Florida's physical therapists (PTs) and physical therapist assistants (PTAs) see their licenses as more than the state's permission to practice but as the embodiment of years dedicated to education, clinical experience, and personal sacrifice. Although they have an unwavering commitment to patient rehabilitative and therapeutic care, a single allegation or complaint to the Florida Board of Physical Therapy (Board) can place everything they've worked for at risk.
Whether the Board pursues charges related to documentation errors, supervision violations, substance abuse issues, or patient abuse, Florida PTs and PTAs quickly discover how delicate the status of their licenses are when subject to sanctions like:
- Probation measures that limit or restrict the ability to practice freely
- Restitution and fines that cause financial burdens
- License suspension or revocation that ends a physical therapy career
When allegations arise naming Florida PTs and PTAs as the subject of complaints, they deserve an experienced legal team to protect their careers. They require a dedicated outlet to respond to the Board, collect mitigating evidence, and build a defense strategy to challenge assertions or charges.
The Lento Law Firm stands prepared to use our extensive experience to keep PTs and PTAs aligned with their careers. Whether addressing investigators, managing disciplinary hearings, or pursuing appeals, our Professional License Defense Team will provide the assistance licensees need. Call us at 888-535-3686 now or fill out our confidential consultation form, and we will contact you.
Florida PT and PTA Duties
From its headquarters in Tallahassee, the Board uses the Florida Physical Therapy Practice Act to govern the practice. It creates and enforces provisions such as minimum acceptable standards of patient care, continuing education requirements, and renewal qualifications among others.
Part of the backbone of the Board's guidance for licensees is outlining the scope of practice for PTs and PTAs. Licensed PTs are responsible for conducting patient evaluations, interpreting physician referrals, and making decisions to create and support patient care plans. On the other hand, PTAs implement treatment components that the supervising PT has delegated.
A majority of the relationship between PTs and PTAs is centered on tasks carried out under strict rules, wherein PTs hold the final responsibility of patient care. Therefore, some of the most significant obligations enforced by the Board are those guiding delegation and supervision.
Board Regulations for Appropriate Delegation
The regulations surrounding delegation and supervision aim to protect patients, clients, and the public at large. PTs may delegate parts of care plans that are within the PTA's scope and competence if they do not require advanced clinical judgment. While each PTA may be at a different point in clinical education experience and may have varying capabilities, they may not carry out the following independently:
- Patient evaluations or reevaluations
- Interpretation of referrals
- Creating or modifying care plans
- Making final discharge decisions
With unlicensed support personnel, such as aides, PTAs may delegate certain tasks to them, but it is at the discretion of the supervising PT. Otherwise, PTs assign aides tasks, but only those that do not require a licensee's decision-making skills and clinical education. For example, PTs can delegate patient transportation, equipment setup, and administrative tasks to aides.
Supervision Rules for Florida PTs and PTAs
When PTs and PTAs are delegating tasks, regardless of the assignment or if it's carried out by a PTA or aide, the Board implements specific rules to ensure accountability and patient safety. Supervision includes clear directives to the PTA (or aide in some cases), such as patient pain levels, treatment goals, specific interventions to use, and any related parameters for physical therapy services.
The Board asserts that PTs must provide "general supervision" over PTAs, which means being available for immediate two-way communication but not necessarily on-site. Supervision rules allow PTs and PTAs to communicate via telephone or videoconference to fulfill requirements. Nevertheless, the level of supervision needed will depend upon factors like the PTA's experience level, patient alertness, and overall complexity. However, PTAs working in acute or inpatient hospital environments must receive direct supervision, meaning the PT is physically present and immediately available.
Aides must have "direct supervision" from any PT or PTA delegating to them. Therefore, they must be immediately available on-premises and able to intervene at any point to protect patient goals and overall safety. Aides may not perform any documentation for billing purposes or provide interventions that require a license from the Board. They can, however, record selected data as directed by the PT—such as vital signs—and assist in routine patient care tasks.
Prohibited Conduct for PTs and PTAs
Licensees must remain knowledgeable of modern therapy techniques, practice advancements, and others that serve patients. Yet, they are also obligated to maintain professional and ethical standards.
Failure to abide by these standards not only compromises patient safety but can lead to disciplinary measures, including fines, probation, or even license revocation. Conduct subject to sanctions from the Board includes but is not limited to the following:
- Providing care outside the scope of practice
- Failure to follow parental consent requirements
- Making misleading, deceptive, or fraudulent representations
- Having a license revoked, suspended, or otherwise acted against for conduct constituting a violation under Florida law
- Influencing the patient or client for the purpose of financial gain
- Failing to identify through written notice or orally to a patient the type of license under which they are practicing
- Declining to give patients information about their rights and how to file a complaint
- Engaging or attempting to engage in sexual misconduct
- Inability to practice with reasonable skill and safety because of illness or use of alcohol, drugs, or narcotics
- Testing positive for any drug when the practitioner does not have a lawful prescription and legitimate medical reason for using the drug
- Intentionally submitting a claim, statement, or bill for payment of services not rendered
- Being convicted of, or entering a plea of guilty or nolo contendere to, any misdemeanor or felony, regardless of adjudication, or failing to report such to the Board within 30 days
Engaging in prohibited conduct, whether intentionally or inadvertently, can result in severe disciplinary consequences. If the allegations are viewed as detrimental to patient safety and that of the public, the Board can seek an immediate injunction against the licensee. While temporary restrictive measures can keep a PT or PTA away from their practice, eventually, the Board must conduct a formal investigation, kicking off the grievance process.
Florida Department of Health Investigations
Physical therapy patients, their family members, colleagues, supervisors, and any member of the public can lodge a complaint against a licensee. It can come from objections to care services given to incidents like disorderly conduct in the public space that question a PT or PTA's fitness to practice.
The Florida Department of Health investigates complaints and other reports of misconduct and violations by the state's healthcare practitioners. Upon reviewing the complaint for possible Florida Physical Therapy Practice Act violations or further state agency rules, it's referred to the Consumer Services Unit (CSU) to determine probable cause. CSU may mediate and conduct investigations involving minor violations but will otherwise forward the matter to the Investigative Services Unit (ISU).
The ISU gathers evidence of the alleged incident, including billing documentation, patient records, information from interviews, and anything else to substantiate the complaint. It then compiles an investigative report and gives it to the Prosecution Services Unit (PSU).
Officials with PSU review the complaint and investigation review with a member of the Attorney General's Office to recommend a course of action to the Board, which may include:
- Emergency Order
- Expert Review
- Closing Order
- Administrative Complaint
Cases are ultimately decided by a Probable Cause Panel (PCP), which contains either two or three Board members who review all evidence and information gathered during the investigation. An Administrative Complaint is recommended when the investigation or the Expert Review supports probable cause.
Licensees may enter into a Settlement Agreement that imposes negotiated penalties. The Board may even suggest a voluntary relinquishment of a license, ceasing the ability to practice until the Board-imposed conditions are met and the individual is eligible for reinstatement. However, if the PT or PTA disagrees with the assertions and the offered agreement, they may petition for an administrative hearing.
Florida Administrative Hearings
The Division of Administrative Hearings (DOAH) holds proceedings for all licensed individuals in Florida, with an Administrative Law Judge (ALJ) assigned to each case. Sometimes, the DOAH may use its Alternative Dispute Resolution (ADR) program. In such a case, a second ALJ acts as an "ADR Judge," who invites the licensee and a Board representative to participate in a settlement conference.
If the case is resolved through a settlement conference, the ADR Judge issues a report advising the ALJ assigned to conduct the final hearing, and the case's jurisdiction is promptly relinquished to the Board. If the parties impasse, however, the case proceeds to a final hearing.
Although not as formal as a courtroom trial, both sides can present evidence, call and cross-examine witnesses, and make arguments to the ALJ. As the prosecuting party, the Board bears the burden of proof—but a very low bar to hurdle—with the DOAH working off the "preponderance of the evidence" standard. Once the ALJ renders its decision, including recommended sanctions (if any), the Board will review the order and may accept, modify, or reject the ALJ's determination. In a majority vote from the seven-member Board, a Final Order becomes legally binding, and notification is sent to the licensee.
Sanctions for Florida Physical Therapists
For more minor violations, the Board can levy a Letter of Concern to the PT or PTA, which is a non-public admonishment of conduct, unlike a reprimand, which is a publicly available disciplinary order. It may also impose citations, which assess a monetary penalty—usually no less than $500—and can include a requirement that the licensee correct the violation, if fixable, within a specified period of time not to exceed 60 days.
As part of a final order imposing appropriate penalties, the Board could consider requiring the PT or PTA to complete probation, which can include, but is not limited, the following mandates:
- Attending Board meetings
- Community service
- Continuing education
- Passage of the Florida laws and rules exam
- Monitored or restricted practice
- Restitution or fines
When the Board levies suspensions (from six months to five years), it may also require the licensee to agree to a corrective actions plan, which can have the same provisions as probation. In addition to any other discipline imposed, the Board shall assess the actual costs related to the investigation and prosecution of a case. If the violation is for fraud or false representation, the Board imposes a fine of $10,000 per offense. Nevertheless, a specific finding in the final order of mitigating or aggravating circumstances allows the Board to impose a penalty other than that provided for in such guidelines.
In cases involving patient harm, public risk, and other serious violations, the Board will permanently revoke a license to practice. Oftentimes, the maximum punishment for subsequent Board offenses is with license revocation, too.
If PTs or PTAs dispute the Board's Final Order, they can appeal to a Florida district court of appeal within 30 days. Appeals are not a rehearing of the matter but a review of the case for legal or procedural errors. Yet, in the event of suspension or revocation, licensees have the ability to seek a stay of the Board's order until the court has reached a final decision.
Protect Your Florida Physical Therapist License
Before PTs and PTAs need to pursue a temporary pause of Board actions from a Florida district court of appeal, they need to understand that a successful defense strategy begins before complaints arise. At the Lento Law Firm, we provide licensees with the legal support they need to continue rendering much-needed physical therapy services to the public.
Some may believe that an attorney is too aggressive a choice to take when negotiating with the Board. However, our Professional License Defense Team has a deep understanding of the regulatory framework governing licensees and is the assistance that PTs and PTAs require to protect their credentials.
The Lento Law Firm will support and advocate for practitioners from the initial investigation through DOAH hearings and judicial appeals. With the help of our Professional License Defense Team, licensees can successfully respond to alleged violations, address administrative complaints, and continue pursuing their careers long into the future. Call us at 888-535-3686 today or fill out our confidential consultation form, and we will contact you.
