Current through Register Vol. 51, No. 3, September 1, 2024
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
309.355(1) requires the
Board of Licensure for Massage Therapy to administer and enforce the provisions
of
KRS
309.350 to
309.364.
KRS
309.355(3) requires the
board to establish by administrative regulation a code of ethics and standards
of practice for massage therapists. This administrative regulation establishes
those standards, which, if violated, are a basis for disciplinary action under
KRS
309.362.
Section
1. Code of Ethical Standards for the Massage Therapist. A massage
therapist shall:
(1) Maintain the
confidentiality of all client information, unless law or court order mandates
disclosure;
(2) Keep the client
well informed of procedures and methods that will be employed during the
session;
(3) Report to the board if
the massage therapist has first-hand knowledge or evidence indicating any
unethical, incompetent, or illegal act has been committed by another
licensee;
(4) Take precautions to
do no harm to the physical, mental, and emotional well-being of clients or
associates;
(5) Make every
reasonable effort to report unlicensed practice of massage therapy to the
board;
(6) Represent his or her
educational and professional qualifications honestly;
(7) Inform clients of the limitations of the
licensee's practice;
(8)
Consistently take measures to improve professional knowledge and competence by
a regular assessment of personal and professional strengths and weaknesses
through continuing education training;
(9) Respect the client's right to treatment
with informed and voluntary consent, either verbal or written, and to refuse,
modify, or terminate treatment regardless of prior consent;
(10) Not engage in sexual conduct or
activities with a client;
(11) Not
engage in an interest, activity, or influence that conflicts with the
practitioner's obligation to act in the best interest of the client;
(12) Respect the client's boundaries with
regard to privacy, disclosure, exposure, emotional expression, beliefs, and
reasonable expectations of professional behavior;
(13) Refuse to accept gifts or benefits,
which are intended to influence a referral or treatment that are purely for
personal gain and not for the good of the client;
(14) Conduct all business and professional
activities with honesty and integrity;
(15) Respect the inherent worth of all
clients;
(16) Provide only those
services that the licensee is qualified to perform; and
(17) Respect the client's autonomy.
Section 2. Standards of Practice
for the Massage Therapist.
(1) In the practice
of massage therapy, a massage therapist shall:
(a) Perform a written or verbal intake
interview with the client to evaluate if any contraindications to massage
therapy exist and if modifications including pressure, technique, and duration
of treatment are applicable;
(b)
Evaluate each client through observation, palpation, and any relevant records
provided by the client;
(c)
Acknowledge the limitations of, and contraindications for, massage;
(d) Plan and implement a treatment session or
program individualized for the client;
(e) Refer the client to other professionals
or services if the treatment or service is beyond the massage therapist's scope
of practice;
(f) Maintain for a
minimum period of five (5) years accurate, timely, and organized records of
every client;
(g) Provide massage
therapy services that meet or exceed the generally accepted practice of the
profession;
(h) If a plan of care
or treatment is applicable, explain the plan to the client, to others
designated by the client, and to professionals with client
permission;
(i) Unless prohibited
by law, be allowed to pool or apportion fees received with other members of a
business entity in accordance with any business agreement;
(j) Practice massage therapy in sanitary and
safe conditions;
(k) Use proper
draping technique;
1. Before beginning a
massage, the massage therapist shall explain to the client the draping
techniques that will be used; and
2. Provide the client a clean drape large
enough for the purpose of draping the buttocks, genitalia, and chest. These
body parts shall remain covered, except during therapeutic treatment of those
specific areas, with the exception of the genitalia, which shall always remain
covered; and
(l) Have
the right to refuse to treat any person or part of the body at the licensee's
discretion.
(2) In the
practice of massage therapy, a massage therapist shall not:
(a) Provide treatment to the anus or anal
canal, including, treatments such as colonic irrigations and enemas;
or
(b) Provide treatment to the
genitals, including, for conditions such as erectile dysfunction or pelvic
floor issues.
(3)
Interacting with other medical professionals. With written permission from the
client, the massage therapist may interact with the client's physician or other
healthcare providers if the client is under direct medical care.
(4) If the client is self-referred and under
the care of a health care professional, the massage therapist may, with written
permission from the client:
(a) Advise the
health care professional that the patient is seeking massage
treatment;
(b) Provide to the
health care professional the massage therapist's evaluation results;
(c) Advise the health care professional of
the noted treatment plan; and
(d)
Provide a follow-up report upon completion of the massage treatment plan to
enhance communication between the multidisciplinary care-giving team.
(5) Breast massage. A licensee
performing massage of the tissue of the breast shall:
(a) Obtain the client's informed written
consent prior to providing the service;
(b) Maintain proof documenting specialized
training in breast massage which addresses breast anatomy, breast pathology,
and breast massage technique and which was provided by an approved massage
therapy program or board approved continuing education provider;
(c) Inform the client prior to the
commencement of the service that this service may be performed through a
draping sheet if the client so desires and the licensee shall provide the
service through a draping sheet if the client so prefers;
(d) Inform the client prior to the
commencement of the service that the client may discontinue the service at any
time and the licensee shall honor that election by discontinuing the provision
of the service if that request is made;
(e) Keep detailed Subjective Objective
Analysis Plan notes for the service such as notes related to all emotional
factors that the client reports to the licensee which might impact the client's
suitability for the service and the precautions that the licensee has taken to
ensure that the service is provided in a manner accounting for those emotional
factors; and
(f) Refrain from an
act or statement which the client may construe as being sexual in
nature.
Section
3. Standards for Documentation. The massage therapist and client
shall agree upon the purpose of the massage session.
(1) Documentation shall not be required if
the massage session is for general relaxation, a sports event massage, or
public demonstration as in chair massage.
(2) If a written plan of treatment is
requested or required, the client file shall include the following
documentation:
(a) The initial evaluation,
which shall include:
1. The client's name,
age, and gender;
2. Date of the
session; and
3. Pertinent medical
history, including:
a. Client sensitivities
and allergies;
b. Medical
diagnoses, if available, and the source of the diagnosis;
c. Contraindications; and
d. Medications as disclosed by the
client;
(b)
Progress notes signed by the massage therapist rendering the massage therapy,
which shall include:
1. Subjective information
including the area of complaint as stated by the client and the date of
onset;
2. Objective information
including any observations and objective testing, if applicable;
3. Ongoing assessments, if
applicable;
4. Actions taken by the
massage therapist; and
5. The
client response to massage therapy treatment; and
(c) A plan of treatment, if applicable,
consisting of:
1. Modalities to be
rendered;
2. Frequency and duration
of treatment;
3. Referral to other
professionals, if indicated;
4.
Client self-help education and instruction; and
5. The goals or desired outcome of the
treatment.