Practice Agreement · RN
Registered Nurse Practice Agreement in Maryland
Maryland 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 a physician-supervision or collaborative-practice-agreement requirement in Maryland. RNs practice under a physician's orders, standing orders, or delegation, consistent with the Maryland Nurse Practice Act — categorically different from the APRN-specific collaboration frameworks above.
What a Registered Nurse practice agreement covers in Maryland
Governed by the Maryland 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 Maryland Nurse Practice Act, Health Occupations Article, Title 8. Maryland law does not require a collaboration 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
- COMAR 10.34.29 (Drug Therapy Management)regulation
Maryland Board of Pharmacy regulation implementing Health Occupations Article §§ 12-6A-01 to 12-6A-10, governing prescriber-pharmacist agreements, protocols, and therapy management contracts.
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 Maryland; they administer medications pursuant to the orders of a licensed prescriber.
Written agreement
Not required
Unconditional — general RN licensure has never been subject to a physician collaboration/supervision agreement in Maryland.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — General RN licensure does not implicate the physician-only Professional Corporation regime in the first place — non-clinical businesses an RN might own fall outside that framework and carry no ownership restriction confirmed in this pass.
Legal sources for these rules (1)
- Md. Health Occupations Code Title 8 — Nurses (RN scope)
About Maryland's rules
Maryland's APRN categories are NOT uniform: CRNPs/CNMs gained full practice authority in 2015 (after an 18-month new-graduate mentorship), but CRNAs remain fully supervised with NO prescriptive authority at all (Maryland is one of ~11 states granting CRNAs none), and only the psychiatric-mental-health population focus of CNS practice is independent. Maryland does not recognize PLLCs — professional entities use physician-only Professional Corporations, so multi-disciplinary PC ownership questions are open items below.
Other clinicians in Maryland: see the state overview.