Rule 360-32-.05. Additional Requirements Regarding Physician Delegation to an APRN

1. (1) The delegating physician shall be available for immediate consultation with the advanced practice registered nurse. If the delegating physician is not available, then a designated physician must be available, if one has signed on to the protocol agreement.
2. (2) The delegating physician shall document and maintain a record of direct onsite observation of the practice of the APRN, conducted at least once annually, except for physicians with protocols that qualify under O.C.G.A. § 43-34-25(g.1). Additionally, the delegating physician shall conduct a review of medical records on a quarterly basis; this review may be conducted via telecommunications to monitor quality of care being provided to the patients.

3. (3) The delegating physician shall make certain that the medical acts provided by the APRN pursuant to the protocol agreement are:

   1. (a) Commensurate with the education, training, experience, and competence of the APRN:

      1. 1. A delegating physician shall ensure that an APRN to whom he/she delegates prescriptive authority receives pharmacology training appropriate to the delegating physician's scope of practice at least annually. Documentation of such training shall be maintained by the physician and provided to the Board upon request.
      2. 2. A delegating physician shall ensure that an APRN to whom he/she delegates prescriptive authority pursuant to O.C.G.A. § 43-34-25(d.1) completes one hour of continuing education biennially in the appropriate ordering and use of hydrocodone, oxycodone, and compounds thereof.
      3. 3. A delegating physician shall ensure that an APRN to whom he/she delegates the authority to sign death certificates completes one hour of continuing education biennially regarding the recognition and documentation of the causes of death and appropriate execution of death certificates.
      4. 4. A delegating physician who fails to comply with subparagraph (3)(a)1., 2., or 3. of this rule by delegating authority to an APRN who has not received the appropriate training is subject to disciplinary action.
   2. (b) Within the scope of practice, specialty area or field and certification of the APRN;
   3. (c) Within the comparable specialty area or field of the delegating physician; and
   4. (d) Well documented in accurately maintained patient specific medical records.
4. (4) The delegating physician is responsible for all the medical acts performed by the APRN.
5. (5) A delegating physician shall notify the Board within ten (10) working days of the date of termination of a nurse protocol agreement with the delegating physician and APRN.
6. (6) In the event of the death or departure of a delegating physician, an APRN must notify the Board within 7 days. If a designated physician is available according to an approved protocol agreement, he or she may serve as the delegating physician for up to 60 days (from the date of death or departure) until a new protocol agreement is approved by the Board. In the event that there is no designated physician, the APRN will not have prescriptive authority until a new signed protocol agreement is submitted to the Board.
7. (7) The Board may request at any time to review the nurse protocol agreement and any supporting documentation. Failure to provide this written information to the Board within 30 days shall be a basis for and may result in disciplinary action. The Board may require changes in these documents if the Board determines that they do not comply with O.C.G.A. 43-34-25 and/or accepted standards of medical practice.

Authority: O.C.G.A. §§ 43-1-19, 43-1-25, 43-34-5, 43-34-23, 43-34-25.

History. Original Rule entitled "Additional Requirements Regarding Physician Delegation to an APRN" adopted. F. Dec. 12, 2006; eff. Jan. 1, 2007.

Amended: F. Mar. 12, 2007; eff. Apr. 1, 2007.

Repealed: New Rule of same title adopted. F. Oct. 6, 2009; eff. Oct. 26, 2009.

Repealed: New Rule of the same title adopted. F. Dec. 13, 2019; eff. Jan. 2, 2020.

Amended: F. Mar. 19, 2024; eff. Apr. 8, 2024.

Amended: F. May 5, 2026; eff. May 25, 2026.