Current through Register Vol. 54, No. 44, November 2, 2024
(a)
General
rule. A physical therapist assistant may provide patient care services
only under the supervision of a licensed physical therapist. Except as
otherwise provided in the act or this subchapter, a physical therapist
assistant may provide patient care services only under the direct on-premises
supervision of a licensed physical therapist.
(b)
Supervision generally.
The required level of supervision depends upon the following factors:
(1) The performance of selected acts and
services by the physical therapist assistant is the responsibility of the
licensed physical therapist at all times.
(2) Supervision shall be based upon the
following:
(i) The complexity and acuity of
the patient's needs.
(ii) The
proximity and accessibility of the licensed physical therapist to the certified
physical therapist assistant.
(iii)
The amount of supervision available in the event of an emergency or critical
event.
(iv) The type of practice
setting in which the service is provided.
(3) The supervising licensed physical
therapist may determine and require that the physical therapist assistant
provide services under greater supervision than would otherwise appear to be
required under section 9.1(c)(3) of the act (63 P. S. §
1309.1(c)(3)) or this
section, including requiring that the physical therapist assistant provide
services under direct on-premises supervision.
(c)
Practice setting. A
physical therapist assistant holding a current certificate of authority to
provide services under indirect supervision may do so in accordance with this
section and section 9.1(c) of the act.
(1)
When care is delivered to an individual in an acute care hospital, acute
inpatient rehabilitation center, long-term acute care hospital setting or as
otherwise required by Federal or State law or regulation, the physical
therapist assistant shall be under the direct on-premises supervision of a
licensed physical therapist.
(2)
When care is provided to an individual in a preschool, primary school,
secondary school or other similar educational setting, a licensed physical
therapist shall make an onsite visit and examine the patient at least every
four patient visits or every 30 days, whichever occurs first.
(3) When care is provided to an individual in
an early intervention setting, a licensed physical therapist shall make an
onsite visit and examine the patient at least every four patient visits or
every 30 days, whichever occurs first.
(4) When care is provided to a patient in a
physical therapy independent private practice outpatient facility, a licensed
physical therapist shall provide direct on-premises supervision for a physical
therapist assistant for at least 50% of the hours worked by the physical
therapist assistant during the calendar week unless otherwise required under
Federal law. The physical therapist shall be immediately available by
telecommunication when not providing direct on-premises supervision.
(5) When care is provided to a patient in an
outpatient facility of a practice owned or affiliated with a hospital or
healthcare system, a licensed physical therapist shall provide direct
on-premises supervision for a physical therapist assistant for at least 50% of
the hours worked by the physical therapist assistant during the calendar week
unless otherwise required under Federal law. The physical therapist shall be
immediately available by telecommunication if not providing direct on-premises
supervision.
(6) For home health
care, a licensed physical therapist shall make an onsite visit and actively
participate in the treatment of the patient at least every seven patient visits
or every 14 days, whichever occurs first. For purposes of this paragraph,
active participation includes examination of the patient. Multiple visits on a
single date constitute only a single patient visit in determining whether the
licensed physical therapist is required to make an onsite visit.
(7) For care provided in a long-term care
nursing facility, skilled nursing facility or extended care facility, a
licensed physical therapist shall make an onsite visit and actively participate
in the treatment of the patient at least every seven patient visits or every 14
days, whichever occurs first. For purposes of this paragraph, active
participation includes examination of the patient. Multiple visits on a single
date constitute only a single patient visit in determining whether the licensed
physical therapist is required to make an onsite visit.
(d)
Emergency situations.
The emergency situation provisions of section
9.1(i) of the act
apply only to those current certified physical therapist assistants who are
authorized by the Board under section
9.1(c)(4) of the
act and §
40.165 (relating to authorization
to provide services as a physical therapist assistant under indirect
supervision) to provide services under supervision of a licensed physical
therapist other than direct on-premises supervision.
The provisions of this §40.173 issued under 3(a)
of the Physical Therapy Practice Act (63 P. S. §
1303(a)); and section 16 of
the act of July 4, 2008 (P. L. 293, No.
38).
This section cited in 49 Pa. Code §
40.152 (relating to definitions);
and 49 Pa. Code §
40.181 (relating to refusal,
suspension or revocation of
certification).
