1. (1) A supervising anesthesiologist shall supervise an anesthesiologist assistant within the terms, conditions, and limitations set forth in a supervising agreement with the anesthesiologist assistant. Supervision requires the availability of an anesthesiologist who can delegate, coordinate, direct, consult, or oversee the implementation of the anesthesiologist’s intentions within the same facility.
2. (2) A supervising anesthesiologist must be immediately available to the anesthesiologist assistant such that the supervising anesthesiologist is able to intervene if needed. A supervising anesthesiologist is considered immediately available if he/she is physically located within the same facility as the anesthesiologist assistant and not otherwise occupied in a way that prevents him/her from immediately conducting hands-on intervention, if needed.
3. (3) A supervising anesthesiologist shall personally participate in the most demanding procedures in the anesthesia plan, which shall include induction and emergence.
4. (4) A supervising anesthesiologist shall be responsible for pre-operative, intra-operative and post- operative care and shall be responsible for ensuring compliance with the applicable standard of care by an anesthesiologist assistant acting under the supervising anesthesiologist’s supervision and control.
5. (5) A supervising anesthesiologist shall be board certified by the American Board of Anesthesiology or the American Osteopathic Board of Anesthesiology or be board eligible, must hold an active, unrestricted and unencumbered license from the Board of Medical Examiners or Board of Osteopathic Examination and have an active practice in the medical specialty of anesthesiology.
6. (6) A supervising anesthesiologist may supervise up to four anesthesiologist assistants at one time.

7. (7) Prior to practicing as an anesthesiologist assistant, he/she must have entered into a supervisory agreement with a supervising anesthesiologist. The supervising agreement shall at a minimum:

   1. (a) Delineate the services that the anesthesiologist assistant is authorized to provide and the manner in which the anesthesiologist will supervise the anesthesiologist assistant; ANESTHESIOLOGIST ASSISTANTS
   2. (b) Include the method and frequency of review of the anesthesiologist assistant’s practice activities;
   3. (c) Be reviewed at least annually and revised as the supervising anesthesiologist deems necessary;
   4. (d) Be signed and dated by the supervising anesthesiologist and anesthesiologist assistant prior to implementation; and
   5. (e) Contain the mechanisms for evaluation of serious or significant adverse outcomes to a patient(s) and/or deviations from the standard of care.
8. (8) An anesthesiologist assistant shall have a designated supervising anesthesiologist and shall notify the Board of the name address, and license number of their supervising anesthesiologist.
9. (9) An anesthesiologist assistant shall maintain a copy of the supervising agreement either on paper or electronically at the anesthesiologist assistant’s practice locations and make the supervising agreement available upon request by the Board or an authorized agent of the Board.

Authority: T.C.A. §§ 63-21-104 and 63-21-107. Administrative History: Emergency rules filed May 20, 2026; effective through November 16, 2026.