CHAPTER 201
PRACTICE OF PHYSICAL THERAPISTS
AND PHYSICAL THERAPIST ASSISTANTS
645—201.1(148A,272C) Code of ethics for physical therapists and physical therapist assistants.
	201.1(1) Physical therapy. The practice of physical therapy shall minimally consist of:
	a. 	Interpreting all referrals;
	b. 	Evaluating each patient;
	c. 	Identifying and documenting individual patient’s problems and goals;
	d. 	Establishing and documenting a plan of care;
	e. 	Providing appropriate treatment;
	f. 	Determining the appropriate portions of the treatment program to be delegated to assistive personnel;
	g. 	Appropriately supervising individuals as described in rule 645—200.6(272C);
	h. 	Providing timely patient reevaluation;
	i. 	Maintaining timely and adequate patient records of all physical therapy activity and patient responses consistent with the standards found in rule 645—201.2(147).
	201.1(2) A physical therapist shall:
	a. 	Not practice outside the scope of the license;
	b. 	Inform a referring practitioner when any requested treatment procedure is inadvisable or contraindicated and shall refuse to carry out such orders;
	c. 	Not continue treatment beyond the point of possible benefit to the patient or treat a patient more frequently than necessary to obtain maximum therapeutic effect;
	d. 	Not directly or indirectly request, receive, or participate in the dividing, transferring, assigning, rebating, or refunding of an unearned fee;
	e. 	Not profit by means of credit or other valuable consideration as an unearned commission, discount, or gratuity in connection with the furnishing of physical therapy services;
	f. 	Not obtain third-party payment through fraudulent means. Third-party payers include, but are not limited to, insurance companies and government reimbursement programs. Obtaining payment through fraudulent means includes, but is not limited to:
	(1)	Reporting incorrect treatment dates for the purpose of obtaining payment;
	(2)	Reporting charges for services not rendered;
	(3)	Incorrectly reporting services rendered for the purpose of obtaining payment which is greater than that to which the licensee is entitled; or
	(4)	Aiding a patient in fraudulently obtaining payment from a third-party payer;
	g. 	Not exercise undue influence on patients to purchase equipment, products, or supplies from a company in which the physical therapist owns stock or has any other direct or indirect financial interest;
	h. 	Not permit another person to use the therapist’s license for any purpose;
	i. 	Not verbally or physically abuse a patient or client;
	j. 	Not engage in sexual misconduct. Sexual misconduct includes the following:
	(1)	Engaging in or soliciting a sexual relationship, whether consensual or nonconsensual, with a patient or client;
	(2)	Making sexual advances, requesting sexual favors, or engaging in other verbal conduct or physical contact of a sexual nature with a patient or client;
	k. 	Adequately supervise personnel in accordance with the standards for supervision found in rule 645—200.6(272C);
	l. 	Assist in identifying a professionally qualified licensed practitioner to perform the service, in the event that the physical therapist does not possess the skill to evaluate a patient, plan the treatment program, or carry out the treatment.
	201.1(3) Physical therapist assistants. A physical therapist assistant shall:
	a. 	Not practice outside the scope of the license;
	b. 	Not obtain third-party payment through fraudulent means. Third-party payers include, but are not limited to, insurance companies and government reimbursement programs. Obtaining payment through fraudulent means includes, but is not limited to:
	(1)	Reporting incorrect treatment dates for the purpose of obtaining payment;
	(2)	Reporting charges for services not rendered;
	(3)	Incorrectly reporting services rendered for the purpose of obtaining payment which is greater than that to which the licensee is entitled; or
	(4)	Aiding a patient in fraudulently obtaining payment from a third-party payer;
	c. 	Not exercise undue influence on patients to purchase equipment, products, or supplies from a company in which the physical therapist assistant owns stock or has any other direct or indirect financial interest;
	d. 	Not permit another person to use the physical therapist’s or physical therapist assistant’s license for any purpose;
	e. 	Not verbally or physically abuse a patient or client;
	f. 	Not engage in sexual misconduct. Sexual misconduct includes the following:
	(1)	Engaging in or soliciting a sexual relationship, whether consensual or nonconsensual, with a patient or client; and
	(2)	Making sexual advances, requesting sexual favors, or engaging in other verbal conduct or physical contact of a sexual nature with a patient or client;
	g. 	Work only when supervised by a physical therapist and in accordance with rule 645—200.6(272C). If the available supervision does not meet the standards in rule 645—200.6(272C), the physical therapist assistant shall refuse to administer treatment;
	h. 	Inform the delegating physical therapist when the physical therapist assistant does not possess the skills or knowledge to perform the delegated tasks, and refuse to perform the delegated tasks;
	i. 	Sign the physical therapy treatment record to indicate that the physical therapy services were provided in accordance with the rules and regulations for practicing as a physical therapist or physical therapist assistant.
645—201.2(147) Record keeping.
	201.2(1) A licensee shall maintain sufficient, timely, and accurate documentation in patient records. A licensee’s records shall reflect the services provided, facilitate the delivery of services, and ensure continuity of services in the future.
	201.2(2) A licensee who provides clinical services shall store records in accordance with state and federal statutes and regulations governing record retention and with the guidelines of the licensee’s employer or agency, if applicable. If no other legal provisions govern record retention, a licensee shall store all patient records for a minimum of five years after the date of the patient’s discharge, or, in the case of a minor, three years after the patient reaches the age of majority under state law or five years after the date of discharge, whichever is longer.
	201.2(3) Electronic record keeping. The requirements of this rule apply to electronic records as well as to records kept by any other means. When electronic records are kept, the licensee shall ensure that a duplicate hard-copy record or a backup, unalterable electronic record is maintained.
	201.2(4) Correction of records.
	a. 	Hard-copy records. Notations shall be legible, written in ink, and contain no erasures or whiteouts. If incorrect information is placed in the record, it must be crossed out with a single nondeleting line and be initialed by the licensee.
	b. 	Electronic records. If a record is stored in an electronic format, the record may be amended with a signed addendum attached to the record.
	201.2(5) Confidentiality and transfer of records. Physical therapists and physical therapist assistants shall preserve the confidentiality of patient records. Upon receipt of a written release or authorization signed by the patient, the licensee shall furnish such physical therapy records, or copies of the records, as will be beneficial for the future treatment of that patient. A fee may be charged for duplication of records, but a licensee may not refuse to transfer records for nonpayment of any fees. A written request may be required before transferring the record(s).
	201.2(6) Retirement or discontinuance of practice. If a licensee is the owner of a practice, the licensee shall notify in writing all active patients and shall make reasonable arrangements with those patients to transfer patient records, or copies of those records, to the succeeding licensee upon knowledge and agreement of the patient.
	201.2(7) Nothing stated in these rules shall prohibit a licensee from conveying or transferring the licensee’s patient records to another licensed individual who is assuming a practice, provided that written notice is furnished to all patients.
These rules are intended to implement Iowa Code chapters 147, 148A and 272C.
[Filed 11/26/03, Notice 9/17/03—published 12/24/03, effective 1/28/04]