NH PT Juris cheat sheet

Physical therapy is defined as the evaluation, treatment, and prevention of disability, injury, and pain through physical or mechanical means, including exercise, manual therapy, modalities, and instruction in functional activities.

Physical therapist means a person licensed under the New Hampshire Physical Therapy Practice Act to practice physical therapy; a physical therapist assistant may practice only under the supervision of a licensed physical therapist and may not perform evaluation, diagnosis, prognosis, or modification of the plan of care.

Scope includes examination, evaluation, diagnosis, prognosis, and intervention for impairments, functional limitations, and disabilities, plus consultation, education, and screening; it excludes surgery, prescription of drugs, and diagnosis of disease except as it relates to physical therapy.

Licensure requires graduation from an accredited physical therapy or physical therapist assistant program, successful completion of the national examination (NPTE), and submission of an application with the required fee to the board.

The board may issue a license by endorsement to an applicant licensed in another jurisdiction who meets equivalent requirements and is in good standing; criminal history record checks and jurisprudence requirements may apply.

A license must be renewed on the schedule set by the board; practicing on an expired or lapsed license is unlawful, and late renewal may require a reinstatement fee or additional review.

Temporary or provisional permits may allow limited practice under supervision while an application is pending, subject to board rules on duration and supervision.

Unlicensed practice and aiding unlicensed practice are grounds for discipline, and a licensee must report known unlicensed practice to the board.

Use of the titles physical therapist, PT, physical therapist assistant, and PTA is restricted to licensees; misrepresentation of credentials is a violation.

The physical therapist retains responsibility for the plan of care and for all care delegated; delegation must consider the complexity of the patient, the assistant's competence, and the predictability of outcomes.

Supervision levels: direct supervision means the supervising therapist is physically present and immediately available; general supervision means the therapist is available by telecommunication and the assistant has access for consultation.

A physical therapist assistant may perform selected interventions and progress patients within the established plan of care but may not perform initial evaluation, interpret findings independently, establish a diagnosis or prognosis, or discharge the patient.

Support personnel such as physical therapy aides perform non-skilled tasks (transport, setup, clerical) and may not provide skilled interventions or treatment procedures; they work under the supervising therapist or assistant.

A physical therapist must be accessible to the assistant for consultation during treatment; the frequency of on-site supervision and re-evaluation is governed by the plan of care and board rules.

Delegation to a student or intern requires the supervising therapist to be responsible for the care; the student may not practice independently or be substituted for licensed staff.

The therapist must re-examine the patient when there is a change in condition, a failure to progress, or new clinical findings, and must document the revised plan.

Supervision of multiple assistants and support staff must not compromise patient safety; the therapist must ensure adequate oversight consistent with each patient's needs.

A therapist who delegates must verify the assistant's licensure status; assigning skilled care to an unlicensed person is a violation.

New Hampshire permits limited direct access: a physical therapist may examine and treat a patient without a physician referral, subject to the conditions and limits set by the Practice Act and board rules.

The initial examination includes history, systems review, and tests and measures to establish a diagnosis, prognosis, and plan of care; findings must be documented.

A therapist must refer the patient to an appropriate health care provider when findings suggest a condition outside the scope of physical therapy, when the condition fails to improve, or when the patient's status worsens.

Direct access does not expand scope; the therapist may not order imaging, prescribe medication, or diagnose medical disease beyond the physical therapy diagnosis.

Screening for red flags and contraindications is required before intervention; treatment may not proceed when findings indicate a need for medical evaluation.

Referral requirements for specific settings (e.g., workers' compensation, school-based services, and insurance networks) may be stricter than the Practice Act and must be verified.

The therapist must obtain and document informed consent for examination and intervention, including the patient's right to refuse or withdraw.

Patient education about the plan of care, expected outcomes, and alternatives is part of the examination and intervention process.

If a patient presents with a condition requiring a referral, the therapist documents the referral and the rationale in the record.

Documentation must be timely, accurate, legible, and sufficient to identify the patient, the date and type of service, the clinical findings, the intervention, the patient's response, and the plan.

Records are the property of the practice or facility, but the patient has a right to access and obtain copies, subject to applicable law and reasonable fees.

Informed consent requires disclosure of the nature of the intervention, risks and benefits, alternatives, and the right to refuse; consent must be documented and may be withdrawn at any time.

Protected health information may be disclosed only with patient authorization or as required or permitted by law, such as for treatment, payment, operations, or mandatory reporting.

Minimum necessary disclosure and reasonable safeguards apply; discussing identifiable patient information in public areas or with unauthorized persons is a breach.

Corrections to records must be made by addendum or clearly marked correction, not by alteration or deletion of the original entry; falsification is a disciplinary offense.

Patient rights include privacy, dignity, freedom from abuse and exploitation, participation in care decisions, and access to information about the therapist and the plan of care.

Electronic records must be secured and access controlled; sharing passwords or leaving records unsecured is a confidentiality violation.

Retention and release of records must follow state and federal requirements, including responding to lawful subpoenas and court orders.

Licensees must practice within their competence and scope, maintain professional boundaries, and avoid dual or exploitative relationships with patients and their families.

Sexual contact or romantic involvement with a current patient is prohibited and is grounds for discipline; a specified period after termination of the professional relationship may also be restricted.

Accepting gifts, loans, or financial arrangements that exploit the patient relationship is prohibited; fee arrangements must be transparent and disclosed.

Mandatory reporting: a licensee must report suspected child abuse or neglect, abuse or neglect of vulnerable adults, and known unlicensed practice or serious misconduct by another licensee to the appropriate authority.

Reports must be made in good faith and within the time required by law; failure to report is itself a violation subject to discipline.

Ethical obligations include honesty in billing and documentation, avoiding conflicts of interest, and not misrepresenting credentials or outcomes.

Impairment from substance use or a health condition that affects practice must be addressed; licensees may have a duty to report an impaired colleague who poses a risk to patients.

Advertising must be truthful and not misleading; claims of specialization or superior outcomes require substantiation.

Patient abandonment, refusing to treat based on protected characteristics, and practicing while impaired are unprofessional conduct.

The board regulates licensure, sets standards of practice, investigates complaints, and imposes discipline; it is composed of members appointed as provided by statute, including physical therapist and public members.

A complaint may be filed by a patient, employer, colleague, or member of the public; the board reviews the complaint, may conduct an investigation, and may dismiss, settle, or proceed to a hearing.

Disciplinary actions include reprimand, probation with conditions, suspension, revocation, civil penalties, and required remediation or education.

Due process applies: the licensee is entitled to notice of the charges, an opportunity to respond, and a hearing with the right to counsel.

Grounds for discipline include unprofessional conduct, practicing beyond scope, fraud or deception, impairment, failure to report, and violation of board orders.

Continuing competence: licensees must complete the continuing education required for renewal, which typically includes jurisprudence and ethics hours and documented professional development.

Licensees must maintain records of continuing education for the period required by the board and submit them on audit or request.

Failure to complete continuing education requirements may result in a lapsed license, a conditional renewal, or disciplinary action.

Board actions may be reported to national databases and other jurisdictions; licensees must disclose disciplinary history on renewal and endorsement applications.