CRNA · Ohio
Collaborative Practice Agreement for Certified Registered Nurse Anesthetists in Ohio
Yes, a written physician agreement is required. Ohio does not name a specific instrument.
No independent-practice pathway. H.B. 52 (signed 3/10/2026, eff. 6/8/2026 — current law) replaced Ohio's prior 'supervision and immediate presence' standard with a lighter 'collaboration' model requiring the physician/podiatrist/dentist to be physically present in the FACILITY (not necessarily the same room) during anesthesia induction/maintenance/emergence.
What the collaboration must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
On-site presence required
CURRENT LAW as of this file's date (post-H.B.-52, eff. 6/8/2026): the collaborating physician/podiatrist/dentist must be 'physically present in the facility' during induction, maintenance, and emergence of general anesthesia — coded ON_SITE in the facility-wide sense, a real relaxation from the prior same-room 'immediate presence' standard. Confirmed via convergent triangulation across five independent sources in a follow-up pass (still not a first-hand fetch of the enacted §§4723.433/.434 text itself, which remained unreachable across two separate research sessions).
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
OARRS review (OAC 4723-9-12) applies to APRNs who prescribe — since CRNAs don't independently prescribe, they're inferred (not explicitly confirmed) to fall outside that requirement.
Written agreement
Required
NOT a standard care arrangement — confirmed directly: 'CRNAs have a supervised practice and do not practice under a standard care arrangement' (Ohio Board of Nursing). Pre-H.B.-52, Ohio Rev. Code §4723.43(B) required anesthesia be administered 'with supervision and in the immediate presence of a physician, podiatrist, or dentist.' Post-H.B.-52 (current law), new §§4723.433/.434 establish a 'collaboration' relationship instead. CONFIRMED via a follow-up pass: no INDIVIDUAL written collaboration agreement between a CRNA and a specific physician/podiatrist/dentist is required (unlike the APRN SCA model) — instead, HEALTH CARE FACILITIES must maintain a facility-level written policy establishing standards/procedures for CRNA collaboration, and CRNAs act per that policy and facility-delineated privileges. A podiatrist-collaborating CRNA cannot administer general anesthesia in a podiatrist's office; a dentist-collaborating CRNA is limited to procedures the dentist is authorized to perform (Ch. 4715).
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — Same no-CPOM-doctrine framework as `np` — no CRNA-specific ownership rule found or expected to differ from the general nursing-entity statute (§4723.16).
Legal sources for these rules (5)
- Ohio Rev. Code §4723.43(B) — CRNA anesthesia administration (pre-H.B.-52 text confirmed; post-H.B.-52 amendment not independently re-fetched verbatim)
- Ohio Rev. Code §§4723.433, 4723.434 (new, enacted by H.B. 52) — 'collaboration' model, not independently fetched verbatim
- H.B. 52 (136th General Assembly), signed 3/10/2026, eff. 6/8/2026 — CRNA supervision-to-collaboration reform
- AANA — 'Modernized CRNA Practice Law Secured for Ohio CRNAs' (press release)secondary
- Ohio Board of Nursing — 'APRN Licensure and Practice in Ohio' (2025 edition — predates H.B. 52; CRNA content there is now superseded, CNM/CNS content still current)
What a collaborating physician costs here
Typical monthly cost in Ohio
$500 – $600
Estimate for one Certified Registered Nurse Anesthetist. This state's proximity rules add a small premium.
About Ohio's rules
Ohio recently relaxed CRNA supervision from 'immediate presence' to facility-wide 'collaboration' (H.B. 52, eff. 6/8/2026, now current law), and will loosen RN laser-delegation rules similarly (H.B. 377, eff. 8/25/2026 — NOT yet law as of this file's date). No independent-practice pathway exists for NP/PMHNP/PA despite active pending reform bills (a 2,000-hour NP threshold, PA proximity removal) — none enacted. Ohio has no corporate-practice-of-medicine doctrine (State Medical Board, 2012). Non-nurse midwifery has no current licensure pathway.
Other clinicians in Ohio: see the state overview.