Physical Therapy Regulations and Responsibilities, Exams of Nursing

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California Jurisprudence Exam:

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Define Physical Therapy - Answer The practice of PT includes the promotion and maintenance of physical fitness through the use of physical therapy intervention in order to enhance the bodily movement as related to the health and wellness of individuals Define PTOR - Answer Physical therapist that completed the initial evaluation -The Pt can be transferred to another PT, but it must be in WRITING What is another name for PT and PTA - Answer Physical therapist = "Physiotherapy"

Physical therapy aide = "Physical therapy technician" Both are interchangeable What are the powers and duties of the physical therapy board of Ca? - Answer 1. Highest priority is protection of the public

2. Creator and enforcer of the Practice Act
3. Issue, suspend, revoke, and discipline PT licensees within state of Ca
4. Publishing newsletter denoting actions taken by the board 5.Board shall hear all matters 6.Appoint individuals to proctor examinations, those appointed CANNOT be a board member Do the PTBC have the authority to inspect PT facilities and Pt records - Answer - Yes, they can obtain Pt records as long as they get written or verbal consent -If the Pt's written authorization has been provided, the release of records shall be given within 15 days or a penalty of $1,000 will occur for every day starting on the 16th day What is the "Board" made up of? - Answer 1 Licensed PT involved with education

3 Licensed PT's with at least 5 years experience 3 persons of the public who do not hold a license How long can a Board member serve? - Answer Terms: Four years, expires 1st day of June -No person can serve more than two consecutive terms- eight years max What are the qualification required for licensure? - Answer -18 yrs or older -graduated from an accredited program -Filed an application with the board, and meets the requirements prescribed -Not addicted to any substance -Not committed any crime -An applicant can only qualify once to as a PTLA/ PTALA PTLA/PTALA practicing restrictions - Answer PTLA must be under the DIRECT and IMMEDIATE supervision unlike PTALA -A licensed supervising PT must be on-site at ALL times for BOTH -Can practice 120 days pending the results of the first licensing examination administered.

-A supervising PT shall document receipt of the letter authorizing the PTLA or PTALA status and record the expiration date of that status in the employee record. -During this period the applicant shall identify himself or herself only as "PTLA" or PTALA as appropriate. -An applicant will loose their "LA" status they fail the examination on the first try Are there other alternative routes to obtain a PTA licensure - Answer If the board finds someone to have proper training and adequate experience equivalent to that received at the PTA school, they can challenge the board and apply for licensure Who creates the NPTE exam - Answer Federation of State Board of Physical Therapy creates the licensing examination of PT and PTA What are the two exams that you have to past in order to obtain a license - Answer 1. State laws and regulation

2. NPTE What are a few regulations regarding the NPTE - Answer 1. If an applicant fails to pass the NPTE, a re-examination fee must be paid

2. An applicant is allowed to sit for the NPTE 3 times per application per 12-month period (If they do not pass they have to do a new application and pay the fee)
3. Once you past the NPTE you have 5 years to pay for the initial license or its considered abandoned Where is the Physical Therapy Board of Ca located at? - Answer Sacramento Applicant may be issued a license without written exam, if ALL the following criteria are met - Answer 1. If the PT or PTA is licensed in a state, district, or territory of the U.S. and has met requirements for licensing
4. Has graduated from an accredited program
5. If they filed an application w/ the board What are the Educational standards for a PT and PTA program? - Answer 1. CAPTE approved
6. Clinical experience for PT's 18wks of full time work and PTA 16wks of full time work How much is the Application Fee? - Answer $300.

Just to clearify PT's have to pay two seperate fees for application and license which is the 300 and 150 PTA's however, both fees are included in one which is the 300 How much is the initial license fee? - Answer $150. How much is the Biannual renewal fee? - Answer $300. How much is a delinquency fee aka late fee? - Answer $150.00 (50% of renewal fee) How much is a Duplicate wall certificate and renewal receipt? - Answer $50. each How much is a endorsement or letter of good standings? - Answer $60. What are the Foreign Education Requirements - Answer 1. Full transcript of the professional instruction completed

2. Proficiency in English by the (TOEFL)

3. 9months of clinical service w/ an APTA certified CI at an approved location (if clinical service was done outside of Ca it still counts towards the 9months) 4.Take NPTE if the education meets sufficient standards Are there any other alternatives for foreign students to complete clinical service?

• Answer Three months can be waived if a course in law and ethics is completed Three months can also be waived if four CEU's worth of ethics are complete When does your license expire? - Answer Expires at 12a.m. on the last day of the birth month of the licensee during the second year of a two-year term if not renewed -The PTBC will send a notice of renewal 60days prior to expiration Exemption from renewal fee's - Answer If you are active military you will be exempt from paying renewal fee, but are only allowed to practice within the military service -Upon discharge, if you were discharged before the 60day expiration you have to pay the fee. If you were discharged within/after the 60 day expiration you are exempt from the fee.

Terms and Conditions for Continuing Education (CEU) - Answer For every ONE UNIT = TEN Hours of CE -Within the two years you have to complete 30hours/3units of CE, you can not exceed this amount -2hrs of ethics/laws and 4hrs of BLS for CE -"Hour" is the unit of measurement, defined as at least 50min of instruction -15 hours (1/2 of normal requirements) for FIRST TIME license renewal (this is the same at the fees being 1/2 the first time around) -You must keep your CE for at least 5yrs and the facilities have to keep it for 7yrs What are a few reasons why someone would be exempt from CEU - Answer 1. Proof that you were out of the country for a year or longer

2. If you are active military and were out of state for a year or longer
3. If you yourself were disable or mentally incapable of doing CEU
4. If you were taking care of a family member who was mental or physically disable. -You still have to pay for the license fee, and your license is still active during this time you just don't have to do CE -You can not be exempt two consecutive renewal periods

Define Inactive status - Answer -Inactive status is used if exemption is needed for two or more renewal period -It has the same renewal time and fee cost, but you are unable to practice in inactive status -No CE What are a few alternative methods to obtain CEU' s - Answer 1. Publishing peer reviewed article= 5hrs per articles

2. Developing CE course= 4hrs per course
3. Subject matter expert for FSBPT, ABPTS= 6hrs per
4. Board appointed task= 6hrs (1-4 caps out at 16hrs)
5. Being a CI, rotation has to be a min of 4wks to count. 1week counts for 1hr (this caps out at 12hrs) What must CE provide? - Answer 1. Appropriate training or certification to teach the subject matter that is pertinent to the practice of PT
6. They have to have a syllabus with learning objectives, bibliography, and a course schedule or outline
7. Educational goals and leaning objectives

4. Include everyone that created the course
5. Periodic review of course material
6. A place to provide feedback and complaints
7. Must maintain records of completion for 7yrs
8. Disclosure of products sold what topical medications can a Physical Therapist apply or administer? - Answer a)Bacteriocidal agents b)Deriding agents c)Topical anesthetic agents d)Anti-inflammatory agents e)Antispasmodic agents f)Adrenocortico-agents What are the parameters of a physical therapist performing tissue penetration? - Answer Upon specified authorization of a physician and surgeon, PT can perform tissue penetration for the purpose of evaluating neuromuscular performance as long as the physician therapist does not develop or make diagnostic or prognostic interpretations of the data obtained.

What are the certification hours and exam/reexamination fee for Electroneuromyography and Kinesiological electromyography - Answer Electroneuromyography: certification 400hrs of training under a licensed PT or physician authorized to perform ENM & 200 ENM exams Kinesiological electromyography: certification 200hrs of training under a licensed PT or a physical authorized to perform KENM & 50 KENM exams Exam/reexam is $500, application fee $100, and renewal fee $ Appropriate abbreviation after being licensed - Answer "Licensed Physical Therapy" LPT "Registered Physical Therapy" RPT Do you have to be a PT to have shares in a PT corporation? - Answer No, you do not need to be a PT to be a shareholder of a corporation. However those who are not PT's can not exceed 49%. In other words PT's should own at least 51% of the shares. Other professionals who can own shares:

1. Medical Dr, including naturopathic physicians and psychologist

2. Acupuncture
3. OTs
4. SPT
5. RNs
6. PAs How are topical medications administered by the PT and are PTs allowed to perscibe medication? - Answer Administered through: direct application, Iontophoresis, or phonophoresis (ultrasound) And NO PTs can not prescribe medications PT to PTA ratio - Answer ONE PT to every TWO PTAs In NO CASE shall the total number of PTAs exceed twice the number of PTs regularly employed at a facility at one time Documentation re PTA students - Answer A PTA can be a CI however all clinical performances occurs under the supervision of a PT
7. Supervision MUST occur on site

2. The supervising PT will conduct a weekly case review on the patient's that the PTA student has seen and documented
3. PTA CI's can countersign students notes but it must occur on the SAME day
4. CI's must sign with first initial and last name on ALL entries Aides - Answer -A licensed PT can supervise ONE aide -Aides must be 18yrs of age or older -PTs must make sure the aides are capable of completing the Pt related task PRIOR to Tx -PT shall see/eval patient prior to the aide providing patient related task -Aides require immediate supervision at ALL TIMES the PT must be in the same facility and within close proximity, immediately available if needed Define Patient related task - Answer Physical therapy service delivered DIRECTLY to the patient Ex: Therapeutic exercise Define Non-patient related task - Answer Tasks related to the OBSERVATION of the patient Ex: Transport of the Pt, providing only physical support of the Pt during gait or transfer training, housekeeping, and clerical duties

Patients medical records how long should they be kept - Answer 7 YEARS! Unemanicpated minors records are kept for at least one year after the patient turns 18 years and not in any case less than seven years Good rule of thumb - Answer ALWAYS notify your PTOR if there are any changes in Pts condition not within the planned progress or treatment goals, and any change in Pts general condition So basically any CHANGE in the Pt status With co-signing documentation - Answer PTA student can have their notes signed by a PTA or PT (CI) PT student can have their notes signed by a PT PTA licensed applicant has to have their notes signed by a PT PT licensed applicant has to have their notes signed by a PT What is the criteria regarding direct access physical therapy - Answer 1. A person may initiate physical therapy treatment directly from a PT as long as it's within the scope of practice

2. If at anytime the PT believes the patient has a condition that falls outside of PT scope of practice or the patient is not progressing towards treatment goals the therapist must refer them out
3. Written authorization from the patient needed in order to contact the physician of direct access care How long does the patient have to be treated under the direct access of physical therapy - Answer If within the scope of physical therapy, the PT has 45 calendar days (including weekends) or 12 visits (whatever comes first) for treatment of the patient. A notice stating this information shall be provided for the patient both orally and in writing When are patient referrals considered unlawful - Answer Consider unlawful if the financial interest is equal to or greater than 5% of the whole service provided or $5, And if the referral is provided to immediate family such as: Spouse of licensee, children of licensee, parents or licensee or licensee's spouse, and spouses of the licensee children Are there any exceptions regarding a referral - Answer A referral can be given for a good service if there is no alternative provider within 25miles or 40min of Pt's home

-The provide some type of written document stating they are getting money back from the facility they are recommending them to -If another facility becomes available, then a referral to this facility shall occur within 6months from the time that the licensee becomes aware of the alternative provider -or the Pt should be made aware about it What happens if the PT is caught writing and receiving kick back from referral? - Answer IT is a MISDEMEANOR with up to 6months imprisonment and/or up to $2500 fine. What happens if your caught providing unnecessary PT services to a Pt? - Answer Repeated excessive prescription of treatment is guilty of a MIDEMEANOR which carries a fine up to $600 and or imprisonment up to 180 days. All licenses are issued and filled by who? - Answer All licenses are issued and filled by the PTBC What happens if you cheat on the NPTE exam - Answer -Cheating is a MISDEMEANOR -The board can disqualify the applicant from taking an exam

-Deny the application for licensure or revoke license -Any one involved are liable for the cost of the damages sustained by entities administering the exam not to exceed $10,000 plus litigation fees What happens if you are suspended or convicted of unprofessional conduct? - Answer Disciplinary Action: for unprofessional conduct a license can receive a citation denial, or be on probation as well as suspended (For Not More Than 12 MONTHS) -If guilty of unprofessional conduct, can be liable for the cost of the investigation and prosecution associated with the disciplinary action. Sexual Activity - Answer The patient or client is NOT able to give free, full, or informed consent to any sexual activity. -If a PT provider is charged as a registered sex offender, his/her license will be immediately revoked without potential for reissue Suspension of licensee - Answer -Can be suspended if you do not pay your child support -Automatic suspension of license shall occur for a licensee convicted of fraud related to workers compensation or medi-cal

What does the board look at when evaluating a case to reinstate a license? - Answer 1. Nature and severity of the acts under consideration

2. Evidence of any of the acts
3. Elapsed time since the acts
4. Extent to which applicant has complied with probation restitution or any sanctions imposed against them
5. Evidence of rehab submitted by the applicant How long before a licensee can petition to reinstate their license after it has been revoked or suspended - Answer 1. Three years for unprofessional conduct -this can be reduced to two years if the board allows it
6. Two years: For early termination of a probation sentence of three years or more
7. One year for modification of a mental or physical condition or reinstatement of a license that was initially revoked for a mental or physical illness or on probation for a period of less than three years -NO petition is considered while a practitioner is under sentence for any criminal offense

In order to petition the board for your license what must you have? - Answer Each petition must have at least two recommendations by PT's who know the individual and are aware of the disciplinary actions that the licensee has received Who issues the probationary licenses? - Answer The executive officer of the board issues the probationary licenses. What happens and what must you do if you receive a public letter of Reprimand (meaning your license is being revoked or issued?) - Answer 1. May include requirements for training or education and cost recovery for the investigation

2. Board will notify the licensee 30 days prior to the intended issuance of the letter
3. Licensee must indicate in writing at least 15 days prior to the intended issuance date whether or not they agree to issuance of the letter -YOU WILL BE DENYED OR REVOKED is you are a licensed sex offender Licensee whose matter has been heard by Medical Quality Hearing Panel may? - Answer 1. Have the license revoked or suspended upon order of the board
4. have their right to practice suspended (not to exceed a year)
5. Be placed on probation and required to pay probation monitoring cost

4. Be publicly reprimanded by the board
5. Have other action taken in relation to discipline as part of an order of probation Who does the PTBC assign to the rehabilitation evaluation committee - Answer 1. Members who have been free from substance abuse for three years prior to appointment on the committee
6. Members serve for a term of 4 years
7. This committee determines if safe return to practice can occur as well as what treatment facilities should be used for the program for practicipants If you agree and attend rehab, does that excuse you from your initial charge? - Answer NO If you were to go to rehab it would be confidential What happens if you work as a PTA without a license or proper licensure? - Answer Any person who holds himself/herself as a PTA without appropriate licensing by the PTBC is guilty of a MISDEMEANOR. This can be with a up to a $1000 fine and/or imprisonment for up to 6 months

How long does a citation last on your record? - Answer It will be five years before a citation is wiped from the individuals record. All citations remain until the most recent citation has been present for five years How much are can the administrative fines be and what does the PTBC based them on? - Answer Typically not less than $100 no more than $2500: Amount is based on good/bad faith of cited person, nature/severity of violation, history of similar violations, intent of cooperation with board, attempts of the cited individual to minimize damages from violation Why would the administrated fines increase - Answer May increase up to $5000 if the board determines at least one of the following circumstances apply:

1. involves present/immediate threat to health and safety of another person
2. Multiple violations or willful disregards of the law
3. Violations perpetrated against a senior citizen or disabled person
4. Hx of two or more prior citations for the same or similar violations Disputing citation - Answer -FORMAL meeting to be held within 30days of being notified of the citation -Within 10 days of receipt, cited individuals can ask for an INFORMAL conference with the board's executive officer to discuss charges

-If the charges are not excused, than a FORMAL hearing will be held 30days from the INFORMAL conference What can a PT do if they are unable to complete the correction for which they were cited for? - Answer If unable to complete correction within the time line provided, the cited individual may request, in writing, an extension within the time set forth for abatement (AKA removal of a problem) -Failure to comply with an order will result in disciplinary action Define Mandated Reporters - Answer A person who has regular contact with vulnerable individuals is legally required to report when abuse is observed or suspected (All you need to report is reasonable suspicion) -self-harm -injury from firearm -elder abuse -child abuse -spousal abuse What should you do if you suspect abuse? - Answer MUST make an initial report by TELEPHONE IMMEDIATELY or as soon as possible and fax or send/transmit a

written follow-up report within two working days for an injury and 36 hrs for suspected child abuse upon receiving the info concerning the event Define Multiple Reporters - Answer When two or more reporters jointly have knowledge of a known or suspected instance of child abuse or neglect, and when there is agreement among them, the telephone report may be made by a member of the team selected by mutual agreement: a single report may be made by the one who was selected. What should the report include? - Answer 1. Name of victim

2. Location of victim
3. Character/extent of injury
4. ID of alleged abuser -Mandated reporters have immunity, and their identity is confidential -Failure to report is a MISDEMEANOR Failure to report to the board within 30 days for any of the following is considered unprofessional conduct? - Answer 1. Brining of an indictment or info charging a felony against a licensee
5. Arrest of a licensee
6. Conviction of a licensee

4. Any disciplinary action taken by another licensing entity
5. Any report required to be made pursuant to business and professional code DO's for advertising - Answer 1. Name of the practitioner
6. Addresses and telephone #'s of the offices maintained by practitioners
7. Any other languages that are spoken by the staff
8. office hours
9. Certifications, practice, or specialized fields the practitioner/provider has DON'T for advertising - Answer 1. If you give before and after picture but do not explain the procedure or what the process was to achieve the results
10. Fee prices must be exact, and can not use the words "as low as", "and up to", "lowest prices"
11. Making or stating a claim that your better than other facilities
12. Make a scientific claim without any profession proof or evidence.
13. Give something of value to the press or member for professional publicity, unless its made publicly known What is a NTC 12-01 and how must it be presented or given to the Pt? - Answer The form informs the consumer on:

1.Treatment expectations

2. patient rights
3. How to file a complaint
4. How to verify a license -Can be given directly to the Pt or prominently posted -If given a written hand out it need to be signed and dated by either the Pt or their representative and stored in Pt medical records How many days do you have to notify the board of an email or address change? - Answer 30 Days How long does the board have to inform you if your application is approved, denied, or needs to be fixed? - Answer The board has 30 days to inform you if the application is complete or deficient If deficient or once errors have been fixed, the board has 60 total days to report a decision for approving an applicant.