Oklahoma Administrative Code
Title 435 - State Board of Medical Licensure and Supervision
Chapter 20 - Physical Therapists and Assistants
Subchapter 7 - Supervision of Physical Therapist Assistants
Section 435:20-7-1 - Direction and supervision of physical therapist assistants
Universal Citation: OK Admin Code 435:20-7-1
Current through Vol. 42, No. 1, September 16, 2024
(a) Responsible supervision.
(1)
Physical therapists have a duty to provide therapy services that protect the
public safety and maximize the availability of their services. The physical
therapist assistant is the only individual permitted to assist in selected
treatment interventions. A physical therapist assistant shall be an agent of
supervised by a specific physical therapist or group of physical therapists
working in the same practice setting or physical facility. A physical therapist
assistant may not be supervised by any other person including those licensed in
other professions. The physical therapist of record is accountable and
responsible at all times for the direction of the actions of the physical
therapist assistant when treating their his/her patient. When determining the
extent of assistance the physical therapist assistant can provide, the physical
therapist should consider:
(A) the physical
therapist assistant's experience and skill level
(B) the patient/client criticality and
complexity
(C) the setting in which
the care is being delivered
(D) the
predictability of the patient/client outcomes
(E) the needed frequency of
re-examination
(2) A
physical therapist shall not delegate to a less qualified person any service
that requires the skill, knowledge and judgment of a physical therapist. For
each date of service, a physical therapist shall provide all therapeutic
interventions that require the expertise of a physical therapist and shall
determine the use of assistive personnel that provides delivery of service that
determine when assistive personnel may be used to provide delivery of services
in a is ssafe, effective, and efficient manner for each patient.
(A) A physical therapist assistant shall work
under a physical therapist's direct or general supervision. A physical
therapist assistant may document care provided without the co-signature of the
supervising physical therapist, but must include the name of the supervising PT
in each patient/client treatment note . The physical therapist assistant will
respond to acute changes in the patient's physiological state and report these
findings promptly to the physical therapist. Contact, or attempts to contact
the supervising physical therapist of record, will be documented in the medical
record.
(B) A physical therapist
and a physical therapist assistant may use physical therapy aides for
designated and immediately supervised routine tasks. The physical therapist
shall not delegate the same type and level of duties to the physical therapy
aide as are delegated to the physical therapist assistant. A physical therapy
aide shall work under immediate supervision of the physical therapist or
physical therapist assistant who is continuously on-site and present in the
facility.
(b) Patient Care Management. Upon accepting a patient for provision of services, the physical therapist becomes the Physical Therapist of Record for that patient and is solely responsible for managing all aspects of the physical therapy plan of care for that patient. The Physical Therapist of Record shall:
(1) Perform the initial examination and
evaluation
(2) Establish a plan of
care and remain responsible to provide and/or supervise the appropriate
interventions outlined in the plan of care.
(3) Perform the re-examination/re-evaluation
of the patient in light of their goals and revision of the plan of care when
indicated. This will be performed no less frequently than:
(A) every 30 days in acute care, outpatient,
inpatient rehabilitation and long term care settings with documented case
consultation no less frequently than every 15 days;
(B) every 60 days in home health settings
with documented case consultation no less frequently than every 30
days;
(C) every 90 days in
consultative DDSD with documented case consultation no less frequently than
every 45 days;
(D) very 10th visit
for DDSD for patients under 21 years of age with documented case consultation
no less frequently than every 5th visit;
(E) every 60 days in educational settings
with documented case consultation no less frequently than every 30
days;
(4) Establish the
discharge plan, and provide or review the documentation of the discharge
summary prepared by the physical therapist assistant.
(5) A physical therapist's responsibility for
patient care management shall include oversight of all documentation for
services rendered to each patient, including awareness of fees charged or
reimbursement methodology used. A physical therapist shall also be aware of
what constitutes unreasonable or fraudulent fees.
(c) Designation of a new Physical Therapist of Record. In the event that the Physical Therapist of Record can no longer assume these responsibilities, care must be turned over to another physical therapist who will become the new Physical Therapist of Record. The Therapist of rRecord must make sure that the new Physical Therapist of Record is authorized and qualified to receive the patient, must obtain acceptance from the receiving physical therapist, document the hand-over of the patient and maintain the care and responsibility of the patient until the new Physical Therapist of Record is acknowledged in the documentation.
(d) Designation and responsibilities of Supervising Physical Therapist and Alternate Supervising Physical Therapist. Both the physical therapist and physical therapist assistant are responsible for completion of the Form #5, Verification of Supervision.
(1) A Form #5, Verification of Supervision
must be completed annually for each clinical practice setting in which the
physical therapist assistant works, identifying the supervising physical
therapist for the physical therapist assistant. The physical therapist
assistant will be responsible to inquire of their supervising physical
therapist(s) or the Board, the number of persons being supervised by that
physical therapist. If responsible supervision is not practiced, both the
supervising physical therapist and the physical therapist assistant are in
violation of this rule. Any revised or new Form #5 for a physical therapist
assistant at a clinical practice setting will supersede theexisting Form #5 for
that setting. A physical therapist assistant will not practice in any clinical
setting without the necessary Form #5. It is the responsibility of both
physical therapists and physical therapist assistants to notify the Board of
any changes to a Form #5 that they have signed.
(2) A physical therapist will not supervise
and utilize more than four (4) licensed personnel or applicants for licensure.
Only three (3) may be physical therapist assistants or applicants for physical
therapist assistant licensure. Any of the four (4) may be applicants for
physical therapist licensure. This total is inclusive of all geographic
locations or employing agencies.
(3) For each practice setting in which he or
she works, the physical therapist assistant and the supervising physical
therapists must indicate on the Form #5, Verification of Supervision which of
the method of supervision described in (A) or (B) below will be employed in
that practice setting.
(A) A physical
therapist will provide direct or general supervision of a physical therapist
assistant and is will be listed on the Form #5 as the supervising physical
therapist. In the event that he or she is unable to provide supervision, a
supervising physical therapist may:
(i)
temporarily delegate the supervision of up to three licensed physical therapist
assistants to an alternate supervising physical therapist who agrees to provide
consultation to the physical therapist assistant(s) for existing plans of care
for a period of time not to exceed thirty (30) days. In this event, a new Form
#5 is not required, but the alternate supervising physical therapist must be
identified as the Therapist of Record in the documentation.
(ii) designate a new Therapist of Record, as
in 435:20-7-1 -(c) above, to assume full responsibility of the plan of care who
may, if they so chose, delegate to a physical therapist assistant under their
supervision as listed on their Form #5.
(B) A group of physical therapists, working
in the same practice setting may provide supervision to a physical therapist
assistant providing the following conditions are met:
(i) all supervising physical therapists are
listed on a Form #5 for the physical therapist assistant.
(ii) the ratio of physical therapists to
physical therapists assistants in that practice setting does not exceed the
ratio of one (1) physical therapist to three (3) physical therapist assistants
or applicants for licensure at any given time.
(iii) The group director, who must be a
licensed physical therapist or physical therapist assistant, is identified and
assumes responsibility for accurate information on the Form #5 and the
appropriate ratio of physical therapist to physical therapist assistants. The
Board may assign disciplinary action to the clinical director or all members of
the group for violation of the supervision rules.
(e) Supervision of additional physical therapist assistants. In unique cases, a physical therapist may petition the Chair of the Physical Therapy Committee to receive permission to supervise additional physical therapist Assistants assistants or applicants for licensure, but this decision to supervise additional assistive personnel must be reviewed and approved by the committee at the next scheduled meeting..
(f) Limits of practice for the physical therapist assistant. The physical therapist assistant may not:
(1) Specify, other than to
the Physical Therapist of Record, perform or interpret definitive (decisive,
conclusive, final) evaluative and assessment procedures. Definitive evaluation
procedures may not be recommended to anyone other than the patient's physical
therapist, unless previously approved by the physical therapist.
(2) Alter overall treatment, goals and/or
plan.
(3) Recommend adaptive
equipment, assistive devices, or alterations to architectural barriers to
persons other than a physical therapist.
(4) File discharge documents for permanent
record until approved by a physical therapist.
(5) Perform duties or tasks for which he/she
is not trained.
Revoked and reenacted at 10 Ok Reg 2453, eff 6-11-93; Amended at 16 Ok Reg 2005, eff 6-14-99; Amended at 26 Ok Reg 1080, eff 5-11-09
Disclaimer: These regulations may not be the most recent version. Oklahoma may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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