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Tennessee OT Assistants

Definition of a OTA

Any person who has met the qualifications for licensed occupational therapy assistant and holds a current, unsuspended or unrevoked, license which has been lawfully issued by the Board. Such person assists and works under the supervision of a licensed occupational therapist.

What are OTAs allowed to do?

The Occupational Therapy Assistant can implement and coordinate intervention plan under the supervision of the licensed Occupational Therapist.

The Occupational Therapy Assistant can provide direct services that follow a documented routine and accepted procedure under the supervision of the Occupational Therapist.

The Occupational Therapy Assistant can adapt activities, media, environment according to the needs to the patient/client, under the supervision of the licensed Occupational Therapist.

What are the responsibilities of the OT when delegating to a OTA?

It is the responsibility of the occupational therapist and the occupational therapy assistant to seek the appropriate quality and frequency of supervision that ensures safe and effective occupational therapy service delivery. This decision is based on client’s level of care, OTA caseload, experience and demonstrated performance competency.

    • The frequency of the face to face collaboration between the Occupational Therapy Assistant and the supervising Occupational Therapist should exceed direct contact of once a month if the condition of the patient/client, complexity of treatment, evaluation procedures, and proficiencies of the person practicing warrants it.
    • The Occupational Therapist shall be responsible for the evaluation of the patient and the development of the patient/client treatment plan. The Occupational Therapy Assistant may contribute information from observations and standardized test procedures to the evaluation and the treatment plans.

What type of therapist supervision is required?

Supervision is a collaborative process that requires both the licensed occupational therapist and the licensed occupational therapy assistant to share responsibility. Appropriate supervision will include consideration given to factors such as level of skill, the establishment of service competency (the ability to use the identified intervention in a safe and effective manner), experience and work setting demands, as well as the complexity and stability of the client population to be treated.

Supervision of an Occupational Therapy Assistant with permanent licensure means initial direction and inspection of the service delivery and provision of relevant in-service training, according to the level of supervision the occupational therapy assistant requires.


Therapists must maintain documentation of each supervisory visit and must identify a plan for continued supervision. Records must include, at a minimum, the following information:

1. Location of visit; a method of identifying clients discussed

2. Current plan for supervision (daily, weekly, bi-monthly, monthly, other)

3. Type of supervision provided. These include but are not limited to

    • In person
    • Phone contact
    • Electronic contact

4. Identification of type(s) of interventions observed. These include but are not limited to:

    • Interventions
    • Training
    • Consultations

5. Other supervisory actions. These include but are not limited to:

    • Discussion/recommendation for interventions and/or goals
    • Discussion/training in documentation
    • Demonstration/training in intervention techniques
    • Assessment/re-assessment/discharge
    • Additional Comments

6. An agreement statement signed and dated by both parties, that the supervisory visit did occur and met the needs of the supervisor and supervisee.

7. It is the responsibility of the supervising occupational therapist to provide and the occupational therapy assistant to seek a quality and frequency of supervision that ensures safe and effective occupational therapy service delivery. Both parties (supervisor and supervisee) must keep copies of the supervisory records. Visit records must be maintained for three (3) years and must be provided to the Board and/or its representative, upon request.

Supervision Related to Skill Level

Supervision of occupational therapy services provided by a licensed occupational therapy assistant is recommended as follows:

    • Entry level occupational therapy assistants are persons working on initial skill development (less than 1 year of work experience) or who are entering new practice environments or developing new skills (one or more years. of experience) and should require close supervision.
    • Intermediate level occupational therapy assistants are persons working on increased skill development, mastery of basic role functions (minimum one - three years of experience or dependent on practice environment or previous experience) and should require routine supervision.
    • Advanced level occupational therapy assistants are persons refining specialized skills (more than 3 years work experience, or the ability to understand complex issues affecting role functions) and should require general supervision.
    • Licensed occupational therapy assistants, regardless of their years of experience, may require closer supervision by the licensed occupational therapist for interventions that are more complex or evaluative in nature and for areas in which service competencies have not been established.
    • Certain occupational therapy assistants may only require minimal supervision when performing non-clinical administrative responsibilities.


Tenn. Code Ann. ยง 63-13-103

Tenn. Comp. R. & Regs. 1150-02-.01

Tenn. Comp. R. & Regs. 1150-02-.10

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