APRN Independent Practice

It has been the KBN’s position, and its interpretation of the applicable statutes and regulations, that APRNs in Kentucky independently perform advanced nursing practice. You can find the Legal Opinion regarding APRNs as Independent Practitioners here or in the Document Library. Here is a summary:

• KRS 314.042 (8) and (9) provide the only statutory requirements for physician involvement; requiring an APRN enter into a collaborative agreement for prescriptive authority (CAPA) with a physician prior to prescribing drugs
  
• The APRN is individually responsible and accountable for his or her acts and decisions independent of the physician signing the APRN’s CAPA
  
• There is nothing in regulation or statute that limits the number of licensed Kentucky APRNs with whom a licensed Kentucky physician may enter into a CAPA
  
• No relevant statutes require:
• Supervision of the APRN by a physician
  
• A physician to review APRN charts or a percentage of APRN charts, or
  
• A specific distance between a licensed Kentucky physician and APRN when entering into a CAPA
  
• For more information regarding CAPAs, please see the page regarding A​PRN Collaborative Agreement Prescriptive Authority CAPA.

APRNs Opening an Independent Practice

There is nothing in regulation prohibiting APRN from opening their own practice. However, All [nurses] shall be responsible and accountable for making decisions that are based upon the individuals' educational preparation and experience in nursing and shall practice nursing with reasonable skill and safety. See KRS 314.021. Nursing practice should be consistent with Kentucky Nursing Laws, established standards of practice, and be evidence based.

Also, physician ownership and involvement is required for licensed pain management facilities. A pain management facility is any facility where greater than 50% of the patients are provided treatment for pain that includes the use of controlled substances and pain management is the subject of any advertising by the facility, or is a the primary practice component of the facility. See KRS 218A.175.

Resources Related to an APRN Individual Practice

• Kentucky Association of Nurse Practitioners & Midwives (KCNPNM)
• The scope of practice of nurses in cosmetic and dermatological procedures and independent practice
• Buppert, Carolyn, The Nurse Practitioner’s Business Practice and Legal Guide, 6th ed. Jones & Bartlett (2017)