Written Protocol · RN
Kentucky Standing Order for Registered Nurses
Recognized but not required in every case. The Standing Order is the written instrument Kentucky law names for a Registered Nurse working with a physician. Below: the board that governs it, what it contains when one is used, and the supervision rules that apply either way.
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 voluntary Registered Nurse agreement covers in Kentucky
Kentucky requires no written agreement for registered nurses. These are the clauses a practice includes when it chooses to put one in writing. The Kentucky Board of Nursing governs registered nurses here.
A Registered Nurse administers medication and treatment as prescribed by a physician, physician assistant, dentist, or advanced practice registered nurse, including through standing orders and protocols the facility's policies adopt.
Standing orders are prewritten, approved in policy by the medical staff, and dated, timed and authenticated by the ordering physician; a protocol also needs an initial order to start.
- The Standing Order also carries 2 scope clauses, authored in the document itself.
Statutes and rules these clauses cite
- Kentucky Board of Nursing Advisory Opinion Statement #14, Roles and Responsibilities of the Nurse in the Implementation of Patient Care Orders (revised 2/2026)board guidance
Section 5: 'protocol' and 'standing orders' are not defined in KRS Chapter 314; the facility determines when and how nurses implement them. Standing orders are prewritten orders from the qualified healthcare provider (physician, PA, APRN, dentist), approved in policy by medical staff, that a nurse may initiate without an initial order when the patient meets specific criteria (e.g., influenza vaccine); protocols require an initial provider order. Both must be dated, timed and authenticated by the ordering provider. Board opinion: nurses (RNs and LPNs) may implement provider-issued protocols and standing orders, including medication administration, following a nursing assessment. Not a regulation; no force of law.
- KRS 314.011(6)(c), (10)(a), (10)(c)statute
Definitions (effective June 27, 2025): registered nursing practice includes administering medication and treatment as prescribed by a physician, physician assistant, dentist, or APRN; licensed practical nursing practice includes care under the direction of an RN, APRN, PA, physician, or dentist and administering medication or treatment as authorized by a physician, PA, dentist, or APRN, as further authorized or limited by the board.
What Kentucky does require
The supervision and prescribing rules that apply to registered nurses regardless of any agreement.
Proximity
Not codified
Supervision ratio
Not codified — no cap on file
Chart review
Not codified
Meeting cadence
Not codified
Prescriptive authority
No agreement needed to prescribe · 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.
Kentucky's single-profession-ownership reading (KRS 274.015) means an RN-owned nursing PSC or PLLC likely cannot include a physician co-owner the way North Carolina's § 55B-14 permits. For medical-aesthetics (med-spa) businesses performing delegated medical procedures, RN ownership of the entity does not remove the requirement for physician delegation and oversight of the procedures themselves.
Sources for the supervision 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.