NAC640A.250. Practice by occupational therapy assistant or provisional licensee.

     1. An occupational therapy assistant or a provisional licensee shall not practice occupational therapy without the general supervision of an occupational therapist. Immediate physical presence or constant presence on the premises where the occupational therapy assistant or provisional licensee is practicing is not required of the supervising occupational therapist. To provide satisfactory general supervision, the occupational therapist shall:

     (a) Provide an initial program of intervention, and any subsequent changes to the initial program, for patients assigned to the occupational therapy assistant or provisional licensee.

     (b) Not less than 1 hour for each 40 hours of work performed by the occupational therapy assistant or provisional licensee and, in any event, not less than 1 hour each month, engage in:

          (1) Clinical observation of the occupational therapy assistant or provisional licensee; or

          (2) Direct communication with the occupational therapy assistant or provisional licensee. The mode and frequency of that communication is dependent upon the setting for the practice of the occupational therapy assistant or provisional licensee. Direct communication may consist of, without limitation:

               (I) Direct or joint treatment of a patient;

               (II) Personal supervision of the occupational therapy assistant or provisional licensee while providing services;

               (III) Conversation, in person or by telephone;

               (IV) Exchange of written comments;

               (V) Review of patient records; or

               (VI) Conferences, or other face-to-face meetings.

     (c) Establish the caseload of the occupational therapy assistant or provisional licensee based on the competency of the occupational therapy assistant or provisional licensee as determined by the supervising occupational therapist.

     (d) Review written documentation prepared by the occupational therapy assistant or provisional licensee during the course of treatment of a patient. The completion of this review by the occupational therapist may be evidenced by:

          (1) Preparation of a separate progress note; or

          (2) The occupational therapist signing and dating the document prepared by the occupational therapy assistant or provisional licensee.

     2. The supervising occupational therapist and the occupational therapy assistant or provisional licensee shall jointly:

     (a) Document, in a manner other than the mere signing of service records prepared by another person, the supervision required pursuant to this section by preparing, without limitation:

          (1) Daily or weekly treatment or intervention schedules;

          (2) Logs of supervision, which must include, without limitation, the time and date of supervision, the type of supervision provided and the subject matter covered during the supervision; and

          (3) Patient records.

     (b) Ensure that each record regarding a patient treated by the occupational therapy assistant or provisional licensee is signed, dated and reviewed at least monthly by the occupational therapy assistant or provisional licensee and the supervising occupational therapist. In reviewing the record, the occupational therapist and the occupational therapy assistant or provisional licensee shall verify, without limitation:

          (1) The accuracy of the record; and

          (2) That there is continuity in the services received by the patient pursuant to the program of intervention.

     3. An occupational therapy assistant or provisional licensee may assist a supervising occupational therapist to:

     (a) Prepare and disseminate any written or oral reports, including, without limitation, the final evaluation and discharge summary of a patient; and

     (b) Unless the treatment is terminated by a patient or his or her provider of health care, determine when to terminate treatment.

     4. An occupational therapy assistant or provisional licensee shall document all treatment provided to a patient by the occupational therapy assistant or provisional licensee.

     5. A supervising occupational therapist shall not delegate responsibilities to an occupational therapy assistant or provisional licensee which are beyond the scope of the training of the occupational therapy assistant or provisional licensee.

     6. The provisions of this section do not prohibit an occupational therapy assistant or provisional licensee from responding to acute changes in a patient’s condition that warrant immediate assistance or treatment.

     7. As used in this section, “sign” means to inscribe by handwriting or electronic means one’s name, initials or license number.

     (Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A 5-23-95; R083-99, 9-27-99; R179-01, 9-20-2002; R210-07, 9-18-2008)