Rules & Regulations of the State of Tennessee
Title 1150 - TN Boards of Occupational and Physical Therapy
Chapter 1150-01 - General Rules Governing the Practice of Physical Therapy
Section 1150-01-.02 - SCOPE OF PRACTICE AND SUPERVISION

1. The initial evaluation which may be conducted without such referral;

2. A licensed physical therapist may treat a patient for an injury or condition that was the subject of a prior referral if all of the following conditions are met:

3. No physical therapist may provide treatment pursuant to part two (2) of this subparagraph without having been licensed to practice physical therapy for at least one (1) year and without satisfying other requirements set by the Board.

4. A licensed physical therapist may provide physical assessments or instructions including recommendation of exercise to an asymptomatic person without the referral of a referring practitioner.

5. In emergency circumstances, including minor emergencies, a licensed physical therapist may provide assistance to a person to the best of a therapist's ability without the referral of a referring practitioner, provided the physical therapist shall refer to the appropriate health care practitioner, as indicated, immediately thereafter. For the purposes of this part of this subparagraph, emergency circumstances means instances where emergency medical care is called for. Emergency medical care means bona fide emergency services provided after the sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in:

1. Examining, evaluating and testing individuals with mechanical physiological and developmental impairments, functional limitations, and disability or other health and movement-related conditions in order to determine a physical therapy treatment diagnosis, prognosis, a plan of therapeutic intervention, and to assess the ongoing effect of intervention; and

2. Alleviating impairments and functional limitations by designing, implementing, and modifying therapeutic interventions that include, but are not limited to: therapeutic exercise; functional training; manual therapy; therapeutic massage; assistive and adaptive orthotic, prosthetic, protective and supportive equipment; airway clearance techniques; debridement and wound care, physical agents or modalities, mechanical and electrotherapeutic modalities including patient-related instruction and electrophysiologic studies (motor and sensory nerve conduction, and somatosensory evoked potentials)

3. Reducing the risk of injury, impairments, functional limitation and disability, including the promotion and maintenance of fitness, health and quality of life in all age populations; and

4. Engaging in administration, consultation, education and research; and

5. Manual Therapy Techniques - Consist of a broad group of passive interventions in which physical therapists use their hands to administer skilled movements designed to modulate pain; increase joint range of motion; reduce or eliminate soft tissue swelling, inflammation, or restriction; induce relaxation; improve contractile and noncontractile tissue extensibility; and improve pulmonary functions. These interventions involve a variety of techniques, such as the application of graded forces, which are not performed beyond the joint's normal range of motion. These interventions may be applied to all joints of the body as deemed appropriate.

1. Over-utilization of appropriate physical therapy services or the lack thereof.

2. Providing treatment intervention that is unwarranted by the condition of the patient.

3. Providing treatment that is beyond the point of reasonable benefit.

4. Abandoning the care of a patient without informing the patient of further care options.

5. Failing to practice in accordance with the standards set forth in the "Guide to Physical Therapist Practice," pursuant to rule 1150-01-.02(1) (f).

1. American Physical Therapy Association

1111 North Fairfax Street

Alexandria, VA 22314-1488

Telephone: (703) 684-2782

Telephone: (800) 999-2782

Fax: (703) 684-7343

T.D.D: (703) 683-6748

Internet: www.apta.org

2. Board of Physical Therapy

227 French Landing, Suite 300

Heritage Place, MetroCenter

Nashville, TN 37243

Telephone: (615) 532-3202 ext. 25135

Telephone: (888) 310-4650 ext. 25135

Fax: (615) 532-5164

Internet: www.state.tn.us/health

1. The licensed physical therapist shall perform the initial evaluation of the patient with the development of a written treatment plan, including therapeutic goals, frequency and time period of services.

2. The licensed physical therapist shall perform and document re-evaluations, assessments, and modifications in the treatment plan at least every thirty (30) days. For patients seen longer than sixty (60) days, the licensed physical therapist shall inspect the actual act of therapy services rendered at least every sixty (60) days.

3. The licensed physical therapist may not supervise a physical therapist assistant that is delivering services at a site further than sixty (60) miles or one (1) hour from the licensed physical therapist. The supervising licensed physical therapist must be available to communicate by telephone or other means whenever the physical therapist assistant is delivering services.

4. The discharge evaluation must be performed and the resulting discharge summary must be written by the licensed physical therapist.

5. The licensed physical therapist and the physical therapist assistant shall be equally responsible and accountable for carrying out the provisions of this subparagraph.

1. A physical therapist may use physical therapy aides for designated tasks that do not require clinical decision making by the licensed physical therapist or clinical problem solving by the licensed physical therapist assistant. Direct supervision must apply to physical therapy aides and is interpreted to mean that services are provided under the supervision of an on-site physical therapist or physical therapist assistant licensed and practicing in Tennessee.

2. A physical therapist may use other assistive personnel for selected physical therapy designated tasks consistent with the training, education, or regulatory authority of such personnel. Other assistive personnel (nationally certified exercise physiologists or certified athletic trainer and massage therapists, etc) must perform the delegated task under the on-site supervision of a physical therapist. The physical therapist shall then co-sign all related documentation in the patient records.

3. "On-site supervision" means the supervising physical therapist or physical therapist assistant must: