What License Is Needed for the Two BON Delegation Rules?

Board of Nursing delegation rules recognize two license tiers with different delegation authority: a Registered Nurse (RN) license lets you delegate nursing tasks to LPNs/LVNs and to unlicensed assistive personnel (UAP), while a Licensed Practical Nurse or Licensed Vocational Nurse (LPN/LVN) license lets you delegate a narrower set of tasks to UAPs only, and only where the state nurse practice act allows it. Which license you hold determines what you can hand off, to whom, and under what conditions. It does not change one thing: accountability for the outcome stays with the nurse who made the delegation decision.

What Each License Lets You Delegate

Most state BON regulations follow the framework published by the National Council of State Boards of Nursing (NCSBN), which sets out two tiers of delegation authority tied directly to license type.¹

An RN may delegate specific nursing tasks to LPNs/LVNs or to unlicensed assistive personnel. RN education and scope of practice give the widest latitude to decide which tasks are appropriate, assess patient stability, and supervise the person carrying out the work. This is the tier used most often in acute care, hospitals, and any setting where patient conditions can change quickly.

An LPN/LVN may delegate certain tasks to UAPs where the state nurse practice act permits it. That authority is narrower than an RN’s and is generally limited to routine, predictable activities for patients whose conditions are stable. Not every state grants LPNs delegation authority at all. States that do typically require an RN or physician to remain involved in overall care oversight.

Advanced Practice Registered Nurses (APRNs) also hold delegation authority. NCSBN guidelines apply to APRNs when they delegate to RNs, LPNs/LVNs, or assistive personnel, placing that authority above the RN tier in the chain.

Delegation Is Not the Same as Assignment

Before you rely on either license’s delegation authority, confirm the handoff is actually delegation. An assignment means giving someone a task that already sits within their normal job duties and basic training. A nurse aide taking vital signs is carrying out an assignment, because that skill was part of their educational program. Delegation means authorizing someone to perform a specific nursing activity that goes beyond their traditional role and routine responsibilities. Because the task sits outside the delegatee’s usual scope, the delegating nurse must first confirm the person has received additional education, training, and a competency check for that particular activity.¹

The distinction has real consequences. When a UAP performs a routine assignment and something goes wrong, liability analysis focuses on whether the task was within their job description. When a UAP performs a delegated task, the licensed nurse who made the delegation decision is accountable for the outcome.²

Tasks No License Can Delegate

Some activities cannot be handed off, whatever license you hold. Nursing judgment and critical decision-making are not delegable.¹ That principle rules out:

The initial patient assessment that establishes baseline condition and drives subsequent care decisions.
Nursing diagnosis, meaning the identification of actual or potential health problems based on assessment data.
Care planning and goal-setting, including choosing the interventions to reach those goals.
Evaluating whether an intervention worked and deciding what to change next.

Medication administration sits in a gray area. Roughly two-thirds of states allow RNs to delegate medication administration to trained UAPs in certain settings, particularly nursing homes with medication aides or medication technicians who have completed specialized training. Even in those states, first doses, injectables, inhalants, IV fluid regulation, and as-needed medications are typically excluded from what a UAP can administer.³

The Five Rights Every Delegation Must Satisfy

Holding the right license is necessary, not sufficient. Every delegation decision, RN or LPN, must pass through the five rights of delegation. BONs use these to evaluate whether a nurse delegated appropriately.

Right task. The activity falls within the delegatee’s job description or the facility’s written policies, and those policies describe the expectations and limits of the activity.
Right circumstance. The patient’s condition is stable. If it changes, the delegatee must notify the licensed nurse immediately, and the nurse must reassess whether delegation remains appropriate.
Right person. The licensed nurse, the employer, and the delegatee share responsibility for confirming the delegatee has the skills and knowledge to perform the activity safely. That means current, unrestricted credentials, knowledge of the specific procedure, and demonstrated competency in performing it.
Right direction and communication. The nurse gives specific instructions, including what data to collect, how to collect it, and when to report back. The delegatee cannot modify the activity without consulting the nurse first.
Right supervision and evaluation. The nurse monitors the activity, follows up when it is complete, evaluates the patient outcome, remains available to intervene, and ensures the work is documented.

All five conditions must be met before delegation begins. Skipping one exposes the nurse to disciplinary action, even if the patient was not harmed.¹

How the Care Setting Shifts Which License Applies

The rules do not change from one setting to another, but the setting does change which license’s authority you will actually be using. In acute care, patient conditions are less predictable, changes happen fast, and the consequences of a missed observation can be severe. RN-level delegation authority is the standard here. An LPN working in acute care is typically receiving delegated tasks from an RN rather than delegating to others.

In community and independent-living settings where patients have stable, predictable conditions, the framework opens up. Routine tasks such as assisting with hygiene, mobility, and basic monitoring are more commonly delegated. In states that permit LPN delegation, these stable-condition environments are where that authority is most likely to come into play. Patient stability is the pivot: if the condition changes, the delegatee must notify the licensed nurse, who then reassesses whether the delegation should continue.¹

Accountability Does Not Transfer With the Task

Delegating a task does not delegate accountability. The licensed nurse who makes the delegation decision remains accountable for the overall outcome of patient care. The delegatee is responsible for performing the specific task correctly, but if the delegation itself was inappropriate, the nurse who authorized it faces the consequences.²

That split creates ongoing obligations. The nurse must be available during the delegated activity, must receive and act on status reports, and must evaluate the outcome once the task is complete. A nurse who delegates a blood glucose check and then becomes unreachable has not met the supervision standard, even if the reading comes back normal. An employer directive to delegate certain tasks does not relieve the nurse of the duty to evaluate whether each specific delegation decision is safe.⁴

What Happens When Delegation Goes Wrong

When a BON determines that a nurse delegated improperly, discipline can range from a written reprimand to permanent license revocation. Options include monetary fines, mandatory continuing education, probationary periods with practice restrictions, and suspension. Severity typically tracks with whether a patient was harmed and whether the nurse showed a pattern of unsafe delegation.

State rules vary, and not knowing your state’s nurse practice act is not a defense. Every licensed nurse is expected to know what delegation is permitted in the state where they practice. Your state BON’s website publishes the relevant statutes and administrative rules, and most boards offer advisory opinions or FAQ documents addressing common delegation questions.⁵

1
National Council of State Boards of Nursing. National Guidelines for Nursing Delegation
2
National Center for Biotechnology Information. StatPearls – Five Rights of Nursing Delegation
3
National Council of State Boards of Nursing. Medication Administration in Nursing Homes – RN Delegation to UAP
4
American Nurses Association. 2025 Code of Ethics for Nurses Provision 4.4
5
National Council of State Boards of Nursing. Delegation