Where Nurse Registries Get Into Trouble: Control, Compliance, and Communicable Disease Screenings

How Control Over Health Screenings Can Jeopardize Independent Contractor Status

Nurse registries operate under a very specific regulatory framework. You are not the employer. You are not the care provider. You are a referral service connecting independent caregivers with clients.

That distinction is everything.

And one of the most common ways registries unintentionally blur that line is through communicable disease screening processes.

The Legal Requirement: What the State Actually Says

Florida law requires that:

• Each caregiver must provide a health statement
• The statement must come from a licensed healthcare professional
• It must confirm the caregiver is “free from communicable disease”

Equally important—what the law does not require:

• The registry does not have to create the form
• The registry does not have to administer the screening
• The registry does not have to control how the caregiver obtains it

The responsibility is placed on the independent contractor to furnish compliant documentation.

FAB 2018-4: Why Control Matters

Under Field Assistance Bulletin (FAB) 2018-4, the Department of Labor highlights control as a central factor in determining independent contractor status.

Control is not limited to caregiving tasks.

It includes:

• How requirements are completed
• What process must be followed
• Where the worker must go
• What tools or forms must be used

When a registry begins influencing these areas, it starts to look less like a referral source—and more like an employer.

Where Nurse Registries Get Into Trouble

Many registries, with good intentions, attempt to simplify compliance by building internal systems.

This often includes:

• Creating their own communicable disease screening forms
• Requiring caregivers to use those forms
• Directing caregivers to specific providers
• Managing or administering the screening process internally

On the surface, this feels helpful.

From a regulatory standpoint, it introduces risk.

The Control Problem (Rooted in FAB 2018-4)

When a registry creates and controls the screening process, it may be interpreted as:

• Dictating how a caregiver satisfies a legal requirement
• Limiting the caregiver’s independence in choosing providers
• Structuring compliance in a way that resembles employer oversight

This is the exact type of “manner and means” control that FAB 2018-4 cautions against.

Even if the intent is administrative efficiency, regulators evaluate how it looks in practice.

And in practice, control is control.

A Real-World Reality Check

This is not theoretical.

Offering or controlling health screenings has been shown to:

• Create operational inefficiencies
• Introduce clinical and licensure liability
• Trigger complaints and regulatory scrutiny

In some cases, it has led to investigations simply because the activity falls outside the traditional role of a nurse registry.

As outlined in internal planning and operational history, even well-intentioned screening programs can:

• Drift into clinical service delivery
• Expose the registry to liability
• Ultimately, it requires discontinuation to remain compliant

The Compliance-Safe Approach: Stay Neutral

The safest model is simple and defensible:

Verify compliance. Do not control how compliance is achieved.

That means:

• Accept valid documentation that meets the statute
• Avoid designing or requiring specific forms
• Allow caregivers to independently obtain their health statements

This preserves the integrity of the independent contractor relationship.

Where MyHealthForm.com Fits In

This is exactly the problem MyHealthForm.com was built to solve.

Instead of registries:

• Creating internal forms
• Managing screenings
• Assuming liability

MyHealthForm.com provides:

• A third-party, independent solution
• A structured screening process based on established tools used by major institutions
• RN-reviewed screenings operating under a physician-approved protocol
• A compliant health statement that meets Florida requirements

Most importantly, it allows registries to:

• Refer caregivers to a solution
• Avoid directing or controlling the process
• Maintain clear separation from clinical activity

Why This Strengthens Independent Contractor Compliance

Using a neutral third-party option reinforces:

• The caregiver’s independence
• The registry’s role as a referral service
• A clear boundary between administration and control

It aligns directly with the principles outlined in FAB 2018-4.

The Bottom Line

Policies and procedures show regulators that you understand the rules.

Operations show them how you actually apply them.

If your registry is:

• Creating internal screening tools
• Controlling how caregivers complete requirements
• Managing compliance processes

…it may be time to reassess.

Because under FAB 2018-4, control—no matter how well-intentioned—can shift the entire classification analysis.

Final Thought

The goal is not just to meet the requirement.

It is to meet the requirements in a way that protects your model.

And sometimes the most compliant move a nurse registry can make is simple:

Step back—and let independent contractors remain independent.