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Pennsylvania Physical Therapy Assistants

Definition of a PTA

"Physical therapist assistant" shall mean an individual who has met all the requirements of this act and is certified as a physical therapist assistant in accordance with this act. Any person or individual who is registered and in good standing with the board shall be deemed certified until such time as the board promulgates regulations regarding certification.

What are PTAs allowed to do?

 A physical therapist assistant may perform only activities for which the physical therapist assistant has received formal education and training, including the following activities:

    • Providing patient-care services as specified in the patient’s plan of care.
    • Modifying treatment techniques as indicated in the patient’s plan of care.
    • Responding to acute changes in the patient’s physiological state.
    • Performing selected tests and measurements consistent with the physical therapist assistant’s formal education and training.

What activities are expressly prohibited?

A physical therapist assistant may not authorize the discharge of a patient from physical therapy services.

Physical therapist assistants may not interpret referrals or tests, perform evaluation procedures, initiate treatment programs, assume responsibility for planning patient care or perform activities which require the formal education or training and the skill and knowledge of a licensed physical therapist.

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

 When patient-care services are provided by the physical therapist assistant, the physical therapist shall document reevaluations and adjustments to a patient plan of care and goals at least every 30 calendar days or when there is a significant change in patient status warranting an earlier patient evaluation.

What type of therapist supervision is required?

Such acts and services of a physical therapist assistant shall not include evaluation, testing, interpretation, planning or modification of patient programs. For purposes of this section the term "supervision" means as follows:

In all practice settings, the performance of selected acts and services by the physical therapist assistant shall be:

    • The responsibility of the licensed physical therapist at all times.
    • Based on the following factors:
      • Complexity and acuity of the patient's needs.
      • Proximity and accessibility of the licensed physical therapist to the certified physical therapist assistant.
      • Supervision available in the event of an emergency or critical event.
      • Type of practice setting in which the service is provided.

In all practice settings, the initial patient contact shall be made by a licensed physical therapist for evaluation of the patient and establishment of a plan of care.

Practice Settings

Supervision requirements of a physical therapist assistant shall be dependent upon the practice setting in which the care is delivered:

    • When care is delivered to an individual in an acute care hospital, acute inpatient rehabilitation center, long-term acute care hospital facility 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.
    • 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 shall occur first.
    • 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 of a physical therapist assistant for at least 50% of the hours worked by the physical therapist assistant during the calendar week unless otherwise required by Federal law, and the physical therapist shall be immediately available by telecommunication if not providing direct on-premises supervision.
    • 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.
    • 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 fourteen (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.
    • 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 fourteen (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.

A physical therapist assistant may only provide physical therapy acts and services when the licensed physical therapist is available and accessible in person or by telecommunication to the physical therapist assistant during all working hours of the physical therapist assistant and is present within a 100-mile radius of the treatment location. A physical therapist assistant shall consult with the supervising physical therapist in the event of a change in the patient's condition which may require the assessment of a licensed physical therapist.

Change of Supervisor

In the event of a change of the supervising licensed physical therapist, the subsequent supervisor shall assume responsibility for the ongoing supervision of any certified physical therapist assistant providing physical therapy acts and services and shall become the supervising physical therapist.

Emergency: In an emergency situation, such as serious illness or death of a family member, which causes the unanticipated absence of the supervising physical therapist for not more than two days per month, a certified physical therapist assistant may continue to render services to only those patients for which the certified physical therapist assistant has previously participated in the intervention for established plans of care not to exceed the regularly scheduled operational hours of the particular day or days the supervising physical therapist is absent. Every effort shall be made by the licensed physical therapist or certified physical therapist assistant to obtain supervision in the care described in this subsection. A licensee utilizing this section shall maintain a written record noting the date and the emergency, which shall be available for board review, and shall submit a report to the board biennially setting forth each day absent under this paragraph and the reason for such absence. A licensed physical therapist may utilize this emergency provision no more than ten days per calendar year

Authorization to provide services as a physical therapist assistant under indirect supervision

An applicant for a certificate of authority to provide services as a physical therapist assistant under indirect supervision by a licensed physical therapist shall submit to the Board on forms supplied by the Board a completed application, including all necessary supporting documents, and pay the fee for initial application for certification to provide services under indirect supervision.

Unless there are grounds to deny the application the Board will grant a certificate of authority as described in this section to an applicant who:

    • Demonstrates that the applicant satisfies the certification requirements.
    • Demonstrates that the applicant satisfies the requirements for certification to provide services as a physical therapist assistant under indirect supervision of a licensed physical therapist by either verifying that the applicant:
      • Has at least 2,000 hours of experience providing patient-related acts and services under the supervision of one or more licensed physical therapists, as verified by those physical therapists.
      • Worked as a physical therapist assistant for at least 3 years between October 2, 2003, and October 2, 2008, the 5-year period immediately preceding the effective date of section 9.1(c)(4) of the act and providing a detailed resume or other adequate documentation to corroborate the verification. Part-time work will be acceptable if it is at least equivalent to 3 years of full-time work.

What is the ratio between supervising PTs and PTAs?

A licensed physical therapist shall not supervise more than three (3) physical therapist assistants at any time.

Citations

63 P. S. § 1

63 P. S. § 9.2

49 Pa. Code § 40.53

49 Pa. Code § 40.165

49 Pa. Code § 40.171

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