Practice Agreement · RN
Registered Nurse Practice Agreement in Kentucky
Kentucky 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.
RNs (general licensure, not an APRN) are not subject to physician supervision in Kentucky. KRS 314.011 defines registered nursing practice (assessment, care planning, delegation/supervision of other personnel) with no physician-oversight language; RNs administer medication/treatment 'as prescribed' by an authorized prescriber, but that is a scope limit on prescribing, not a supervision requirement on the RN's own practice.
What a Registered Nurse practice agreement covers in Kentucky
Governed by the Kentucky Board of Nursing. Each numbered item is a statutory requirement the agreement must satisfy.
The Registered Nurse ("RN") shall practice under the orders, standing orders, or delegation of the Physician, consistent with the Kentucky Nursing Practice Act, KRS Chapter 314. Kentucky law does not require a collaborative agreement for this Registered Nurse's general scope of practice; the Physician shall instead be available to the Registered Nurse for consultation regarding clinical and patient care issues arising under any order or delegation.
- The agreement on file also carries 2 scope, 2 education, 2 registration clauses, generated in the document itself.
Statutes and rules cited
- 201 KAR 2:220regulation
Establishes minimum requirements for the development and maintenance of collaborative care agreements between a pharmacist and a practitioner.
- KRS 315.010(4)statute
Chapter 315 definitions, including "collaborative care agreement."
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
Not codified — left to the agreement
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
RNs do not have independent prescriptive authority in Kentucky; KRS 314.011 only authorizes administering medication/treatment as prescribed by a physician, PA, APRN, or dentist.
Written agreement
Not required
Unconditional — general RN licensure is never subject to physician supervision or a collaborative agreement in Kentucky, unlike the APRN/PA categories above.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional LLC (KRS Ch. 275) or PSC (KRS Ch. 274) — 'nurses' are explicitly listed as an eligible profession, so an RN may own a nursing-services PLLC/PSC. Non-clinical businesses an RN might own (staffing agency, general wellness business) fall outside these chapters entirely and carry no ownership restriction.
KY's single-profession-ownership reading (KRS 274.015, see state-level `notes`) means an RN-owned nursing PSC/PLLC likely cannot include a physician co-owner the way NC's § 55B-14 explicitly permits — a more restrictive position than several peer states on file. For medical-aesthetics (med-spa) businesses performing delegated medical procedures, RN ownership of the entity doesn't remove the requirement for physician delegation/oversight of the procedures themselves — unconfirmed KY-specific citation for that delegation rule in this pass.
Legal sources for these rules (3)
- KRS 314.011 — Definitions (Registered Nursing Practice)secondary
- Kentucky Board of Nursing — RN Scope of Practice
- KRS Ch. 274, 275 — Professional Service Corporations; Limited Liability Companies (ownership eligibility)
About Kentucky's rules
KY's PSC/PLLC statutes (KRS Ch. 274, 275) are commonly read to restrict ownership to persons rendering the 'same or related' professional service — a physician generally cannot co-own a single PSC/PLLC with a PA or APRN, unlike NC/VA's explicit combination statutes. Secondary-sourced interpretation, not a confirmed ruling — verify before relying on it. Kentucky opted out of the federal Medicare CRNA supervision requirement in April 2012; facilities may still impose their own.
Other clinicians in Kentucky: see the state overview.