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OAAPN | Year In Review: 2026 Ohio Board of Nursing and Ohio Law Rules

Client Alert

Originally published by Ohio Association of Advanced Practice Nurses (OAAPN)

February 9, 2026

As 2026 charges forward, we want to highlight key changes to Ohio law and the Ohio Board of Nursing rules that have directly impacted APRN practice over the past year (and a little beyond that).

Psychiatric Inpatient Documents

Effective September 20, 2024, Senate Bill 81 gave APRNs the ability to sign documents related to the admission, discharge, and treatment of psychiatric inpatients. To be eligible to sign these documents, the following must be met:

  1. The APRN must be employed by or have credentials at the facility;
  2. The APRN’s collaborating physician is employed by or is a medical staff member at the facility;
  3. The APRN’s collaborating physician has authorized the APRN to sign these documents for the physician’s patients; and
  4. This authority is set forth in the APRN’s standard care arrangement.

Intimate Examinations

Senate Bill 109 became law at the end of 2024 to enhance the safety of Ohio patients. As it pertains to the practice of nursing, the law prohibits RNs, APRNs, and nursing students from performing an intimate examination on an anesthetized or unconscious patient, absent an exception. For example, the prohibition does not apply when a patient or their legal representative has given specific, informed consent for the intimate examination, consistent with the procedure set forth in ORC 4723.93(D).

Signature Authority

We kicked off 2025 celebrating the passage of Senate Bill 196, also known as Global Signature. As a result of Global Signature, APRNs may now sign and complete certain paperwork associated with patient care within their scope of practice. APRN signature recognition extends to several different patient care forms including certification of disability for patients to receive disabled parking placards and patient orders for life-sustaining treatment (POLST) and other end-of-life care documents. Although APRNs are still not permitted to sign death certificates, Global Signature expanded a CNS’s, CNP’s, and CNM’s authority to determine and pronounce an individual’s death. APRNs may also now develop protocols and authorize pharmacists to use such protocols for dispensing nicotine replacement therapy and epinephrine. While we continue to advocate for greater APRN signature authority, Global Signature was a positive step for both APRNs and patients across the state.

Duties Related to Fetal Death

Senate Bill 196 also established a new provision in the Ohio Nurse Practice Act related to fetal death. If a woman presents herself to a CNM, CNS, or CNP as a result of experiencing a fetal death, and the woman is not referred to a hospital, the APRN must provide the woman with the following:

  1. A written statement, not longer than one page in length, that confirms that the woman was pregnant and that she subsequently suffered a miscarriage that resulted in fetal death;
  2. Notice of the right of the woman to apply for a fetal death certificate;
  3. A short, general description of the nurse’s procedures for disposing of the product of a fetal death.

A copy of the written statement and documentation that the requirements listed above were provided must be documented in the woman’s medical record.

-->You can access the full article at this OAAPN LINK for a review of these additional areas:

  • Retail IV Therapy Clinics
  • Release from Permanent Restrictions
  • Disciplinary Action
  • Course on Drugs and Prescriptive Authority
  • Overdose Reversal Drugs
  • Office Based Opioid Treatment
  • Withdrawal Management for Substance Use Disorder
  • Safe Haven Program
  • House Bill 508 - Proposed Retirement of the SCA
  • House Bill 52 - CRNA Practice Revisions
  • House Bill 337 - Laser Hair Removal
  • House Bill 537 - Midwife Bill

If you have any questions about how these change impact your practice, please contact BMD Health Law Member and OAAPN General Counsel, Jeana Singleton at jmsingleton@bmdllc.com.


Ohio House Bill 537: Proposed Regulations for Midwives and Birthing Centers

House Bill 537, introduced in the Ohio House of Representatives, proposes a comprehensive regulatory framework for certified nurse-midwives, certified midwives, licensed midwives, and traditional midwives. The legislation would clarify scope of practice, establish licensure standards, and impose new requirements for freestanding birthing centers and home births. Healthcare providers and facilities should be aware of the proposed changes and their potential operational impact.

Proposed Health Information Privacy Reform Act Expands Protections Beyond HIPAA

The Health Information Privacy Reform Act (HIPRA) seeks to extend privacy protections to health data not covered under HIPAA, including data collected by apps and wearables. HIPRA introduces broader definitions of protected health information, strengthens privacy and security requirements, establishes patient notification rights, and sets national de-identification standards. Companies processing health data should monitor developments to ensure compliance.

Medicare Updates on Skin Substitutes: LCDs Withdrawn, Payment Changes Take Effect

Medicare’s planned Final Local Coverage Determinations (LCDs) for skin substitutes were withdrawn in late December 2025, meaning previous coverage rules remain in effect. The 2026 Medicare Physician Fee Schedule introduces a single payment rate of approximately $127.14 for these products. Providers should review implications for diabetic foot and venous leg ulcer treatments.

Understanding the Seven Core Elements of an Effective Healthcare Compliance Program

The Affordable Care Act requires healthcare providers participating in Medicare, Medicaid, and CHIP to maintain an effective compliance program. Guidance from the Department of Health and Human Services and the Office of Inspector General outlines seven core elements that form the foundation of these programs, from written policies and compliance oversight to auditing, training, and corrective action. This alert highlights each element and explains how practices can tailor compliance programs to their size and risk profile while meeting federal expectations.

Preventing a Board Investigation

Healthcare professionals in Ohio are subject to licensing board investigations that can lead to disciplinary action. Staying compliant with regulations, documenting carefully, and operating within your professional scope can help prevent issues. If contacted by a board, working with an attorney is critical to protect your license and rights.