(A) Delegation in physical therapy is the sole responsibility of the physical therapist.
(B) The responsibility for physical therapy care rendered by the physical therapist assistant, and other licensed personnel rests with the supervising physical therapist.
(C) The physical therapist performs the following, none of which may be delegated:
(1) Interpreting available information concerning the referral;
(2) Providing the initial evaluation;
(3) Developing the plan of care, including the short term and long term goals;
(4) Identifying and documenting precautions, special problems, contraindications, anticipated progress, and plans for reevaluation;
(5) Selecting and delegating only appropriate tasks in the plan of care;
(6) Designating or establishing channels of written and oral communication;
(7) Assessing the competence of the physical therapist assistant, other licensed personnel, and unlicensed personnel to perform assigned tasks;
(8) Directing and supervising the physical therapist assistant, other licensed personnel, and unlicensed personnel in delegated tasks; and
(9) Reevaluating and adjusting the plan of care, when necessary, and performing the final evaluation, determining discharge, and establishing the follow-up plan.
(D) The physical therapist may refer patients to another discipline, which is not considered delegation. A referral to another discipline, including a physician, shall be documented in the medical record.
(E) Delegation of duties or tasks to the physical therapist assistant must be done in accordance with the scope of practice of the physical therapist assistant.
(1) A physical therapist assistant may not initiate or alter the plan of care without prior evaluation by and approval of the supervising physical therapist.
(2) A physical therapist assistant may adjust a treatment procedure in accordance with a change in patient status within the established plan of care.
(3) A physical therapist assistant may respond to inquiries regarding patient status to appropriate parties within the healthcare system and within the protocol established by the supervising physical therapist.
(4) The physical therapist assistant shall refer inquiries regarding a patient's prognosis to the supervising physical therapist. The physical therapist assistant may reinforce the physical therapist's position regarding the patient's prognosis.
(5) The physical therapist assistant may gather historical information about a patient to perform a screening that may determine the need for physical therapy intervention. This type of screening does not include physical contact with the patient.
(6) The physical therapist assistant shall document in the medical record according to the established protocols. All documentation shall be co-signed by the supervising physical therapist.
(F) Delegation of tasks related to the operation and delivery of physical therapy to other licensed personnel must be done in accordance with the scope of practice of the other licensed personnel's professional license, education and training, the level of competence as determined by the supervising physical therapist, and in consideration of the patient's overall needs and medical status.
(1) The physical therapist or physical therapist assistant shall demonstrate involvement, in accordance with paragraph (F) of rule 4755-27-04 of the Administrative Code, in each treatment session in which a component of care is delegated.
(2) Documentation by the other licensed personnel is restricted to an accounting of the activities provided, which includes the patient's response to intervention. The remainder of the documentation is the responsibility of the supervising physical therapist or supervising physical therapist assistant.
(G) The unlicensed personnel may be assigned routine duties that assist in the delivery of physical therapy care and operations, such as:
(1) Maintenance and care of equipment and supplies;
(2) Preparation, maintenance, and cleaning of treatment areas;
(3) Transportation of patients;
(4) Office and clerical functions;
(5) Assisting patients preparing for, during, and at the conclusion of treatment (such as changing clothes, assisting during transfer, and altering position during treatment);
(6) Personally assisting the physical therapist, physical therapist assistant, student physical therapist, and/or student physical therapist assistant while the physical therapist, physical therapist assistant, student physical therapist, and/or student physical therapist assistant is concurrently providing services to the same patient.
R.C. 119.032 review dates: 02/05/2009 and 04/01/2014
Promulgated Under: 119.03
Statutory Authority: 4755.411
Rule Amplifies: 4755.411
Prior Effective Dates: 2/1/92, 7/8/96, 8/14/00, 5/1/04, 5/1/05, 5/1/06, 1/1/08, 5/1/08