Practice Agreement · RN
Registered Nurse Practice Agreement in California
California law does not require a Registered Nurse to hold a named agreement with a physician. Practices still use one to define the working relationship; here is what it covers and what the state does require.
FULL for general nursing scope (Bus. & Prof. Code §2725) — no physician-supervision requirement for baseline RN practice. SUPERVISED_ONLY carve-out for medical-aesthetic delegation (Botox/fillers/laser): treated as a delegated medical act, not baseline RN scope, per Medical Board of California guidance and 16 CCR §1364.50.
What a Registered Nurse practice agreement covers in California
Governed by the California Board of Registered Nursing. Each numbered item is a statutory requirement the agreement must satisfy.
The Registered Nurse ("RN") shall practice under the orders of the Physician and, where applicable, under standardized procedures developed collaboratively by Practice administration and health professionals, including the Physician and the Registered Nurse, as authorized under Business and Professions Code § 2725(c) and Title 16, California Code of Regulations §§ 1470–1474. The Physician shall be available to the Registered Nurse for consultation regarding clinical and patient care issues arising under any such order or standardized procedure.
- The agreement on file also carries 2 scope, 2 education, 2 registration clauses, generated in the document itself.
Statutes and rules cited
- Cal. Bus. & Prof. Code § 4052statute
Authorizes a pharmacist, under a collaborative practice agreement with a health care provider with prescriptive authority (or under a prescriber's written order/authorization consistent with entity policy), to initiate, adjust, or discontinue drug therapy for a patient, subject to notification and other conditions.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
Proximity
physician-delegated elective cosmetic procedure using a laser or intense pulsed light device: Available remotely (no on-site requirement)
16 CCR §1364.50 (confirmed verbatim via direct fetch): the delegating physician need not be on-site but must be 'immediately available' — defined as 'contactable by electronic or telephonic means without delay, interruptible, and able to furnish appropriate assistance and direction throughout the performance of the procedure.' The regulation says 'licensed health care provider' generically rather than naming RNs by profession, though MBC's own Medical Spas guidance describes this standard as applying to RN-performed procedures.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · no controlled-substance authority
Confirmed: general RNs (non-APRN) have no independent prescriptive authority — §2725 ties medication administration to orders from a physician, dentist, podiatrist, or clinical psychologist.
Written agreement
Not required
Unconditional for general nursing practice. For medical-aesthetic delegation, a written delegation order/standardized procedure from a supervising physician is required — legal hook is 16 CCR §1474 (general standardized-procedure content rules) plus §1364.50 (physician-availability standard specific to laser/IPL). The Medical Board's own 'Medical Spas' guidance page confirms: medical-scope procedures 'must be owned by physicians,' and qualified personnel are limited to physicians, RNs under physician supervision, and PAs under physician supervision.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — An RN CANNOT own the medical-scope portion of a med-spa business outright (Bus. & Prof. Code §2400). Corp. Code §13401.5(a), CONFIRMED via direct fetch, allows RNs (among 15 listed allied professions) to hold shares in a MEDICAL professional corporation as a minority (≤49%) shareholder, capped further at not exceeding the number of physician shareholders — distinct from an RN wholly owning their OWN nursing-scope entity (fine for nursing services, not for medical services like injectables).
Corp. Code §13401.5(a)'s RN-inclusion and percentage structure are confirmed via a dedicated follow-up fetch, superseding the original secondary-sourced hedge (an early fetch attempt had incorrectly suggested RNs were absent from the list; two later, independent fetches confirmed they are included).
Legal sources for these rules (7)
- Bus. & Prof. Code §2725 — Nursing Practice Act, general RN scope
- Bus. & Prof. Code §2400 — General CPOM bar
- 16 CCR §1364.50 — Physician availability for laser/IPL cosmetic procedures (confirmed verbatim)secondary
- 16 CCR §1474 — Standardized procedure guidelines (confirmed verbatim — no ratio/chart-review/meeting figures found within it)secondary
- Medical Board of California — 'Medical Spas' consumer guidance (fetched directly)
- MBC news release, 'iLaser MediSpa' enforcement action (2013, Michael William Smith and Julie Seokyung Kim, Los Angeles) — source PDF still unreadable by automated tooling, but facts corroborated via named parties/location across two independent research passes
- Corp. Code §13401.5(a) — Medical corporation minority-ownership cap for RNs, confirmed verbatim
About California's rules
California's NPs reach genuine full independence (AB 890/SB 1451, ~6 years total) and CNMs need zero physician involvement for definitionally 'low-risk' pregnancy care — no hours threshold. NPs/PAs may also majority-own their own practice corporations (Corp. Code §13401.5), cutting against the assumption that CA's strict, actively-enforced CPOM regime (2026 AG settlements against Carbon Health, Aspen Dental) blocks all non-physician ownership. CRNA is order-based, not supervision-based. Esthetician laser use is a flat criminal misdemeanor — no delegation pathway exists.
Other clinicians in California: see the state overview.