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Board of Nursing

Legislative Updates

Legislative Updates:Current through July 1, 2009

Board Specific Updates

Public Chapter 264

Chapter 264 of the 2009 Public Acts provides that advanced practice nurses and physician assistants can perform physicals for police officers and issue certified statements for disability or deafness to obtain motor vehicle registration, license plates, placards, and decals from the Department of Safety as long as this function is expressly included in the written protocol developed jointly by the supervising physician and the advanced practice nurse or physician assistant. 

Public Chapter 228

Chapter 228 of the 2009 Public Acts provides that each practice site (prescriber's office or pharmacy that are required to report to the database) where a controlled substance is dispensed shall provide electronic access to the controlled substance monitoring database.  Failure to comply may result in a one hundred dollar ($100.00) civil penalty for each day of continued violation where there is a continued pattern or practice of not providing electronic access to the database.  A dispenser of controlled drugs (prescriber's, prescriber's office, pharmacist or pharmacy) shall not be subject to a civil suit or held civilly liable for failure to check the database or for actions taken after reasonable reliance on the database information.

Public Chapter 67

Chapter 67 of the 2009 Public Acts provides that physicians, dentists, optometrists, podiatrists, veterinarians, advanced practice nurses with a certificate of fitness to prescribe, and physician assistants shall report to local law enforcement within three (3) business days if they have good reason to believe that a person has obtained or attempted to obtain a controlled substance when they have either received the same controlled substance, a prescription for the same controlled substance, or a therapeutically equivalent controlled substance from another practitioner within the previous thirty (30) days.

This Public Chapter became effective on July 1, 2009.

Public Chapter1054
Administration of Rectal Diazepam Gel by School Volunteers

This act allows for volunteers educated by qualified registered nurses, in public and non-public schools to administer rectal diazepam gel, an anti-seizure medication, to a student in an emergency situation. An ad hoc committee is developing the education plan, policies and procedures.

The complete Public Act, including provisions for any areas of exemption; enforcement of the Act; and action to be taken for violations of the Act, is available on the following Web site: tennessee.gov/sos/index.htm

This law is effective July 1, 2008

Public Chapter 1035
Tamper Resistant Prescription Paper

Tennessee Code Annotated, 63-3-127 governing Podiatrists, 63-5-122 governing Dentists, 63-6-236 governing Medical Doctors, 63-7-123(b)(3) governing Nurse Practitioners, 63-8-126 governing Optometrists, 63-9-116 governing Osteopathic Physicians and 63-19-107(2)(E) governing Physician Assistants are amended to add: All handwritten, typed or computer-generated prescription orders must be issued on tamper-resistant prescription paper which meets the current Centers for Medicare and Medicaid Service Guidance to State Medicaid Directors…and meets or exceeds specific TennCare requirements for tamper-resistant prescription paper. This legislation is a result of a federal law/mandate intended to reduce fraud and abuse.

All prescriptions for TennCare patients must be written using tamper resistant pads/paper. Exceptions are prescriptions sent to the pharmacy electronically, prescriptions communicated to the pharmacy by telephone and drugs administered in nursing facilities. The provisions of this act with respect to TennCare prescriptions shall take effect October 1, 2008 in compliance with federal requirements. The provisions of this act with respect to non-TennCare related prescriptions shall take effect July 1, 2009.

On October 1, 2008 prescriptions will be required to have a minimum of one feature from each of the following three CMS categories: 1) Industry-recognized feature(s) designed to prevent unauthorized copying. An example is paper that shows the word “Void” or “Illegal” if the prescription is photocopied. 2) Industry-recognized features(s) designed to prevent erasure or modification of information written by the prescriber. This may be uniform non-white background color or quantity check off boxes with refill indicator.  3) Industry-recognized feature(s) designed to prevent use of counterfeit prescription forms. Security features and descriptions are listed on prescriptions (required by TennCare tamper-resistant pads after October 1, 2008) or a heat sensing imprint, which causes the imprint to disappear if someone touches the imprint or design.

Prescribers who ordinarily transmit prescriptions via e-prescribe of fax will need a supply of tamper-resistant pads if they prescribe controlled substances since these prescriptions may not be transmitted electronically at this time.

The complete Public Act, including provisions for any areas of exemption; enforcement of the Act; and action to be taken for violations of the Act, is available on the following Web site: tennessee.gov/sos/index.htm

This law is effective October 1, 2008 in respect to TennCare prescriptions and July 1, 2009 for non-TennCare related prescriptions.

Public Chapter 936
Improving Patient Safety through Medication Use Prescription Labeling Act of 2008

Adds TCA 53-10-110:
Any person dispensing a legend drug for an elder person shall include on the label of the container in which the legend drug is dispensed the indication for which the drug is being prescribed if requested by the prescriber, patient or patient's caregiver and the prescriber, patient or patient's caregiver provides the indication or indications to the person dispensing the legend drug. For purposes of this section, "elder person" means any person who is sixty (60) years of age or older.

Public Chapter 850
Exemption for Medication Administration
 
This law permits the administration of medication by unlicensed persons trained under the division of mental retardation who administer personal support services to clients in their own homes pursuant to a contract or agreement under Medicaid or other program of the Division of Mental Retardation Services; or unlicensed persons employed by agencies of the Department of Mental Health and  Developmental Disabilities to provide residential or adult day programs to clients; or unlicensed persons trained in accordance with §68-1-904(c); or unlicensed persons employed by community based licensed intermediate care facilities for the mentally retarded who will administer medication only at a location other than the community based facility. The employees of the community based facilities for the mentally retarded may receive medication administration training specific to the person served. When administered by employees of community-based licensed intermediate care facilities for the mentally retarded, medications shall be packaged in individual doses labeled with the name of the patient, the time of administration and the drug name and dosage.
 
Persons employed by an agency licensed under the Mental Health, Developmental Disability, and Personal Support Services Licensure Law, Title 33, Chapter 2, Part 4, who provide personal support services to clients living in their own homes may assist the clients with medication except for injections, upon a written authorization by the client or the client's authorized representative. For the purpose of this section, assistance is limited to opening medication packaging and providing medication reminders and does not permit giving the client any form of medication. Before any such person is authorized to assist the client with medication, the person shall receive and be able to document training in medication assistance performed by or under the general supervision of a registered nurse and consistent with the state's home and community-based services (HCBS) training in assisting with medications. This is not to be interpreted in any manner or fashion to include, or to be the same as, medication administration that would be only appropriate and acceptable for licensed professional nurses.
 
The complete Public Act, including provisions for any areas of exemption; enforcement of the Act; and action to be taken for violations of the Act, is available on the following Web site: tennessee.gov/sos/index.htm
 
This law is effective April 30, 2008

Public Chapter 782
Nurse Anesthetists

This new law amends the Nurse Practice Act relative to nurse anesthetists. It adds language to allow a nurse anesthetist who graduated from a nurse anesthesia program approved by the American Association of Nurse Anesthetists Council on Accreditation prior to January 1, 1999 to be eligible for a certificate to practice as an advanced practice nurse.

The complete Public Act, including provisions for any areas of exemption; enforcement of the Act; and action to be taken for violations of the Act, is available on the following Web site: tennessee.gov/sos/index.htm

This law is effective April 21, 2008

Public Chapter 747
ADVANCED PRACTICE NURSES
This Public Chapter adds a new subsection to Tenn. Code Ann. § 48-249-1109 allowing Advance Practice Nurses ("APNs") to enter into PLLCs with allopathic and osteopathic physicians. This gives APNs the ability to enter into PLLCs with physicians. The complete text of the Public Chapter is available on the following website: 
http://www.tennessee.gov/sos/acts/index.htm
This Public Chapter became effective on April 10, 2008.

Public Chapter 154
Prenatal Testing of Pregnant Women for HIV

This chapter requires all providers of healthcare services of prenatal care of pregnant women to these for human immunodeficiency virus (HIV), except in cases when the woman refuses. Testing shall occur as early in the pregnancy as possible and again during the third trimester. Women who present for delivery and have no documentation supporting a negative test for HIV and have not been tested during the last trimester shall be tested. If a woman refuses such test, she must be counseled regarding consequences of exposure of her unborn child to HIV.

The complete text of the Public act, including provisions for any areas of exemption; enforcement of the Act; and action to be taken for violations of the Act, is available at tennessee.gov/sos/acts/index.htm

This law is effective May 15, 2007.

 

Public Chapter 298
CONTROLLED DRUGS RECLASSIFICATION

Public Chapter 298 primarily corrects some discrepancies between Tennessee law listing Schedules for controlled substances compared to the DEA Schedules for the same drugs or chemicals. Some of the listed drugs have had their Schedule changed in recent years by the DEA, however they had not be reclassified in Tennessee law. Although individual states may place a drug into a more restrictive Schedule than DEA, states do not have the authority to be less restrictive than DEA. The language of this Act brings Tennessee in line with DEA classifications. Some of the more frequently encountered drugs affected are listed below along with their common trade names.

  • Gamma hydroxybutyric acid (GHB) is classified by DEA as a Schedule I, however in Tennessee law it was still listed as a Schedule IV. PC 298 brought TN in line with DEA.
  • Glutethimide (Doriden) is classified by DEA as a Schedule II however TN still listed as Schedule III. PC 298 now matches DEA and Glutethimide (Doriden) is Schedule II.
  • Buprenophine (Suboxone or Subutex) is a DEA Schedule III, however TN had it listed as Schedule V. PC 298 changed it to a Schedule III in TN.
  • Some other changes for consistency include Dichloralphenazone (Midrin), Zaleplon (Sonata), Zopiclone (Lunesta), Butorphanol (Stadol), Fencamfamin (Reactivan), Fenproporex (Gacilin or Solvolip), Mefenorex (Pondonil), Modafinil (Provigil), and Sibutramine (Meridia) being listed as Schedule IV in TN to match DEA.
  • Of interest in veterinary medicine, Carfentanil (Wildnil) is now classified as Schedule II which is consistent with DEA classification. The combination drug tiletamine-zolazepam (Telazol) is now listed as Schedule III in both TN and DEA.

The complete text of the Public Act, including provisions for any areas of exemption; enforcement of the Act; and action to be taken for violations of the Act, is available at tennessee.gov/sos/acts/index.htm

Public Chapter 364
NEW EXEMPTION TO THE NURSE PRACTICE ACT

This Public Chapter adds a new exemption (12) that reads: Persons trained in accordance with § 68-1-904(c)(2) (Health), who are employed by agencies that are both licensed under title 37(Juveniles) and under contract with the department of children's services to provide services can assist children and youth with the self-administration of certain medications in a group home setting. Before any such person is authorized to assist the child or youth with self administration of medication, that person must have received and be able to document six (6) hours of training in medication administration from a registered nurse licensed pursuant to this chapter. For the purposes of this subdivision (12), assisting with self-administration of medications is not to be interpreted in any manner or fashion to include, or to be the same as, medication administration that would be only appropriate and acceptable for persons who are authorized to do so by specific professional acts under this title or by rules or regulations.

The complete text of the Public Acts, including provisions for any areas of exemption; enforcement of the Act; and action to be taken for violations of the Act, is available at tennessee.gov/sos/acts/index.htm

This law is effective June 6, 2007.

Public Chapter 399
EXEMPTION IN THE NURSE PRACTICE ACT FOR PERSONAL SUPPORT SERVICES

Tennessee Code Annotated, Section 63-7-102(11), is amended by deleting the existing language of the subdivision in its entirety and by substituting instead the following: (11) A person employed by an agency licensed under title 33, chapter 2, part 4 (Mental Health and Developmental Disabilities), providing personal support services to clients living in their own home or private residence may assist the client with medication, except for injections, upon a written authorization by the client or the client's authorized representative. For the purpose of this section, assistance is limited to opening medication packaging and providing medication reminders and does not permit giving the client any form of medication. Before the unlicensed person is authorized to assist the client with medication as stated above, the person must have received and be able to document training in medication assistance performed by or under the general supervision of a registered nurse and consistent with the State’s home and community-based services (HCBS) training in assisting with medications. For the purposes of this subdivision (11), assisting with medications is not to be interpreted in any manner or fashion to include, or to be the same as, medication administration that would be only appropriate and acceptable for persons who are authorized so to do by specific professional acts under this title or by rules or regulations.

The complete text of the Public Acts, including provisions for any areas of exemption; enforcement of the Act; and action to be taken for violations of the Act, is available at tennessee.gov/sos/acts/index.htm

This law is effective June 11, 2007.

Public Chapter 530
“TENNESSEE NURSE HOME VISITOR PROGRAM ACT”

This Act establishes the nurse home visitor program to provide visiting nurse services to low income, first time mothers during their pregnancies and through their children’s second birthday. The program shall be administered in communities throughout the state by entities selected on a competitive basis by the Department of Health.

The complete text of the Public Acts, including provisions for any areas of exemption; enforcement of the Act; and action to be taken for violations of the Act, is available at tennessee.gov/sos/acts/index.htm

This law is effective June 26, 2007.



Updates Applicable to All Boards

Public Chapter 513
Domestic Abuse Reporting

This public chapter requires the Department of Health to undertake a statewide campaign to remind all health care providers of their duty to report domestic abuse. Any licensed health care practitioner who knows, or has reasonable cause to suspect, that a patient's injuries, whether or not such injuries cause a patient's death, are the result of domestic violence or domestic abuse, shall report to the department of health, office of health statistics, on a monthly basis. Health care practitioners, in active status, can report suspected domestic abuse via the Domestic Violence Reporting System. Note: the name of the victim of domestic violence is never reported!

If you are a health care practitioner, in active status, and would like instructions on how to make a report please call (615) 741-1954 or E-mail DomesticViolence.Health@tn.gov

This Public Chapter became effective on July 1, 2009.

Public Chapter 581
Voluntary Provision of Health Care Services

Chapter 581 of the 2009 Public Acts provides that a person licensed by any of the health related boards who provides voluntary health care services to a patient of a sponsoring organization shall not be civilly liable for any act or omission in rendering these services, unless the act or omission constitutes gross negligence or willful misconduct.

This Public Chapter became effective on July 1, 2009.

Public Chapter 425
Health Care Liability

This public chapter revises provisions governing notice that must be given by any person asserting a potential claim for medical malpractice to each health care provider against whom the claim is being made; revises provisions governing certificate of good faith that must be filed.

This Public Chapter became effective on July 1, 2009.

Public Chapter 1060
Child Abuse Reporting

Public Chapter 1060 provides immunity from civil and criminal liability for reporting abuse of children by a health care examiner when there is harm or reason to believe there is a mandate to report. No immunity is provided for reports by perpetrators of harm to children.

The complete Public Act, including provisions for any areas of exemption; enforcement of the Act; and action to be taken for violations of the Act, is available on the following Web site: tennessee.gov/sos/index.htm

This law is effective July 1, 2008

Public Chapter 83
Mandatory Domestic Violence Reporting

Health care practitioners shall report cases of suspected or confirmed domestic violence to the Tennessee Department of Health. The system was operational in October 2007 and requires certain data to be reported using the reporting tool located on the Department of Health website.

The complete text of the Public Act, including provisions for any areas of exemption; enforcement of the Act; and action to be taken for violations of the Act, is available on the following website: tennessee.gov/sos/acts/index.htm

Public Chapter 410
Non-Smoker Protection Act

Public Chapter 410 creates the Non-Smoker Protection Act which prohibits smoking in all enclosed public places within the State of Tennessee including, but not limited to, the following places:

(2) “Areas available to and customarily used by the general public in businesses and non-profit entities patronized by the public including, but not limited to, banks, Laundromats, factories, professional offices, and retail service establishments; and

(7) “Health care facilities”. (Nursing homes and long-term care facilities are exempted)

The legislation requires offices and health care facilities to do the following:

  • Inform all existing employees and any prospective employees upon their application for employment of the prohibition on smoking; and
  • “No Smoking” signs or the international “No Smoking” symbol, shall be clearly and conspicuously posted at every entrance to every public place and place of employment where smoking is prohibited.

The Department of Health, shall while an establishment is undergoing otherwise mandated inspections, inspect for compliance with this Act. Information about these inspections will be communicated with the appropriate offices and/or health care facilities in the future.

The complete text of the Public Act, including provisions for any areas of exemption; enforcement of the Act; and action to be taken for violations of the Act, is available on the following website:tennessee.gov/sos/acts/index.htm

Public Chapter 529
Prohibition of Employment of Illegal Aliens

If the Commissioner of Labor and Workforce Development receives a complaint that a person, licensed by a state regulatory board, knowingly employs, recruits or refers for a fee for employment an illegal alien, that person is subject to an investigation and contested case hearing.

If there is proof a person knowingly employed, recruited or referred for a fee for employment, an illegal alien, which occurred while acting within the scope of practice of his/her license, the regulatory board will be required to revoke, suspend, or deny the person’s license.

For the first violation, the regulatory board will be required to suspend the person’s license until they show they no longer employ, recruit or refer for a fee for employment, an illegal alien. This can be made by the person filing a sworn statement that they no longer employ illegal aliens.

If a second violation occurs within three (3) years from the first order, the regulatory agency will be required to suspend the person’s license for one (1) year.

The complete text of the Public Act, including provisions for any areas of exemption; enforcement of the Act; and action to be taken for violations of the Act, is available on the following website: tennessee.gov/sos/acts/index.htm.

The act shall take effect January 1, 2008

Public Chapter 1190
Long Term Care

The long term care system shall recognize that aging is not a disease, but rather a natural process that often includes increasing needs for assistance with daily living activities. To the maximum extent possible and appropriate, the system shall be based on a model of care delivery which acknowledges that services delivered in the home and community-based settings are not primarily medical in nature, but rather, support services that will provide needed assistance with activities of daily living and that will allow persons to "age in place" in their homes and communities.

The complete text of the Public Act, including provisions for any areas of exemption; enforcement of the Act; and action to be taken for violations of the Act, is available on the following website: Tennessee.gov/sos/acts/index.htm

Public Chapter 864
Restroom Access Act

PC 864 requires any place of business that is open to the general public for the sale of goods or services ("retail establishment") that has an employee toilet facility to allow a customer to use such facility during normal business hours, if:

  1. The customer requesting the use of the employee toilet facility suffers from a medical condition that requires immediate access to a toilet facility or utilizes an ostomy device; the customer must present the employee with proof of an eligible medical condition, such as a document issued by a licensed medical provider;
  2. Three or more employees of the retail establishment are working at the time of the request;
  3. There is not a restroom available for public use in the retail establishment or otherwise immediately accessible to the customer; and
  4. The employee toilet facility is not located in an area that poses an obvious safety or security risk.

This bill provides immunity from civil damages to any retail establishment or an employee of a retail establishment for any act or omission in allowing a customer to use an employee toilet facility that is not a public restroom if the act or omission:

  1. Is not willful or grossly negligent;
  2. Occurs in an area that is not accessible to the public; and
  3. Results in an injury to or death of the customer or any individual other than an employee accompanying the customer.

This bill does not require any retail establishment to make any physical changes to an employee toilet facility. Any retail establishment or employee of a retail establishment that does not comply with the toilet facility access requirements of this bill commits a Class C misdemeanor punishable only by a fine of up to $50.


Statutes and Rules


Statutes

Statutes are proposed and made law by the Tennessee State General Assembly (Legislature). The Board, following specific notice requirements and hearings, adopts rules. Both have the force of law and may be used in the regulation of a profession. The statutes pertaining to this Board are found at T.C.A. 63-1 (Division of Health Related Boards) and T.C.A. 63-7 (Nursing).

Click here to review the Tennessee Code Annotated. (This link will take you to a website that is not maintained by the Tennessee Department of Health).

 

 

Rules

Click here for Rules and Regulations pertaining to the Tennessee Board of Nursing

Policies


Policies

Multi-State Regulation


Nurse Licensure Compact Law

DESCRIPTION

This law enacts the interstate nurse licensure compact that allows for the mutual recognition of nurses licensed by participating states. The compact sets up a model for nurse licensure that is similar in many ways to the driver's license model. Under the compact, a nurse holds one license-- in the state of residence. The nurse is able to practice nursing in other states that have passed the compact under the authorization of the multistate privilege. If the nurse chooses to move his/her residence to another compact state, the nurse has 30 days to practice while the new home state license is being processed. Once the new license is issued, the original license becomes invalid.

States within the compact (party states) cooperate with each other by sharing licensure, discipline and significant investigative information with each other to protect citizens from nurses who might attempt to evade board disciplinary action by moving to another state. Nurses today frequently practice across state lines through telephone or Internet communication. When those nurses fail to obtain licensure in every state in which they practice, patients are left with no recourse through the regulatory process when violations of the practice act occur.

Until all or most states participate there will not be a financial impact on the board. The compact provides for transition issues such as allowing nurses to hold more than one license when licensed in a party state and a state that is not a party state.

Article 1 sets out the findings and purpose of the compact. Nurse licensure laws protect the public. Nurses are increasingly mobile and frequently use advanced technology to deliver patient care across state lines. A simpler licensure system promotes compliance with licensure laws and cooperation among states. The compact establishes that the nurse is accountable for the licensure law in the state in which the patient is located at the time care is rendered.

Article 2 speaks to definitions used in the compact that must be understood the same by cooperating party states.

Article 3 describes the general provisions and jurisdiction. A license issued by the home state will be mutually recognized by each party state as authorizing a multistate licensure privilege to practice in the party state. Party states may, in accordance with due process laws, limit or revoke the multistate privilege. All licensure actions must be reported promptly to the coordinated licensure information system and this information will be relayed promptly to the home state. Nurses must practice according to the licensure laws of the state where the patient is located and that practice will be subject to the jurisdiction of state licensure board and courts. Nursing practice is defined not only as patient care but also all nursing practice as defined by the state licensing board. This compact does not affect the advanced practice of registered nursing. Individuals who are not a resident of a party state shall still be able to apply for a license in a party state, but that license will not grant them the multistate privilege in other party states.

Article 4 describes the licensure process in a party state. The licensure board in a party state is required to check the coordinated licensure information system to determine if an applicant holds or has held a license in any other state and if there is disciplinary action against the license or privilege. A nurse shall hold a license in only one party state at a time that is issued by the home state. When a nurse changes residence between two party states, the nurse applies for licensure in the new home state and the former home state license is no longer valid. When moving from a non party state to a party state and obtaining licensure, the non party state licensure is not affected and will remain in force. In moving from a party state to a nonparty state, the license issued by the prior home state converts to an individual state license valid only in the former home state without the multistate privilege.

Article 5 addresses adverse actions. The licensing board of a party state is required to promptly notify the administrator of the coordinated licensure information system of any remote state actions and any significant investigative information yet to result in remote state action. The licensing board shall have the authority to complete any pending investigation on a nurse who changes residence during the course of the investigation. A remote state may take action affecting the multistate privilege. Only the home state may take action against the license. The licensing board shall give the same priority and effect to reported conduct received from a remote state as it would if the conduct occurred in the home state and shall apply its own state laws to determine action. Nothing in the compact shall override a party state's decision to allow participation in an alternative program (professional assistance) in lieu of licensure action. Party states must require nurses participating in an alternative program to not practice in any party state during the term of the contract with the alternative program without the prior authorization of the other party state.

Article 6 speaks to additional authorities invested in the party state licensing boards. If permitted by state law, the state may recover the costs of investigation and disposition of cases resulting in adverse action. The state may issue subpoenas, issue cease and desist orders and promulgate uniform rules and regulations.

Article 7 describes the coordinated licensure information system. All party states will cooperate in creating a database for all registered and licensed practical nurses that will contain the disciplinary history of each nurse. All party states will promptly report adverse actions against a nurse's license, actions against a multistate privilege, any current significant investigative information, denials of applications and the reasons for denial. Current significant investigative information will be made available only to party state licensing boards. Any information contributed to the coordinated licensure information system that is subsequently required to be expunged by the laws of the party state contributing the information shall be expunged from the coordinated licensure information system.

Article 8 addresses compact administration and interchange of information. The executive director of the state licensure board or his/her designee shall be the administrator of the compact for his/her state. The compact administrator shall provide the compact administrator of each party state information to facilitate administration of the compact. Compact administrators have the authority to develop uniform rules to administer the compact that shall be adopted by the party states.

Article 9 speaks to immunity. The party states shall not be liable on account of any act or omission in good faith while engaged in the performance of their duties under this compact.

Article 10 addresses entry into force, withdrawal and amendment. The compact shall become effective when it has been enacted into law. A party state may withdraw from the compact by enacting a statute and providing six months notice of the withdrawal to the executive heads of all other party states. Withdrawal shall not affect the validity of states remaining in the compact. This compact will not invalidate or prevent a party state from any nurse licensure agreement with a non party state. The compact may be amended by the party states, but will not become effective and binding unless and until it is enacted into the laws of all party states.

Article 11 speaks to construction and severability. The provisions of the compact shall be severable if any part is declared to be contrary to the constitution of any party state or of the United States. In the event of settling disputes arising under the compact, the party state may submit the issues to an arbitration panel composed of the administrator in the home state, the compact administrator of the remote state involved and a compact administrator agreed upon by all the party states involved. The decision of the majority will be binding.

FAQ


Nurse Licensure Compact Law Frequently Asked Questions (FAQs)

The Tennessee General Assembly enacted the Nurse Licensure Compact in 2002. As of July 1, 2008, the following states belong to this mutual recognition model of multistate nursing regulation: Arizona, Arkansas, Colorado, Delaware, Idaho, Iowa, Kentucky, Maine, Maryland, Mississippi, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia and Wisconsin. Nurses who reside in other compact states who hold a multistate license “have the “multistate privilege” to practice in Tennessee without the requirement for a license issued by the Tennessee Board of Nursing. The following questions and answers provide information about the Nurse Licensure Compact and how it will affect employment of nurses from other compact (party) states that have enacted the Compact.

Q:        What does a ‘multistate privilege to practice’ mean?
A:         Similar to the driver’s license model, this is the mechanism in the Nurse Licensure Compact that allows a nurse who is licensed in one compact state (home state) to legally   practice in another compact state (remote state). It is important to understand that the Nurse Licensure Compact requires the nurse to adhere to the practice laws and rules of the state in which the client(s) receives care.

Q:        Where will nurses obtain/renew their license under this mutual recognition model of licensure?
A:         Nurses must meet the requirements to obtain and renew their license in their primary state of residence.  Primary state of residence as defined in the Compact means “the person’s fixed permanent and principal home for legal purposes; domicile”.

Q:        How will the Nurse Licensure Compact affect nurses who live in Compact states?
A:         As of July 1, 2003, a nurse who resides in Tennessee and holds an unencumbered Tennessee multistate nursing license will have the ‘multistate privilege to practice’ in any of the other compact states. Likewise, a nurse who resides in and is licensed by another compact state and holds a multistate license will have the ‘multistate privilege to practice’ in Tennessee.  When a nurse changes his/her primary state of residence to another compact state he/she will be required to apply for and obtain a nursing license in that state. A nurse who lives in a compact state no longer must obtain (or renew) a license in any of the other states that have enacted the Nurse Licensure Compact.

Q:        Will the nurse who lives in a non-compact state and practices in Tennessee still need to have a license to practice in Tennessee?
A:         Yes.  Nurses who practice nursing in Tennessee but live in a non-compact state, such as California or Georgia, must continue to hold a license issued by the Tennessee Board of Nursing. The Nurse Licensure Compact will not change how they obtain or renew their Tennessee license.  However, the Tennessee nursing license will be a single state license for non-compact state residents. It will not include the multistate licensure privilege to practice in other compact states.  This privilege is extended only to those nurses who reside in Tennessee.

Q:        How will employers verify licensure status of nurses under this mutual recognition model?
A:         For nurses who holds a license issued by the Tennessee Board of Nursing, employers will continue to verify licensure status via the internet (www.tennessee.gov/health) or through our automated telephone verification system at 888-778-4123.  Please note that verification via internet will include the multistate privilege to practice for those nurses who reside in Tennessee and hold an unencumbered license.

For those nurses who are licensed in another compact state and are seeking employment in Tennessee, employers are asked to access the nationally coordinated licensure information system called NURSYS. Basic licensure information as well as disciplinary history for a licensee will be provided through this system at www.nursys.com, or contact the website/office of the state of licensure.

NOTE: With the implementation of this new model of licensure and the continuation of the single state license for nurses who reside in non-compact states, it is most important that employers verify the licensure status of all nurses seeking employment in Tennessee.

Q:        How will employers be informed of new states joining the Nurse Licensure Compact?
A:         This information will be available on the website of the National Council of State Boards of Nursing (www.ncsbn.org).  It is most important that employers remain informed as other states join the Compact. Please note that there may be a lag time between enactment of the Nurse Licensure Compact and implementation.

Q:        How will complaints about nurses be handled within this mutual recognition model?
A:         The compact authorizes the nurse licensing board of any compact state (home or remote)           to investigate allegations of unsafe practice by any nurse practicing in that state.  Based upon the outcome of the investigation, a remote state licensing board may deny the nurse’s multistate privilege to practice in that state.  Only the nurse’s home state (state of residence) licensing board may take action against the nurse’s license.  States will continue to apply the same administrative and due process procedures for imposing discipline as they have always done.  However, compact states will have more timely access to information, including current significant investigative information and the disciplinary history of nurses, through the coordinated licensure information system (NURSYS).  Should you have a complaint to report about a nurse practicing in Tennessee, submit it to the Health Related Boards Investigative Division (1-800-852-2187).

Q:        How do I get more information about mutual recognition and the Nurse Licensure  Compact?
A:         The Nurse Licensure Compact and other information related to the mutual recognition of nursing regulation are available on the Board website. The National Council of State Boards of Nursing (NCSBN) website (www.ncsbn.org) lists the states that have enacted the Nurse Licensure Compact and provides in-depth information on the mutual recognition model.  NCSBN may be accessed directly or through a link on the Tennessee Board of Nursing’s website.  If you have specific questions about this new model of nursing regulation please contact the Board office.