In New York, there are four types nursing professions:
Licensed Practical Nurses (LPNs),
Clinical Nurse Specialists (CNSs),
Registered Professional Nurses (RNs),
and Nurse Practitioners (NPs).
Nurse Practitioners are becoming an increasingly common sight in healthcare settings. They offer a comprehensive perspective and personal touch to health care. By providing high-quality care and counseling, NPs can lower the cost of health care for patients and make it more accessible.
There are many entrepreneurship opportunities for nurse practitioners in New York State, beyond a traditional healthcare office. Some of the possibilities include a home healthcare, urgent care clinic, occupational health services, health coaching, medical spas, consulting, education and training, medical writing, health product development, mobile clinics, and travel nursing.
Many Nurse Practitioners have considered starting their own private practice. They enjoy the autonomy and the ability to set their own schedule, make decisions on patient care, and directly impact the health and well-being of their community. These are just a few of the compelling benefits of striking out on your own. But starting a private practice requires careful planning, a detailed understanding of legal and regulatory requirements, and a solid business strategy. Let’s look at how this can be accomplished.
Starting Your Own NP Practice with Less than 3600 Hours of Practical Experience
According to New York Education Law § 6902(3), nurse practitioners are granted the authority to diagnose illnesses and physical conditions, as well as to perform therapeutic and corrective measures within their specialty area of practice. As such, NPs are not required to work under the direct supervision of a physician under certain circumstances.
However, nurse practitioners must comply with specific regulations for starting their own practice with less than 3600 hours of practical experience. Nurse practitioners must practice in accordance with written practice protocols and a written practice agreement with a collaborating physician unless and until they’ve completed 3,600 hours of experience. This experience must consist of practicing as a licensed or certified NP (i) in accordance with the laws of New York or another state, or (ii) while employed by the United States veteran's administration, the United States armed forces or the U.S. public health service.
Starting Your Own NP Practice with More than 3600 Hours of Practical Experience
An NP with more than 3600 hours of practical experience is free to practice independently. New York law authorizes NPs to own their practices outright as a sole proprietor, a PLLC, or PC. You’ll have to choose a type of business organization for your NP practice.
Sole Proprietor
This is someone who owns an unincorporated business by themselves. The owner is liable for all business operations. The owner does business in their own name or with a "trade name." A business certificate is needed only if a trade name is used. It’s called a “Certificate of Assumed Name.” This form of operation provides no asset protection to the owner.
Prior Approval Needed from the Office of Professions
Prior to filing entity formation documents – either PLLC or PC, you must be approved by the Office of Professions to form the entity. This requires the filing of an affidavit stating the proposed name of the entity, the licensed profession it will pursue, and its ties to other professional entities. This has to be submitted first and approval received before forming the entity. This process typically takes 2-4 months.
The naming of the professional practice is often, in our practice, the most painful part of starting the business. The Office of Professions has a number of requirements that need to be met, and the name cannot be superior (e.g., “Best” or “Advanced”), made-up (e.g., “Vita-Care” or “MegaMed”), misleading (e.g., “Cure” or “Healing”), or refer to specific forms of practices that have special meanings (e.g., “Clinic” or “Hospital”). Often our clients point out other professional practices that break those rules – and many do if they are before 2020, when enforcement began ramping up. There are other rules, and they need to be navigated to avoid unnecessary delays in approval from the Office of Professions for your new entity.
Professional Limited Liability Company (PLLC)
Once permission to form the entity is received, a PLLC is formed by filing Articles of Organization pursuant to § 1203 of the Limited Liability Company Law. The name of an LLC must include the words “Limited Liability Company” or the abbreviation “LLC” or “L.L.C.” The name of the LLC must be distinguishable from the names of other LLC’s, corporations or limited partnerships on file with the Department of State.
Professional Corporation (PC)
This is a C-corporation or S-corporation that’s organized to provide professional services in industries that require a state license in order to practice. A business corporation may be formed by filing a Certificate of Incorporation pursuant to § 402 of the Business Corporation Law once permission to form the entity is received.
After the corporate is in existence, an organization meeting of the incorporator(s) must be held for the purpose of adopting by-laws, electing directors, and transacting any other business. The initial by-laws of a corporation are adopted by its incorporator(s) at the organization meeting.
A corporation must keep correct and complete books and records of account and must keep minutes of the proceedings of its shareholders, board of directors, and executive committee (if any). The corporation must also keep a record containing the names and addresses of all shareholders, the number and class of shares held by each, and the dates when they respectively became the owners of record of their shares.
Domestic business corporations are required to file a Biennial Statement two years after the filing of the Certificate of Incorporation with the Department of State and every two years after that.
Contact Us
Contact the experienced New York small business attorneys at LOVE LAW FIRM with questions about starting a business as a Nurse Practitioner. We help business owners and potential business owners every day at the LOVE LAW FIRM.
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Francine E. Love is the Founder & Managing Attorney at LOVE LAW FIRM PLLC which dedicates its practice to serving entrepreneurs, start-ups and small businesses. The opinions expressed are those of the author. This article is for general information purposes and is not intended to be and should not be taken as legal advice.
