§ 40.53. Nondelegable activities; accountability.
(a) A physical therapist may delegate to a physical therapist assistant or supportive personnel that which he is educated to perform subject to the limitations in this section.
(b) A physical therapist may not assign or delegate to physical therapist assistants or supportive personnel functions which require the formal education or training and the skill and knowledge of a licensed physical therapist, including the following functions:
(1) Interpretation of referrals.
(2) Initial patient contact and initial evaluation or reevaluation.
(3) Determination or modification of a patient plan of care.
(4) Final discharge assessment/evaluation or establishment of discharge plan.
(5) Therapeutic techniques and procedures beyond the skill and knowledge of the physical therapist assistant.
(6) Duties, the delegation of which is inconsistent with minimum standards of acceptable physical therapy practice embraced by the physical therapy community in this Commonwealth.
(7) Mobilization. Mobilization is defined as a group of techniques comprising a continuum of skilled passive movements to the joints or related soft tissues, or both, throughout the normal physiological range of motion that are applied at varying speeds and amplitudes, without limitation.
(8) The performance of consultations.
(c) A physical therapist may not assign or delegate to supportive personnel activities which require the formal education or training and skill and knowledge of a licensed physical therapist or registered physical therapist assistant.
(d) When patient-care services are provided by the physical therapist assistant, the physical therapist shall document reevaluations and adjustments to a patient plan of care and goals at least every 30 calendar days or when there is a significant change in patient status warranting an earlier patient evaluation.
(e) A physical therapist may not assign or delegate to a physical therapist assistant or supportive personnel screenings to determine the need for the following:
(1) Primary, secondary or tertiary services.
(2) Further examination or intervention.
(3) Consultation by a physical therapist.
(4) Referral to another health care practitioner.
(f) For purposes of this section, screening is defined as determining the need for further examination or intervention, or both, by a physical therapist or for referral to another health professional.
Authority The provisions of this § 40.53 amended under sections 3(a), 6(d.1), 8(b), 9.1, 9.2 and 11(a)(6) of the Physical Therapy Practice Act (63 P. S. § § 1303(a), 1306(d.1), 1308(b), 1309.1, 1309.2 and 1311(a)(6)); and section 812.1 of The Administrative Code of 1929 (71 P. S. § 279.3a).
Source The provisions of this § 40.53 adopted May 4, 1990, effective May 5, 1990, 20 Pa.B. 2437; amended July 24, 1992, effective July 25, 1992, 22 Pa.B. 3872; amended August 27, 2004, effective August 28, 2004, 34 Pa.B. 4697; amended December 21, 2012, effective December 22, 2012, 42 Pa.B. 7652. Immediately preceding text appears at serial pages (322366), (336901) and (336903).
Notes of Decisions Insurance Coverage
The Pennsylvania Motor Vehicle Financial Responsibility Law obligated the insuror to pay for physical therapy treatments provided by a trained but unlicensed technician operating under the general supervision of a physician, notwithstanding the ‘nondelegable’ nature of the duties of a physical therapist pursuant to this section. Nelson v. Nationwide Mutual Insurance Co., 36 Pa. D & C 4th 1 (1998).
Cross References This section cited in 49 Pa. Code § 40.52 (relating to unprofessional conduct; physical therapists).
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