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Licensure of Inpatient Psychiatric Service Providers

Inpatient Psychiatric Service Providers require licensure if they are private psychiatric hospitals providing acute inpatient mental health services. Private psychiatric units/hospitals are licensed annually.

Licensure Applications

New unit or program
Cover letter for new programs
5122-14-03 OAC
Application for Licensure -DMH-LIC-007
Survey Checklist
Logs required to be maintained for ODMH review
Request for a Waiver or Variance
Areas of Focus for 2010 through 2013

Licensure renewal - Non-survey year
Letter regarding application materials
Application For Licensure -DMH-LIC-007
Logs required to be maintained for ODMH review
Request for a Waiver or Variance
Areas of Focus for 2010 through 2013

Licensure renewal - Survey year
Letter regarding application materials
On-Site Survey Schedules for 2012-2014  2012   2013    2014
On-site ODMH Day Survey Instructions
Application For Licensure -DMH-LIC-007
Logs required to be maintained for ODMH review
Request for a Waiver or Variance
Areas of Focus for 2010 through 2013

Standards and Rules Webinars

Patient Rights - Private Psychiatric Inpatient Providers
Presented February 15, 2012, by Denise Cole, Program Administrator, Kathryn Remer, Consumer Advocacy & Protection Specialist, and Janel M. Pequignot, Chief, Standards Development and Administrative Rules

Seclusion and Restraint: Ohio Administrative Code for Licensed Private Psychiatric Hospital Providers Presented December 19, 2011, by Janel M. Pequignot, Chief, Standards Development and Administrative Rules

Incident Notification & Risk Management Rule Change Webinars
On October 13, 2011 Denise Cole, ODMH Private Psychiatric Program Administrator and Rob Nugen, ODMH Community Client Safety Manager conducted three webinars to address and explain the upcoming changes to the Incident Reporting rules for private psychiatric hospitals, residential facilities and community agencies. Part 1 is a combined presentation conducted by Ms. Cole and Mr. Nugen addressing definitions and rule changes that are common in all three treatment settings. Part 2 is sub-divided into two breakout sessions: Breakout A: addressed the changes specific to Private Psychiatric Hospitals and Breakout B: addressing changes specific to Community Agencies and Residential facilities. These changes go into effect January 1, 2012.
View Part 1 of the incident reporting rules webinar: Combined Community Mental Health Agency, Residential Facility, and Private Psychiatric Hospitals.
View Slides used in the incident reporting webinar Part 1
View Breakout Session A of the incident reporting rules webinar: For Private Psychiatric Hospitals.
View Slides used in the incident reporting webinar Breakout Session A

Ohio Administrative Code Changes Webinar

On June 23, 2011, Janel M. Pequignot, Chief, ODMH Standards Development and Administrative Rules, conducted a webinar to review revisions to Ohio Administrative Code Chapter 5122-14 for Inpatient Private Psychiatric Service Providers that became effective July 1, 2011.
View the OAC Changes Webinar
View slides used in the OAC Changes Webinar

Incident Notification Form

DMH-LIC-013 (PDF format)
DMH-LIC-013 (Word format)


Report a Complaint

If you wish to submit a complaint concerning a licensed or certified Ohio Department of Mental Health provider, please complete all applicable fields on the form below and submit. We will respond to all complaints. Thank you.
Complaint Form DMH-LIC-0982 (PDF)

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