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In the world of healthcare staffing, staying compliant with state regulations is of utmost importance. One crucial aspect that staffing firms need to be aware of is the licensure requirements for nurses in different states. State nurse pool licensure is a critical consideration for staffing firms, and understanding the nuances of these regulations is essential. Over the past few years over 20 states have required staffing firms to register to get a license. In this blog post, we will explore which states require licensure for nursing pool professionals, how to obtain this licensure, and how to maintain it over time.

States Requiring Nursing Pool Licensure

The first step in understanding state nurse pool licensure is knowing which states require it. Each state in the U.S. has its own set of regulations regarding the licensure of nurse staffing firms. It is important to note that while some states require licensure for staffing firms placing only nurses, others have specific requirements for roles outside of nursing as well.

States such as Florida, Kentucky, and Colorado are known for having wide sweeping licensure requirements covering almost all healthcare roles. In Florida, for example, any firm placing healthcare workers other than in home health must have a healthcare staffing license. Similarly, Kentucky requires all firms staffing positions in assisted living, long term care, and hospitals to hold a license.

Other states, like Illinois, carve out firms that place specific types of positions like RN, LPN, and CNA roles. Iowa, for instance, requires staffing firms to register with the state if they place RNs, LPNs, CNAs, CMAs, and Medication managers. 

It is crucial for staffing firms to be aware of the licensure requirements in each state they operate in to avoid legal complications like fines, and ensure that nurses can provide care without interruption.

Obtaining Nursing Pool Licensure

Obtaining nursing pool licensure can be a complex process, but it is a necessity for staffing firms to operate legally if they don’t plan on using a partner like an Employer of Record (EOR) to carry the license for them. Here are the general steps to obtain nursing pool licensure:

  1. Research State Requirements: First, staffing firms should thoroughly research the specific licensure requirements in each state they intend to operate in. This includes identifying the licensure type (e.g., registered nurse, licensed practical nurse) and the licensing authority for that state.
  2. Staffing: Some states require your agency to have an RN on your internal staff to manage the contracted nurses working at your client facilities. This can be a big barrier as RN salaries are higher than most, and would require a high amount of contractors on assignment to reach profitability.
  3. Application Submission: The next step is to submit the required licensure applications to the appropriate state licensing board or agency. These applications typically include information about the nurse’s education, experience, and background.
  4. Background Checks and Fingerprinting: Many states require nurses to undergo background checks and fingerprinting as part of the licensure process to ensure the safety and integrity of healthcare providers.
  5. Examination or Endorsement: Depending on the state, nurses may need to pass a licensing examination or provide evidence of their current licensure from another state through a process known as endorsement. The requirements vary from state to state.
  6. Fees and Documentation: Be prepared to pay application fees and provide various documentation, such as transcripts, verification of licenses from other states, and proof of clinical experience.
  7. Continuing Education: Some states require nurses to complete continuing education courses to maintain their licensure. Staffing firms should ensure that their nurses meet these requirements.

Maintaining Nursing Pool Licensure

Once nursing pool licensure is obtained, staffing firms must focus on maintaining it over time. Here are some key strategies for ensuring ongoing compliance:

  1. Stay Informed: Keep abreast of changes in licensure requirements and regulations in each state where your firm operates.
  2. Provide Education: Offer support and resources to your nurses to help them meet continuing education requirements.
  3. Record Keeping: Maintain accurate records of nurses’ licenses, certifications, and any required background checks, and ensure that they are up to date.
  4. Reporting: Many states require monthly, quarterly, or annual reports to be sent to their state offices to ensure you are complying with the requirements of the license when doing business in their state. This can be a time consuming and tedious process so ensuring you have proper staffing to support this reporting is critical for staffing firms.
  5. Compliance Audits: Regularly audit your operations to ensure that all nurses meet licensure and background check requirements.


State nurse pool licensure is a critical consideration for staffing firms operating in the healthcare industry. Understanding which states require licensure, how to obtain it, and how to maintain it over time is essential for legal compliance and providing high-quality nursing services to healthcare facilities. By following these guidelines and staying informed about state regulations, staffing firms can navigate the complex world of nursing pool licensure successfully.

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