Nursing Wiki

Nurse Licensure Compact

The Nurse Licensure Compact is an agreement among states that lets a registered nurse or a licensed practical or vocational nurse hold one multistate licence, issued by the state where they live, and practise in every other participating state.

It is not a national licence. Work done in another compact state is governed by that state's own practice act, its own board of nursing, and its own scope rules. The compact moves the licence, not the rules. See nurse practice acts and boards of nursing.

The version in force today, usually called the enhanced compact, went live in January 2018 with 29 states joining together. It added uniform licensure requirements, including a fingerprint-based criminal background check, that the original agreement had not imposed.

Enacted and implemented are different words

This distinction causes more trouble for individual nurses than anything else about the compact, and it has cost people assignments.

Enacted means a legislature passed a bill and the governor signed it. Implemented means the board of nursing has finished the work behind it: connecting to the national licensure database, running the background checks, changing its licensing systems, and actually issuing and honouring multistate licences. The gap between the two runs from a few months to several years.

Connecticut is the clean illustration. The bill was signed in May 2024 and the compact went live on 1 October 2025, nearly seventeen months later. For all of that time a Connecticut nurse's licence was still only a Connecticut licence.

Pennsylvania shows a third state in between. For two years it was in partial implementation: nurses holding a multistate licence from elsewhere could work in Pennsylvania, but Pennsylvania residents could not obtain one. That ended on 7 July 2025, when the state fully implemented.

Where it stands

The compact's own status data, published in October 2025, covers 55 United States jurisdictions:

  • 40 states where a multistate licence is live and working.
  • Three jurisdictions have enacted it without switching it on: Massachusetts, the U.S. Virgin Islands, and Guam. Guam is a partial case, in the position Pennsylvania occupied until July 2025: nurses from other compact states may practise there, but Guam residents cannot yet hold a multistate licence.
  • Nine jurisdictions had bills pending: Alaska, the District of Columbia, Hawaii, Illinois, Michigan, Minnesota, Nevada, New York and Oregon. None passed during the 2025 legislative sessions.
  • Three have no compact bill at all: American Samoa, the Northern Mariana Islands, and California.

California is the conspicuous absence. It is the highest-paying state in the country for registered nurses and has not had a compact bill filed. Working there requires a California licence issued by the California Board of Registered Nursing.

Published counts of compact states disagree with each other, for a reason worth knowing. Counting jurisdictions, 43 have enacted the compact, a figure that includes Guam and the U.S. Virgin Islands. Counting states, 41 have enacted and 40 have implemented. Any number between 40 and 43 can be defended depending on what is being counted.

Implementation dates move, and states join between one status publication and the next. Anything relied on for an assignment should be checked against the receiving state's board of nursing.

Who the compact covers

The compact covers registered nurses and licensed practical or vocational nurses only. Nurse practitioners and the other advanced practice roles still need a licence in every state where they practise, and a separate advanced practice compact has been drafted but is not operational. See levels of nursing.

The multistate licence is issued by the nurse's primary state of residence, which cannot be chosen for convenience. A nurse living in a state that is not in the compact cannot hold a multistate licence at all, however many compact states they work in.

Where a nurse trained does not matter to the compact. A nurse educated abroad who lives in a compact state and meets the requirements holds the same multistate licence as anyone else, because the test is residence rather than the origin of the qualification. Getting to that point is a longer road. See internationally educated nurses.

Qualifying

The uniform requirements the compact applies in every participating state are a licence in good standing from the home state, graduation from an approved nursing programme, a passed licensing examination, a state and federal fingerprint-based criminal background check, no felony convictions, no misdemeanour convictions related to nursing practice, no current participation in an alternative-to-discipline programme, and a valid Social Security number.

The 60-day residence rule

Since January 2024, a nurse who moves their primary residence to another compact state must apply for a multistate licence in the new state within 60 days. Missing the window can cause the multistate privilege to lapse.

The operative word is residence. Primary state of residence is where a nurse pays federal income tax, votes, or holds a driver's licence. A thirteen-week assignment in another state is not a change of residence and does not start the clock, so travel nurses working out of a fixed home base are unaffected. Nurses who genuinely relocate are the ones the rule catches.

Telehealth

What matters is where the patient is, not where the nurse is sitting. A nurse must be licensed in the state where the patient is located at the time care is given, so a multistate licence covers telephone triage, remote monitoring and video visits into any other participating state without a second application.

It does nothing for a call into a state outside the compact. A nurse doing remote work that reaches patients in California or Illinois needs a licence from those states, exactly as if the visit were in person.

Discipline, and how employers check

The home state issues the licence and holds the primary disciplinary authority over it. A state where the nurse practised on the multistate privilege can also investigate and act against practice within its own borders, and participating boards feed licensure and disciplinary data to the national database, so an action taken in one state reaches the home board rather than disappearing.

Discipline can also cost the privilege itself. When a licence is encumbered by a restriction or a disciplinary action, the multistate privilege falls away and the licence reverts to a single-state licence, valid only at home. A nurse in that position who keeps working across a state line is practising without a licence there.

Employers can confirm all of this at no cost through Nursys, the national verification service, which shows whether a licence is multistate or single-state and which states it authorises. Checking it is faster than asking, and it is the only version of the answer that is not the candidate's own account. Agencies placing nurses across state lines have the same obligation and the same tool. See nurse staffing agencies.

What the compact is worth, in numbers

Two datasets show how much of temporary nursing now runs through it.

Contract work follows the compact. Of the 4.68 million travel assignments advertised on NurseRecruiter between 2009 and 2026, 71 percent were in compact states, and eight of the ten states with the most assignments advertised per employed nurse are members. The exceptions, Alaska and Oregon, each require a licence by endorsement before a nurse can start, which is weeks of delay on a thirteen-week contract. See where the assignments are.

Travel nurses hold the licence far more often than other nurses. In the first large profile of the travel workforce, roughly two thirds of travel registered nurses held a multistate licence against about a third of nurses who did not travel. The compact is not a convenience for this kind of work so much as the thing that makes it practical.

Why it matters

For a nurse taking short contracts, each participating state removes a licence application, a fee, and often several weeks of waiting between assignments. That friction is a larger share of earnings than it was during the travel nursing boom, because contract rates have fallen a long way from their 2022 peak while the paperwork has not got faster.

For employers, the compact is a recruiting radius. A hospital in a compact state can hire a nurse living in any of the other participating states and have them working immediately rather than months later, which matters when the average vacancy takes close to three months to fill. See nurse turnover and retention.

Sources

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