(a) One or more physicians licensed by the board may delegate, to one or more physician assistants or advanced practice registered nurses acting under adequate physician supervision whose practice is facility-based at a hospital or licensed long-term care facility, the administration or provision of a drug and the prescribing or ordering of a drug or device if each of the delegating physicians is:
(1) the medical director or chief of medical staff of the facility in which the physician assistant or advanced practice registered nurse practices;
(2) the chair of the facility’s credentialing committee;
(3) a department chair of a facility department in which the physician assistant or advanced practice registered nurse practices; or
(4) a physician who consents to the request of the medical director or chief of medical staff to delegate the prescribing or ordering of a drug or device at the facility in which the physician assistant or advanced practice registered nurse practices.
(a-1) The limits on the number of advanced practice registered nurses or physician assistants to whom a physician may delegate under § 157.0512 do not apply to a physician under Subsection (a) whose practice is facility-based under this section, provided that the physician is not delegating in a freestanding clinic, center, or practice of the facility.

(b) A physician’s authority to delegate under Subsection (a) is limited as follows:
(1) the delegation must be made under a physician’s order, standing medical order, standing delegation order, or another order or protocol developed in accordance with policies approved by the facility’s medical staff or a committee of the facility’s medical staff as provided by the facility bylaws;
(2) the delegation must occur in the facility in which the physician is the medical director, the chief of medical staff, the chair of the credentialing committee, a department chair, or a physician who consents to delegate under Subsection (a)(4);
(3) the delegation may not permit the prescribing or ordering of a drug or device for the care or treatment of the patients of any other physician without the prior consent of that physician; and
(4) delegation in a long-term care facility must be by the medical director and is limited to the prescribing or ordering of a drug or device to not more than seven advanced practice registered nurses or physician assistants or their full-time equivalents.
(b-1) A facility-based physician may not delegate at more than one hospital or more than two long-term care facilities under this section unless approved by the board. The facility-based physician may not be prohibited from delegating the prescribing or ordering of drugs or devices under § 157.0512 at other practice locations, including hospitals or long-term care facilities, provided that the delegation at those locations complies with all the requirements of § 157.0512.
(c) Physician supervision of the prescribing or ordering of a drug or device must conform to what a reasonable, prudent physician would find consistent with sound medical judgment but may vary with the education and experience of the particular advanced practice registered nurse or physician assistant. A physician shall provide continuous supervision, but the constant physical presence of the physician is not required.
(d) An alternate physician may provide appropriate supervision on a temporary basis as defined and established by board rule.