Current through Register Vol. XLI, No. 50, December 13, 2024
Section 16-1-9 - Supervision of a Physical Therapist Assistant9.1. In all practice settings, the following are required:9.1.1. An initial visit shall be made by a physical therapist for evaluation of the patient and establishment of a plan of care.9.1.2. The physical therapist shall make the final visit to terminate the plan of care unless the patient or physician terminates the plan of care. 9.1.3. No more than 4 physical therapist assistants, physical therapist assistants holding a temporary permit, or physical therapy aides, or any combination thereof, can be supervised by a physical therapist at any one time. 9.1.4. The only exceptions to the level of supervision or supervisory ratio are subsections 9.5 and 9.6, and 9.7 of this section.9.2. Supervision requirements of a physical therapist assistant depend upon the practice setting in which the care is delivered: 9.2.1. When care is delivered in a hospital or other acute-care center, free-standing, outpatient, or independent practice setting, a physical therapist must provide on-site supervision, with the exception that general supervision is permitted in a hospital or other acute-care center, free-standing, outpatient, or independent practice setting 40% of the time once the physical therapist assistant performing treatment has at least 1000 hours of experience. The supervising physical therapists shall document when general supervision is utilized under this subdivision. 9.2.2. General supervision may be utilized when care is delivered in a skilled/unskilled nursing facility, distinct part skilled/unskilled nursing unit or swing-bed unit in an acute-care hospital, home health, or school system setting, and when providing telehealth services, and the following requirements must be observed and documented in the patient records when general supervision is used: 9.2.2.a. A physical therapist must be accessible by telecommunications to the physical therapist assistant at all times that the physical therapist assistant is treating patients; and available to make a joint onsite visit or telehealth session with the physical therapist assistant within 24 hours as prudent practice indicates.9.2.2.b. The physical therapist must visit the patient at least once every 10 physical therapist assistant visits, or within 30 calendar days, whichever occurs first. 9.2.2.c. In the event that the supervising physical therapist changes, the new supervising physical therapist must discuss the patient's diagnosis and plan of care with the previous supervising physical therapist before the next physical therapist assistant visit or telehealth session is made. Either physical therapist must document such communication.9.3. When the physical therapist and the physical therapist assistant are not within the same physical setting, the performance of the delegated functions by the physical therapist assistant must be consistent with safe and legal physical therapy practice as set forth in W. Va. Code § 30-20-1, et. seq., accompanying legislative rules and regulations, and established policies of the Board. Said performance shall be predicated on the following factors: 9.3.1. Complexity and activity of the patient's needs; 9.3.2. Proximity and accessibility to the physical therapist;9.3.3. Supervision available in the event of emergencies or critical events; and9.3.4. Type of setting in which the service is rendered. 9.4. The physical therapist assistant may not perform the following physical therapy activities: 9.4.1. Interpretation of referrals; 9.4.2. Physical therapy initial evaluation and re-evaluation; 9.4.3. Identification, determination, or modification of plans of care (including goals and treatment programs);9.4.4. Final discharge assessment/evaluation or establishment of the discharge plan; or 9.4.5. Therapeutic techniques beyond the education, skill, and knowledge of the physical therapist assistant. 9.5. In an emergency situation, such as serious illness or injury of the therapist or therapist's family member or death of a family member, which causes the unanticipated absence of the supervising physical therapist for not more than three consecutive days, and no more than 12 days per calendar year, a licensed physical therapist assistant may continue to render services, under the supervision of another physical therapist, to only those patients for which the licensed 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. When this provision is utilized, the ratio in subdivision 9.1.3. may be exceeded, and the physical therapist shall document the dates and the emergency situation. 9.6. In a temporary situation, which causes the absence of the supervising physical therapist up to one day, and no more than 80 hours in a calendar year, a licensed physical therapist assistant may continue to render services, under general supervision of the supervising physical therapist, to only those patients for which the licensed 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 the supervising physical therapist is absent. When this provision is utilized, the level of supervision in subdivision 9.2.1. may be exceeded, and the physical therapist shall document the hours, date, and temporary situation. 9.7. A physical therapist assistant shall directly supervise a physical therapy aide only in emergency situations necessary to assure patient's safety.