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Laws, rules and regulations, not Alerts, specify the requirements for practice and violating them constitutes professional misconduct. Not adhering to this Alert may be interpreted as professional misconduct only if the conduct also violates pertinent law, rules and regulations, some citations of which are listed at the end of this Alert.

Alert 4: Supervision of Physical Therapist Assistant

A physical therapist assistant (PTA) is authorized under Education Law to provide patient/client-related activities, as directed by a licensed and currently registered physical therapist (PT).

A PTA is prohibited by section 6738(a) of Education Law from performing evaluation, testing, interpretation, planning or modification of patient/client programs.

A PT conducts the initial evaluation and develops the plan of care, and the treatment may be provided by the PTA.

Generally, supervision of a PTA by a licensed PT must be on-site supervision, but not necessarily direct personal supervision. On-site supervision of a PTA means that the supervising PT is physically present in the same facility and is readily available to the PTA, unless otherwise provided in Education Law. For exceptions to the on-site supervision requirement, see Practice Alert 5.

A licensed PT must not supervise more than four PTAs. This limitation does not apply to hospitals, as long as the PTAs receive adequate supervision by PTs in the best interest of public health and safety. The limitation is also different in certain settings for which special provisions are established for the supervision of PTAs by PTs (see Practice Alert 5).

A PTA under the onsite supervision of a PT may provide treatment to children in early intervention programs.

A physician or other licensed health professional may not provide the supervision required by law of a PTA.

When the supervising PT is not present, due to vacation, illness or other commitments, the PTA may provide care only under the supervision of another PT.

A PT may not delegate to the PTA any activities which are outside the legal scope of practice of the PTA or beyond the competency of the specific PTA. Failure to follow these requirements could result in charges of professional misconduct against the supervising physical therapist and the physical therapist assistant.

Physical therapy treatments are based on an initial evaluation and plan of care determined by a PT. The initial evaluation by the PT should be specific in terms of its description of the patient/client's level of functioning; it should also be specific in outlining long- and short-term goals. PTAs may perform limited measurement procedures, such as range of motion and strength, in order to conduct the treatments assigned to the PTA and may document the results in patient/client charts. PTAs are educated and trained to determine gross functional aspects of range of motion and strength in order to conduct the treatments assigned to them and may perform services within these parameters. Any modification or recommendations regarding a patient/client's treatment must be done by the PT.

PTAs may write progress notes if the notes are limited to a summary of overall treatment and not an evaluation or assessment of the patient/client's progress or a description of the degree to which the patient/client met the treatment goals.

Citations of Pertinent Law, Rules or Regulations:
Education Law, Section 6509 – definition of professional misconduct
Education Law, Section 6738 – definition of physical therapist assistant
Regents Rules, Part 29.1(b)(10) – delegation of professional responsibilities
Regents Rules, Part 29.1(b)(9) – accepting professional responsibilities
Regulations of the Commissioner, Section 77.6 – supervision of PTA