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Business and licensing issues when launching a Kentucky medical spa, part 2

Today we pick up where we left off in part 1 of this post. Namely, we take a closer look at licensing matters and business considerations for the advanced practice regular nurse (APRN) who wants to set up their own medical spa in Kentucky.

Kentucky Board of Nursing

The Kentucky Board of Nursing (KBN) is the primary state government agency involved in licensing issues in an APRN-owned medical spa. KBN provides a wealth of information on these topics.

APRNs must analyze their own licenses as well as those of employees or associates who will supply services at the clinic or spa. Every planned service must have corresponding staff licensed or certified to legally perform that procedure in Kentucky. While we discussed Botox injections and dermal fillers in part 1, some APRNs may want to offer other services such as liposuction, microneedling, laser treatments, Kybella injections and others.

Issues may include:

  • Is your primary license (Kentucky RN or multistate RN) in good standing and are you current on continuing education requirements and fees?
  • Is your Kentucky APRN license current, including required national certifications, or do you hold a valid temporary license?
  • Will you need a collaborative prescriptive agreement (CAPA) with a physician if the nonscheduled legend drugs or controlled substances you will dispense are not within your own prescriptive authority?
  • Will you need a federal controlled substance registration certificate?
  • Does your license cover the services you will provide, will colleagues have proper licensing and will you need to supervise others (such as RNs or LPNs)?
  • Will you have a doctor or pharmacist on staff how will that change what services to offer?
  • Do you qualify as the medical director?
  • And others

Business start-up considerations

Your attorney can also help set up your business. This will involve many important decisions that will impact how the business runs. For example:

  • What business entity (sole proprietorship, LLC, partnership, corporation and others) would serve your purposes, considering business control, tax exposure and risk of personal liability?
  • Where should the business be and are there zoning issues? Will you lease or purchase space?
  • Do you want an independent business or a franchise?
  • What contracts will you need such as CAPAs, vendor agreements, purchase agreements, franchise agreement, service contracts, commercial leases, real estate purchase documents and many others?
  • What insurance policies will you need?
  • How will you associate with colleagues – for example, you could be partners, independent contractors or use another kind of legal affiliation – or will you hire employees?
  • What about other regulatory aspects of the business like sterilization of equipment, storage of prescription drugs and other health and safety rules?
  • Will you need capital and what sources of financing are available?
  • What kinds of software will you need?
  • And others

State and federal employment law is complex, and your lawyer can help you define your needs should you decide to be an employer. You will need to consider a variety of contracts like noncompetes, employment agreements, confidentiality and trade secret agreements, or others. You will need to investigate setting up or contracting for a payroll system compliant with tax and wage-and-hour laws.


The legal issues that arise when launching a medical spa are many and intricate. A lawyer can negotiate, draft or review business contracts as well as complete and file legal documents needed for business formation like a partnership agreement or articles of incorporation. Retain qualified legal counsel to provide comprehensive advice and representation.