South Carolina S 360: Certified Registered Nurse Anesthetists

Bill Text

2025-2026 Bill 360 Text of Previous Version (Feb. 19, 2025) - South Carolina Legislature Online 

South Carolina General Assembly
126th Session, 2025-2026

Bill 360

Indicates Matter Stricken
Indicates New Matter

(Text matches printed bills. Document has been reformatted to meet World Wide Web specifications.)

A bill

TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY AMENDING 
SECTION 40-33-20, RELATING TO DEFINITIONS IN THE NURSE PRACTICE ACT, SO AS TO 
REMOVE DEFINITIONS CONCERNING APPROVED WRITTEN GUIDELINES FOR PRACTICE BY 
CERTIFIED REGISTERED NURSE ANESTHETISTS; BY AMENDING SECTION 40-33-34, RELATING 
TO PRACTICE REQUIREMENTS FOR ADVANCED PRACTICE REGISTERED NURSES, SO AS TO 
REVISE PROVISIONS CONCERNING CERTIFIED REGISTERED NURSE ANESTHETISTS BY 
REMOVING SUPERVISED PRACTICE REQUIREMENTS AND PROVIDE PRESCRIPTIVE PRACTICE 
AUTHORITY, AMONG OTHER THINGS; AND BY REPEALING SECTION 40-47-197 RELATING TO 
SUPERVISION OF CERTIFIED REGISTERED NURSE ANESTHETISTS BY PHYSICIANS AND 
DENTISTS.

Be it enacted by the 
General Assembly of the State of South Carolina:

SECTION 1. Section 40-33-20(9) and (19) of the S.C. Code is 
amended to read:

 (9) "Approved 
written guidelines" means specific statements developed by a certified 
registered nurse anesthetist and a supervising licensed physician or dentist or 
by the medical staff within the facility where practice privileges have been 
grantedReserved.

 (19) 
"Certified Registered Nurse Anesthetist" or "CRNA" means an advanced practice 
registered nurse who:

 (a) 
has successfully completed an advanced, organized formal CRNA education program 
at a minimum of the master's level accredited by the national accrediting 
organization of this specialty area and that is recognized by the board;

 (b) 
is certified by a board-approved national certifying organization; and

 (c) 
demonstrates advanced knowledge and skill in the delivery of anesthesia 
services.

 A CRNA must practice in 
accordance with approved written guidelines developed under supervision of a 
licensed physician or dentist or approved by the medical staff within the 
facility where practice privileges have been granted.

SECTION 2. Section 40-33-34(H) of the S.C. Code is amended to 
read:

 (H)(1) Nothing in this section may be 
construed to require a CRNA to obtain prescriptive authority to deliver 
anesthesia care.

 (2) 
A CRNA shall practice pursuant to approved written 
guidelines developed with the supervising licensed physician or dentist or by 
the medical staff within the facility where practice privileges have been 
granted and must include, but are not limited to:

 (a) the following 
general information:

 (i) name, 
address, and South Carolina license number of the registered nurse;

 (ii) name, 
address, and South Carolina license number of the supervising physician, 
dentist, or the physician director of anesthesia services or the medical 
director of the facility;

 (iii) dates the 
guidelines were developed, and dates the guidelines were reviewed and amended;

 (iv) physical 
address of the primary practice and any additional practice sites;

 (b) these 
requirements for providing anesthesia services:

 (i) 
documentation of clinical privileges in the institutions where anesthesia 
services are provided, if applicable;

 (ii) copy of job 
description;

 (iii) policies 
and procedures that outline the pre-anesthesia evaluation, induction, 
intra-operative maintenance, and emergence from anesthesia;

 (iv) evidence of 
outcome evaluation for anesthesia services.

 (3) The original and any 
amendments to the approved written guidelines must be reviewed at least 
annually, dated and signed by the CRNA and physician or dentist, and must be 
made available to the board for review within seventy-two hours of request. 
Failure to produce the guidelines is considered misconduct and subjects the 
licensee to disciplinary action. A random audit of approved written guidelines 
must be conducted by the board at least biennially.

 (4) A person who changes 
primary practice settings or physician or dentist shall notify the board of 
this change within fifteen business days and provide verification of approved 
written guidelines. A CRNA who discontinues his or her practice shall notify 
the board within fifteen business days.

 (5) The physician or 
dentist responsible for the supervision of a CRNA must be identified on the 
anesthesia record before administration of anesthesia.A CRNA 
who applies for prescriptive authority:

 (a) must be licensed by the board as a 
CRNA;

 (b) shall submit a completed 
application on a form provided by the board;

 (c) shall submit the required fee;

 (d) shall provide evidence of:

 (i) completion of forty-five contact 
hours of education in pharmacology acceptable to the board within two years 
before application or during the time of the organized educational program; or

 (ii) prescriptive authority in another 
state meeting twenty hours in pharmacology accepta