NE Administrative Code

Question 1

NE license requirements/documentation for PTs (5 items)

Answer 1

1) EDUCATION. Submit an official transcript sent directly from the issuing institution, verifying completion of an approved PT educational program.

2) EXAMINATION. Submit proof of passing the licensureexamination with a scaled score that is greater than or equal to 600 on the NPTE and pass the Jurisprudence (NE LAW) Examination with a scaled score that is greater than or equal to 600.

3) LICENSED IN ANOTHER JURISDICTION CURRENTLY PRACTICING.

4) LICENSED IN ANOTHER JURISDICTION AND HAS NOT PRACTICED WITHIN THE 3 YEARS PRECEDING THE APPLICATION.
Applicants must provide documentation of obtaining 50 hours of acceptable continuing education for a PT within the 3 years immediately preceding the date of application.

5) PASSED LICENSURE EXAMINATION BUT NOT PRACTICING.
Applicants that have met the license requirements and who passed the licensure examination more than 3 years prior to the time of application must provide documentation of obtaining 50 hours of acceptable continuing education for a PT within the 3 years immediately preceding the date of application.

Question 2

Define:
Adequate Patient Records (include 6 items)
Approved Education Program
Audit

Answer 2

Adequate pt records: legible records containing sufficient info to ID the patient, evaluation of objective findings, diagnosis, plan of care, treatment record, discharge plan

Approved edu. program: A program for the education and training of PTs/PTAs accredited by CAPTE of the APTA or by equivalent standards established by the Board.

Audit: The selection of licensees or certificate holders for verification of satisfactory completion of continuing competency requirements during a specified time period.

Question 3

Define:
Certification Examination

Hour

Answer 3

Certification Examination: The National PTA Examination and Jurisprudence (NE LAW) Examination approved by the Department upon the recommendation of the Board.

Hour:at least 60 minutes of participation in an organized learning experience otherwise known as a “contact hour”
-(A) 1 academic semester hour is equal to 15 contact hours. An approved 3 credit hour course provides 45 contact hours of continuing education credit
(B) 1 academic quarter hour is equal to 10 contact hours. An approved 3 credit hour course provides 30 contact hours of continuing education credit.

Question 4

Define:
Supervisory Visit

Answer 4

An on-site visit by the supervising PT in consultation with the PTA. The on-site visit may occur in any clinical setting where the supervising PT renders patient care.

Question 5

License Requirements for a PT based on training in a foreign country

Answer 5

To obtain a license based on training as a PT in a foreign country, applicants must submit a complete application provided by the Department and provide documentation demonstrating that the applicant meets the licensing requirements of Neb. Rev., and this chapter

Question 6

Requirements to perform PT services as a PTA student:

Answer 6

All patient care services delivered by a PTA student, working under the clinical instruction of a PTA must be rendered under the direct supervision of a supervising PT or PTA.

Question 7

Define: continuing competency activities

Answer 7

appropriate learning experiences PTs/PTAs undertake to expand their scope of knowledge beyond the initial preparation for the profession of physical therapy.

Question 8

Requirements/timeline of continuing education

Answer 8

On or before November 1 of each odd-numbered year, individuals holding an active license in the State of Nebraska must complete at least 20 hours of acceptable continuing education for a PT and 10 hours of acceptable continuing education for a PTA during the preceding 24-month period.

Question 9

What documentation is required to receive licensing after foreign training for PT?
(5 items)

Answer 9

004.01(A) EDUCATION. An applicant who graduates from a PT education program located outside of the U.S. must show that the education program is substantially equivalent to an approved PT program. The applicant must provide:

(1) An official transcript that shows graduation from a physical therapy education program that prepares the applicant to engage without restriction in the practice of PT

(2) Documentation that shows that the applicant’s school of physical therapy is recognized by its own ministry of education or other appropriate recognition agency recommended by the Board and approved by the Department;

(3) Documentation that shows completion of a credential evaluation through the Foreign Credentialing Commission on Physical Therapy (FCCPT), the Commission on Graduates of Foreign Nursing Schools
(CGFNS) that uses the FSBPT Coursework Tool approved by the Board that determines that the applicant has met uniform criteria for educational requirements sent directly to the Department from the evaluating agency;
(a) Applicants that do not hold a license in another jurisdiction of the United States, must have completed the most current Coursework Tool evaluation; and
(b) Applicants that hold a license in another jurisdiction of the United States and who are actively practicing, must have completed the Coursework Tool evaluation based on graduation date or more recent

(4) Documentation of proficiency of the English language by obtaining the following:
(a) Test of English as a Foreign Language (TOEFL) internet based test (IBT) total minimum score of 89 which includes: Reading Listening, Writing and Speaking
(b) Hold an official United States Citizenship and Immigration Services’ Health Care Worker Certification issued no more than five years immediately preceding the date of the application by the Foreign Credentialing Commission of Physical Therapy (FCCPT) or Commission on Graduates of Foreign Nursing Schools (CGFNS); or
(c) Applicants of physical therapy programs from Australia, Canada, with the exception of Quebec, Ireland, New Zealand, the United Kingdom, and the United States are deemed to be proficient in the English language.

004.01(B) EXAMINATION. Documentation of passing the licensure examination sent directly to the Department by the examining entity.

Question 10

What are the certification requirements for a PTA?
(5 items of documentation)

Answer 10

A complete application and the following documentation:

(A) EDUCATION. Submit an official transcript, sent directly from the issuing institution, verifying completion of an approved PTA educational program.

(B) EXAMINATION. Documentation of passing the certification examination with a scaled score that is greater than or equal to 600 on the National Physical Therapist Assistant Examination; and documentation of passing the Jurisprudence (NE LAW) Examination with a scaled score that is greater than or equal to 600.

(C) CREDENTIALED IN ANOTHER JURISDICTION AND CURRENTLY PRACTICING. Applicants must meet requirements for a credential as outlined

(D) CREDENTIALED IN ANOTHER JURISDICTION AND HAS NOT PRACTICED WITHIN THE 3 YEARS PRECEDING THE APPLICATION.
Applicants must meet requirements for a credential as outlined and must provide documentation of obtaining 15 hours of acceptable continuing education for a PTA within the 3 years immediately preceding the date of application.

(E) PASSED THE CERTIFICATION EXAMINATION MORE THAN 3 YEARS AGO BUT NOT PRACTICING. Applicants that have met the credentialing requirements outlined, who passed the certification examination more than 3 years prior to the time of application must provide documentation of obtaining 15 hours of acceptable continuing education for a PTA within the 3 years immediately preceding the date of application.

Question 11

Renewal, Waiver of continuing education and inactive status

Answer 11

The applicant must meet the requirements set out in 172 NAC 10 and this chapter. All PT and PTA licenses expire on November 1st of each odd-numbered year.

Question 12

Law concerning fine-wire electromyography and dry needling

Answer 12

A PT who wishes to perform tissue penetration for the purpose of fine-wire electromyography or dry needling must meet one of the following requirements:
(A) Completion of a pre-service or in-service training, including:
(i) Pertinent anatomy and physiology;
(ii) Choice and operation of equipment;
(iii) Knowledge of test indications;
(iv) Proper technique of tissue penetration;
(v) Sterile methods, hazards, and complications;
(vi) Post-test care;
(vii) Knowledge in test interpretation; and
(viii) For the purposes of fine-wire electromyography, documentation of 10 kinesiology electromyography examinations in an educational environment or, for the purposes of dry-needling, tissue palpation;

(B) Authorization from another state to perform fine-wire electromyography or dry-needling with substantially equivalent requirements;

(C) For the purpose of fine-wire electromyography, certification from the American Board of Physical Therapy Specialties in the area of Clinical Electrophysiology.

Question 13

Requirements for supervision of PTAs (6 items)

Answer 13

(A) A PT may provide general supervision for no more than 2 PTAs at any point in time during the PT’s work day;

(B) All physical therapy services performed by a PTA under the general supervision of a supervising PT:
(i) All telecommunications must be documented in the medical records of patients under care of the supervising PT; and
(ii) When the supervising PT is unavailable, they must transfer responsibility of all patient care to another qualified PT who will assume responsibility for all patient care including those being rendered by the PTA under general supervision; and

(C) The supervising PT maintains primary responsibility for all patient care services including those rendered by a PTA under general supervision;

(D) A supervising PT must re-evaluate or re-examine each patient and the plan of care of the patient receiving PT services from a PTA a minimum of least 1 time every 30 calendar days under general supervision. More frequent re-evaluations or re-examinations by the supervising PT may be warranted,
dependent upon the following parameters:
(i) Patient complexity and acuity;
(ii) Upon request by the PTA;
(iii) When a change in treatment plan is warranted;
(iv) Any significant change in the medical status of the patient; and
(v) Upon request by the patient; and

(E) The supervising PT must provide final documentation for discharge of patient care being rendered by a PTA under general supervision, including patient response to treatment at the time of discharge; and

(F) The PTA may participate in the discharge process for patient care by providing subjective and objective patient information to the supervising PT.

Question 14

General supervision of PTAs in satellite clinics, which include what settings?

Answer 14

May use general supervision by supervising PT in:
(1) Rehabilitation facilities;
(2) Acute care facilities;
(3) Skilled nursing facilities;
(4) Nursing homes;
(5) Schools-based settings;
(6) Outpatient clinics;
(7) Home health; and
(8) Client preventative facilities.

Question 15

Supervisory Requirements of PTAs in satellite clinics: (4 items)

Answer 15

(i) A supervisory visit with the PT will be made every 30 days or at a higher frequency if warranted. More frequent reevaluations or re-examinations by the supervising physical therapist may be warranted, dependent upon the following parameters:
(1) Patient complexity and acuity;
(2) Upon request by the PTA
(3) When a change in treatment plan is warranted;
(4) Any significant change in the medical status of the patient;
(5) Upon request by the patient;

(ii) A supervisory visit may occur in any clinical setting where the supervising PT renders patient care. The on-site visit must include:
(1) Direct patient contact for the purpose of reevaluation or reexamination of patient status;
(2) A review of the plan of care with revision and or termination of treatment as warranted; and
(3) A re-assessment for utilization of outside resources for physical therapy services; and

(iii) The supervising PT must provide final documentation for discharge of patient care being rendered by a PTA in a satellite clinic under general supervision, including patient response to treatment at the time of discharge. The PTA may participate in the discharge process for patient care by providing subjective and objective patient information to the supervising physical therapist;

(iv) A PT is not authorized to establish a satellite clinic for the purpose of rendering physical therapy services staffed solely by a PTA.

Question 16

Requirements for the assignment of services to the PTA:
It is the responsibility of the supervising physical therapist to determine which tasks require the clinical reasoning expertise of the physical therapist and which tasks can be safely assigned to the
physical therapist assistant under general supervision.
- Why? and Including which settings? (9 items)

Answer 16

Why: Depending on clinical practice setting and patient complexity and acuity
(i) Rehabilitation facilities;
(ii) Acute care facilities;
(iii) Skilled nursing facilities;
(iv) Nursing homes;
(v) School-based settings;
(vi) Out-patient clinics;
(vii) Home health;
(viii) Industrial rehabilitation facilities; and
(ix) Client preventative services.

Question 17

Factors in Direct Patient care that the supervising must consider when delegating to PTA (5 items)

Answer 17

(1) Predictability of action - How confident is the PTA in predicting consequences of action related to patient care?

(2) Stability of the environment - How confident is the PTA in clinical problem solving issues related to change in patient status?

(3) Observability of patient status – How easy is it to observe or perceive relevant clinical indicators of patient status?

(4) Ambiguity of patient status – How difficult is it to interpret phenomena related to change in relevant clinical indicators?

(5) Criticality of patient treatment – What consequences exist for a poor choice in patient intervention?

Question 18

Responsiblities of the supervising PT for each patient’s care (6 items)

Answer 18

(A) Be responsible for managing all aspects of PT services provided to the patient and assume legal liability for PT and related services provided under their supervision;

(B) Provide initial evaluation and documentation of the evaluation;

(C) Provide periodic reevaluation and documentation of the reevaluation;

(D) Provide documentation for discharge, including the patient’s response to therapeutic intervention at the time of discharge;

(E) Be responsible for accurate documentation and billing for services
provided; and

(F) On each date physical therapy services are provided to a patient, a PT must:
(i) Provide all therapeutic interventions that require the expertise of a PT for example, sharp wound debridement and high velocity low amplitude manual therapy techniques (grade 5 joint mob); and
(ii) Determine the appropriate us of PTAs or PT aides

Question 19

What are PT aides authorized to do?
(under supervision or PT or PTA)

Answer 19

-clerical, housekeeping, facility maintenance or patient transportation services related to the practice of physical therapy such as:
(A) Transporting patients;
(B) Assisting a patient in preparation for treatment;
(C) Removing and applying assistive and supportive devices; and
(D) Other non-treatment related tasks

Question 20

How may a PT aide perform treatment-related tasks with direct supervision?

Answer 20

when treatment is initiated by a PT/PTA and only under direct supervision. A physical therapy aide:
(A) Must not solely provide an intervention;
(B) Must receive training from a PT for all treatment related tasks that the aide will perform;
(C) Must receive supervision, orders, and directions only from a PT or PTA and
(D) Must be knowledgeable of the preparation of equipment and accessories and all other operational activities relevant to equipment and accessories necessary for treatment.

Question 21

Unprofessional conduct: elaborate on-
1) competence
2) confidentiality

Answer 21

1) competence:
A PT/PTA must not provide services for which they are not trained or experienced. Unprofessional conduct in the practice of physical therapy includes: Performing or agreeing to perform procedures when the procedures are known to be a departure from the standards of acceptable and prevailing practice in physical therapy. Unprofessional conduct does not include a single act of ordinary negligence.

2) confidentiality:
Without the prior written consent of a patient, a PT/PTA must hold in confidence information obtained from a patient, except in those unusual circumstances in which to do so would result in clear danger to the person or to others, or where otherwise required by law.

Question 22

Unprofessional conduct in professional relationships: (11 items)

Answer 22

A PT/PTA must safeguard the welfare of patients and maintain professional relationships with patients. These acts/behaviors:

(A) Exploiting another person for one’s own advantage;
(B) Performing or agreeing to perform PT services that have been requested when the services are known to be contraindicated or unjustified;
(C) Performing or agreeing to perform procedures that have been requested when the procedures are known to be outside of the PT/PTA’s scope of practice;
(D) Verbally or physically abusing patients;
(E) Falsification or unauthorized destruction of patient’s records;
(F) Attempting to provide diagnostic or treatment information to a patient that is beyond the PT/PTA’s level of education, training and expertise;
(G) Delegating to other personnel those patient related services for which the clinical skills and expertise of a PT/PTA are required;
(H) Encouraging or promoting the practice of PT by untrained or unqualified persons;
(I) Failure to safeguard the patient’s dignity and right to privacy;
(J) Failure to maintain adequate patient records;
(K) Delegating to a PTA those patient related services for which the clinical skills and expertise of a PT are required.

Question 23

Types of Sexual misconduct (2 items)

Answer 23

(A) Engaging in sexual relationships, whether consensual or nonconsensual, with any patient while a PT/PTA and patient relationship exists;

(B) Engaging in sexual harassment of patients:
includes making unwelcome sexual advances, requesting sexual favors, and engaging in other verbal or physical conduct of a sexual nature which results in:

(i) Providing or denying PT to a patient;
(ii) Creating an intimidating, hostile, or offensive environment for the patient; or
(iii) Interfering with a patient’s ability to recover.

Question 24

Miscellaneous types of unprofessional conduct (9 items)

Answer 24

(A) The violation of an assurance of compliance entered into under the Uniform Credentialing Act;
(B) Failure to follow policies or procedures implemented in the practice situation to safeguard patient care;
(C) Failure to exercise appropriate supervision over persons who are authorized to practice only under the supervision of a PT;
(D) Failure to obtain patient informed consent before treatment;
(E) Failure to take steps to transfer the continuum of care of the patient, as appropriate, to another health care provider in the event of elective termination of PT services by the PT;
(F) Engaging in conduct that subverts or undermines the integrity of the examination or the examination process including, utilizing in any manner recalled or memorized examination questions
from or with a person or entity, failing to comply with all test center security procedures, communicating or attempting to communicate with other examinees during the test, or copying or sharing examination questions or portions of questions;
(G) Failure to complete continuing competency requirements as established by rules and regulations as specified in this chapter;
(H) Promoting any unnecessary device, treatment intervention or service resulting in the financial gain of the practitioner or of a third party
(I) Participating in underutilization or overutilization

Question 25

How to renew credentials (before expiration date and with continuing competency requirements)

Answer 25

004.01 RENEWAL INFORMATION. The credential holder must provide:

(A) Legal name and any other names by which the credential holder is known;
(B) Complete mailing address;
(C) Social security number (SSN) or Alien Registration Number (A#). (or both if they have both)
(D) Telephone number and e-mail address.

004.02 DOCUMENTATION. submit the following documentation and information with the renewal application to the department:

(A) CITIZENSHIP OR LAWFUL PRESENCE. 1.
(B) CONVICTION INFORMATION. If the credential holder has been convicted of a felony or misdemeanor in Nebraska or another jurisdiction since his or her last renewal or during the time period since initial credentialing if such occurred within the previous two years, the credential holder must submit:

(i) A copy of the court record related to all misdemeanor and felony convictions, that includes the statement of charges and final disposition, if the conviction(s) occurred in a state other than Nebraska;
(ii) An explanation of the events leading to the conviction (what, when, where, why) and a summary of actions that the credential holder has taken to address the behaviors or actions related to the conviction; and
(iii) A letter from the credential holder’s probation officer addressing the terms and current status of the probation, if the credential holder is currently on probation.

(C) DRUG OR ALCOHOL RELATED CONVICTIONS. submit evaluation and discharge summaries where drug or alcohol treatment was obtained or required. May be submitted by the provider directly to the department.

(D) OTHER CREDENTIAL INFORMATION. If the credential holder holds a credential in another jurisdiction and that credential has been disciplined, provide the name of the jurisdiction, credential number, a list of any disciplinary actions taken against the individual’s credential, and a copy of the disciplinary action(s), including charges and disposition.

(E) DENIAL. If the credential holder was denied a credential in another jurisdiction, provide an explanation of the basis for the denial and a copy of the denial documentation.

004.03 WAIVERS OF CONTINUING COMPETENCY REQUIREMENTS. Continuing competency requirements and renewal fees can be waived under certain circumstances.

004.03(A) MILITARY SERVICE. Credential holders actively engaged in military service are not required to pay the renewal fee or meet the continuing competency requirements. The department may conduct an audit of military status. Each credential holder selected for audit must produce documentation of active military services within 30 days.

004.03(B) FIRST CREDENTIALED. The department waives continuing competency requirements for credential holders who were first credentialed within the 24-month period immediately prior to the renewal date.

004.04 INACTIVE STATUS. When a credential holder wants to have his or her credential placed on inactive status, the credential holder must comply with the requirements of Neb. Rev. Stat. § 38-142(3).

Question 26

How is unprofessional conduct treated?

Answer 26

With DISCIPLINARY ACTION . A credential holder may be denied, refused renewal, or have other disciplinary measures taken against the credential for grounds specified, including for unprofessional conduct

Question 27

HOw to petition voluntary surrender or limitation of credentials. Documentation includes 9 items)

Answer 27

(A) legal name and any other names

(B) complete mailing address;

(C) telephone number and e-mail address;

(D) The credential(s) and credential number(s) that would be surrendered or limited;

(E) The desired time frame for offered surrender or limitation:
(i) Permanently; (forever, no exceptions)
(ii) Indefinitely; or
(iii) Definite period of time (specify);

(F) The specific reason for offered surrender or limitation of the credential;

(G) Any specific terms and conditions that the credential holder wishes to have the department consider and apply to the offer;

(H) An attestation that all the information on the offer is true and complete; and

(I) signature and date.

Question 28

How to be reinstated with credentials in NE (3 items)

Answer 28

007.01 ELIGIBILITY. An individual may apply for reinstatement as follows:

(A) An individual whose credential has expired, been placed on inactive status, voluntarily surrendered for an indefinite period of time, or suspended or limited for disciplinary reasons, may apply for reinstatement at any time.
(B) An individual whose credential has been voluntarily surrendered for a definite period of time may apply for reinstatement after that period of time has elapsed.
(C) An individual whose credential has been revoked may apply for reinstatement only after a period of two years has elapsed from the date of revocation.

007.02 INELIGIBILITY. An individual whose credential has been permanently voluntarily surrendered is not eligible to have his or her credential reinstated and may not apply for a new credential to practice the same profession or occupation.

007.03 APPLICATION AND DOCUMENTATION. To reinstate a credential, an individual must submit a complete application, have met the continuing competency requirements, and meet the requirements set out in Neb. Rev. Stats. § 38-129 and §§ 4-108 through 4-111.

007.03(A) INFORMATION. The individual must submit the following information:
(i) Legal name and any other names by which the individual is known;
(ii) Complete mailing address;
(iii) Social security number (SSN) or Alien Registration Number (A#). (or both)
(iv) Telephone number and e-mail address;
(v) Whether the individual holds a credential(s) in another jurisdiction(s) to provide health services, health-related services or environmental services; and
(vi) If making application following voluntary surrender or disciplinary action, information relating to what actions the individual has taken to address the reasons that caused the action.

007.03(B) DOCUMENTATION. submit the following-

(i) CITIZENSHIP OR LAWFUL PRESENCE. Documentation that the individual meets the requirements set out
(ii) OTHER CREDENTIAL INFORMATION. If the individual holds a credential to provide health services, health-related services, or environmental services in another jurisdiction, provide the name of the jurisdiction, credential number, type of credential, date issued, and expiration date for each credential the applicant holds or has held;
(iii) DISCIPLINARY ACTION. If the credential has been disciplined, a list of any disciplinary actions taken against the individual’s credential and a copy of the disciplinary action(s), including charges and disposition;
(iv) DENIAL. If the individual was denied a credential, an explanation of the basis for the denial and a copy of the denial documentation;
(v) CONVICTION INFORMATION. If the individual has been convicted of a felony or misdemeanor in Nebraska or another jurisdiction since the credential was last renewed or since the effective date of the disciplinary action was taken by the department, the individual must submit:

      (1) A copy of the court record related to all misdemeanor and felony convictions, that includes the statement of charges and final disposition, if the conviction(s) occurred in a state other than Nebraska;  
       (2) An explanation of the events leading to the conviction (what, when, where, why) and a summary of actions that the applicant has taken to address the behaviors or actions related to the conviction;  
       (3) A letter from the individual’s probation officer addressing the terms and current status of the probation, if the individual is currently on probation;  

(vi) DRUG OR ALCOHOL RELATED CONVICTIONS. To aid in the evaluation of an individual’s drug or alcohol related conviction(s), an individual may submit evaluation and discharge summaries where drug or alcohol treatment was obtained or required. Evaluations and discharge summaries may be submitted by the provider directly to the department.