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RULE §322.2Role Delineation

(a) The role of the PT.

  (1) The PT holds primary responsibility for physical therapy care rendered under his supervision.

  (2) The PT's professional responsibilities include, but are not limited to:

    (A) Performance and documentation of the initial physical therapy examination and evaluation of the patient;

    (B) Interpretation of the practitioner's referral;

    (C) Development and documentation of a plan of care;

    (D) Implementation of, or directing implementation of, the plan of care;

    (E) Delegation of tasks to appropriate personnel;

    (F) Direction and supervision of the PTA and physical therapy aide;

    (G) Completion and accuracy of the patient's physical therapy record;

    (H) Performance and documentation of the reexamination and reevaluation of the patient as described in this section; and when necessary, modification of the plan of care;

    (I) Discharge of a patient or discontinuation of treatment;

    (J) Development of any follow-up plan for the patient; and

    (K) Collaboration with members of the health care team when appropriate.

  (3) The PT shall not implement any plan of care that, in his judgment, is contraindicated.

(b) The role of the PTA.

  (1) A PTA may provide physical therapy services only under the supervision of a PT (See §322.3 of this title (relating to Supervision)).

  (2) A PTA may be assigned responsibilities by a supervising PT to:

    (A) screen patients designated by a PT as possible candidates for physical therapy services (See §322.1(b) of this title (relating to Evaluation and screening));

    (B) provide physical therapy services as specified in the physical therapy plan of care (See §322.1(c) of this title (relating to Physical therapy plan of care development and implementation)) which may include but are not limited to:

      (i) preparing patients, treatment areas, and equipment;

      (ii) implementing treatment programs that include therapeutic exercises; gait training and techniques; ADL training techniques; administration of therapeutic heat and cold; administration of ultrasound; administration of therapeutic electric current; administration of ultraviolet; application of traction; performance of intermittent venous compression; application of external bandages, dressings, and support; performance of goniometric measurement;

      (iii) modifying treatment techniques as indicated in the plan of care;

    (C) respond to acute changes in physiological state;

    (D) teach other health care providers, patients, and families to perform selected treatment procedures and functional activities; and

    (E) identify architectural barriers and report them to the PT.

  (3) The PTA may not:

    (A) specify and/or perform definitive (decisive, conclusive, final) evaluative and assessment procedures;

    (B) alter a plan of care or goals;

    (C) recommend wheelchairs, orthoses, prostheses, other assistive devices, or alterations to architectural barriers to persons;

    (D) sign progress notes which design or modify the plan of care.

(c) The role of the physical therapy aide.

  (1) All rules governing the services provided by a PTA are further modified for the physical therapy aide.

  (2) A physical therapy aide may be assigned responsibilities by the supervising PT or PTA to provide services as specified in the physical therapy plan of care within the scope of on-the-job training with supervision by a PT or PTA who is on the premises and readily available to respond in person.

  (3) A physical therapy aide may not:

    (A) perform any evaluative or assessment activities;

    (B) initiate physical therapy treatment, to include exercise instruction; or

    (C) write or sign physical therapy documents in the permanent record, except as provided for in §322.1(e) of this title (relating to Documentation of treatment).

Source Note: The provisions of this §322.2 adopted to be effective April 15, 1999, 24 TexReg 2935; amended to be effective December 29, 2002, 27 TexReg 12214; amended to be effective April 4, 2011, 36 TexReg 2126

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