Protocol Desk · 2026-W39
Where your medical director has to stand: three states say on-site or within 50 miles
This week's brief is the proximity map for registered nurses working under a written protocol. Five jurisdictions, two answers: be in the building, or be reachable.
Strictest and loosest: where the physician must be, for registered nurses
3 jurisdictions codify a physical-presence or radius rule; 2 accept remote availability or set no rule.
Florida: on-site presence required
For RN delegation, Florida codifies physical presence: the supervising physician is expected at the location, not on the phone. A protocol that assumes a remote medical director does not satisfy the presence element here.
Georgia: within a set radius of 50 miles
Georgia sets distance rather than presence: the physician must be within 50 miles of the practice site. That makes the medical director's home base a compliance fact about the site, not just a staffing preference.
Ohio: on-site presence required
Ohio also requires on-site presence for the physician behind RN delegation. Practices running multiple locations off one medical director carry that constraint per site.
California: available remotely
California accepts remote availability for the physician standing behind RN work. The protocol still has to name who is reachable and how, but the physician need not be at the site.
New York: available remotely
New York likewise treats remote availability as sufficient rather than requiring presence or a radius. The weight sits on the standing order and who answers it.
Every outside claim carries the source it was read from this week. Our own research dates are on each state page. Published 2026-09-21.