Signing for a Certified Registered Nurse Anesthetist in Florida: what the physician takes on

anesthesia administration in a licensed ambulatory surgical center (ASC): On-site presence required

Fla. Admin. Code R. 59A-5.0085(b) (current verbatim text, confirmed directly against flrules.org, last amended 2/26/2026 — supervision language unchanged by that amendment): a physician, or CRNA 'under the on-site medical direction of a licensed physician,' 'shall be in the center during the anesthesia and post-anesthesia recovery period until all patients are cleared for discharge.' Consistent with Florida not having opted out of the federal CMS physician-supervision-of-CRNAs condition of participation (42 CFR 482.52).

anesthesia administration in a licensed hospital: No proximity requirement

R. 59A-3.245 (current verbatim text, confirmed directly against flrules.org, last amended 8-15-18) uses a materially different framework than the ASC rule above — no bare 'on-site... until cleared for discharge' mandate. Instead: the anesthesia department must be 'directed by a physician member of the organized professional staff,' preanesthesia evaluation may be performed by a CRNA 'where authorized by established protocol approved by the medical staff,' and discharge is by 'a member of the organized medical staff.' Coded NONE here only in the narrow sense that this specific rule doesn't itself codify a physical-proximity standard — the medical-staff-direction and protocol-approval requirements are real, substantive constraints, just not a distance/presence rule the way the ASC rule is.

As needed, in person or via telehealth

Not fixed by statute or rule — the Board of Nursing's official protocol template (floridasnursing.gov/forms/aprn-protocol-format.pdf) uses only generic language: parties 'share equally in the responsibility for reviewing treatment protocols as needed,' with the physician 'available by telephone or by other communication device when not physically available.' Actual cadence is whatever the individual protocol specifies. Facility-level anesthesia policy review is separately governed by medical-staff bylaws, not this generic protocol template.

Covered by the practice agreement · controlled substances permitted

The general APRN Schedule II 7-day-supply cap (§464.012(3)(a)) technically applies, but CRNA drug authority in practice is expressed through anesthesia-specific facility-protocol ordering rather than a prescription pad — same structural pattern as Texas's anesthesia-order model (§157.058).

Non-licensee ownership permitted — Same no-CPOM-doctrine framework as `np`. Ch. 621 (Professional Service Corporation Act), §621.09 additionally permits an all-CRNA (or all-APRN) professional entity if voluntarily organized under that Act — Florida's closest analog to a same-profession ownership carve-out — though most practices use an ordinary LLC instead, since Ch. 621 organization isn't mandatory.