CRNA · South Carolina
Supervision Agreement for Certified Registered Nurse Anesthetists in South Carolina
Yes, a written supervising-physician agreement is required. South Carolina does not name a specific instrument.
CRNAs are governed by §40-33-34's separate 'anesthesia care' provisions, not the PA/NP/CNM/CNS combined-ratio framework. Written guidelines developed with a supervising physician/dentist (or approved by facility medical staff) are required, and that physician/dentist must be identified on the anesthesia record before administration. Pending bills (S.360/H.4044) would remove supervision and add prescriptive authority; not yet law.
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
Not codified — left to the agreement
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 · no controlled-substance authority
CRNAs administer anesthesia-related drugs under written guidelines rather than holding independent DEA prescriptive authority under current SC law; a pending bill (S.360/H.4044) would grant prescriptive authority, but it is not enacted as of this writing.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Corporation under Title 33, Chapter 19 for nursing services, or physician-owned per SC's common-law CPOM doctrine.
Legal sources for these rules (2)
What a supervising physician costs here
Typical monthly cost in South Carolina
$500 – $600
Estimate for one Certified Registered Nurse Anesthetist. Standard-tier state.
About South Carolina's rules
A physician may not hold practice agreements/scope-of-practice guidelines with more than a COMBINED 6 full-time-equivalent PA+NP+CNM+CNS at once (§40-47-195(D)(1)(c)) — a single shared cap, not four separate ones. A widely-repeated '3 PA' cap was repealed in 2019 (Act 32). SC remains restricted-practice for APRNs; a 2,000-hour full-practice-authority bill (S.45/H.3580) is pending, not yet law.
Other clinicians in South Carolina: see the state overview.