Facing disciplinary action from the Michigan Board of Physical Therapy is a serious situation with potentially career-altering consequences. Licensed physical therapists (PTs) and assistants (PTAs) dedicate years to building their reputation, expertise, and patient trust, and a single allegation can jeopardize everything.
For instance, a veteran PT working at a busy downtown Lansing medical center suddenly receives notification of a patient complaint accusing them of unfair billing practices. What could have likely been a small oversight on records for insurance claims can quickly lead to an investigation, disciplinary action, and the negative effects it has on a licensee, such as:
- Lost income and steep fines
- Mandatory monitoring that leads to a damaged reputation
- Suspension of the authority to practice
- License termination that limits future career opportunities
Whether PTs or PTAs are providing patient care in hospitals in Saginaw or Ann Arbor, rehabilitative clinics in Flint or Kalamazoo, or private practices in Monroe or Traverse City, they deserve the best counsel to support their defense. When state agencies launch an intrusive investigation to substantiate allegations, licensees must contact the Lento Law Firm.
From corresponding with the board to engaging in disciplinary hearings and pursuing appeals, our Professional License Defense Team will provide much-needed assistance. Call us at 888-535-3686 now or fill out our confidential consultation form, and we will contact you.
Michigan Board of Physical Therapy Licensees
Within Michigan's Licensing and Regulatory Affairs (LARA), the state's top PT enforcement agency is tasked with implementing the state's Public Health Code and prevailing federal standards to govern the profession. In addition to issuing and renewing credentials, the 11-member board sets the standards for the scope of practice for PTs, PTAs, and unlicensed individuals.
Licensed PTs perform patient evaluations, interpret physician recommendations and referrals, and create patient care plans. PTAs work under supervising PTs and act in an assistive role. Unlicensed individuals, such as physical therapy aides and support staff, have fewer duties corresponding to their experience level. The only tasks they may complete independently are administrative work, routine assistance without skilled intervention, and preparing treatment areas. Aides may not engage in any activity or duty that requires clinical judgment, like care plan modifications or evaluations. While they may document some items—vital signs, height, and weight—it's at the discretion of the supervising PT.
For all licensees regulated by the board, the practice of physical therapy does not include the identification of underlying medical problems. Therefore, they may not establish medical diagnoses or prescribe related treatments.
Delegation and Supervision
One of the most significant parts of a licensee's duties in the practice is maintaining guidelines governing delegation and supervision. Although assignments given to supervised personnel may seem like mundane daily tasks, they can easily become the reasons the board seeks discipline following a complaint.
PTs may delegate to no more than four PTAs at a time—as long as the intervention does not require advanced clinical judgment. PTs must provide "general supervision," meaning that the PT is not required to remain physically present on-site but must be continuously available when PTAs perform procedures, including availability via telecommunications. Supervisors will maintain an accurate record of the names of the PTAs under delegation and the tasks, functions, or interventions conducted and must regularly meet with them in person.
When it comes to unlicensed individuals, PTs must use "direct supervision," meaning being physically present and immediately available for direct contact with the patient or client during each visit. PTs, who may not supervise more than three aides or support staff at a time, must evaluate patients before delegating tasks and provide predetermined procedures and protocols to delegate.
Physical Therapist Prohibited Actions and Unlawful Acts
Michigan PTs and PTAs focus mainly on the medical and rehabilitative side of patient care. However, services include far more than the latest joint rehabilitation techniques and injury recovery strategies. Licensees are bound to follow numerous professional standards and may not engage in the following while in the practice of physical therapy services:
- Practicing outside of the boundaries of professional competence
- Failing to provide continuity of care
- Harassment or unfair discrimination
- Substance or alcohol abuse that affects the ability to practice
- Negligent, incompetent practice, or malpractice
The board also places emphasis on not being involved in a dual or multiple relationship with a current or former patient or a member of the individual's immediate family when there is a risk of harm or exploitation. For instance, if a PT or PTA may not:
- Take on a professional role even though a personal, scientific, legal, financial, or other relationship could impair the exercise of professional discretion
- Exploit any professional relationship to further personal, religious, political, business, or financial interests, including soliciting a patient or client
- Engaging in a sexual relationship with a current patient, client, or delegatee
Aside from conflict of interests, PTs and PTAs are under strict orders to keep accurate, legible records for all services rendered to patients. They must keep records for each patient, including full documentation of tests and examinations performed, observations made, and treatments provided. Unless a longer retention period is otherwise required, licensees must retain each record for a minimum of seven years, but 15 years in cases where "penetration" is a required medical service.
Furthermore, licensees are required to inform the board when certain developments occur outside of the practice. For instance, if a PT or PTA is under investigation by another licensing agency or if a court has rendered civil fines for damages or criminal convictions, they have 30 days to notify authorities.
Investigation Process
The first step in the grievance process is when a patient, a patient's family member, colleague, assistant, or supervisor files a complaint. Within LARA's Bureau of Professional Licensing (BPL), the Investigations & Inspections (I&I) Division takes charge of the investigation. But first, the Complaint Intake Section conducts an initial review to determine whether the complaint falls under the BPL or board's jurisdiction and merits further review.
Upon establishing a potential violation of board rules, Michigan state law, or its Public Health Code, I&I receives the case. However, if the complaint involves possible impairment due to substance use or mental health disorders, the Complaint Intake Section may refer the case to the Health Professional Recovery Program (HPRP).
I&I staff generally perform the following during investigations:
- Identify all parties with information related to the violation
- Interviewing the person filing the complaint (complainant)
- Collecting evidence, such as patient records, supervision schedules, and other information needed
- Interview the accused (respondent)
Once the investigation is completed, I&I recommends how to proceed. If the allegations are unsubstantiated, I&I can close the matter. I&I can also refer for expert review to determine if the conduct was below the minimal standards for the physical therapy profession. If substantiated, I&I can draft an administrative complaint for formal charges. Once the administrative complaint is served, respondents have 30 days to respond in writing. Failure results in automatic sanctions.
Compliance Conference
Once the respondent replies to the formal charges, LARA schedules a compliance conference. It is an opportunity for the respondent to negotiate a settlement before the matter proceeds to an administrative hearing.
The disciplinary subcommittee (DSC) must approve any settlement before it's considered legal and binding. In cases involving substance abuse, DSC may accept the respondent into a recovery program as an alternative to discipline, but only if the following requirements are met:
- The respondent acknowledges the impairment
- Withdraws from or limits their scope of practice
- Agrees to participate in a treatment plan
If the DSC rejects the respondent's proposed settlement, they may propose a counteroffer. If rejected, the matter will proceed to an administrative hearing.
Administrative Hearings
Whenever potential sanctions can result in a change of license status—suspension or revocation—the board must provide licensees with the opportunity for a contested case hearing. PTs and PTAs may also petition the Michigan Office of Administrative Hearings and Rules (MOAHR) when they seek to challenge the proposed discipline.
Before an Administrative Law Judge (ALJ), licensees and their legal representation will enter proceedings with the state represented by a member of the Attorney General's Office. The ALJ will also schedule an informal pre-hearing conference. The meeting will narrow the issues and plan for the hearing but also act as another attempt to enter into a settlement offer before official proceedings.
Although less formal than a jury trial in a courtroom, administrative hearings follow structured procedures and have due process provisions that allow parties to present evidence, including calling witnesses for testimony and cross-examination.
The burden of proof lies with the state, but it only needs to prove its case by a preponderance of the evidence—meaning it's more likely than not that the licensee is responsible for the alleged violations. After reviewing all testimony and evidence, the ALJ issues a Proposal for Decision (PFD) outlining their conclusions and recommended disciplinary action, if warranted.
Within 60 days, the DSC reviews the PFD and renders its decision. They can:
- Accept the ALJ's decision and recommended discipline
- Use the PFD to modify the final decision and adverse action
- Reject the PFD and move forward with previously imposed sanctions and conditions
A final order will include the substantiated violations, a short description of the conduct involved, and any restrictions or sanctions. After individuals receive the decision, though, there are opportunities for appeal remaining.
Within 60 days of the decision, individuals may file for reconsideration with the board, but it will only consider clear factual errors or new evidence that was previously available at the time of adjudication and has enough weight to significantly affect the case. Judicial review sought through a Michigan Circuit Court also has a narrow jurisdiction, with only procedural irregularities and constitutional violations subject to action from a judge.
License Discipline and Lasting Effects
When state agencies impose discipline, it isn't just the licensees and authorities who know about it. Until all conditions are met, such as a period of probation or suspension, it is documented on the board's public website for anyone to see.
Specific penalties depend on the seriousness of the offense, the licensee's disciplinary history, and any aggravating or mitigating circumstances. PTs and PTAs can be subject to one or more of the following:
- Monetary fines and restitution for damages
- Written reprimands
- Periods of probation limiting or restricting the ability to practice, often with conditions such as counseling or mantuary continued education
- Licenses suspension, typically from 90 days to one year, with restatement subject to board discretion
- Permanent revocation of a license to practice physical therapy in Michigan
When individuals keep their credentials but are ordered to complete conditions, any departure from them is subject to additional discipline. Regarding the implementation of a substance abuse recovery program through HPRP, those who falsely represent progress, such as misreporting usage or meeting attendance, are not just in trouble with the board—they are subject to felony charges.
Although Michigan has yet to enact the multi-state PT Compact granting license reciprocity with over three dozen other states, individuals will have immense trouble finding work as licensed professionals elsewhere. When seeking practice credentials in other states, governing boards will be aware through agency information sharing, leaving those with extensive experience as PTs and PTAs without a chance to continue their rewarding careers.
Protect Your Michigan Physical Therapist License
Michigan PTs and PTAs deserve the best legal counsel when allegations and complaints arise. Sanctions on a licensee's record can severely diminish their ability to practice freely, and the Lento Law stands prepared to protect their investment. Our Professional License Defense Team recognizes that navigating complaints and Public Health Code violations can quickly become complex.
Success demands a deep understanding of board-specific procedures, I&I investigation protocols, and how MOAHR adjudicates hearings. For someone who has invested years of study, field experience, and top-tier patient care into their careers, the Lento Law Firm has what it takes to protect their future. No matter where in Michigan PTs or PTAs work, we will help respond to state agencies and pursue dismissal of all charges against them. Call the Lento Law Firm Professional License Defense Team at 888-535-3686 today or fill out our confidential consultation form, and we will contact you.
