Rhode Island: Ownership and Oversight
Full FPA with collaboration redefined as a relationship, not a document. Rhode Island grants APRNs immediate independence and goes a step further than most FPA states: its regulations define collaboration itself as an independent working relationship that requires no written agreement, no designated physician, and no shared location.
Who the Statute Actually Covers
- The definition that does the work (216-RICR-40-05-3): "collaboration" means an independent working relationship between an APRN and other licensed health professionals that does not require a written collaboration agreement, a specific designated physician, or co-located services; "independent practice" means an APRN working without a formal collaborative agreement with a physician.
- Scope: advanced practice registered nursing is defined as an independent and expanded scope including advanced assessment, diagnosing, prescribing, and ordering; CNPs may serve as the primary or acute care provider of record; prescribing includes controlled substances with state and DEA registration; 10 CE hours per biennium.
- PA framework (R.I. Gen. Laws ch. 5-54): PAs practice in collaboration with physicians with the degree of collaboration determined at the practice level; verify current agreement mechanics with the Board of Medical Licensure when drafting.
1. Who Can Own What
| Entity / Path | Who May Own | Key Limits |
|---|---|---|
| Professional entities | Licensee-owned professional corporations/LLCs under Rhode Island professional entity statutes when those forms are used. | Verify combinations with Rhode Island counsel. |
| NP-owned practice | Fully independent from licensure; RI's provider-of-record language makes payer credentialing of NP-led practices comparatively smooth. | — |
| PA path | Practice-level collaboration; no ownership prohibition in the practice act. | — |
| Lay / MSO | Standard structuring; licensing-law policing. | — |
2. Collaborative and Supervisory Oversight
| Role | Agreement Required | Oversight Mechanics | Path to Independence |
|---|---|---|---|
| PA | Collaboration with physicians per ch. 5-54, practice-level mechanics. | No ratio; no statutory chart-review percentage; verify current requirements with the Board. | None formalized; collaboration is practice-defined. |
| NP / APRN | None. Immediate full practice authority; collaboration exists as a professional relationship, not a regulatory document. | No agreements, ratios, transition hours, or review requirements at any stage. | Independent from licensure. |
3. Primary Authorities
- 216-RICR-40-05-3 (APRN scope; collaboration and independent-practice definitions; provider of record).
- R.I. Gen. Laws ch. 5-34 (nursing); ch. 5-54 (physician assistants).
Practical read: Rhode Island's regulation is worth quoting verbatim in course materials because it captures what FPA actually means — collaboration continues as good practice, but the state explicitly says no document, no designated physician, no shared roof. It is the cleanest citation in the country for explaining the difference between clinical collaboration and regulatory collaboration.
General education, not legal advice. Verify current statutes, board rules, and opinions before relying on this summary.