The aesthetics industry is booming—and nurses, NPs, and PAs are leading the charge in launching their own medspas. But here’s the hard truth: many of these practices are technically operating illegally without even realizing it.
Whether it’s the wrong business entity, outdated agreements, or missing supervision logs, small missteps can turn into major liability. The Boards don’t care if it was an honest mistake. And your license could be on the line.
If you're opening a medspa, or already running one-ask yourself these 3 essential questions before moving forward:
For help with California medspa compliance check out my Decoding Compliance webinar
💼 1. Is Your Corporate Structure Legal in Your State?
This is the most important foundation of your entire practice.
If you skip this step, or get it wrong, you’re putting your license and business at serious risk.
A medical spa is a medical practice, it must be owned by a medical corporation, not a generic LLC or S-corp.
You may also need to form a Management Services Organization (MSO) to handle operations, branding, and staff—but this must be done in alignment with state law.
All patient revenue must flow into the medical corporation, not your personal or business account.
You’ll also need a medspa-specific accountant to help manage payment flow, taxes, and ensure financial compliance.
Work with an attorney who is deeply familiar with your state’s medical board requirements and aesthetic law—not just any business lawyer.
📝 Tip: Discuss structure with both your attorney and medical director from day one. Working with Dr. C includes access to her vetted network of attorneys, CPAs, insurance agents, practice managers, etc.
📑 2. Do You Have a Legally Valid Contract With Your Medical Director?
Don’t rely on templates-or worse, collaborative agreements-especially if you're in California.
California does not recognize “collaborative agreements” for NP, PA, or RN-run medspas.
Instead, you need a complete, board-compliant practice agreement that outlines supervision, protocols, scope of practice, and responsibilities.
Whether you’re a nurse, PA, or NP, the law treats this as a medical practice, and the contract must reflect that.
A qualified attorney, not your friend’s PDF, should draft and review this agreement.
Be cautious: without a legal, updated agreement, you and your medical director are both at risk.
🚨 Contracts protect everyone! Don’t go without one.
⚠️ 3. Are You Documenting Supervision and Compliance Properly?
“You don’t know what you don’t know” is not a defense if the Board comes knocking.
Most medspas that get investigated had no idea they were out of compliance until it was too late.
The Board will ask:
How often does your supervising physician visit the site?
Are protocols signed and up to date?
Are chart reviews being documented?
Is there a record of meaningful oversight?
If you can’t prove this on paper, they may view your practice as operating without appropriate medical supervision.
📂 Documentation is your best legal defense. Don’t treat it as optional.
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