Ohio’s Nurse Aide Registration Form HEA 7713 is completed and submitted by the employing facility, not by individual aides, and it lists every nurse aide the facility has used since its last survey so each one’s active status on the state registry can be confirmed or renewed.1Ohio Department of Health. Nurse Aide Registration Form HEA 7713 Nursing homes, hospitals, residential care facilities, home health agencies, hospice programs, adult care facilities, intermediate care facilities for individuals with intellectual disabilities, and staffing agencies all use the same form. The facility’s home administrator and director of nursing both sign it before it goes to the Ohio Department of Health Nurse Aide Registry.
If you are the aide, your employer handles this paperwork. If you are the administrator, director of nursing, or staffing coordinator responsible for submitting it, the sections below walk through what each field is asking for and where facilities typically get tripped up.
Who Should Be On the Form
List every nurse aide the facility has used since its last survey, including aides supplied through temporary staffing services. That last piece catches some facilities off guard: an aide who came through an agency and worked even briefly still belongs on your submission if that work happened after your previous survey.
HEA 7713 is not an on-ramp to the registry. An aide who has never been on the Ohio Nurse Aide Registry cannot get there through this form. Initial placement runs through an approved training and competency evaluation program, the state-administered test, or one of Ohio’s alternative eligibility pathways. Once someone is on the registry, HEA 7713 is what keeps them active as they continue working for you.
Section I: Facility Information
The top half of the form identifies the facility. Every field is required, and incomplete forms come back for correction.1Ohio Department of Health. Nurse Aide Registration Form HEA 7713 Fill in:
- Facility name and Medicare number. The Medicare number begins with “36” followed by four digits.
- Street address, city, county, state, and ZIP.
- Telephone and fax numbers.
- Contact person and email, which the Registry will use if it needs clarification.
- Type of facility, by checking the correct box: Nursing Home, Hospital, RCF, Home Health Agency, Hospice, ACF, ICF/MR, Staffing Agency, or Other.
- Home administrator name, license number, and signature.
- Director of nursing name, license number, and signature.
Both signatures are mandatory. A form arriving with only one will be returned.
Section II: Nurse Aide Information
Section II is one line per aide. For each person you list, provide:
- Full name (last, first, middle initial).
- NAR number, the aide’s registry identification number.
- Street address, city, county, state, and ZIP.
- Date of hire, meaning when the facility first employed this individual as a nurse aide.
- Last date used, meaning the last calendar date the aide actually worked in a nurse aide capacity at the facility.
The Last Date Used field causes more returned forms than anything else. Do not write “current.” Do not leave it blank. Enter an actual date. Writing “current” or skipping the field causes the form to bounce back, and while the correction is in transit the aide’s registry data can go stale and the registration can lapse.1Ohio Department of Health. Nurse Aide Registration Form HEA 7713
Why the Dates Matter: The 24-Month Rule
A nurse aide can only be re-registered through HEA 7713 if they have performed paid nursing or nursing-related services within the past 24 months, working at least 7.5 consecutive hours or 8 hours within a 48-hour period during that window.1Ohio Department of Health. Nurse Aide Registration Form HEA 7713 If 24 consecutive months pass without any paid nursing work, the aide’s eligibility lapses, and they must complete a new approved training program and pass the state competency test again before any facility can put them back on the registry.2Ohio Department of Health. Ohio Nurse Aides Frequently Asked Questions
That is the whole reason the Last Date Used field cannot be fudged. The Registry uses those dates to confirm the 24-month rule is being met. A vague entry means the Registry cannot verify eligibility, and the aide’s active status is what suffers.
Extra Documentation for Non-Medicare-Certified Facilities
If your facility is not Medicare certified, expect the Registry to return HEA 7713 with a request for a supplemental statement before it can process the submission. A physician or nurse with personal knowledge of the aide’s work must verify in writing:
- The aide’s name.
- The nature of the nursing or nursing-related services performed.
- The specific dates the aide last worked at least 7.5 consecutive hours or 8 hours within a 48-hour period.
- Confirmation that the aide was compensated for the services.1Ohio Department of Health. Nurse Aide Registration Form HEA 7713
If the verifying physician or nurse cannot personally confirm compensation, the aide has to provide separate proof of payment. Gather this documentation before sending the form so you are not making two trips.
Where to Send the Form and How to Reach the Registry
Download the current HEA 7713 from the Ohio Department of Health website and submit it to the Ohio Department of Health Nurse Aide Registry.3Ohio Department of Health. Nurse Aide Registration for Facilities Contact information printed on the form itself:
- Phone: (800) 582-5908 in-state, or (614) 752-9500.
- Fax: (614) 564-2461.
- Email: NAR@odh.ohio.gov.
Confirm the current mailing address and whether fax is accepted for your submission by calling before you send. Use a trackable method so you have proof of delivery while you wait. Any of the common defects (missing signature, “current” in the Last Date Used field, a blank Medicare number) sends the form back and delays registration for every aide on it.1Ohio Department of Health. Nurse Aide Registration Form HEA 7713
Confirming an Aide’s Status After You Submit
Ohio maintains an electronic registry rather than issuing paper certificates. Once the Registry processes your HEA 7713, each aide’s status updates in the public database. Verify at nurseaideregistry.odh.ohio.gov using either the aide’s full NAR number, or the aide’s last name paired with a first name or the last four digits of their Social Security number.4Ohio Department of Health. Nurse Aide Registry
Facilities are required to check this database before using any nurse aide, and any prior aide service at another facility counts toward the four-month grace period Ohio allows for a new hire to complete training and be added to the registry.2Ohio Department of Health. Ohio Nurse Aides Frequently Asked Questions The four months are counted cumulatively across every facility the person has worked at, and every calendar day counts from the first day the individual is used as a nurse aide, whether or not the person actually worked that day.5Ohio Legislative Service Commission. Ohio Revised Code 3721.28
If the Aide Is Not Yet on the Registry
HEA 7713 cannot place a first-time aide on the registry. That step happens through completing an approved nurse aide training and competency evaluation program and passing the state-administered written and skills tests, or through one of the alternate paths in Ohio Revised Code 3721.28, including out-of-state reciprocity and certain nursing-student and hospital-orderly qualifications.5Ohio Legislative Service Commission. Ohio Revised Code 3721.28 Federal law also prohibits charging an individual any fee for placement on the registry itself, separate from training and testing costs.6eCFR. 42 CFR 483.156 Once the aide is on the registry, HEA 7713 is what your facility uses from then on to keep them there.