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Out-of-state complaint against a Kentucky nurse and duty to report to the Kentucky Board of Nursing

Traveling nurses have come into focus during the pandemic as communities experience outbreaks of coronavirus and require significant expansions of nursing staff. Traveling nurses licensed in Kentucky utilize two ways of legally practicing in some other states.

First, a Kentucky nurse can obtain a multistate license through the Kentucky Board of Nursing (KBN) that gives them the privilege to practice in many other states that, like Kentucky, are members of the Nurse Licensure Compact (NLC). Second, a Kentucky nurse who wants to work in a non-NLC state must apply for a single-state license there, likely through endorsement of the Kentucky license, or may meet requirements for emergency practice privileges.

In either circumstance, a Kentucky nurse could face disciplinary action before the other state’s board/commission of nursing (BON) after a complaint about their professional performance, criminal conviction, or action on a professional license. What could be the impact of this potential discipline on the nurse’s home state license?

Complaints in NLC states

We recently wrote about the Nurse Licensure Compact through which nurses whose primary state of residence (PSOR) is Kentucky can obtain a multistate license for other compact states. Member states in our region include Tennessee, Missouri, Arkansas, Virginia, West Virginia, Indiana and others.

When someone files a complaint against a Kentucky nurse practicing out of state with an NLC license, the compact provides a procedure for how the state BON is to handle the allegations. The remote state’s BON contacts the KBN, and the two state boards negotiate which will take primary responsibility for the investigation and potential charges.

Basically, one state will investigate, but both states may take negative action against the license, including the KBN against multistate privileges. Notably, if Kentucky restricts its license, it can impact the privilege to practice in other compact states.

Complaints in non-compact states

When a Kentucky nurse holds a single-state license in a non-NLC state, they may face complaints and potential disciplinary actions by that state’s BON. Federal law requires that every BON report adverse actions it takes against a nurse’s license to the National Practitioner Data Bank (NPDB), where it would be available for the KBN to see. In addition, Kentucky could check the Nursys® database to which all NLC states and some others report disciplinary action.

Should the KBN determine that the other state’s disciplinary action should also impact the Kentucky license, it may initiate action against the nurse’s license.


Kentucky law requires its licensed nurses to self-report their misdemeanor or felony convictions, whether from Kentucky or other states to the KBN as described on this government website. The nurse may also file a letter of explanation for the circumstances surrounding the matter. It is strongly recommended that any nurse facing this situation speak with an experienced attorney as soon as possible for advice before reporting, if possible. Criminal activity can be the basis of license, discipline leading up to revocation.

Kentucky law requires its licensed nurses to self-report any action taken on a professional license from other states or from other professions if previously licensed in another role to the KBN staff as described on the government website. Experience has shown that the KBN has enforced the self-reporting requirement against nurses.

Defend against charges that could harm your license and career

Of course, the state must regulate nursing to protect the public from medical mistakes and negligence, abuse or neglect, fraud or misrepresentation, incompetence, ethical missteps or criminal activity as well as from practicing while under the influence of alcohol or drugs or with symptoms of a mental or physical health problem that impacts the ability to practice.

But nurses are sometimes wrongly accused, and they need to effectively present their side of the story.

Any Kentucky nurse under investigation or accused of violating the standards required of their license or the NLC in the state in which they are practicing should seek immediate legal counsel. There are opportunities in the disciplinary process to assert a strong defense or file an appeal as well as the potential to negotiate a resolution.