Supervision, Delegation, and Use of Physical Therapist Assistants and Aides
Who may do what
The PT is responsible for the episode of care: examination, evaluation, diagnosis, prognosis, plan of care, and discharge. The PTA is licensed to perform selected interventions and collect data under the PT's plan. The aide is unlicensed and may perform only non-skilled support tasks-cleaning, transport, clerical work-not skilled treatment.
Supervision rules
Oregon uses supervision standards set by statute and Board rule. The PT must be available for consultation and must provide the level of supervision required for the patient and the intervention. The PT must perform the initial evaluation and periodic re-evaluation; the PTA cannot alter the plan. Delegation must be patient-specific and documented.
Worked example
A PT evaluates a stroke patient, sets goals, and delegates gait training to a PTA. The PTA notices new foot drop and a change in safety. The PTA does not change the plan; the PTA stops, documents, and contacts the PT. The PT re-examines and revises the plan. That sequence protects the patient and satisfies supervision duties.
Traps
Letting a PTA do the initial evaluation or discharge is a common exam error. An aide applying a hot pack or leading exercise is not assisting-it is unlicensed skilled care. The PT being reachable by phone is not always enough; the rule may require on-site or direct supervision for particular interventions. Document delegation, not just the treatment.