Sec. 10.38.03.02. Standards of Practice

A. Physical Therapists.

(1) The physical therapist who establishes or changes the plan of care shall be ultimately responsible for patient care until another physical therapist:

(a) Provides services to the patient; or

(b) Provides supervision to the treating physical therapist assistant.

(2) The physical therapist shall:

(a) Exercise sound professional judgment in the use of evaluation and treatment procedures;

(b) Provide:

(i) Physical therapy services to not more than an average of three patients per clinical treatment hour per calendar day, excluding group therapy; and

(ii) Each patient with adequate treatment time consistent with accepted standards in delivering physical therapy care;

(c) Provide the patient with accurate information about the physical therapy services provided;

(d) Respect the right of the patient to refuse treatment;

(e) Evaluate the patient and develop a plan of care before the patient is treated;

(f) Work within the physical therapist's competency in physical therapy evaluation and treatment;

(g) Reevaluate the patient as the patient's condition requires, but at least every 30 days, unless the physical therapist, consistent with accepted standards of physical therapy care, documents in the treatment record an appropriate rationale for not reevaluating the patient;

(h) Provide direct supervision of students and aides;

(i) Ascertain and periodically reevaluate the ability of students and aides to perform the assigned duties;

(j) Delegate to the physical therapist assistant only treatment that is within the competency and scope of practice of the physical therapist assistant;

(k) Provide direction and instruction for the physical therapist assistant that is adequate to ensure the safety and welfare of the patient; and

(l) Document ongoing communication with the physical therapist assistant regarding changes in a patient's status and treatment plan.

(3) The physical therapist may:

(a) Enter into an agreement or employment relationship provided that such agreement or relationship does not impede the physical therapist's exercise of independent judgment in the treatment of a patient or cause the physical therapist to practice physical therapy contrary to the Maryland Physical Therapy Act; and

(b) Decline to carry out evaluation or treatment of a patient who has been referred to the physical therapist by a health care practitioner if:

(i) In the physical therapist's judgment, the evaluation or treatment is contraindicated or unjustified; and

(ii) The physical therapist documents the decision in the patient's record.

B. Physical Therapist Assistants.

(1) The physical therapist assistant shall:

(a) Follow the direction and plan of care of the physical therapist in the treatment of a patient;

(b) Exercise sound judgment and adequate care in the performance of duties;

(c) Immediately discontinue any treatment procedure that appears to be harmful to the patient and so notify the supervising physical therapist;

(d) Use only methods and procedures within the scope of the practice of limited physical therapy;

(e) Respect the right of the patient to refuse treatment;

(f) Work within the physical therapist assistant's competency in treatment that is within the scope of practice of limited physical therapy;

(g) Document ongoing communication regarding changes in a patient's status and treatment authorized by the physical therapist; and

(h) Provide the following services:

(i) Treat not more than an average of three patients per clinical treatment hour per calendar day, excluding group therapy; and

(ii) Provide each patient with adequate treatment time consistent with accepted standards in physical therapy care.

(2) The physical therapist assistant may:

(a) Enter into an agreement or employment relationship provided that the agreement or relationship does not impede the physical therapist assistant's exercise of appropriate patient treatment or cause the physical therapist assistant to practice limited physical therapy in violation of the Maryland Physical Therapy Act; and

(b) Participate in the clinical education activities of a physical therapist assistant student if direct supervision of the student is provided by the physical therapist.

(3) The physical therapist assistant may not initiate treatment until:

(a) The patient has been evaluated and the plan of care has been developed by a physical therapist; and

(b) A supervising physical therapist has been assigned to the physical therapist assistant.