The New Patient Who Never Saw the PT
At a busy Omaha outpatient clinic, the owner-physical therapist is covering two buildings and is not on site. A physical therapist assistant (PTA) with 15 years of experience is scheduled to see a new patient, Mr. R, who has acute neck pain and numbness in two fingers. The front desk tells the PTA that the PT 'will sign off tomorrow.' The PTA performs an initial examination, identifies hypomobility, writes a plan of care with cervical traction and strengthening, and treats the patient. The PT later signs the note without changing it. The patient asks whether the PTA is 'the doctor' and whether the plan will be reviewed. The clinic bills the visit as a physical therapy evaluation. The PTA asks whether she can continue the plan for the next two weeks while the PT is away.
1. Identify the legal and regulatory violations in how Mr. R's first visit was handled. Which tasks are nondelegable to a PTA under Nebraska law, and why?
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The core violation is that a PTA performed an initial examination and evaluation and established the plan of care. In Nebraska, the physical therapist must perform the initial examination, evaluation, diagnosis, prognosis, and establish or modify the plan of care. A PTA may provide delegated interventions after the PT has evaluated the patient and set the plan, and must work under the supervision the Board requires. The PT's later signature does not retroactively convert the PTA's evaluation into a PT evaluation; supervision cannot cure a nondelegable act. The clinic also billed a PT evaluation when no PT performed it. The PTA's question about continuing for two weeks highlights the supervision issue: she may continue delegated treatment only within the PT's plan and with the PT available as required, but she cannot independently manage the case or alter the plan.
2. What should the PT have done before the visit, and what corrective steps are required now?
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Before the visit, the PT should have performed the initial evaluation and written the plan, or rescheduled the patient until a PT was available. If the PT could not be on site, another licensed PT should have covered. Now the clinic should stop the PTA from treating under an invalid plan, have a PT perform a proper evaluation, and issue a new plan. The PT should review the patient's status, disclose the staffing issue as appropriate, and correct the record factually. The clinic should also audit similar visits, retrain front desk and clinical staff on scheduling and delegation, and correct any claim submitted for a PT evaluation that did not occur. A self-report to the licensing board may be advisable depending on the facts and the clinic's compliance policy.
3. How should the visit be documented and billed, if at all?
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The record must state who performed each service and what was actually done. It should not describe the PTA's examination as a PT evaluation. The visit cannot be billed as a PT evaluation unless a PT performed the evaluation. If a PTA provided skilled interventions under a valid PT plan, the billing must follow the payer's rules for PTA services and the clinic's supervision requirements. Because the plan itself was invalid, the safest course is to correct or void the claim and not build further claims on the defective visit. Documentation should be amended transparently, not altered to hide the error. The PT remains responsible for the accuracy of the record and the claim.