Objective Three

Direction and Supervision of Physical Therapy Personnel

 A person licensed under the Physical
Therapy Practice Act to engage in the
practice of physical therapy.
Person who is directly responsible for
the actions of the Physical Therapist
Assistant (PTA)
An educated individual who works under
the direction and supervision of a
physical therapist.
Only personnel allowed to assist the PT
with interventions.
Supervision is based on
The PTAs level of experience
Complexity of the tasks
Amount of risk involved
 A qualified PT must at least be accessible by telecommunication to the
PTA at all times while the PTA is treating patients.
A qualified PT must conduct the initial visit for evaluation and establish
the plan of care.
The PT must regularly meet with the PTA regarding patients.
When the PTA is involved with patient care, PT meetings will be arranged:
The PTA can request one for reevaluation of patient or
At least once a month in accordance with the needs of the patient
The visit should include:
On-site re-assessment of the patient
On-site review of the plan of care (revisions or terminations)
Assessment and recommendation for utilization of outside resources
 PTAs may perform physical therapy procedures that have been selected and
delegated by the PT as long as they are in agreement with the PTA licensure.
PTAs can modify a specific treatment procedure following changes in patient
status within the scope of the traditional treatment plan.
PTAs must work under the direction & supervision of the PT in all practice
settings.
When not within the same physical settings, the delegated functions given to
the PTA:
Must be consistent with safe and legal physical therapy practice
Shall be predicated on the following factors:
Complexity and acuity of the patients needs, proximity, and accessibility to the PT
Supervision available in the event of emergencies or critical incidents
Type of setting in which the service is provided
 When supervising a PTA in an off-site setting, the following
requirements must be noted:
General supervision is required (PT must be available by phone).
PT visits must be made at least once a month to:
Reexamine the patient
Review the patients care plan
Evaluate the possible needs of any additional resources
There must be regularly scheduled and documented conferences regarding each
patient.
 Levels of Supervision
Direct
General Direct
Personal
PT is physically
PT (or PTA if allowed
PT is not required to present and
by state) must be
be on site immediately
physically present
available

PT must be available Recommended for Supervision is

at least by PT students and PTA continuous when
telecommunication students directing PT aides
* Utah
 Third-party payers can affect the PTAs ability to participate in certain aspects of
patient care.
If the PTA utilization does not match the requirement set by the third-party
payer, the provider may not receive payment for those services and could be
charged with fraud.
Types of regulations that can be found in the Medicare system:
PTAs providing services to Medicare clients:
Must have graduated from an accredited program.
Must have passed a licensure examination (even if it isnt required by the state they are working in).
A higher level of supervision (direct) for PTAs is required in the private practice setting.
General supervision is required in other setting (supervisory visits required every 30 days).
Students should only be supervised by a PT or a PT/PTA team (also required by APTA).
 PTA must be under the general supervision of a PT (if not in person then the PT
must be available through telecommunications).
The PTA needs to follow the plan of care designed specifically for the patient by
the PT.
PTA may provide physical therapy interventions except for joint mobilization
(advanced mobilizations) and sharp wound debridement.
PT must give care to the patient at least once every tenth visit or every 30 days.
A full-time PT can supervise up to three full-time equivalents supportive
personnel.

*The PTA must remember that his or her scope of work must first be determined by
the states practice act and then polished with the APTA guidelines.
Clynch, Holly M. The Role of the Physical Therapist Assistant: Regulation
and Responsibilities. Philadelphia: F.A. Davis Company, 2017. Print.

Utah Physical Therapy Practice Act

Utah Physical Therapy Practice Act Rule