Nearly One in Three Newly Licensed Nurse Practitioners in Four States Graduated From For-Profit Programs, Study Finds

California and Florida Have the Highest Shares

The study identified substantial differences in the educational backgrounds of newly licensed nurse practitioners across the four states in 2024.

California recorded the highest share, with approximately two in five newly licensed nurse practitioners educated at for-profit institutions. Florida followed at more than one-third, while the proportions in Texas and Iowa were lower.

Despite these differences, the upward trend across all four states suggests that for-profit education has become a more prominent pathway into advanced practice nursing.

The figures describe the educational backgrounds of newly licensed practitioners in the states examined. They should not be interpreted as a national estimate for every state or as evidence that all nursing programs within a particular category operate in the same way.

The study also does not establish why the trend developed at different rates across the four states. Differences in educational markets, the availability of programs and students' enrollment decisions may warrant further investigation.

What Are For-Profit Nursing Programs?

For-profit educational institutions operate under a business model that allows owners or shareholders to benefit financially from the institution's activities. They differ structurally from public universities and nonprofit colleges, which operate under different ownership, funding and financial arrangements.

For-profit institutions may offer online coursework, flexible schedules and programs designed for working adults. These features can appeal to practicing Registered Nurses (RN) / Travel Nursing who need to balance ongoing clinical hospital shifts and travel assignments with advanced graduate education and family responsibilities.

However, the for-profit category includes institutions and programs with different structures and characteristics. Institutional status alone does not establish the quality of an individual program.

For prospective nurse practitioners, the central questions remain whether a program meets applicable educational standards, provides appropriate clinical training, prepares graduates for relevant certification examinations and satisfies state licensure requirements.

The rapid growth documented in the study makes it increasingly important to understand how different educational pathways prepare nurses for advanced clinical responsibilities.

Why the Findings Matter for Nursing Education

Nurse practitioners are registered nurses who complete additional graduate-level education and meet applicable certification and licensure requirements to practice in an advanced clinical role.

Depending on their training, specialty and state regulations, NPs may assess patients, diagnose conditions, order and interpret diagnostic tests, prescribe medications and manage treatment plans.

Preparing clinicians for these responsibilities requires more than delivering academic coursework. Students need opportunities to develop clinical judgment, apply evidence-based practice, communicate effectively with patients and recognize situations requiring consultation or referral.

As enrollment expands across different types of educational institutions, reliable information about program quality becomes increasingly important.

Prospective students may encounter substantial differences in tuition, scheduling, clinical placement arrangements and student support. Comparing these factors before enrolling can help nurses assess whether a program fits their professional goals and financial circumstances.

Accreditation, Certification and Clinical Training Remain Important

The study's findings are a reminder that nurses considering advanced education should evaluate individual programs rather than relying solely on an institution's reputation, marketing or ownership structure.

Several factors deserve particular attention:

• Accreditation and program approval: Students should verify the program's current accreditation status and determine whether it meets the requirements relevant to their intended specialty and state of practice. They should also confirm that the program satisfies applicable state board of nursing requirements.
• Clinical placement opportunities: Graduate nursing education includes supervised clinical learning. Applicants should establish how clinical placements are arranged, which responsibilities students will undertake and whether the institution provides adequate support in securing appropriate clinical experiences.
• Certification eligibility: Many nurse practitioner roles require national certification in the relevant specialty. Applicants should confirm that completing the program will meet the educational requirements of the applicable certification organization.
• Licensure requirements: Requirements differ by state and by advanced practice role. Nurses planning to relocate after graduation should investigate the requirements of the state where they intend to practice.
• Program outcomes and costs: Tuition, fees, completion rates, certification examination pass rates and available graduate outcome data can help prospective students compare options. Students should also review financial aid conditions and understand the potential repayment obligations associated with borrowing for graduate education.

These considerations apply to programs across the public, nonprofit and for-profit sectors.

What the Study Does — and Does Not — Tell Us About Quality

One of the most important distinctions in the research is the difference between measuring where nurses studied and measuring how well they perform in clinical practice.

The researchers documented a substantial increase in the proportion of newly licensed nurse practitioners educated at for-profit institutions. The study did not establish that graduates of these programs provide better or worse patient care than graduates of public or nonprofit institutions.

It also did not demonstrate that the growth in for-profit education has caused changes in patient outcomes, clinical competence or healthcare quality.

Those questions require additional evidence. Researchers would need suitable measures of educational preparation and clinical performance, along with methods to account for differences in students, training experiences, specialties and practice environments.

Without such evidence, it would be inappropriate to assume that the ownership category of a school predicts the competence of an individual nurse practitioner.

The findings instead raise questions about the availability and comparability of information that students, employers, regulators and policymakers can use to evaluate nursing education.

Implications for Healthcare Employers

Healthcare employers have a direct interest in ensuring that nurse practitioners entering the workforce are prepared for the clinical responsibilities of their positions.

Hospitals, primary care practices, specialty clinics and other healthcare organizations may consider educational history as part of a broader assessment of an applicant's qualifications. However, evaluating candidates requires more than identifying whether their school was public, nonprofit or for-profit.

Employers also need to assess applicable licensure and certification, clinical experience, specialty preparation, professional references and the candidate's ability to meet the requirements of the position.

More consistent reporting of educational outcomes could help healthcare organizations better understand how different programs prepare graduates for practice.

Useful information may include certification examination pass rates, program completion rates, clinical training arrangements and other indicators of graduate readiness. Such measures would be most informative when definitions are consistent and differences in student populations are taken into account.

For employers recruiting nurse practitioners, transparent and comparable program data could support workforce planning while helping distinguish between individual educational programs.

Why This Matters for the U.S. Nursing Workforce

Nurse practitioners are an important part of the U.S. healthcare workforce. Their advanced training allows them to provide a range of services in primary care and other clinical settings, often collaborating alongside or complementing Physicians / MD-DO in multidisciplinary care teams, subject to applicable state laws and practice requirements.

Their role can be especially important in areas where patients face difficulties accessing timely medical appointments or where healthcare organizations struggle to recruit clinicians.

As demand for advanced practice nursing services grows, educational institutions play an important role in preparing the next generation of practitioners.

Expanding the number of available educational pathways may create opportunities for registered nurses seeking career advancement. At the same time, growth in enrollment makes effective oversight, transparent reporting and access to appropriate clinical education increasingly important.

Workforce planning therefore involves two related objectives: preparing enough qualified clinicians to meet healthcare needs and ensuring that educational pathways provide the preparation required for safe, effective practice.

The study does not determine whether the expansion of for-profit programs has improved or weakened the overall supply of qualified nurse practitioners. It identifies a significant change in educational patterns that deserves further examination.

The Importance of Better Public Reporting

The researchers have highlighted the importance of better information about nursing program outcomes.

Prospective students often need to compare programs using information published by individual institutions, accreditation organizations and state agencies. Differences in reporting practices can make comparisons difficult, particularly when programs use different definitions or present outcome measures over different periods.

More standardized public reporting could help students evaluate their options before making a substantial financial and professional commitment.

For example, comparable information about certification examination performance, graduation rates and clinical training opportunities could provide a clearer picture of how individual programs operate.

Regulators and policymakers could also use reliable data to identify areas where additional oversight or student support may be warranted.

However, outcome measures must be interpreted carefully. A single metric cannot fully capture the quality of a nursing education program, and differences in student characteristics or program design may affect the results.

A broader approach that combines transparent reporting, appropriate accreditation standards and continued evaluation of graduate outcomes would provide a stronger basis for assessing nursing education.

What Nurses and Prospective Nurse Practitioners Should Know

For registered nurses considering a move into advanced practice, the findings offer a practical reminder to research programs carefully before applying.

A flexible schedule or convenient online format may be valuable, particularly for nurses who intend to continue working while studying or clinicians interested in expanding into Telehealth / Remote / Virtual Jobs in remote triage, ambulatory monitoring, and virtual care management. However, applicants should also understand the program's total cost, clinical requirements, expected time to completion and eligibility for certification and licensure.

Students should use official state board of nursing resources and the relevant accreditation and certification organizations to verify requirements rather than relying exclusively on promotional materials.

For practicing nurses, the study may also be relevant when considering graduate education as part of a longer-term career plan. The choice of program can affect the time and financial investment required to enter an advanced practice role.

What Patients Should Understand

The findings do not suggest that patients should avoid nurse practitioners based on the type of institution where they completed their education.

The study examined educational trends among newly licensed practitioners. It did not compare the quality of care delivered by individual clinicians or establish a relationship between for-profit education and patient outcomes.

Patients should continue to consider relevant professional credentials, clinical expertise, communication, experience and the needs of their particular medical situation when choosing a healthcare professional.

The broader policy question is how to ensure that all educational pathways preparing advanced practice nurses provide appropriate training and that reliable information is available to evaluate their outcomes.

What Comes Next?

The growth of for-profit education among newly licensed nurse practitioners raises important questions about how the United States prepares its advanced practice nursing workforce.

The findings document a substantial shift in the educational backgrounds of new practitioners in California, Florida, Iowa and Texas. They also highlight the need for better information about program outcomes and further research into whether educational setting is associated with differences in clinical preparation or patient care.

Future studies could examine certification examination performance, clinical training experiences, workforce distribution and patient outcomes across different educational settings. Such research would help determine whether observed differences in educational pathways are associated with meaningful differences in practice.

For now, the central message is that the type of institution is only one part of the picture. Program-level quality, accreditation, clinical preparation and transparent outcome reporting remain essential considerations for students, employers and policymakers.

As the demand for advanced practice nursing services continues to evolve, ensuring that educational expansion is accompanied by strong preparation and reliable oversight will remain an important issue for the U.S. healthcare system.