Practice Agreement · RN
Registered Nurse Practice Agreement in Missouri
Missouri 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.
General RNs are not subject to § 334.104 collaborative practice arrangements — that statute applies specifically to APRNs. RN scope is defined by Chapter 335 and Board of Nursing rule; RNs practice under their own licensed scope (assessment, care planning, medication administration per order), not a physician-delegation regime.
What a Registered Nurse practice agreement covers in Missouri
Governed by the Missouri State 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. Unlike the Collaborative Practice Arrangement required of Nurse Practitioners and Physician Assistants, Missouri law does not require such an arrangement 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, 1 education, 2 registration clauses, generated in the document itself.
Statutes and rules cited
- Mo. Rev. Stat. § 334.104statute
Nurse Practitioner Collaborative Practice Arrangement requirements, chart-review percentages, on-site frequency, and the 6-FTE collaboration cap.
- Mo. Rev. Stat. § 334.735statute
Physician Assistant Collaborative Practice Arrangement requirements, filing of the collaborating-physician form, and the 6-FTE collaboration cap.
- Mo. Rev. Stat. § 338.010statute
Definition of the practice of pharmacy, including administration of drugs pursuant to a physician's order, standing order, or protocol.
- Mo. Rev. Stat. § 338.198statute
Pharmacist participation in dispensing/administering medications under a Nurse Practitioner's or Physician Assistant's Collaborative Practice Arrangement.
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 Missouri; they administer medications per order from an authorized prescriber.
Written agreement
Not required
Unconditional — general RN licensure is never subject to a collaborative practice arrangement in Missouri, unlike the APRN categories above.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — General RN licensure does not require a healing-arts professional corporation. Non-clinical businesses an RN might own (home health agency, staffing agency) fall under general corporation/LLC law, not the healing-arts regime.
Not independently verified in depth this research pass — general inference from RN licensure not requiring Chapter 356 professional-corporation status.
Legal sources for these rules (2)
- RSMo §§ 335.011–335.096 — The Nursing Practice Act
- RSMo § 335.016 — Definitions
About Missouri's rules
PA/APRN collaboration is governed by nearly-identical §§ 334.104/334.735: a 6-FTE combined ratio cap, 10%/20% chart-review every 14 days, biweekly physician presence, and a 120-hour controlled-substance Rx cap. A pre-2024 numeric 75-mile proximity rule was reportedly rescinded by both boards — current text uses an undefined 'geographic proximity' standard; verify with counsel before relying on any specific mileage figure.
Other clinicians in Missouri: see the state overview.