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New York PT Assistants

Definition of a PTA

A "physical therapist assistant" means a certified person who works under the supervision of a licensed physical therapist performing such patient related activities as are assigned by the supervising physical therapist.

Nothing in this section shall prohibit a hospital from employing physical therapist assistants, provided they work under the supervision of physical therapists designated by the hospital and not beyond the scope of practice of a physical therapist assistant. The numerical limitation of this section shall not apply to work performed in a hospital, provided that there be adequate supervision in the best interest of public health and safety.

What are PTAs allowed to do?

PTTAs may perform limited measurement procedures, such as range of motion and strength, in order to conduct the treatments assigned to the PTA and may document the results in patient/client charts. PTAs are educated and trained to determine gross functional aspects of range of motion and strength in order to conduct the treatments assigned to them and may perform services within these parameters. 

What activities are expressly prohibited?

Duties of physical therapist assistants shall not include evaluation, testing, interpretation, planning or modification of patient programs.

What are the responsibilities of the PT when delegating to a PTA?

A PT may not delegate to the PTA any activities which are outside the legal scope of practice of the PTA or beyond the competency of the specific PTA. Failure to follow these requirements could result in charges of professional misconduct against the supervising physical therapist and the physical therapist assistant.

What type of therapist supervision is required?

Supervision of a physical therapist assistant by a licensed physical therapist shall be on-site supervision, but not necessarily direct personal supervision.

A physical therapist assistant shall be under the general supervision of a physical therapist licensed in the State of New York.

On-site supervision shall mean that the supervising physical therapist is physically present in the same facility and is readily available to the physical therapist assistant, except with respect to maintenance programs in residential health care facilities.

Supervision in other Settings

Supervision of a physical therapist assistant by a licensed physical therapist,

    • In a residential health care facility, as defined in article twenty-eight of the public health law,
    • In a diagnostic and treatment center licensed under article twenty-eight of the public health law that provides, as its principal mission, services to individuals with developmental disabilities,
    • In a facility, as defined in section 1.03 of the mental hygiene law, or
    • Under a monitored program of the office of mental retardation and developmental disabilities as defined in subdivision (a) of section 13.15 of the mental hygiene law,

shall be continuous but not necessarily on site when the supervising physical therapist has determined, through evaluation, the setting of goals and the establishment of a treatment plan, that it will be a maintenance program. 

The provisions of this section shall not apply to the provision of physical therapy services when the condition requires multiple adjustments of sequences and procedures due to rapidly changing physiological status and/or response to treatment, or to children under five (5) years of age.

Supervision is a School Setting

A physical therapist assistant services in public primary or private primary or secondary schools and for preschool children, and receiving services under continuous supervision of a physical therapist assistant, who has direct clinical experience providing age appropriate physical therapy services for a period of not less than two (2) years, by a licensed physical therapist shall not be construed as requiring the physical presence of such licensed physical therapist at the time and place where such services are performed.

"Continuous supervision" shall include:

    • The licensed physical therapist`s setting of the goals, establishing a plan of care, determining on an initial and ongoing basis whether the patient is appropriate to receive the services of a physical therapist assistant, determining the frequency of joint visits with the patient by both the supervising licensed physical therapist and the physical therapist assistant, except that in no instance shall the interval, between joint visits, be more than every ninety (90) calendar days, subject to the licensed physical therapist`s evaluation;
    • An initial joint visit with the patient by the supervising licensed physical therapist and physical therapist assistant;
    • Periodic treatment and evaluation of the patient by the supervising licensed physical therapist as indicated in the plan of care and as determined in accordance with patient need, except that in no instance shall the interval between such treatment exceed every twelfth (12th) visit or thirty (30) days whichever occurs first; and
    • Notification of the supervising licensed physical therapist by the physical therapist assistant whenever there is a change in status, condition or performance of the patient.

This does not apply to the provision of physical therapy services when a child`s condition requires multiple adjustments of sequences and procedures due to rapidly changing physiologic status and/or response to treatment.

What is the ratio between supervising PTs and PTAs?

The number of physical therapist assistants supervised by one licensed physical therapist shall not exceed the ratio of four (4) physical therapist assistants to one (1) licensed physical therapist as shall be determined by the commissioner`s regulations insuring that there be adequate supervision in the best interest of public health and safety.

What may a PTA document?

PTAs may write progress notes if the notes are limited to a summary of overall treatment and not an evaluation or assessment of the patient/client's progress or a description of the degree to which the patient/client met the treatment goals.

Can a PTA document this care without the co-signature of a therapist?

Education Law is silent regarding the matter of PTs co-signing the notes of PTAs. However, because PTs are responsible for the evaluation, testing, interpretation, planning, and modification of patient programs, it is not uncommon for them to co-sign PTA notes as an indication that they are aware of the actions of PTAs in relation to their plan. Indeed, in some instances, hospitals and long term care facilities have developed policies that require PTs to co-sign the notes of PTAs under their supervision. (It is within the authority of a health care agency to develop and enforce policies and procedures that exceed state or federal requirements.)

Education law does not require that a licensed physical therapist co-sign the notes of a student, limited permittee or other licensee. The required supervision of a student, limited permittee or physical therapist assistant may be verified through clear documentation of the physical therapist’s review of patient progress and changes in the treatment plan. However, insurance companies and other third-party payers may require a co-signature for reimbursement.

Citations

N.Y. EDN Law 136 § 6738

NYCCR §77.6

NY PT Board Practice Alert 4

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