1. (a) An eligible organization must create a treatment plan for the member as part of the authorization process for private duty nursing (PDN) services. The initial treatment plan must be signed by the member's attending physician [medical doctor (MD), or doctor of osteopathy, (DO)], a physician assistant (PA), or advanced practice registered nurse (APRN).

2. (b) The treatment plan must include all of the following:

   1. (1) Diagnosis;
   2. (2) Prognosis;
   3. (3) Anticipated length of treatment;
   4. (4) Number of PDN requested hours per week;
   5. (5) Assessment needs and frequency (e.g., vital signs, glucose checks, neuro checks, respiratory);
   6. (6) Medication method of administration and frequency;
   7. (7) Age-appropriate feeding requirements (diet, method and frequency);
   8. (8) Respiratory needs;
   9. (9) Mobility requirements including need for turning and positioning, and the potential for skin breakdown;
   10. (10) Developmental deficits;
   11. (11) Casting, orthotics, therapies;
   12. (12) Age-appropriate elimination needs;
   13. (13) Seizure activity and precautions;
   14. (14) Age-appropriate sleep patterns;
   15. (15) Disorientation and/or combative issues;
   16. (16) Age-appropriate wound care and/or personal care;
   17. (17) Communication issues;
   18. (18) Social support needs;
   19. (19) Name, skill level, and availability of all caregivers; and
   20. (20) Other pertinent nursing needs such as dialysis, isolation.

Added at 23 Ok Reg 33, eff 8-1-05 (emergency)

Added at 23 Ok Reg 1364, eff 5-25-06

Amended at 24 Ok Reg 333, eff 12-1-06 (emergency)

Amended at 24 Ok Reg 930, eff 5-11-07

Amended at 28 Ok Reg 14, eff 8-13-10 (emergency)

Amended at 28 Ok Reg 1429, eff 6-25-11

Amended at 32 Ok Reg 1081, eff 8-27-15

Amended at 39 Ok Reg 1523, eff 9-12-22

Amended at 41 Ok Reg, Number 17, effective 4-11-24 (emergency)

Amended at 42 Ok Reg, Number 21, effective 9-1-25