Requirements for Out-of-State Advanced Practice Registered Nurses requesting approval to practice in North Carolina during a State of Emergency

• WHAT ARE THE REQUIREMENTS FOR OUT-OF-STATE NURSE PRACTITIONERS WHO WANT TO WORK IN NORTH CAROLINA DURING THE STATE OF EMERGENCY?
• An NP approved to practice in North Carolina, or another state may perform medical acts, as an NP under the supervision of a physician licensed to practice medicine in North Carolina during a state emergency-COVID-19;
• the NP shall notify the NCBON in writing of the names, practice location and telephone number for the NP and each primary supervising physician within 15 days of the first performance of medical acts, as an NP during the state emergency, and the NCBON shall notify the North Carolina Medical Board; and
• teams of MDs and NPs practicing shall not be required to maintain on-site documentation describing supervisory arrangements and plans for prescriptive authority as otherwise required.

Requirements for Nurse Practitioners practicing outside their certification during a State of Emergency

• I’M A NURSE PRACTITIONER APPROVED TO PRACTICE IN NORTH CAROLINA. MY FACILITY WOULD LIKE TO MOVE ME TO PRACTICE IN ANOTHER AREA OF THE FACILITY IN A POPULATION FOCUS I’M NOT CERTIFIED IN. CAN I DO THIS?
• Nurse Practitioners may be reassigned to a new practice area within the same facility (i.e., hospital, multi-specialty group practice) without regard to their academic preparation and national certification and without updating his or her supervisory arrangements, so long as:
• the nurse practitioner is reassigned to perform only those medical duties which the nurse practitioner is competent and qualified to do; and
• the nurse practitioner has reasonable and immediate access to a physician, either in person or electronically, should medical issues arise.
• The NCBON understands many Nurse Practitioners are being asked to practice in a new area or with a new patient population during the state of emergency. During the state of emergency period, health care organizations or supervising physicians may ask Nurse Practitioners to work outside the patient population for which the Nurse Practitioner holds national certification. This may be necessary to meet critical needs in North Carolina. In these situations, the Nurse Practitioner may collaborate with or be supervised by different physicians for whom he/she has not worked with before. Facility administration should ensure that the Nurse Practitioner is reassigned only those activities which the practitioner is safe and competent to perform.

Nurse Practitioner supervision requirements during a State of Emergency

• I’M A NURSE PRACTITIONER, AM I REQUIRED TO HAVE AN ONSITE SUPERVISION IN ORDER TO PRACTICE? WHAT DOES THAT MEAN?
• On-site supervision shall mean having immediate access, either in-person or electronically, to a physician who is physically present on the premises should medical issues arise.

Telehealth practice during a State of Emergency

• CAN AN APRN PRACTICE TELEHEALTH DURING THE STATE OF EMERGENCY?
• NCBON will follow Federal guidelines, which states APRNs licensed anywhere in the US, may practice to their full scope.
• APRNs must have an active, unrestricted approval to practice with their home Board of Nursing and practicing in an organized system or emergency agency.
• Supervision and scope will be at the discretion of the agency with whom the person is practicing.

2021 Regulatory Waiver Extension Notification

2020 Regulatory Waiver Notification