Arizona Jurisprudence – PT – Flashcards
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"On-Site Supervision"
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•On sitting is present in the facility or on the campus (the facility and adjacent buildings) where assistive personnel or a holder of an interim permit is performing services. •The Pt shall be immediately available to assist •Maintains continued involvement in appropriate aspects of each treatment session in which a component of treatment is delegated
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"General Supervision"
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Supervising PT is on call and is readily available via telecom when PTA is providing treatment
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When can an aide or other assistive personnel (not a PTA) perform designated routine tasks?
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Only under the on-site supervision of a Lic. PT who is present in the facility
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What is the required level of supervision for an Interim permit holder?
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On-site supervision from a LICENSED PT
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What is the required level of supervision for a PT student or a PTA student
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On-site supervision from a LICENSED PT
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At d/c what is required of a PT? -2 aspects
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•Documentation of discharge •Response to therapeutic interventions at the time of d/c
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Who's responsibility is it to verify the qualifications of a PTA and other assistive personnel under the PTs direction and supervision?
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The supervising PT
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In most usual situations, Is a co-signature required (from supervising PT) in a PTA note
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N0, a PTA note need not be co-signed by the supervising PT
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Does injury need to occur in order for disciplinary action to be taken?
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No. Disciplinary action can be taken regardless of whether actual injury to the patient is established
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What would restrict the board's ability to forgo suspension and permit a licensee to participate instead in a substance recovery program
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•A felony conviction related to a controlled substance
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Requirements regarding displaying your license
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•a copy of the license and current renewal verification should be placed in a location accessible to public view at the licensee's place of practice •If this is not an option, then at the very least the licensee MUST produce that documentation on request
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What is the "compliance period"
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two-year license renewal cycle ending 8/31 of even numbered years
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How many hours must an interim permit holder be under onsite supervision?
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at least 500
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What must the PT, by law, provide the referring practitioner (if any)
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info from the patient assessment, diagnosis, POC within 1 week after initial evaluation •In writing and place a copy of the written notice in the patient's records OR •Orally and place a contemporaneously made note of the verbal communication in the patient's record
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How many assistive personnel can a PT supervise at any given time?
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no more than 3
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What must a PT consider when supervising the max number of assistive personnel?
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•At least 1 of the assistive personnel is a PTA •No more than 2 of the assistive personnel are PTAs performing selected treatment interventions under General Supervision •Assistive personnel, other than a PTA, perform a physical therapy task only under the Onsite Supervision of a physical therapist
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Before delegating performance of a selected treatment intervention to a PTA working under GENERAL SUPERVISION, the supervising PT must ensure that the PTA....
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•Is certified (in accordance with AZ law) •Has completed 2,000 hours of experience as a PTA working with patients under Onsite Supervision
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What must the supervising PT do before delegating performance of a selected physical therapy intervention or physical therapy task to assistive personnel working under GENERAL SUPERVISION or ONSITE SUPERVISION?
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Assess the education or training to perform the selected physical therapy intervention or physical therapy task in a safe, effective and efficient manner
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What is the expectation of a PTs response to a PTA under General Supervision?
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•PT responds to a communication from the PTA within 15 minutes •Go to the location at which and on the same day that the PTA provides a selected treatment intervention if the PT, after consultation with the PTA determines that going to the location is in the best interest of the patient
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How often must a PT complete a re-evaluation for a patient being seen by a PTA under General Supervision
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Every 4th visit OR every 30 days Whichever occurs first •At which point the PT will provide each therapeutic intervention for the patient (?)
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What must a PTA (who provides selected treatment interventions) under General Supervision document in the patient record?
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•Name and license number of the supervising PT •Weather the PTA consulted the supervising PT during the course of the selected treatment intervention and if so the subject of the consultation and any decisions made •This is along with all the other stuff (e.g. date, patient name, etc.)
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Is a co-sign needed for an entry made into the medical record made by someone besides the PTA and PT?
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Yes. Any entry made in the patient's medical record by someone other than the PT or PTA needs to be co-signed by the supervising PT
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Each entry into the medical record must meet the minimum requirement of a...b...c...
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a)legible b)accurately dated signed with name and legal designation
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What to do about erroneous information in the medical record
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The error is corrected in a manner that allows the erroneous error to be legible. Corrected information is dated and initialed
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Initial evaluation must document...
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1. Patient's reason for seeking PT services 2. relevant medical diagnoses or conditions 3. The patient's signs and symptoms 4. Objective data from tests and measures 5. PT's interpretations of the results of the exam 6. Clinical rationale for therapeutic interpretations 7. POC that includes proposed therapeutic interventions, measurable goals, frequency and duration of therapeutic interventions 8. Patient's prognosis
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Therapeutic intervention notes must include...
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1. Patient's subjective report of current status or response to therapeutic interventions 2. Therapeutic interventions provided or appropriately supervised 3. Objective data from tests and measures if completed 4. Instructions provided to the patient 5. Any changes to POC
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When is a PT required to perform a Re-evaluation ?
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1. When a patient fails to progress as expected 2. progresses sufficiently to warrant a change in the plan of care 3. every 4th visit/30 days
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What must be documented in a Re-Eval
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1. Patient's subjective report of current status or response to therapeutic interventions 2. Assessment of the patient's progress 3. The patient's current functional status 4. Objective data from tests and measures, if collected 5. Rationale for continuing therapeutic interventions 6. Any changes in the POC
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What qualifies as a Discharge summery, if completed in acute-care hospital?
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Final Therapeutic intervention note on the last date that a therapeutic intervention is provided constitutes documentation of the conclusion of care if the entry is made by a physical therapist
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If care is NOT provided in an acute-care hospital or if a physical therapist does not provide the therapeutic intervention of the last date it is provided, A PT must document the following...
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1. The Date of termination of treatment 2. Reason that therapeutic intervention terminated 3. Inclusive dates for the episode of care being terminated 4. Total number of days on which therapeutic intervention was provided during the episode of care 5. Patient's current functional status 6. Patient's progress toward achieving the goals in the POC 7. Recommended d/c plan
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What must be done if a referring practitioner is deriving direct OR indirect compensation from the referral?
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Before conducting an evaluation or initiating physical therapy, the licensee shall ensure that the disclosure is in writing and states "I am required by law to inform you in writing that your referring physician [or specify if different from a physician] derives either direct or indirect compensation related to your physical therapy."
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Mandatory Reporting Requirements (applying to Applicants, Licensees or certificate holders)
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Charge (not just conviction) with a misdemeanor involving conduct that may affect patient safety or a felony shall provide written notice of the charge to the Board within 10 working days after the charge is filed ****An applicant/Licensee/Certificate holder may request a list of reportable misdemeanors from the Board
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Continuing Competence Requirements for Renewal
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A licensed PT shall earn 20 contact hours of continuing competence activities for each compliance period to be eligible for renewal of license
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When does the continuing competence compliance periods for a licensee begin
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September 1st following the issuance of an initial license or license renewal and ends Aug 31st OF EVEN numbered years
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The following are not eligible for continuing competence credit
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1. A regularly scheduled educational opportunity provided within institution, such as rounds or case conference 2. staff meetings 3. A publication or presentation by a licensee to a lay or non-professional group 4. Routine teaching of personnel, students or staff as part of a job requirement
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What is the designation for graduates of physical therapy education, not yet licensed?
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They are considered Assistive Personnel (others include PTA, PT aides and other assistive personnel who are trained or educated health care providers and whoa ten to physical therapist assistances or physical therapy aides but who perform specific designated tasks related to physical therapy under the supervision of a physical therapist)
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How does one determine what is appropriate for Assistive Personnel, including graduates of PT programs not yet licensed?
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The supervising physical therapist determines what acts, tasks and procedures will be delegated to assistive personnel, including graduates
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Can a Graduate of a PT program delegate to assistive personnel?
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NO. Only licensed PTs can do this
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How does a student PT designate themselves?
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SPT is NOT recognized in Arizona. Graduates must designate the graduate's employment status as assistive personnel in any documentation. Any notes must be c0-signed by supervising PT
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Summary of responsibilities of the supervising Physical Therapist
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•Verifying qualifications of the PTA, PT aides and other assistive personnel •Knowing the education, training and skill level of the physical therapist assistants, aides and other assistive personnel •For each patient on each date of service, determining when selected acts, tasks or procedures may be delegated to assistive personnel to ensure that the care provided is safe, effective and efficient •Ensuring that delegated tasks do not exceed the education and training of the assistive personnel •Documenting the clinical rationale for utilizing assistive personnel and delegating selected acts, tasks, or procedures to assistive personnel
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A physical Therapist must provide on-site Supervision for the following:
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1. Interim Permit Holders 2. PT students 3. PTA students 4.PT aides/technicians/"techs"
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The PT is exclusively responsible for performing and documenting...
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1. The initial eval 2. Periodic re-eval 3. All of the therapeutic interventions that requires the PT's expertise 4. Accurate documentation and billing of the services provided 5. d/c of each patient, including the response to treatment at the time of d/c
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What is (and is not) an interim permit holder?
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•It is NOT just a temporary license to practice (PT or PTA) •it is NOT an unrestricted license to practice(PT or PTA) •It is a permit issued by the AZBPT that allows a person to practice as a PT or to work as a PTA for a specific period of time under the conditions prescribed by the Board before the person is issued a license or certificate •Under most conditions issued to foreign educated PT applicants •Also given to PT applicants who have not held a license for more than 3 consecutive years for purposes of determining the applicant's competence
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How many contact hours and in what period are required for renewal of PT licensure
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•20 contact hours of continuing competence •During 2 year licensure period
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How many contact hours need to be from Category A
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10 of the 20
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How many of the contact hours from Category A can be from non-clincal coursework
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No more than 5 of the 10
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What is the modified requirement for a PT that is issued a PT license for less than a year (due to time of application, for example)?
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If the license was granted for less than a year then the PT shall have only a 10 contact hour requirement to fulfill in order to renew ****ALL MUST BE FROM CATEGORY A
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What components make up an "adequate patient record"
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1. Legible 2. Eval of
