Practice Agreement · RN
Registered Nurse Practice Agreement in Virginia
Virginia 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 Virginia. § 54.1-3000 defines 'professional nursing' (RN) with no physician supervision/collaboration language, in explicit contrast to 'practical nursing' (LPN), which the statute defines as performed 'under the direction or supervision of a licensed medical practitioner, a professional nurse... or other licensed health professional.' Current Board of Nursing regs (18VAC90-19, successor to repealed 18VAC90-20) likewise impose supervision only on LPNs, not RNs.
What a Registered Nurse practice agreement covers in Virginia
Governed by the Virginia 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 standing protocols of the Physician, as authorized under Va. Code § 54.1-3408 and the scope of practice recognized by the Virginia Board of Nursing. Unlike the practice agreements required of Nurse Practitioners and Physician Assistants, Virginia law does not require a negotiated practice agreement for Registered Nurses; the Physician shall instead be available to the Registered Nurse for consultation regarding clinical and patient care issues arising under any standing order or protocol.
- The agreement on file also carries 2 scope, 2 education, 2 registration clauses, generated in the document itself.
Statutes and rules cited
- Va. Code § 54.1-2957statute
Licensure and practice of advanced practice registered nurses, including the practice agreement requirement (subsection C/D) and the autonomous-practice attestation pathway for experienced nurse practitioners (subsection I). Contains no numerical cap on the number of nurse practitioners a physician may serve as patient care team physician for.
- Va. Code §§ 54.1-2952, 54.1-2952.01statute
Six-physician-assistant-per-physician cap (§ 54.1-2952) and the autonomous-practice attestation pathway for physician assistants with three years/1,800 hours-per-year of full-time clinical experience (§ 54.1-2952.01).
- Va. Code § 54.1-3300.1statute
Authorizes pharmacist-practitioner collaborative agreements for drug therapy, lab test, and device management, including Board of Pharmacy authorization required before prescribing Schedule II-V controlled substances under such an 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
No RN prescriptive-authority provision exists in Virginia law; § 54.1-3000 only lets RNs administer medications 'as prescribed by any person authorized by law to prescribe.'
Written agreement
Not required
Unconditional — general RN licensure is never subject to physician supervision or a practice agreement in Virginia, unlike the APRN/PA categories above.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — General RN licensure does not require a healing-arts Professional Corporation (§ 13.1-543) or PLLC (§ 13.1-1102) in the first place — RNs (unlike APRNs) are not enumerated as an eligible owner under either statute, but also don't independently render the kind of licensed clinical services those statutes govern. Non-clinical businesses an RN might own (home health agency, staffing agency) fall under general Stock Corporation/LLC law, not the healing-arts regime, and carry no ownership restriction.
For medical-aesthetics (med-spa) businesses performing delegated medical procedures (e.g. Botox, laser), RN ownership of the entity doesn't remove the requirement for physician delegation/oversight of the procedures themselves — ownership and clinical delegation authority are separate questions. The specific delegation regulation (commonly cited as 18VAC85-20-91 for laser) could not be independently verified in this research pass — confirm before relying on it.
Legal sources for these rules (3)
- Va. Code § 54.1-3000 — Definitions (Professional vs. Practical Nursing)
- 18VAC90-19 — Regulations Governing the Practice of Nursing
- Va. Code §§ 13.1-543, 13.1-1102 — Professional Corporation / PLLC ownership eligibilitysecondary
About Virginia's rules
No provider type below has a codified chart-review percentage, countersignature rule, or numeric proximity radius — all are left to the practice agreement. CPOM (ownership) is governed by Title 13.1's PC/PLLC statutes, which explicitly list APRNs (NP/CRNA/CNM/CNS) as eligible independent owners but do not enumerate PAs — the PA ownership pathway is an inference from that omission, not a confirmed holding. Virginia has no independent corporate-practice-of-medicine common-law doctrine (a 1992 AG opinion, secondary-sourced only).
Other clinicians in Virginia: see the state overview.