(b)

1. (1) The practice of licensed physical therapy assistants shall be performed under the supervision of the licensed physical therapist.

2. (2) The supervising therapist shall be readily available for consultations, evaluations, and establishment of each program prior to:

   1. (A) Delegation of any treatments; and
   2. (B) Determination of patient discharge.

(c)

1. (1) If physical therapy services are rendered by an individual who does not meet at least the assistant-level qualifications (aide/technician), a qualified physical therapist shall be on the premises and immediately available to provide assistance and direction throughout the time the services are rendered.
2. (2) Physical therapy services shall be provided under the direction of a physician member of the medical staff.

3. (3)

   1. (A) Physical therapy services shall be supervised by a physical therapist licensed by the board.
   2. (B) Physical therapy assistants and aides shall comply with all state licensure requirements.

4. (4)

   1. (A) A policy and procedure manual for physical therapy shall be developed.
   2. (B) The manual shall have evidence of ongoing review and/or revision.
   3. (C) The first page of each manual shall have the:

(i) Annual review date; and

1. (ii) Signature of the department supervisor and/or person or persons conducting the review.

2. (5) There shall be written policies and procedures that shall include:

   1. (A) Job descriptions for each type of employee;
   2. (B) Infection prevention and control measures;
   3. (C) Standards of care;
   4. (D) Criteria for ensuring continuous communication of the patient’s therapy and progress to the physician;
   5. (E) Assembly and operation of equipment;
   6. (F) Physical therapy services provided and a list of services made available to the medical staff;

   7. (G)

      1. (i) Documentation specifying who may perform special procedures and give patient instruction.
      2. (ii) This shall be verified by the physician director;
   8. (H) Safety practices;
   9. (I) Orientation practices for new employees; and
   10. (J) Cleaning, disinfecting, and sterilizing procedures.
3. (6) There shall be an adequate supply of reference material for the physical therapist that shall include current literature.
4. (7) All physical therapy prescriptions/work requests shall be authorized by a written and signed physician’s order.

5. (8)

   1. (A) Equipment shall be:

      1. (i) Adequate for the services offered; and
      2. (ii) Maintained in good repair.
   2. (B) Equipment shall be serviced, calibrated, and operated according to the manufacturer’s directions.
   3. (C) All physical therapy equipment shall be under the control of the physical therapy supervisor.

   4. (D) A preventive maintenance program shall be implemented with:

      1. (i) Periodic inspection of all equipment; and
      2. (ii) Appropriate records maintained for the life of each piece of equipment.
   5. (E) All temperature-dependent patient use equipment shall have the temperature checked and recorded before each patient use or at least daily, if used, to ensure patient safety.

6. (9) Physical therapy records for each patient shall include:

   1. (A) Current written plan of care;
   2. (B) Statement of treatment objectives;
   3. (C) Statement of patient’s short-term and long-term rehabilitation potential;
   4. (D) Functional limitations;
   5. (E) Justification of continued rehabilitative care; and
   6. (F) Documentation of daily treatments.

7. (10)

   1. (A) Clinically relevant educational programs shall be conducted on a regularly scheduled interval not less than twelve (12) times per year.

   2. (B) There shall be evidence of:

      1. (i) Program dates;
      2. (ii) Attendance; and
      3. (iii) Subject matter.
8. (11) All physical therapy personnel who participate in direct patient care shall be competent in life support measures.
9. (12) There shall be an ongoing QA/PI program.
10. (13) Hospitals that have swimming pools shall comply with applicable sections of the Department of Health Rules Pertaining to Swimming Pools and Other Related Facilities, 20 CAR pt. 136.
11. (14) Contracted physical therapy services shall be under current agreement and the contractor shall fulfill all requirements of this section.