerous cost

reductions and operational efficiencies. The

Board operates as a well-run, self-sufficient,

and publicly accountable business, as

evidenced by operating with the lowest staff to

licensee ratio among professional licensing

boards in the State.

The Board has been recognized nationally by

receiving the national R. Louise McManus

Award (Executive Director), Board

Regulatory Achievement Award, Exceptional

Leadership Award (Past President), the

Elaine Ellibee Award (Current Supervising

Member and Past President); Exceptional

Contribution Award (Board staff), and the

TERCAP Certificate of Achievement.

26 MOMENTUM26 MOMENTUM

• Go to eLicense.ohio.gov• Log into your account• Scroll to the panel displaying your license type and number• Click the “Options” link on the appropriate license panel • Click on the link “Change Name”• Upload one of the certified court records listed below:

• Click “Submit”

If you have difficulties logging into your account or uploading documents, contact the Customer Service Center at 614-466-3947, “Option 1” (weekdays 8am-5pm, except for holidays). If you need assistance after business hours, email nursing.registration@das.ohio.gov. and include a brief description of the issue, your first and last name, telephone number, email address, and license number, if you have it.

For other questions, email licensure@nursing.ohio.gov and include a brief description of the issue, your first and last name, telephone number, email address, and license number, if you have it.

Make sure you timely update your address – it is a requirement by law that licensees report address changes, within 30 days of the change, to the Board. Your address of record is used for communication purposes.

• Go to eLicense.ohio.gov• Log into your account• Scroll to the panel displaying your license type and number• Click the “Options” link on the appropriate license panel • Click on the link “Change Address”• Click “Submit”• Address changes made online are processed through the system automatically

How Do I Change My NAME with the Board?

How Do I Change My ADDRESS with the Board?

o Marriage Certificate/Abstract o Court Record indicating change of name o Divorce Decree o Documentation from another state/country consistent with the laws of that jurisdiction

If you have difficulties, contact the Customer Service Center at 614-466-3947, “Option 1” (weekdays 8am-5pm, except for holidays). If you need assistance after business hours, email nursing.registration@das.ohio.gov and include a brief description of the issue, your first and last name, telephone number, email address, and license number, if you have it.

For other questions, email licensure@nursing.ohio.gov and include a brief description of the issue, your first and last name, telephone number, email address, and license number, if you have it.

Requests received online are processed in 2-3 business days

IF YOU HAVE NOT USED OHIO ELICENSE WITHIN 12 MONTHS, YOUR PASSWORD HAS EXPIRED.

To see if you can log into your account, go to http://elicense.ohio.gov.• Click on “Forgot your password?” and enter your email address; then check

your email for a password reset link from “elicense-noreply@das.ohio.gov.”• Copy the entire link (begin with “https” and ending with your last name)

and paste the entire link into Google Chrome to get to the reset password page.

• The reset link sent to you will expire after 24 hours; reset your password as soon as possible.

CHANGING YOUR EMAIL IN THE OHIO ELICENSE SYSTEMOhio eLicense uses your email address to generate communications AND serves as your user ID for login/accessing your license information. Step 1 – When you change your current email to a new one via your Manage Profile page, a notification is sent to the current email asking you to confirm that you requested the change. Step 2 – Once you confirm the request, a notification will be sent to your new email confirming that the change has been made.

If you have questions or need assistance, call the CustomerService Center at (614) 466-3947 and select “Option 1” (weekdays 8am-5pm, except for holidays).

BEST WEB BROWERS TO USE FOR OHIO ELICENSE• Google Chrome (recommended)• Moxilla firefox• Microsoft Internet Explorer (Version 11)

CHECK YOUR RENEWAL STATUS If you are unsure of your renewal status, please go to https://elicense.ohio.gov/oh_verifylicense. If it shows an expiration date of this year, it means either you have not started to renew; you have not completed the renewal process; or you have not placed your license on inactive status.

IT IS IMPORTANT TO CHECK YOUR APPLICATION STATUS!If your application is in “Pending” or “Generate Fee” status, the application has not yet been received by the Board because it is incomplete. Return to your application to see if all the information is complete and you paid the fees.

If your application shows as “Submitted” or “In Review,” you can check if documents are still needed, without calling the Board. Log into Ohio eLicense -- be sure you are on the “Welcome to your eLicense Dashboard,” and select “Application Status” from Options.

If you are checking your Submitted or In Review APRN endorsement, select “Application Status” from the down arrow box to the right of your APRN endorsement. Please do not submit more than one application – that will delay processing.

IF YOU FORGOT YOUR PASSWORD OR YOUR PASSWORD HAS EXPIRED

Ohio Board of Nursing 27

Last Name First Name LT1 Lic. #1 Last Name First Name LT1 Lic. #1 Last Name First Name LT1 Lic. #1

July 2021 Disciplinary Actions

BOARD DISCIPLINARY ACTIONSThe following includes lists of Board disciplinary actions taken at public meetings regarding licensed nurses or certificate holders. You can review thetype of action taken by checking the individual’s credential at the Ohio eLicense Center at: http://www.nursing.ohio.gov/Verification.htm#VERInfo, or by clicking on License and Certificate Verification on the Board of Nursing’s website (www.nursing.ohio.gov). You may also request a copy of a public disciplinary record by completing the electronic form on the Board’s website at: http://www.nursing.ohio.gov/iw-DisciplineRecReq.htm or by clicking on Discipline Records Requests on the Board’s website.

Adamson Chelsey P.N. 174457

Ahlstrom Erin R.N. 423750

Alvord Kelly P.N. 116974

Arthur Rhonda R.N. 406298

Asher Erica P.N. 159390

Ayala Dana R.N. 385888

Babalola Mobolaji R.N. NCLEX

Bailey Bianca R.N. 440183

Baker Jaime P.N. 128729

Baker Roxanne R.N. 277277

Bankhead Hasley Ikeia P.N. 175178

Baumgartner Amy R.N. 292799

Benke Brad P.N. 150827

Benndorf Sherrill P.N. 163140

Beverly Stefanie P.N. 119494

Boehler Karen R.N. 250564

Bofah Kwadwo R.N. NCLEX

Bowen Ashley R.N. 325770

Bowman Elena R.N. 281527

Brogan Nicole R.N. 378073

Brooks Kimberly R.N. 318148

Burga Tracy R.N. 316982

Butts Amber P.N. 143116

Byrne Scott P.N. 141487

Cagle James R.N. 334518

Chwojdak Gregory R.N. 350207

Clarke Arlene P.N. 159599

Clemens Youvona R.N. 299150

P.N. 100556

Clemmons Ebony R.N. 227549

P.N. 077010

Clevinger Carol R.N. 247690

Cline Courtney R.N. 373037

Clinton Sheneda R.N. NCLEX

Colborn JoAnn R.N. 413873

Comstock Randall P.N. 141250

Cox Ashley P.N. 139166

Craft Victoria R.N. endorse

Craig Jennifer R.N. 351625

Cullison Tiffany P.N. 156608

Davis Julie R.N. 330937

Davis Lucy R.N. 396158

Davis Sarah D.T. 005862

Davis Tiffany P.N. 146018

Dean Elizabeth R.N. 490722

P.N. 145035

Delgado Jarod P.N. 128682

Dobos Denise R.N. NCLEX

Dubetz Davea R.N. 390616

Durre Lori P.N. 160423

Duru Martin R.N. 366661

Ervin Amy R.N. 382951

P.N. 101389

Euton Angel R.N. 189551

Fancil Casey R.N. 360896

Farmer Janis R.N. 387875

P.N. 122013

Faulkner Pamela R.N. 469976

Frazier Telissa R.N. 406122

Frohman Mariann P.N. 116507

Funk Angela R.N. endorse

Gabor Tracy R.N. 395432

Gardner Denise R.N. 368359

Gerber Wanda P.N. 051273

Giacomoni Michelle R.N. 320001

Gibson Elisha R.N. 388874

Gillum Cynthia R.N. 420623

P.N. 148652

Graves Deborah P.N. 097872

Haines Dawn P.N. 141593

Handshoe Kara P.N. 128735

Hartley Sherry R.N. 343913

Havens Kelley R.N. 448426

Hawkins Jeanette P.N. NCLEX

Heiney Tina R.N. 396217

Heintz Lynda R.N. 298879

CNP 10611

Henderson Dreama R.N. 405233

P.N. 146234

Henderson Kara R.N. 391807

Henke Rebecca R.N. 413489

Hess David R.N. 415047

Hill Falon R.N. 328422

Hipkins Stacia R.N. 349799

Holmes Linda R.N. 245495

Howard Marcia R.N. 328635

Huart Anita R.N. 459090

Hughes Melessia R.N. 324521

Huot Catherine P.N. 084000

Huron II Earl R.N. 404726

P.N. 144430

Ibrow Yussuf R.N. 449070

Ivory Judith R.N. 345894

Januzzi Jenna R.N. 374212

CNP 022643

Jenkins Jennifer R.N. 341654

Johnson Prescious P.N. 152524

Johnson Shawn DT 000299

Jones Trina R.N. NCLEX

Keister Maureen R.N. 284684

Kendall Tyler P.N. 169913

Kennedy Miranda R.N. NCLEX

Kisor Elizabeth R.N. NCLEX

Kloyda Debra R.N. 442060

Kohart Jessica R.N. 317027

Kohler Alfred R.N. 283158

P.N. 090212

Koss Christine R.N. 430232

Kovacs Barbara R.N. endorse

Kreager Lora P.N. 102725

Kuzma Jennifer D.T. 001518

Lee Salena R.N. NCLEX

Leeson Cara R.N. 390608

Leeth Alivia P.N. 143764

Leveille Cam-Suze R.N. 482714

Locke Donna R.N. 367500

Lorenz Cynthia P.N. 144909

28 MOMENTUM

July 2021 Disciplinary Actions

Loveless Amanda DTI 006219

Lowe Bridget R.N. 454788

Lucas Teresa R.N. 409550

P.N. 114386

Lyons Stephanie R.N. 262210

Madison Ashley P.N. 165994

Maltry Anita P.N. 098258

Mangus Carli R.N. 423298

Martin Jennifer R.N. 359844

Massie Karalee R.N. 443678

CNP 021806

Mast Aubree P.N. 171664

McCartney Fotini P.N. 136034

McCusker Cory R.N. 318550

McHone Stacey R.N. 419782

Merchant Javonnda P.N. 146569

Michel Nardine R.N. 481366

Miller Andrew P.N. 164078

Miller Brittany R.N. 395592

CNP 022041

Miller Jessica P.N. 147500

Miller Nicole R.N. 386335

Mills Lauren P.N. 168024

Mitchell Kristen P.N. 097152

Moffett Bryce R.N. NCLEX

Mohney Jill R.N. 482088

Molnar Diane R.N. 207702

Monserrat Martha R.N. 247041

Montgomery Karen R.N. 334830

Moore Kara P.N. 137638

Moore Shannon P.N. 140688

Moran Beverly R.N. 225692

Morgan Dennis R.N. 295130

Moton Lisa R.N. 278017

Mull Kelly P.N. 103396

Nartker Abigail R.N. 314458

CNP 12949

Nava Courtney P.N. 165813

Neale Georgienne R.N. 109889

Nichols Angela R.N. 355784

Nicholson Lori P.N. 109321

Null Mary P.N. 098658

Nunnally Courtney R.N. 367244

Obregon Jason DTI applicant

Offei Perpetual R.N. 440254

Oke Oluwaseum R.N. 462517

P.N. 144179

Patricy Martha P.N. 125526

Patterson Connie P.N. 111299

Paugh Kailey R.N. 424554

Payette Pamela R.N. 387015

P.N. 141894

Peart Tamara R.N. 480859

Pesa Amy R.N. 400598

Peters Angela P.N. 158844

Petrovich Jacquelyn R.N. 444215

Pflager Kirk R.N. 314303

Phillips Roxanne P.N. 115479

Poor Viktor R.N. 389744

Prifogle Laura R.N. 377693

Rafferty Shiloh R.N. NCLEX

Raybourn Beverly P.N. 156699

Reed Trenton R.N. 283558

CRNA 13993

P.N. 097307

Regec Rachel R.N. 389743

Rhodes Michelle R.N. NCLEX

Risner Kyle R.N. 461840

Roberts Christina R.N. 412368

Robinson Jacob R.N. 446966

Rose Tara P.N. 162744

Rosenstengel Caprice R.N. 375193

Rossi Kristen R.N. 440856

Rucker David R.N. 430289

Rudman Troy R.N. 404835

Saas Jennifer R.N. 204041

Sanders Adriane R.N. 370736

Santoiemma Misty P.N. 123239

Saunders Courtney R.N. 388865

P.N. 145084

Schroeder Nicole P.N. 135301

Semmer John P.N. 125777

Sidney Emily R.N. 351656

Simpson Valencia P.N. 167137

Sims Jason R.N. 419089

Sims Latasha P.N. 145069

Skidmore Andrea P.N. 154288

Smith Dakota P.N. 150426

Smith Jasmine R.N. 470053

Smith LaTisha P.N. 139226

Smith Melinda R.N. 248946

Smith Shanda P.N. 172112

Smith Tamatha P.N. 161124

Sobtzak Terese R.N. 422045

Stack Kelly R.N. 429092

Stevenson Beatrice R.N. 219485

Stiegel John R.N. 352744

Stolz Robert R.N. 321559

Swartz Molly R.N. 452084

P.N. 115002

Sykes Jacklyn R.N. 402191

Tanner Gregory R.N. 270002

Temple Jessica P.N. 168830

Thomas Jessica P.N. 130966

Thompson Antoinette R.N. 444987

Thorpe Velvet P.N. NCLEX

Tilocco Denise P.N. 083546

Tovanche Nadia R.N. 406530

P.N. 128519

Tryon Alysha P.N. 164895

Tumen James R.N. 428141

Turner Deborah P.N. 113464

Vacco Nicole R.N. 357161

Walker Katharine R.N. 381662

Wall Amanda P.N. 159423

Wallace Elizabeth R.N. 326726

Wallace Lori P.N. 113993

Weaver Danisha P.N. 148867

Weldon Winter R.N. 267142

Wilbon Tiahna P.N. 159687

Wilbur Dina R.N. NCLEX

P.N. 156213

Winkler Jessica R.N. 360651

Wirth Christina R.N. 380746

Woods Howard R.N. 470754

P.N. 118948

Young Eleanor R.N. 346381

P.N. 106416

Last Name First Name LT1 Lic. #1 Last Name First Name LT1 Lic. #1 Last Name First Name LT1 Lic. #1

Ohio Board of Nursing 29

July 2021 Monitoring Actions Last Name First Name LT1 Lic. #1 Last Name First Name LT1 Lic. #1 Last Name First Name LT1 Lic. #1

Aikins Beverly R.N. 228068

Antonelli Catherina R.N. 247946

Azzarello Angela P.N. 177592

Ball Megan R.N. 414113

Ball Shelly R.N. 470652

P.N. 140865

Balogh Dina P.N. 122620

Berardi Melissa R.N. 335023

Blair Jordan R.N. 443750

Brandewie Bethany P.N. 148465

Brown Nicole P.N. 153987

Campbell Christa R.N. 358675

Campbell Ilisa P.N. 173789

Chase Linda R.N. 330058

Coleman Enid P.N. 166769

Cook Connie R.N. 333054

P.N. 122786

Cook Lashonda P.N. 154785

Cordier Patrick P.N. 142661

Cosiano Tiffany R.N. 410972

P.N. 135420

Courtland Natoshia R.N. 484117

Curnett Tonya R.N. 362008

Dagani Matthew R.N. 356942

Davis Precious P.N. 164786

Dawson Lori R.N. 280984

Dittmer Julie R.N. 302330

Dudley Sheena P.N. 162035

Durst Michelle P.N. 126062

Geer Kara P.N. 145334

Gilbert Melinda P.N. 157926

Gilmore Teasha R.N. 474356

Grooms Jennifer R.N. 301736

Hawkins Thomas R.N. 331388

Henderson Sylena P.N. 171911

Hernon Brenna R.N. 470621

Hess Christopher R.N. 491009

Hill Edward R.N. 373519

Hite Amanda R.N. 341404

Holt Danielle R.N. 440645

P.N. 159712

Hovinga Lindsey R.N. 382969

P.N. 127268

Howard Gwendolyn P.N. 120464

Jimenez Melissa R.N. 337511

P.N. 104015

Johnson Dawn R.N. 291264

Johnson Jannette R.N. 117212

CRNA 03971

Kent Kelly R.N. 323703

Keyes Kimberly R.N. 204773

Keys Lisa R.N. 289461

Koberlein Margaret R.N. 406336

Kreps Kathleen R.N. 490732

Lewis Kristen P.N. 154241

List Stephanie R.N. 290896

CRNA 08573

Littman Richard R.N. 334623

Long Roxanne R.N. 385032

Lover Marina P.N. 179184

MacDougall Anastasia R.N. 341435

Mauchamer Jacqueline R.N. 349010

Merrida LaTonya P.N. 177009

Miller Jamie R.N. 328641

CRNA 18164

Miller Jenny P.N. 136456

Morton Darin D.T. 005779

Moye Laquita R.N. 390206

Murrell Melissa P.N. 130061

Myers Christopher P.N. 130458

Myers Kathryn R.N. 244290

Nickens Nicole R.N. 346914

CNP 020745

Ntchomoho Kevin P.N. 169904

Parry Samantha R.N. 346181

P.N. 117711

Patchen Kyle R.N. 423304

CNP 024202

Pettaway Latasha P.N. 160350

Pryor Anita R.N. 364992

Rambo Adam R.N. 414102

Raymond Mary P.N. 130614

Reese Robert R.N. 376545

Reiter Stephanie R.N. 396047

Ripley Kristen P.N. 169531

Robinson Keena P.N. 155256

Saa Michelle R.N. 449406

Sauber Jane P.N. 169359

Savage Margaret P.N. 106376

Setser Cynthia P.N. 123212

Shaw Lori R.N. 285587

Sherman Dawn R.N. 355858

P.N. 116814

Slovak Monica R.N. 370049

Smith Sabrinia P.N. 152554

Sorg Bambi R.N. 280517

Spildener Victoria R.N. 371349

Streb Melanie P.N. 127746

Strohmeyer Kathleen R.N. 424355

Sykes Jacklyn R.N. 402191

Takacs Starla R.N. 272619

Thiergart Melissa R.N. 221346

Valentine Yvette R.N. 263444

P.N. 087356

Vazquez Allyson R.N. 444716

Weber Jennifer R.N. 405563

P.N. 125242

Whetsel Shannon P.N. 117072

White Tierra P.N. 174211

Winkler Jessica R.N. 360651

Worthington Angela P.N. 102778

Yoakum Charlene R.N. 250357

Zumstein James R.N. 375071

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