Form Hea 7713 PDF Details

The State of Ohio Department of Health, through its Office of Health Assurance and Licensing, mandates the use of the Nurse Aide Registration Form, known as HEA 7713. This essential document plays a pivotal role in ensuring that nurse aides in the state maintain their active status and remain in good standing on the Ohio Nurse Aide Registry. The form requires facilities to report accurately and comprehensively the employment details of nurse aides, including those contracted through temporary staffing agencies. Specifically, it requires that these aides have provided at least 7.5 consecutive hours or 8 hours of nursing or nursing-related services within a 48-hour period in the last 24 months, a criterion necessary for re-registration. The form also emphasizes the necessity of providing precise data regarding the last date the nurse aide was utilized, prohibiting the use of the term "current" or leaving this field blank. This requirement underscores the importance of accurate record-keeping in avoiding the expiration of a nurse aide's registration due to incomplete or inaccurate data submission. Available for download from the Ohio Department of Health's website, this form facilitates communication between health facilities and the Nurse Aide Registry, ensuring that nurse aides meet the state's standards for employment in healthcare settings. Additionally, if a facility is not Medicare certified, the registry demands a supplementary statement from a physician or nurse verifying the aide's provision of care, further highlighting the rigorous standards upheld by the Ohio Department of Health to ensure quality care across the state.

QuestionAnswer
Form NameForm Hea 7713
Form Length6 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 30 sec
Other namesohio hea registration form, hea 7713 form download, ohio nurse aide registration form, ohio aide form printable

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1. The hea 7713 form download involves certain details to be typed in. Ensure that the subsequent blanks are filled out:

Filling out section 1 of ohio aide form printable

2. Right after finishing the previous section, head on to the subsequent step and fill out the essential particulars in all these blank fields - Section I Facility Information, Facility Medicare Number ie, Street Address, City, Telephone, Type of Facility Nursing Home, County, State, ZIP, FAX, Name of Person to Contact Email s, Hospital Hospice Staffing Agency, RCF ACF Other please describe, License Number, and Name of Director of Nursing.

Hospital  Hospice  Staffing Agency, RCF  ACF  Other please describe, and Name of Director of Nursing of ohio aide form printable

3. The next segment is pretty easy, Name Last First MI, NAR Number, Street Address, City, Date of Hire, Last Date Used, County, State, ZIP, Name Last First MI, NAR Number, Street Address, City, Date of Hire, and Last Date Used - every one of these fields has to be filled in here.

Filling in section 3 in ohio aide form printable

4. Filling out Name Last First MI, Street Address, City, Name Last First MI, Street Address, City, NAR Number, Date of Hire, Last Date Used, County, State, ZIP, NAR Number, Date of Hire, and Last Date Used is paramount in this next part - make sure you devote some time and take a close look at every single empty field!

ohio aide form printable conclusion process clarified (portion 4)

5. The last point to finalize this PDF form is pivotal. Make sure to fill out the required fields, for example City, County, State, ZIP, Name Last First MI, NAR Number, Street Address, City, Date of Hire, Last Date Used, County, State, ZIP, Name Last First MI, and NAR Number, before submitting. Otherwise, it could end up in a flawed and potentially unacceptable paper!

ohio aide form printable completion process explained (portion 5)

Always be extremely attentive when completing NAR Number and ZIP, since this is the part where many people make some mistakes.

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