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.

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. History–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.