Disclaimer: Law, rules and regulations, not Guidelines, specify the requirements for practice and violating them constitutes professional misconduct. Not adhering to this Guideline may be interpreted as professional misconduct only if the conduct also violates pertinent law, rules and regulations.
Guideline 7: Delegation of Tasks
Delegation to Licensed Professionals
- You may delegate physical therapy activities that are within the scope of another licensed professional (e.g., physical therapist assistant or massage therapist), as long as the licensee is competent to perform those activities and as long as the tasks are in accordance with any other statutory requirements for supervision.
- Delegating tasks that are beyond the defined scope or the personal competency of another licensed individual may result in charges of professional misconduct against the professional who delegated the task and against the licensee.
Delegation to Unlicensed Personnel
- You may not delegate to an unlicensed person any tasks included in the scope of practice of physical therapy, even under the direct supervision of a licensed physical therapist. It is unprofessional conduct for a licensee to delegate professional responsibilities when the delegating licensee knows that such a person is not qualified by licensure to perform such responsibilities.
- Unlicensed individuals may perform tasks such as answering phones, preparing paperwork, cleaning equipment, and assisting patients to prepare for treatment. An unlicensed assistant may observe patients performing self-directed exercise protocols, but the licensed physical therapist must evaluate or treat the patient during each session. An unlicensed person may not apply hot and cold packs or place electrodes on a patient. Family members or caregivers may be trained to assist the patient in the performance of self-directed tasks where appropriate (e.g., care at home). Unlicensed persons may act as an extra set of hands for the physical therapist or physical therapist assistant who is actually providing treatment. However, they may not: interpret referrals; perform evaluation procedures; initiate, adjust, or perform treatment programs; or assume responsibilities for planning patient care. The professional judgment of the physical therapist determines what constitutes treatment and the activities that, therefore, may and may not be performed by the unlicensed person.
The exception to this is in a nursing home setting where a certified nurse assistant may perform some tasks that are considered physical therapy treatment. In these settings, the certified nurse assistant is referred to as a physical therapy aide. (See 1996 DOH memo)
- Students fulfilling the clinical portion of a physical therapy or physical therapist assistant education program must be under the on-site but not necessarily direct, personal supervision of a licensed physical therapist. The student must be enrolled in a program conducted in a school of physical therapy approved by the New York State Education Department or in a clinical facility affiliated with the school. Supervision of a PTA student must be by a licensed physical therapist. It must be on-site supervision, but not necessarily direct, personal supervision. A PTA may act as a Clinical Instructor for the PTA student. However, overall responsibility for the supervision of the PTA student rests with the PT.
- Using students, persons on a limited permit or physical therapist assistants to provide treatment may be allowed by New York State law, rule, regulation and policy guidelines. However, there are situations where third party insurers, Medicare and Medicaid, and workers’ compensation may require that only treatment performed by a physical therapist will be reimbursed, even though the treatment may legally be performed by those mentioned. It is important to know the requirements of each insurance carrier.
- Individuals who are licensed in another jurisdiction may conduct clinical seminars for physical therapists without being licensed in New York State. Physical therapists who are licensed in another jurisdiction may attend such programs but may not engage in client-related activities.
Citations of Pertinent Law, Rules or Regulations:
Education Law, Section 6509 - "professional misconduct"
Regents Rule, Part 29.1(b)(10) - "unprofessional conduct"
Education Law, Section 6731 - "practice of physical therapy"
Education Law, Section 6736 - "exempt persons"
Education Law, Section 6741 - "exemption"