As health care reform results in fewer acute care days and cost-containment is emphasized, the role of the CNS becomes more important, although not necessarily in acute care, which has been the tradition. If the CNS role is to survive health care reform, it must expand into the community. The literature supports the effectiveness of the CNS in the community. Interviews with nurse managers also strongly support the practice of the CNS in the community to include case management, consultation to community agencies, and community-based practice.