Current through Register Vol. 47, No. 6, September 18, 2024
(1)
Care rendered by unlicensed assistive personnel shall not be documented or
charged as occupational therapy unless direct on-site supervision is provided
by an OT or in-sight supervision is provided by an OTA.
(2) Occupational therapist supervisor
responsibilities. The supervisor shall:
a.
Provide supervision to a licensed OTA, OT limited permit holder and OTA limited
permit holder any time occupational therapy services are rendered. Supervision
may be provided on site or through the use of telecommunication or other
technology.
b. Ensure that every
licensed OTA, OT limited permit holder and OTA limited permit holder being
supervised is aware of who the supervisor is and how the supervisor can be
contacted any time occupational therapy services are rendered.
c. Assume responsibility for all delegated
tasks and shall not delegate a service that exceeds the expertise of the OTA or
OTA limited permit holder.
d.
Provide evaluation and development of a treatment plan for use by the
OTA.
e. Ensure that the OTA, OT
limited permit holder and OTA limited permit holder under the OT's supervision
have current licenses to practice.
f. Ensure that the signature of an OTA on an
occupational therapy treatment record indicates that the occupational therapy
services were provided in accordance with the rules and regulations for
practicing as an OTA.
(3)
The following are functions that only an occupational therapist may provide and
that shall not be delegated to an OTA:
a.
Interpretation of referrals;
b.
Initial occupational therapy evaluation and reevaluations;
c. Identification, determination or
modification of patient problems, goals, and care plans;
d. Final discharge evaluation and
establishment of the discharge plan;
e. Assurance of the qualifications of all
assistive personnel to perform assigned tasks through written documentation of
their education or training that is maintained and available at all
times;
f. Delegation of and
instruction in the services to be rendered by the OTA, including but not
limited to specific tasks or procedures, precautions, special problems, and
contraindicated procedures; and
g.
Timely review of documentation, reexamination of the patient and revision of
the plan when indicated.
(4) Supervision of unlicensed assistive
personnel. OTs are responsible for patient care provided by unlicensed
assistive personnel under the OT's supervision. Unlicensed assistive personnel
shall not provide independent patient care unless each of the following
standards is satisfied:
a. The supervising OT
shall physically participate in the patient's treatment or evaluation, or both,
each treatment day;
b. The
unlicensed assistive personnel shall provide independent patient care only
while under the onsite supervision of the supervising OT;
c. Documentation made in occupational therapy
records by unlicensed assistive personnel shall be cosigned by the supervising
OT; and
d. The supervising OT shall
provide periodic reevaluation of the performance of unlicensed assistive
personnel in relation to the patient.
(5) Minimum frequency of OT interaction. At a
minimum, an OT must directly participate in treatment, either in person or
through a telehealth visit, every twelfth visit for all patients and must
document each visit. The occupational therapist shall participate at a higher
frequency when the standard of care dictates.
(6) Occupational therapy assistant
responsibilities.
a. The occupational therapy
assistant shall:
(1) Provide only those
services for which the OTA has the necessary skills and shall consult the
supervising occupational therapist if the procedures are believed not to be in
the best interest of the patient;
(2) Gather data relating to the patient's
disability during screening, but shall not interpret the patient information as
it pertains to the plan of care;
(3) Communicate any change, or lack of
change, that occurs in the patient's condition and that may need the assessment
of the OT;
(4) Provide occupational
therapy services only under the supervision of the occupational
therapist;
(5) Provide treatment
only after evaluation and development of a treatment plan by the occupational
therapist;
(6) Refer inquiries that
require interpretation of patient information to the occupational
therapist;
(7) Be supervised by an
occupational therapist, either on site or through the use of telecommunication
or other technology, at all times when occupational therapy services are being
rendered;
(8) Receive supervision
from any number of at least one occupational therapist; and
(9) Record on every patient chart the name of
the OTA's supervisor for each treatment session.
b. The signature of an OTA on the
occupational therapy treatment record indicates that occupational therapy
services were provided in accordance with the rules and regulations for
practicing as an OTA.
(7)
Unlicensed assistive personnel. Unlicensed assistive personnel may assist an
OTA in providing patient care in the absence of an OT only if the OTA maintains
in-sight supervision of the unlicensed assistive personnel and the OTA is
primarily and significantly involved in that patient's care.
(8) The occupational therapy limited permit
holder may evaluate clients, plan treatment programs, and provide periodic
reevaluations under supervision of a licensed occupational therapist who shall
bear full responsibility for care provided under the occupational therapist's
supervision.
