Fla. Admin. Code Ann. R. 64B17-6.001 - Minimum Standards of Physical Therapy Practice
(1) Definitions - For purposes of this rule
only, the words and phrases listed below are defined in the following manner:
(a) Acute Care - The stage of illness or
injury characterized by actual or reasonable potential for a rapid change in
medical status that would affect the physical therapy plan of care.
(b) Consultation - The offering of
information aimed at the resolution of perceived problem.
(c) Direction - The physical therapist's
authorization and empowerment of a physical therapist assistant or unlicensed
personnel, as authorized by Rule
64B17-6.007, F.A.C., to carry
out actions requiring licensure under Chapter 486, F.S.
(d) Assessment - Observational, verbal, or
manual determinations of the function of the musculoskeletal or neuromuscular
system relative to physical therapy, including, but not limited to, range of
motion of a joint, motor power, postural attitudes, biomechanical function,
locomotion, or functional abilities, for the purpose of making recommendations
for treatment.
(e) Direct
Supervision - Supervision of subordinate personnel performing directed actions,
while the licensed supervisor is immediately physically available.
(f) General supervision - Supervision of a
physical therapist assistant, other than by direct supervision, whereby the
physical therapist is accessible at all times by two-way communication,
available, to respond to an inquiry when made and readily available for
consultation during the delivery of care, and is within the same geographic
location as the physical therapist assistant.
(g) Program Plan - The establishment of
objectives (goals) and specific remediation techniques.
(h) Standards - Conditions and performances
which are essential for quality physical therapy service and patient
care.
(i) Unlicensed personnel -
Any individual, working or volunteering in a physical therapy setting, not
holding a current license as a physical therapist or physical therapist
assistant.
(2) Physical
Therapy Personnel Responsibilities In General. Physical therapy is a profession
involving skilled practice of patient care. The primary concern of the physical
therapist and physical therapist assistant is always the safety, well being,
and best interest of the patient who must therefore recognize and carry out
services consistent with legal rights and personal dignity of the patient.
Accordingly, it is the responsibility of all physical therapists and physical
therapist assistants to:
(a) Communicate
effectively to the patient the treatment evaluation process and techniques to
be used in any procedures before beginning treatment and anytime during the
course of the treatment process.
(b) Safeguard the confidentiality of
information and require written consent from the patient or legally authorized
representative prior to releasing information to a third party not involved in
the actual care.
(c) Avoid acts
which disregard a patient's modesty by intentionally viewing a completely or
partially disrobed patient if the viewing is not related to the patient
diagnosis or treatment.
(d) Refrain
from engaging in sexual misconduct, which is prohibited by ss. 486.123 and
456.063(1).
(e) Neither use nor
participate in the use of any form of communication containing false,
fraudulent, misleading, deceptive, unfair or sensational statement or claim,
nor use bribery in any form, nor use false advertising, nor misrepresentation
of services or self, nor engage in other unprofessional conduct, including, but
not limited to:
1. Inaccurately recorded,
falsified, or altered patient records,
2. Falsely representing or misrepresenting
facts on an application for employment,
3. Impersonating or acting as a proxy for an
applicant in any examination for certification or registration,
4. Impersonating another certified or
registered practitioner or permitting another to use his or her license for the
purpose of practicing physical therapy or receiving compensation,
5. Providing false or incorrect information
regarding the status of licensure.
(f) Not exploit the patient or client for the
financial gain of the licensee or a third party.
(g) Practice physical therapy with that level
of care, skill, and treatment which is recognized by a reasonably prudent
similar physical therapy practitioner as being acceptable under similar
conditions and circumstances.
(3) Physical Therapist Responsibilities.
Physical therapists shall:
(a) Be
professionally responsible for providing a referring practitioner, or a
practitioner of record, with any information which will assist in the
determination of an accurate medical diagnosis.
(b) Not implement any plan of care that, in
the physical therapist's judgment, is contraindicated. If the plan of care was
requested by a referring practitioner, the physical therapist shall immediately
notify the referring practitioner that he is not going to follow the request
and the reasons for such refusal.
(c) Not direct any function or task which
requires the skill, knowledge, and judgment of the physical
therapist.
(d) Assume the
responsibility for assessing the patient, identifying the level of acuity of
illness, planning the patient's treatment program, and implementing and
directing the program.
(e) Hold
primary responsibility for physical therapy care rendered under the therapist's
direction and shall be available for consultation at all times.
(f) Physical therapist's professional
responsibilities include, but are not limited to:
1. Interpretation of the practitioner's
referral.
2. Provision of the
initial physical therapy assessment of the patient.
3. Initial identification and documentation
of precautions, special problems, contraindications.
4. Development of a treatment plan including
the long and short term goals.
5.
Implementation of or directing implementation of the treatment plan.
6. Direction of appropriate tasks.
7. Reassessment of the patient in reference
to goals and, when necessary, modification of the treatment
plan.
(g) When
participating in student programs, ensure that the academic programs are
accredited or in candidacy by the appropriate accrediting agency recognized by
statute, and that the physical therapist provides direct supervision when
students are performing patient care activities. Direct Supervision of a
student in telehealth occurs when the supervising physical therapist is
immediately physically available to visualize, hear, and speak with the patient
and the student during the encounter in a synchronous fashion.
(h) Complete accurate written medical records
justifying the course of treatment of the patient, including, but not limited
to, initial physical therapy assessment, plan of treatment, treatment notes,
progress notes, examination results, test results, and discharge
summary.
(4) Physical
Therapist Assistant Responsibilities. Physical therapist assistants shall:
(a) Not initiate or change treatment without
the prior assessment and approval of the physical therapist.
(b) Not provide services to a patient who is
an inpatient in a hospital or who is in the acute phase of injury or illness
unless the physical therapist is readily and physically available to provide
consultation.
(c) Not carry out
treatment procedures detrimental to the patient or for which the assistant is
not qualified.
(d) Report all
untoward patient responses or change in medical status to the physical
therapist.
(e) Refer inquiries
regarding patient prognosis to the physical therapist.
(f) Discontinue immediately any treatment
procedures which in the assistant's judgment appear to be harmful to the
patient and shall report them to the physical therapist.
(g) When participating in student programs,
ensure that the academic programs are accredited or in candidacy by the
appropriate accrediting agency recognized by statute, and that the physical
therapist assistant provides direct supervision when students are performing
patient care activities. Supervision of a student in telehealth occurs when the
supervising physical therapist assistant is immediately physically available to
visualize, hear, and speak with the patient and the student during the
encounter in a synchronous fashion.
(h) Complete accurate written medical records
documenting the course of treatment for each patient.
(5) Physical Therapist - Physical Therapist
Assistant Responsibilities and Supervisory Relationships.
(a) Regardless of the setting, physical
therapists and physical therapist assistants shall abide by all Federal and
State Laws and regulations related to the particular site of
practice.
(b) During an acute phase
of injury or illness, or while the patient is an inpatient in a hospital, the
physical therapist shall be readily and physically available for consultation
to the physical therapist assistant.
(c) Delivery of Care:
1. During the delivery of physical therapy
care by the physical therapist assistant to patients who are not inpatients in
a hospital, or who are not in the acute phase of injury or illness, the
physical therapist shall be accessible at all times by telecommunication and
shall be within the same geographic location as the assistant.
2. The physical therapist shall be readily
available to the physical therapist assistant with emphasis placed on directing
the assistant through frequent reporting, both verbal and written and frequent
observations of the care rendered to the patient.
(d) The physical therapist shall not delegate
portions of the skilled physical therapy functions or tasks to any lesser
trained health personnel than the physical therapist
assistant.
(6) The school
setting. The physical therapist shall keep abreast of special knowledge and
skills implicit in school settings and shall practice in accordance with the
previous stated standards.
(7)
Unlicensed Supportive Personnel may be utilized to help in the treatment being
provided by a licensed physical therapist or licensed physical therapist
assistant. Such personnel shall perform such acts only under the direct
supervision of a physical therapist or physical therapist
assistant.
Notes
Rulemaking Authority 486.025 FS. Law Implemented 456.063, 486.021(5), (6), (9), (10), (11), 486.123, 486.125(1), 486.161(3) FS.
New 8-6-84, Formerly 21M-9.30, Amended 9-22-87, Formerly 21M-9.030, Amended 9-5-90, 3-5-92, 3-24-93, Formerly 21MM-6.001, 61F11-6.001, Amended 8-16-95, Formerly 59Y-6.001, Amended 1-8-98, 1-11-99, 4-18-04, 6-1-09, 2-18-16, 7-4-17, 2-16-21.
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