123s of the Nursing Compact Law

June 26, 2023

What Does Having a Multistate Nursing License Mean?

The multistate license is issued in a nurse’s primary state of residence and is recognized across state lines, allowing nurses to have a single multistate license to legally practice virtually or in-person in all Compact States.

Once a nurse obtains a multistate license, they can practice in any Compact State without having to take an exam or apply for licensure. The NCSBN has an electronic verification system so nurses can prove their credentials across state lines. The system allows nurses to easily transfer their licensure across states and practice within the Compact State whereas a single state license limits the nurse to practice only within that particular state. This provides nurses greater mobility in their careers, opens opportunities for travel nursing, telehealth, as well as emergency response. Additionally, patients benefit from improved access to health care services, particularly in underserved areas or during times of crisis.

Having a multistate license also opens the door for nurses to obtain training that might not otherwise be available. Many courses offer live training on patients. From a compliance perspective, having a license in the state where the course is offered is the cleanest path to having the ability to participate in the live training. The multistate license provides an elegant solution to allow nurses a broader opportunity for this type of training.

What is the Nurse Licensure Compact?

The NLC is an agreement allowing reciprocity of a nursing license between states that are part of the NLC (“Compact State”). Initially ratified in 1999, the National Council of State Boards of Nursing (“NCSBN”) sought to minimize barriers to interstate practice. The NLC has now grown to include 38 states with additional states pending implementation (see map below). The NLC allows a nurse whose primary state of residence (i.e., where they file their taxes) is a Compact State and who possesses a nursing license in that state, to obtain a multistate license.

Only RNs, LPNs and LVNs are eligible for the multistate license as advanced practice nurses are not included in the NLC. In addition, the nurse must meet certain uniform licensure requirements such as meeting the licensure requirements for their home state, graduating from a board-approved education program, passing the National Council Licensure Examination (“NCLEX”), and passing a background check.

The map below shows the current status of each state regarding NLC ratification:

Map of U.S. showing the status of each state regarding NLC ratification
*The information contained in this map is general in nature and should not be considered legal advice. Laws are constantly changing. You should always consult with a professional familiar with your particular situation for advice concerning specific matters before making any decisions.

What Else to Know About Multistate Licenses for Nurses?

Nurses may apply for a multistate license only in the nurse’s primary state of residence and require a one-time fee. Per the NLC rules, nurses who are licensed in and legal residents of a Compact State may not hold licenses from other Compact States – they can only hold one Compact State license at a time and must be from their primary state of residence. If a nurse changes their primary state of residence from one Compact State to another, they must transfer their license by applying for licensure by endorsement in the new home state.

Another important note is that nurses are still held to the standards of the Compact State in which they are practicing, regardless of where they obtained their license. Nurses are responsible for complying with the provisions of the Nurse Practice Act in all Compact States in which they practice. If a nurse commits a violation while practicing in another state and disciplinary action is taken, such action is reported to the nurse’s primary state of residence. The home state can then take the same action as if the nurse committed the violation there.

ByrdAdatto Can Help with NLC Licensing Requirements

If you have further questions about the NLC or other licensing requirements, schedule a consultation today.

We are grateful for the significant research and drafting contribution to this article from our Law Clerk, Clint Nuckolls. Clint is a third-year student at SMU Dedman School of Law.

ByrdAdatto Founding Partner Bradford E. Adatto

Bradford E. Adatto

Brad decided to become a lawyer during sixth-grade Career Day, when he promised to represent his best friend, a future doctor. A few decades later, he started his own law firm that focused on representing health care and corporate clients.

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