CNS · Oregon
Supervision Agreement for Clinical Nurse Specialists in Oregon
No. Clinical Nurse Specialists practice independently here. Oregon does not require one.
OAR 851-054-0020: 'The Clinical Nurse Specialist (CNS) independently provides evidence-based advanced nursing care to clients' — no physician collaboration or supervision requirement appears anywhere in OAR division 54. CNSs may obtain DEA registration and prescribe Schedule II-V independently.
What the supervision must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
No proximity requirement
No physician proximity/availability requirement is codified for CNS practice.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
Schedule II-V, per OAR 851-054-0020/0021 and OAR division 56 prescriptive-practice standards, consistent with the CNS's certified specialty.
Written agreement
Not required
Unconditional — no Oregon statute or Board of Nursing rule conditions CNS practice on a physician agreement, unlike Virginia's prescribing/non-prescribing CNS branch.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — ORS 58.376's joint physician/PA/NP professional-corporation ownership pathway names only physicians, PAs, and 'nurse practitioner' licensees — CNS is a separate license category under ORS 678.010, not an NP population focus, so it is unclear whether a CNS independently qualifies as an ORS 58.376 licensee. This is an inference from statutory omission, not a confirmed holding. Absent that pathway, a CNS-involved entity likely defaults to the physician-majority PC under ORS 58.375.
Not independently confirmed against Board of Nursing or Medical Board guidance in this research pass — same open item as the `crna` entry.
Legal sources for these rules (4)
- ORS 678.010 — Definitions (clinical nurse specialist)secondary
- OAR 851-054-0020 — Clinical Nurse Specialist Scope of Practicesecondary
- OAR 851-054-0021 — Standards for Clinical Nurse Specialist Scope of Practicesecondary
- ORS 58.376 — Professional corporations: physician/PA/NP joint ownership (CNS not enumerated — see cpom notes above)secondary
What a supervising physician costs here
Typical monthly cost in Oregon
$500 – $600
Estimate for one Clinical Nurse Specialist. Standard-tier state.
About Oregon's rules
Oregon has no physician-supervision requirement for NP/CNS/CRNA and replaced PA 'supervision' with a non-supervisory 'collaboration agreement' (ORS 677.495-677.525, recodified by H.B. 4010, eff. June 6, 2024). CNM and PMHNP are population foci under the single NP license (OAR 851-050-0005), not separate license categories. CRNA/CNS entity co-ownership with physicians is unconfirmed — ORS 58.376 names only physicians, PAs, and NPs.
Other clinicians in Oregon: see the state overview.