Supervision and Delegation to PTAs and Support Personnel
Supervision and Delegation to PTAs and Support Personnel
This domain tests who may delegate what, how much supervision is required, and who remains accountable.
Core rules
- The PT retains responsibility for the patient’s care, the plan, and the outcome. Supervision is not a transfer of liability.
- PTA supervision must be adequate for the patient and task. The PT must be available for consultation and must see the patient as required by the plan and Board rule. Complex or unstable patients need closer oversight.
- Only tasks within the PTA’s education and statutory scope may be delegated. Evaluation, plan development, plan modification beyond delegated parameters, and discharge planning remain PT functions.
- Support personnel may do non-skilled tasks. They cannot apply skilled modalities, instruct therapeutic exercise as a skilled intervention, or document skilled care as if they were a PTA.
- The PT should verify credentials and provide instruction, especially for new staff or high-risk patients.
Worked example
A PT owns two clinics and leaves an aide alone with a postoperative patient while the PTA is at the other site. The aide applies electrical stimulation and teaches exercises. Reasoning: the aide is performing skilled PT and the PT is not providing required supervision. The PTA also cannot be stretched across sites if that defeats supervision. Correct action: schedule a qualified PTA or PT, or have the PT remain on site.
Traps
“General supervision” does not mean no availability. A PTA’s experience does not permit independent evaluation. Do not let an aide document “treatment” that only a PT or PTA may provide.