Wyo. Code R. 062-0001-7
Physical Therapy, Board of
Chapter 7: Standards of Practice In Supervision of Support Personnel
Effective Date: 04/06/2010 to 01/25/2016
Rule Type: Superceded Rules & Regulations
Reference Number: 062.0001.7.04062010
Section 1. Delegation of responsibility. When a physical therapist delegates patient care responsibilities to physical therapist assistants or other supportive personnel, the physical therapist holds responsibility for supervision of the physical therapy program. Physical therapists shall not delegate to a less qualified person any activity that requires the unique skills, knowledge, and judgment of the physical therapist. The primary responsibility for physical therapy care rendered by supportive personnel rests with the supervising physical therapist. Adequate supervision requires, at a minimum, that the supervising physical therapist perform the following activities:
Section 2. Physical therapist assistants. The physical therapist assistant shall perform specific physical therapy duties under the supervision of a physical therapist who is properly credentialed in the jurisdiction in which the physical therapist assistant practices.
(a) Performance of service in general.
(iii) The physical therapist assistant may interpret data only within the scope of the physical therapist assistant's education. (iv) The physical therapist assistant may respond to inquiries regarding a patient's status to appropriate parties within the protocol established by the supervising physical therapist. (v) The physical therapist assistant shall refer inquiries regarding patient prognosis to a supervising physical therapist. (vi) Documentation other than the initial note and the discharge summary can be written by a physical therapist assistant. (vii) Supervision of physical therapist assistants is divided into three (3) levels
(A) Entry level physical therapist assistant (working on initial skill development or entering new practice). Close supervision by the physical therapist which means daily direct contact at the site of work. (B) Intermediate physical therapist assistant (working on increased skill development and mastery of basic role functions and demonstrates ability to respond to situations based on previous experience). Routine supervision by a physical therapist is recommended which means direct contact at the site of work, with interim supervision occurring by telecommunication. (C) Advanced level physical therapist assistant (refining specialized skills with a better understanding of complex issues). General supervision is recommended with interim supervision available as needed.
(b) Service in home health, long-term care, and school settings.
(i) A qualified physical therapist must be accessible by telecommunication to the physical therapist assistant at all times while the physical therapist assistant is treating the patient. (ii) An initial visit must be made by a qualified physical therapist for evaluation of the patient and establishment of a plan of care. (iii) A joint visit by the physical therapist and physical therapist assistant or a conference between the physical therapist and physical therapist assistant must be made prior to or on the first physical therapist assistant visit to the patient. The physical therapist must complete the initial evaluation. (iv) At least once every thirty (30) calendar days the physical therapist must visit the patient. Following each onsite visit by a physical therapist, the medical/education record must reflect a documented conference with the physical therapist assistant outlining treatment goals and program modification. The physical therapist must make the final visit to terminate the plan of care.
(v) A supervisory onsite visit must include:
(A) An onsite functional assessment.
(B) Review of activities with appropriate revisions or termination of plan of care.
(C) Assessment of utilization of outside resources.
(c) Service in hospitals, outpatient or other clinical settings.
(i) When components of a patient's treatment are delegated to a physical therapist assistant, a physical therapist must provide on-site observation of the treatment and documentation of its appropriateness at least every six (6) treatment sessions or two (2) weeks, whichever comes first. At other times the physical therapist is not required to be on-site, but must be easily available by telecommunications.
Section 3. Physical therapy aides. The physical therapy aide may assist the physical therapist in the following activities:
Section 4. Supervision ratios. A physical therapist, at any one time, may supervise a maximum of three (3) physical therapy personnel if no more than two (2) are physical therapist assistants. A physical therapist assistant may supervise no more than one (1) physical therapy aide.
Section 5. Physical therapy personnel identification. All physical therapy personnel shall wear an identification badge identifying them as a physical therapist, physical therapist assistant or physical therapy aide. Supportive personnel shall not use any term that implies they are licensed physical therapists.