Nevada: Ownership and Oversight
Strict CPOM (NRS 89 + AG opinions), with a nursing-entity gap. Professional entity ownership is restricted to same-profession licensees, with an unusual multi-profession medical combo list, autonomous APRNs with no clean professional-entity vehicle, and PA supervision that carries real teeth.
Who the statute actually covers
- NRS 89 professional entity: owners must be licensed in the profession the entity practices (NRS 89.070), with board-issued certificates verified at filing (NRS 89.040). Nursing is not an NRS 89 profession, so there is no professional-corporation lane for an APRN-owned practice despite APRN scope independence.
- Medical combination list (NRS 89.050(2)(b)): one entity may combine practitioners of medicine, genetic counseling, homeopathy, osteopathy, naprapathy, chiropractic, and psychology. PAs and APRNs are not on the list.
- APRN autonomy (NRS 632.237): Nevada APRNs practice independently; the only physician tether is a Schedule II protocol for APRNs with under 2 years or 2,000 hours of clinical practice.
1. Who can own what
| Entity / Path | Who may own | Key limits |
|---|---|---|
| Medical professional entity | Licensees of the entity's profession (NRS 89.070); combos limited to the NRS 89.050(2)(b) list. | NRS 89.055 prohibits specified acts by medical-entity owners; AG Opinions 219 (1977), 2002-10, and 2010-1 anchor the CPOM doctrine. |
| PA ownership | No provision. PAs are not an NRS 89 profession and have no ownership lane in medical entities. | PA-owned clinic structures have no Nevada statutory basis. |
| APRN ownership | Gap: APRNs have autonomous scope but nursing is not an NRS 89 profession, so there is no professional entity category to own. Typically structured through ordinary entities rendering APRN services, or physician-owned entities employing APRNs. | Structure carefully and get Nevada counsel; the scope statute and the entity statute were never harmonized. |
| Lay / MSO | Not permitted in the professional entity; unlicensed persons cannot hold NRS 89 shares. | MSO at FMV supports the professional entity; watch NRS 89.055 on control. |
2. Collaborative and supervisory oversight
| Role | Agreement required | Oversight mechanics | Path to independence |
|---|---|---|---|
| PA | MD-side: Board-approved supervising physician relationship (NRS 630.275; NAC 630.370); the supervising physician is responsible for all the PA's medical activities. DO-side: written collaborating agreement, signed and notarized, filed with the osteopathic board within 10 days (NAC 633.288). | Generally a maximum of 3 PAs per supervising physician, expandable only by Board petition (NAC 630.495); a PA may serve under no more than 3 supervising physicians. Periodic review and initialing of selected charts, monthly on-site inspection, plus a QA program including skills assessment and direct observation. | None. Nevada PAs have no independence pathway. |
| NP / APRN | None for practice: full practice authority (NRS 632.237). Prescribing: APRNs with fewer than 2 years or 2,000 hours must maintain a written protocol with a collaborating physician for Schedule II controlled substances. | No ratios or chart-review percentages for APRNs. NAC 630.495 restricts a single physician's combined simultaneous PA supervision and APRN collaboration load. | Yes: at 2 years or 2,000 hours, the Schedule II protocol requirement ends, leaving the APRN fully independent. |
3. Primary authorities
- NRS 89.040, 89.050(2)(b), 89.055, 89.070.
- Nev. AG Opinions No. 219 (1977), 2002-10, 2010-1.
- NRS 630.275; NAC 630.370, 630.490, 630.495; NAC 633.288.
- NRS 632.237.
Practical read: Nevada's headline is the mismatch: the nursing board made APRNs independent, but the corporations code never gave them an entity to own, so every Nevada NP practice is a structuring question before it is anything else. The 3-PA cap and monthly on-site inspections make Nevada one of the tightest supervision states in the country.
General education, not legal advice.