Physician duties · CNS · Kentucky
Signing for a Clinical Nurse Specialist in Kentucky: what the physician takes on
The agreement is mandatory for the clinician, which makes its duties mandatory for you. Kentucky does not name a specific instrument.
CNSs are APRNs under KRS 314.042(6)(a) with the same diagnosis/treatment independence and CAPA-NS/CAPA-CS prescribing gates as general NPs. Unlike Virginia, this research pass found no KY provision making CNS independence turn on a prescribing/non-prescribing scope distinction — treat that absence as unconfirmed rather than settled if precision matters.
Independent practice requires: same ≥4-year CAPA-NS and ≥4-year CAPA-CS thresholds as general NPs (KRS 314.042) — no non-prescribing independence carve-out like VA's was found.
What you take on as the physician
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 supervision requirement for clinical practice; no proximity standard codified for the CAPA relationship itself.
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
nonscheduled legend drugs, before 4 years under a CAPA-NS: Separate prescribing terms required · no controlled-substance authority
Same statutory framework as general NPs (KRS 314.042).
Schedule II–V controlled substances, before 4 years under a CAPA-CS: Separate prescribing terms required · controlled substances permitted
Requires individual DEA registration and KASPER enrollment, same as general NPs.
after the applicable 4-year CAPA-NS/CAPA-CS threshold is met: Covered by the practice agreement · controlled substances permitted
Same independent-exit mechanism as general NPs.
Written agreement
Required
Same branch as general NP: no agreement needed to diagnose/treat; CAPA-NS and CAPA-CS are each required only for their respective prescribing category, each independently exitable after 4 years (KRS 314.042).
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional LLC (KRS Ch. 275) or PSC (KRS Ch. 274) — CNSs, as nurses, are explicitly eligible independent owners; no physician ownership required.
Legal sources for these rules (2)
What physicians charge for this role
Typical monthly compensation in Kentucky
$500 – $600
Estimate for one Clinical Nurse Specialist. This state's proximity rules add a small premium.
About Kentucky's rules
KY's PSC/PLLC statutes (KRS Ch. 274, 275) are commonly read to restrict ownership to persons rendering the 'same or related' professional service — a physician generally cannot co-own a single PSC/PLLC with a PA or APRN, unlike NC/VA's explicit combination statutes. Secondary-sourced interpretation, not a confirmed ruling — verify before relying on it. Kentucky opted out of the federal Medicare CRNA supervision requirement in April 2012; facilities may still impose their own.
Other clinicians in Kentucky: see the state overview.