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Health Care Facility Guidance For Partial Implementation Of The Interstate Nurse Licensure Compact

August 2023

Pursuant to the Pennsylvania Department of Health's (Department) authority under 28 Pa. Code § 51.31, effective immediately, the Department will receive and grant exceptions to regulations as outlined below and in accompanying facility-specific guidance to allow health care facilities to employ or contract with registered nurses (RNs) and licensed practical nurses (LPNs) holding an active multistate license (MSL).


Act 68 of 2021 authorizes the Commonwealth of Pennsylvania's entrance into the interstate Nurse Licensure Compact (Compact). Participation in the Compact allows a state to issue its resident nurses an MSL, which permits the licensee to practice in any other Compact state. In accordance with the Pennsylvania Department of State, the Commonwealth is partially implementing the Compact by permitting RNs and LPNs residing in other Compact states and holding an active MSL (eligible MSL nurses) to practice in Pennsylvania.

To facilitate the partial implementation of the Compact, the Department has identified the statutory regulatory provisions that may be a barrier to health care facilities seeking to utilize eligible MSL nurses and will be issuing facility-specific guidance on maintaining compliance with applicable provisions. Additionally, the Department has developed a structured exception process for each eligible health care facility type to use if they would seek to employ or contract with eligible MSL nurses. The purpose of the structured exception request is to offer administrative efficiency for both health care facilities and the Department and to expand the pool of nurses available to help fill staffing gaps across the Commonwealth.

Health care facilities should refer to the facility-specific guidance for information on whether the facility type can seek an exception to utilize eligible MSL nurses, the regulation(s) to which an exception is required, and for contact information to direct questions. Guidance is available for the following health care facility types:

MSL Compact Structured Exception Request Content

An eligible health care facility seeking to utilize the MSL Compact structured exception process must submit an exception request to the Department as outlined in the facility-specific guidance. To streamline this process, the Department has created one form for each eligible facility type, which is attached to the facility-specific guidance. On the form, facilities will select the regulation(s) to which the facility is seeking an exception and include a brief narrative which states that the facility is requesting the exception for the purpose of employing or contracting with eligible MSL nurses and will have a process in place to verify MSLs prior to employing or contracting with eligible MSL nurses.

MSL Compact Structured Exception Request Approval

MSL Compact structured exception requests must be published in the Pennsylvania Bulletin for a public comment period prior to granting the request. After the public comment period concludes and any comments are considered, the Department will issue a written determination to the facility. As with any exception, the Department reserves the right to revoke any exception granted under this process for any justifiable reason.

The MSL Compact structured exception request will not require an onsite survey.

Other Information

Health care facilities will be required to have a mechanism in place to verify the licensure status of eligible MSL nurse. Facilities who want to verify the status of a nurse's MSL can go to, the National Council of State Boards of Nursing's (NCSBN) central repository for licensing information, and click on "Quick Confirm."

Nothing in this guidance should be construed as affecting or interpreting any Federal or State law or regulation outside of the Department's jurisdiction that may limit the ability of health care facilities to utilize eligible MSL nurses.