A.R.S. tit. 32 ch. 19 — Arizona Revised Statutes Title 32 Chapter 19 — Board Of Physical Therapy

32-2001. Definitions In this chapter, unless the context otherwise requires: 1. "Assistive personnel": (a) Includes: (i) Physical therapist assistants. (ii) Physical therapy aides. (iii) Other assistive personnel who are trained or educated health care providers and who are not physical therapist assistants or physical therapy aides but who perform specific designated tasks related to physical therapy under the supervision of a physical therapist. At the discretion of the supervising physical therapist, and if properly credentialed and not prohibited by any other law, other assistive personnel may be identified by the title specific to their training or education. (b) Does not include either: (i) Personnel assisting other health care professionals licensed pursuant to this title in performing delegable treatment responsibilities within their scope of practice. (ii) Student physical therapists and student physical therapist assistants. 2. "Board" means the board of physical therapy. 3. "Business entity" means a business organization that has an ownership that includes any persons who are not licensed or certified to provide physical therapy services in this state, that offers to the public professional services regulated by the board and that is established pursuant to the laws of any state or foreign country. 4. "Dry needling" means a skilled intervention performed by a physical therapist that uses a thin filiform needle to penetrate the skin and stimulate underlying neural, muscular and connective tissues to evaluate and manage neuromusculoskeletal conditions, pain and movement impairments. 5. "General supervision": (a) Means that the supervising physical therapist is on call and is readily available via telecommunications when the physical therapist assistant is providing treatment interventions. (b) Includes supervision provided through telehealth as defined in section 36-3601. 6. "Interim permit" means a permit issued by the board that allows a person to practice as a physical therapist in this state or to work as a physical therapist assistant for a specific period of time and under conditions prescribed by the board before that person is issued a license. 7. "Manual therapy techniques" means a broad group of passive interventions in which physical therapists use their hands to administer skilled movements designed to modulate pain, increase joint range of motion, reduce or eliminate soft tissue swelling, inflammation or restriction, induce relaxation, improve contractile and noncontractile tissue extensibility, and improve pulmonary function. These interventions involve a variety of techniques, such as the application of graded forces. 8. "On-site supervision" means that the supervising physical therapist is on-site and is present in the facility or on the campus where assistive personnel, a holder of an interim permit, a student physical therapist or a student physical therapist assistant is performing services, is immediately available to assist the person being supervised in the services being performed and maintains continued involvement in appropriate aspects of each treatment session in which a component of treatment is delegated. 9. "Physical therapist" means a person who is licensed pursuant to this chapter. 10. "Physical therapist assistant" means a person who meets the requirements of this chapter for licensure and who performs physical therapy procedures according to the physical therapy plan of care of the supervising physical therapist. 11. "Physical therapy" means the care and services provided by or under the direction and supervision of a physical therapist who is licensed pursuant to this chapter. 12. "Physical therapy aide" means a person who is trained under the direction of a physical therapist and who performs designated and supervised routine physical therapy tasks. 13. "Practice of physical therapy" means: (a) Examining, evaluating and testing persons who have mechanical, physiological and developmental impairments, functional limitations and disabilities or other health and movement related conditions in order to determine a diagnosis, a prognosis and a plan of therapeutic intervention and to assess the ongoing effects of intervention, including ordering imaging. (b) Alleviating impairments and functional limitations by managing, designing, implementing and modifying therapeutic interventions including: (i) Therapeutic exercise. (ii) Functional training in self-care and in home, community or work reintegration. (iii) Manual therapy techniques. (iv) Therapeutic massage. (v) Assistive and adaptive orthotic, prosthetic, protective and supportive devices and equipment. (vi) Pulmonary hygiene. (vii) Debridement and wound care. (viii) Physical agents or modalities. (ix) Mechanical and electrotherapeutic modalities. (x) Patient related instruction. (c) Reducing the risk of injury, impairments, functional limitations and disability by means that include promoting and maintaining a person's fitness, health and quality of life. (d) Engaging in administration, consultation, education and research. 14. "Restricted license" means a license on which the board places restrictions or conditions, or both, as to the scope of practice, place of practice, supervision of practice, duration of licensed status or type or condition of a patient to whom the licensee may provide services. 15. "Restricted registration" means a registration on which the board places any restrictions as the result of disciplinary action. 16. "Student physical therapist" means a person who is enrolled in a doctor of physical therapy program that is accredited by or has candidate status by the commission on accreditation in physical therapy education. 17. "Student physical therapist assistant" means a person who is enrolled in an academic physical therapist assistant program that is accredited by or has candidate status by the commission on accreditation in physical therapy education. 32-2002. Board of physical therapy; membership; appointment; qualifications; terms; removal; reimbursement; immunity A. The board of physical therapy is established consisting of members appointed by the governor pursuant to section 38-211. Four members shall be physical therapists who are residents of this state, possess an unrestricted license to practice physical therapy in this state and have been practicing in this state for at least five years before their appointment. One member shall be a physical therapist assistant who is a resident of this state, possesses an unrestricted license issued pursuant to this chapter and has been performing selected interventions in this state for at least five years before the person's appointment. The governor shall also appoint two public members who are residents of this state and who are not affiliated with, and do not have a financial interest in, any health care profession but who have an interest in consumer rights. B. Board members serve staggered four-year terms. Board members shall not serve for more than two successive four-year terms or for more than ten consecutive years. By approval of a majority of the board, a member's service may extend at the completion of a four-year term until a new member is appointed or the current member is reappointed. C. If requested by the board the governor may remove a board member for misconduct, incompetence or neglect of duty. D. Board members are eligible for reimbursement of expenses pursuant to title 38, chapter 4, article 2 to cover necessary expenses for attending each board meeting or for representing the board in an official board approved activity. E. A board member who acts within the scope of board duties, without malice and in the reasonable belief that the person's action is warranted by law is immune from civil liability. 32-2003. Board; powers and duties A. The board shall: 1. Evaluate the qualifications of applicants for licensure. 2. Provide for national examinations for physical therapists and physical therapist assistants and adopt passing scores for these examinations. 3. Issue licenses and permits to persons who meet the requirements of this chapter. 4. Regulate the practice of physical therapy by interpreting and enforcing this chapter. 5. Adopt and revise rules to enforce this chapter. 6. Meet at least once each quarter in compliance with the open meeting requirements of title 38, chapter 3, article 3.1 and keep an official record of these meetings. 7. Establish the mechanisms for assessing continuing professional competence of physical therapists to engage in the practice of physical therapy and the competence of physical therapist assistants to work in the field of physical therapy. 8. At its first regular meeting after the start of each calendar year, elect officers from among its members and as necessary to accomplish board business. 9. Provide for the timely orientation and training of new professional and public appointees to the board regarding board licensing and disciplinary procedures, this chapter, board rules and board procedures. 10. Maintain a current list of all persons regulated under this chapter. This list shall include the person's name, current business and residential addresses, telephone numbers and license number. 11. Subject to title 41, chapter 4, article 4, employ necessary personnel to carry out the administrative work of the board. Board personnel are eligible to receive compensation pursuant to section 38-611. 12. Enter into contracts for services necessary for adequate enforcement of this chapter. 13. Report final disciplinary action taken against a licensee to a national disciplinary database recognized by the board. 14. Publish, at least annually, final disciplinary actions taken against a licensee. 15. Publish, at least annually, board rulings, opinions and interpretations of statutes or rules in order to guide persons who are regulated pursuant to this chapter. 16. Not later than December 31 of each year, submit a written report of its actions and proceedings to the governor. 17. Establish and collect fees. 18. Provide information to the public regarding the board, its processes and consumer rights. B. The board may establish a committee or committees to assist it in carrying out its duties for a time prescribed by the board. The board may require a committee appointed pursuant to this subsection to make regular reports to the board. 32-2004. Board of physical therapy fund (L24, Ch. 222, sec. 29. Eff. until 7/1/28) A. The board of physical therapy fund is established. The board shall administer the fund. B. Except as provided in section 32-2048, pursuant to sections 35-146 and 35-147, the board shall deposit fifteen percent of all monies collected under this chapter in the state general fund and deposit the remaining eighty-five percent in the board of physical therapy fund. C. Monies deposited in the physical therapy fund are subject to section 35-143.01. 32-2004. Board of physical therapy fund (L24, Ch. 222, sec. 30. Eff. 7/1/28) A. The board of physical therapy fund is established. The board shall administer the fund. B. Except as provided in section 32-2048, pursuant to sections 35-146 and 35-147, the board shall deposit ten percent of all monies collected under this chapter in the state general fund and deposit the remaining ninety percent in the board of physical therapy fund. C. Monies deposited in the physical therapy fund are subject to section 35-143.01. 32-2021. Persons and activities not required to be licensed A. This chapter does not restrict a person who is licensed under any other law of this state from engaging in the profession or practice for which that person is licensed if that person does not claim to be a physical therapist or a provider of physical therapy. B. This chapter does not restrict the use of physical agents, modalities or devices by persons qualified under this title to personally render or delegate the use of this treatment. C. The following persons are exempt from the licensure requirements of this chapter: 1. A person in a professional education program approved by the board who is satisfying supervised clinical education requirements related to the person's physical therapist or physical therapist assistant education while under the on-site supervision of a physical therapist. 2. A physical therapist who is practicing or a physical therapist assistant who is working in the United States armed services, United States public health service or veterans administration pursuant to federal regulations for state licensure of health care providers. 3. A physical therapist who is licensed in another jurisdiction of the United States or a foreign educated physical therapist credentialed in another country if that person is performing physical therapy in connection with teaching or participating in an educational seminar for not more than sixty days in any twelve month period. 4. A physical therapist who is licensed in another jurisdiction of the United States or who is credentialed in another country if that person by contract or employment is providing physical therapy to persons who are affiliated with or employed by established athletic teams, athletic organizations or performing arts companies temporarily practicing, competing or performing in this state for not more than sixty days in a calendar year. 5. A physical therapist who is licensed in another jurisdiction of the United States and who enters this state to provide physical therapy to victims of a declared local, state or national disaster or emergency. This exemption applies for the duration of the declared emergency but not longer than sixty days. The physical therapist must also register with the board before practicing. 32-2022. Qualifications for licensure; fingerprint clearance card A. An applicant for a license as a physical therapist who has been educated in the United States shall: 1. Complete the application process. 2. Be a graduate of a professional physical therapy education program that is accredited by a national accreditation agency approved by the board. 3. Have successfully passed the national examination approved by the board. 4. Have successfully passed a jurisprudence examination that tests the applicant's knowledge of board statutes and rules. 5. Obtain a valid fingerprint clearance card issued pursuant to section 41-1758.03. B. An applicant for a license as a physical therapist who has been educated outside of the United States shall: 1. Complete the application process. 2. Provide satisfactory evidence that the applicant's education is substantially equivalent to the requirements of physical therapists educated in accredited educational programs as determined by the board. If the board determines that a foreign-educated applicant's education is not substantially equivalent, it may require the person to complete additional coursework before it proceeds with the application process. It is not necessary that coursework completed by the applicant be identical in all respects to that required by an education program in the United States for an entry-level physical therapy degree, but all required content areas must be evident as required by board rules. Deficiencies may occur only in coursework and not in essential areas of professional education and shall not be of a magnitude that would cause the education to be deemed below entry-level preparation for practice in this state. 3. Provide written proof of legal authorization to practice as a physical therapist without limitation in the country where the professional education occurred. The board may waive this requirement on receipt of written proof that the applicant cannot demonstrate legal authorization based on the citizenship requirements of the country where the professional education occurred. 4. Provide proof of legal authorization to reside and seek employment in the United States or its territories. 5. Have passed the board-approved English proficiency examinations if the applicant's native language is not English. 6. Have participated in an interim supervised clinical practice period before licensure as approved by the board or shall have already met this requirement to the board's satisfaction by virtue of the applicant's clinical practice in another jurisdiction of the United States. 7. Have successfully passed the national examination approved by the board. 8. Have successfully passed a jurisprudence examination that tests the applicant's knowledge of board statutes and rules. 9. Obtain a valid fingerprint clearance card issued pursuant to section 41-1758.03. C. Notwithstanding the requirements of subsection B of this section, if the foreign-educated physical therapist applicant is a graduate of an accredited educational program as determined by the board, the board may waive the requirements of subsection B, paragraphs 2 and 6 of this section. D. An applicant for licensure as a physical therapist assistant shall meet the following requirements: 1. Complete the application process. 2. Be a graduate of a physical therapist assistant education program accredited by an agency approved by the board. 3. Have successfully passed the national examination approved by the board. 4. Have successfully passed a jurisprudence examination that tests the applicant's knowledge of board statutes and rules. 5. Obtain a valid fingerprint clearance card issued pursuant to section 41-1758.03. E. For the purposes of subsection B, paragraph 2 of this section, "substantially equivalent" means that the applicant provides documentation satisfactory to the board that: 1. The applicant graduated from a physical therapist education program that prepares the applicant to engage without restriction in the practice of physical therapy. 2. The applicant's school of physical therapy education is recognized by its own ministry of education. The board may waive this requirement for good cause shown. 3. The applicant has undergone a credentials evaluation as directed by the board that determines that the applicant has met uniform criteria for educational requirements pursuant to board rules. 4. The applicant has completed any additional education required by the board. 32-2023. Application; denial; hearing A. An applicant for licensure shall file a completed application as required by the board. The applicant shall include the application fee prescribed in section 32-2029. B. The board may deny a license to an applicant or a licensee for any of the following: 1. Knowingly making a false statement of fact required to be revealed in the initial application, renewal application or reinstatement application for a license. 2. Committing fraud in the procurement of a license. 3. Committing a felony, whether or not involving moral turpitude, or a misdemeanor involving moral turpitude. In either case conviction by a court of competent jurisdiction is conclusive evidence of the commission. 4. Attempting to engage in conduct that subverts or undermines the integrity of the examination or the examination process, including using 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 examination or copying or sharing examination questions or portions of questions. 5. Engaging in any conduct that would be considered a violation of section 32-2044. C. If the board denies an application because of deficiencies or reasons in an application or for a reason prescribed in subsection B of this section, the board must inform an applicant of those specific deficiencies. On receipt of a written request by an applicant who disagrees with the board's decision to deny an application, the board shall hold a hearing pursuant to title 41, chapter 6, article 10. 32-2024. Examinations A. The board shall prescribe examinations for licensure and determine the passing score. B. An applicant may take the examinations for licensure if either of the following applies: 1. The applicant has met all of the requirements of section 32-2022, subsection A, paragraphs 1 and 2 and has paid the fees prescribed by this chapter. 2. The applicant has: (a) Met all of the requirements of section 32-2022, subsection A, paragraph 1. (b) Paid the fees prescribed by this chapter. (c) Submitted with the application a letter on the official letterhead of the accredited educational institution where the applicant is completing an accredited educational program that includes the signature of the program director, the department chairperson or a similarly authorized person of the university or college and that states that: (i) The applicant is a candidate for a degree as a physical therapist at the next scheduled graduation date. (ii) The date the national examination for licensure is to be taken by the applicant is the one nearest to and before the applicant's expected graduation date and is not more than one hundred twenty days before the date of the applicant's expected graduation date. (iii) The applicant meets any other established requirements of the accredited educational program, if applicable. C. An applicant may take the examinations for licensure if the applicant has met all of the requirements of section 32-2022, subsection B, paragraphs 1 through 5 and has paid the fees prescribed by this chapter. D. An applicant may take the examinations for licensure if either of the following applies: 1. The applicant has met all of the requirements of section 32-2022, subsection D, paragraphs 1 and 2 and has paid the fees prescribed by this chapter. 2. The applicant has: (a) Met all of the requirements of section 32-2022, subsection D, paragraph 1. (b) Paid the fees prescribed by this chapter. (c) Submitted with the application a letter on the official letterhead of the accredited educational institution where the applicant is completing an accredited educational program that includes the signature of the program director, the department chairperson or a similarly authorized person of the university, school or college and that states that: (i) The applicant is a candidate for a certificate or degree as a physical therapist assistant at the next scheduled graduation date. (ii) The date the national examination for licensure is to be taken by the applicant is the one nearest to and before the applicant's expected graduation date and is not more than one hundred twenty days before the date of the applicant's expected graduation date. (iii) The applicant meets any other established requirements of the accredited educational program, if applicable. E. An applicant for licensure who does not pass the national examination after the first attempt may retake the examination one additional time within six months after the first failure without reapplication for licensure. An applicant may retake the examinations as prescribed by the organization that administers the examinations. F. The board shall not issue a license to a person who passes an examination through fraud. G. The national examination for licensure as a physical therapist shall test entry-level competence related to physical therapy theory, examination and evaluation, diagnosis, prognosis, treatment intervention, prevention and consultation. The national examination for licensure as a physical therapist assistant shall test for requisite knowledge and skills in the technical application of physical therapy services. 32-2025. Interim permits A. If a foreign educated applicant satisfies the requirements of section 32-2022, subsection B, before the board issues a license it shall issue an interim permit to the applicant for the purpose of participating in a supervised clinical practice period. An applicant who fails the national examination is not eligible for an interim permit until the applicant passes the examination. B. If an applicant who has been educated in the United States satisfies the requirements of section 32-2022, subsection A or D, but the board determines that there is evidence that the applicant lacks the competence to practice as a physical therapist or work as a physical therapist assistant, the board shall issue an interim permit to the applicant to allow that person to participate in a supervised clinical practice. C. The board may issue an interim permit for at least ninety days but not more than six months. D. An interim permit holder shall complete, to the satisfaction of the board, a period of clinical practice in a facility approved by the board and under the continuous and on-site supervision of a physical therapist who holds an unrestricted license issued pursuant to this chapter. E. At any time during an interim supervised clinical practice period, the board may revoke an interim permit because of the permit holder's incompetence or for a violation of this chapter. Pursuant to title 41, chapter 6, article 10, the board shall hold a hearing on request of a permit holder whose permit is revoked. 32-2026. Licensure by endorsement A. The board shall issue a license to a physical therapist who has a valid unrestricted license from another jurisdiction of the United States if that person, when granted the license, met all of the requirements prescribed in section 32-2022, subsection A or B and any applicable board rules. B. The board shall issue a license to a physical therapist assistant who has a valid unrestricted license or certificate from another jurisdiction of the United States if that person, when granted the license or certificate, met all of the requirements prescribed in section 32-2022, subsection D and any applicable board rules. 32-2027. License renewal; suspension A. A licensee shall renew the license pursuant to board rules. Except as provided in section 32-4301, a licensee who fails to renew the license on or before its expiration date shall not practice as a physical therapist or work as a physical therapist assistant in this state. B. The board shall administratively suspend a license if the licensee does not submit a complete application for renewal and pay the renewal fee pursuant to board rules. 32-2028. Reinstatement of license A. The board may reinstate a license that it suspended pursuant to section 32-2027, subsection B on payment of a renewal fee and reinstatement fee and completion of the application process as prescribed by the board. B. If a person's license has been suspended pursuant to section 32-2027, subsection B for more than three consecutive years, the license expires and that person shall reapply for a license pursuant to section 32-2022 or 32-2026 and pay all applicable fees. The person must also demonstrate to the board's satisfaction competency by satisfying one or more of the following as prescribed by the board: 1. Practicing for a specified time under an interim permit. 2. Completing remedial courses. 3. Completing continuing competence requirements for the period of the lapsed license. 4. Passing an examination. 32-2029. Fees The board shall establish and collect fees of not more than: 1. $300 for an application for an original license. This fee is nonrefundable. 2. $300 for a certificate of renewal of a license. 3. $300 for an application for reinstatement of licensure. 4. $50 for each duplicate license. 32-2030. Business entities; patient records; protocol; exemptions; rules A. A business entity shall not offer physical therapy services pursuant to this chapter unless: 1. The business entity is registered with the board pursuant to this section. 2. The physical therapy services are conducted by a licensee pursuant to this chapter. B. The business entity must file a registration application on a form prescribed by the board. The application shall include: 1. A description of the entity's services offered to the public. 2. The name of the manager who is authorized and who is responsible for managing the physical therapy services offered at each office. 3. The names and addresses of the officers and directors of the business entity. 4. A registration fee prescribed by the board by rule. C. A business entity must file a separate registration application and pay a fee for each branch office in this state. D. A registration expires on August 31 of odd-numbered years in accordance with the physical therapist professional licensing schedule. A business entity that wishes to renew a registration must submit an application for renewal as prescribed by the board on a biennial basis on a form prescribed by the board before the expiration date. An entity that fails to renew the registration before the expiration date is subject to a late fee as prescribed by the board by rule. E. The business entity must notify the board in writing within thirty days after any change: 1. In the business entity's name, address or telephone number. 2. In the officers or directors of the business entity. 3. In the name of the manager who is authorized and who is responsible for managing the physical therapy services in any facility. F. The business entity must establish and implement a written protocol for the secure storage, transfer and access of the physical therapy records of the business entity's patients. This protocol must include, at a minimum, procedures for: 1. Notifying patients of the future locations of their records if the business entity terminates or sells the practice. 2. Disposing of unclaimed physical therapy records. 3. The timely response to requests by patients for copies of their records. G. The business entity must notify the board within thirty days after the dissolution of any registered business entity or the closing or relocation of any facility and must disclose to the board the entity's procedure by which its patients may obtain their records. H. This section does not apply to: 1. A sole proprietorship or partnership that consists exclusively of persons who are licensed by a health profession regulatory board as defined in section 32-3201. 2. A facility regulated by the federal government or a state, district or territory of the United States. 3. An administrator or executor of the estate of a deceased physical therapist or a person who is legally authorized to act for a physical therapist who has been adjudicated to be mentally incompetent for not more than one year from the date the board receives notice of the physical therapist's death or incapacitation. 4. A health care institution that is licensed pursuant to title 36. I. A facility that offers physical therapy services to the public by persons licensed under this chapter must be registered by the board unless the facility is any of the following: 1. Owned by a licensee. 2. Regulated by the federal government or a state, district or territory of the United States. J. Except for issues relating to insurance coding and billing that require the name, signature and license number of the physical therapist providing treatment, this section does not: 1. Authorize a licensee in the course of providing physical therapy services for an entity registered pursuant to this section to disregard or interfere with a policy or practice established by the entity for the operation and management of the business. 2. Authorize a business entity registered pursuant to this section to establish or enforce a business policy or practice that may interfere with the professional judgment of the licensee in providing physical therapy services for the business entity or may compromise a licensee's ability to comply with this chapter. K. The board shall adopt rules that provide a method for the board to receive the assistance and advice of business entities registered pursuant to this section in all matters relating to the regulation of business entities. L. The board shall adopt rules necessary to enforce this chapter in the practice settings of its licensees and registrants if the practice settings are not regulated by the department of health services. 32-2031. Retired status; reinstatement to active status A. The board shall place a licensee on retired status and waive the renewal fee and continuing competence requirements if a licensee presents a written affidavit to the board that the licensee has retired from the practice of physical therapy or from work as a physical therapist assistant, is in good standing with the board and has paid all fees required by this chapter before the waiver. B. During the period of waiver pursuant to subsection A of this section, the retired licensee may not engage in the practice of physical therapy or work as a physical therapist assistant. C. A retired licensee must renew the retired license every two years by verifying the person's contact information and using the same schedule for renewal of an active license. The board may not charge a fee for renewal of a retired license. D. If a licensee fails to renew the retired status of the license on or before its expiration date, the retired license expires. If the person seeks to reinstate the person's retired status after the retired license has expired, the person must make a request for retired status pursuant to subsection A of this section. E. The board may reinstate a retired licensee to active practice or work on payment of the renewal fee and presentation of evidence satisfactory to the board that the retired licensee is professionally able to engage in the practice of physical therapy or work as a physical therapist assistant and still possesses the professional knowledge required. If the retired licensee has held a retired license for more than three consecutive years, the person must also demonstrate competency to the board's satisfaction by satisfying one or more of the following as prescribed by the board: 1. Practicing or working for a specified time under an interim permit. 2. Completing remedial courses. 3. Completing continuing competence requirements for the period of the retired license. 4. Passing an examination as prescribed by the board. 32-2032. Inactive status; reinstatement to active status A. The board shall place a licensee on inactive status and waive the continuing competence requirements if a licensee presents a written affidavit to the board that the licensee is not currently engaged in the practice of physical therapy or working as a physical therapist assistant in this state, is in good standing with the board and has paid all fees required by this chapter. B. During the period of inactive status pursuant to subsection A of this section, the inactive licensee may not engage in the practice of physical therapy or work as a physical therapist assistant in this state. C. A licensee on inactive status must renew the inactive license every two years using the same schedule for renewal of an active license. The board by rule shall prescribe the fee for the renewal of an inactive license. D. An inactive licensee who applies to the board for reinstatement to active licensure within three years after the date the board issues a notice of inactive status must submit the full annual renewal fee and prove to the board's satisfaction that the licensee has met continuing competence requirements as prescribed by the board by rule. E. An inactive licensee who applies to the board for reinstatement to active licensure and who has not been actively engaged in the practice of physical therapy or working as a physical therapist assistant in this state for more than three consecutive years after the date the board issues a notice of inactive status must submit the full annual renewal fee and demonstrate competency to the board's satisfaction by satisfying one or more of the following as prescribed by the board: 1. Practicing or working for a specified time under an interim permit. 2. Completing remedial courses. 3. Completing continuing competence requirements for the period of the inactive license. 4. Passing an examination. 32-2041. Lawful practice A. A physical therapist shall refer a client to appropriate health care practitioners if the physical therapist has reasonable cause to believe symptoms or conditions are present that require services beyond the scope of practice or if physical therapy is contraindicated. B. A physical therapist shall adhere to the recognized standards of ethics of the physical therapy profession and as further established by rule. C. A physical therapist licensed under this chapter shall practice physical therapy as prescribed by this chapter. 32-2041.01. Imaging; ordering; requirements; reporting A. A physical therapist may order imaging. The imaging shall be performed by a health care practitioner who is authorized pursuant to this title to perform the imaging and shall be interpreted by a physician who is licensed pursuant to chapter 13, 14 or 17 of this title and trained in radiology interpretation. B. A physical therapist shall report results for all imaging tests that the physical therapist orders pursuant to subsection A of this section to the patient's health care practitioner of record or the referring health care practitioner, if designated, within seven days after receiving the results. If the patient does not have a health care practitioner of record, the physical therapist shall refer the patient to an appropriate health care practitioner if the physical therapist has reasonable cause to believe that any symptoms or conditions are present that may require services beyond the physical therapist's scope of practice. C. A physical therapist may order imaging pursuant to this section only for a patient with whom the physical therapist has a physical therapist-patient relationship and for whom there is a clinical need for the order. 32-2042. Use of titles; restrictions; violation; classification A. A physical therapist shall use the letters "PT" in connection with the physical therapist's name or place of business to denote licensure under this chapter. A physical therapist on retired status shall use "(retired)" or "(ret.)" after the letters "PT" in connection with the physical therapist's name or place of business to denote the physical therapist's retired status pursuant to section 32-2031. B. A physical therapist assistant shall use the letters "PTA" in connection with that person's name to denote licensure pursuant to this chapter. A physical therapist assistant on retired status shall use "(retired)" or "(ret.)" after the letters "PTA" in connection with the physical therapist assistant's name or place of business to denote the physical therapist assistant's retired status pursuant to section 32-2031. C. A person or business entity or its employees, agents or representatives shall not use in connection with that person's name or the name or activity of the business the words "physical therapy", "physical therapist", "physiotherapy", "physiotherapist" or "registered physical therapist", the letters "PT", "LPT", "RPT", "MPT", "DScPT" or "DPT" or any other words, abbreviations or insignia indicating or implying directly or indirectly that physical therapy is provided or supplied, including the billing of services labeled as physical therapy, unless these services are provided by or under the direction of a physical therapist who is licensed pursuant to this chapter. A person or entity that violates this subsection is guilty of a class 1 misdemeanor. D. A person or business entity shall not advertise, bill or otherwise promote a person who is not licensed pursuant to this chapter as being a physical therapist or offering physical therapy services. E. A person shall not use the title "physical therapist assistant" or use the letters "PTA" in connection with that person's name or any other words, abbreviations or insignia indicating or implying directly or indirectly that the person is a physical therapist assistant unless that person is licensed as a physical therapist assistant pursuant to this chapter. A person who violates this subsection is guilty of a class 1 misdemeanor. 32-2043. Supervision; patient care management A. A physical therapist is responsible for patient care given by assistive personnel, student physical therapists and student physical therapist assistants under the physical therapist's supervision. A physical therapist may delegate to assistive personnel and supervise selected acts, tasks or procedures that fall within the scope of physical therapy practice but that do not exceed the education or training of the assistive personnel. B. A physical therapist assistant who is licensed pursuant to this chapter may provide physical therapy services under the general supervision of a physical therapist who is licensed pursuant to this chapter. C. A physical therapy aide and other assistive personnel shall perform designated routine tasks only under the on-site supervision of a licensed physical therapist. D. A licensed physical therapist must provide on-site supervision of an interim permit holder. E. A physical therapist student and a physical therapist assistant student must practice under the on-site supervision of a licensed physical therapist. F. A physical therapist is responsible for managing all aspects of the physical therapy care of each patient. A physical therapist must provide: 1. The initial evaluation of and documentation for a patient. 2. Periodic reevaluation of and documentation for a patient. 3. The documented discharge of a patient, including the response to therapeutic intervention at the time of discharge. G. A physical therapist must verify the qualifications of physical therapist assistants and other assistive personnel under the physical therapist's direction and supervision. H. For each patient on each date of service, a physical therapist must provide and document all of the therapeutic intervention that requires the expertise of a physical therapist to ensure the delivery of care that is safe, effective and efficient. Documentation for each date of service must be as prescribed by the board by rule. I. A physical therapist assistant must document care provided but may do so without the cosignature of the supervising physical therapist if the physical therapist complies with the requirements of subsections G and H of this section. J. A physical therapist's responsibility for patient care management includes accurate documentation and billing of the services provided. 32-2044. Grounds for disciplinary action The following are grounds for disciplinary action: 1. Violating this chapter, board rules or a written board order. 2. Practicing or offering to practice beyond the scope of the practice of physical therapy. 3. Obtaining or attempting to obtain a license by fraud or misrepresentation. 4. Engaging in the performance of substandard care by a physical therapist due to a deliberate or negligent act or failure to act regardless of whether actual injury to the patient is established. 5. Engaging in the performance of substandard care by a physical therapist assistant, including exceeding the authority to perform tasks selected and delegated by the supervising licensee regardless of whether actual injury to the patient is established. 6. Failing to supervise assistive personnel, physical therapy students or interim permit holders in accordance with this chapter and rules adopted pursuant to this chapter. 7. Conviction of a felony, whether or not involving moral turpitude, or a misdemeanor involving moral turpitude. In either case conviction by a court of competent jurisdiction is conclusive evidence of the commission and the board may take disciplinary action when the time for appeal has lapsed, when the judgment of conviction has been affirmed on appeal or when an order granting probation is made suspending the imposition of sentence, irrespective of a subsequent order. For the purposes of this paragraph, "conviction" means a plea or verdict of guilty or a conviction following a plea of nolo contendere. 8. Practicing as a physical therapist or working as a physical therapist assistant when physical or mental abilities are impaired by disease or trauma, by the use of controlled substances or other habit-forming drugs, chemicals or alcohol or by other causes. 9. Having had a license or certificate revoked or suspended or other disciplinary action taken or an application for licensure or certification refused, revoked or suspended by the proper authorities of another state, territory or country. 10. Engaging in sexual misconduct. For the purposes of this paragraph, "sexual misconduct" includes: (a) Engaging in or soliciting sexual relationships, whether consensual or nonconsensual, while a provider-patient relationship exists. (b) Making sexual advances, requesting sexual favors or engaging in other verbal conduct or physical contact of a sexual nature with patients. (c) Intentionally viewing a completely or partially disrobed patient in the course of treatment if the viewing is not related to patient diagnosis or treatment under current practice standards. 11. Directly or indirectly requesting, receiving or participating in the dividing, transferring, assigning, rebating or refunding of an unearned fee or profiting by means of any credit or other valuable consideration such as an unearned commission, discount or gratuity in connection with the furnishing of physical therapy services. This paragraph does not prohibit the members of any regularly and properly organized business entity recognized by law and composed of physical therapists from dividing fees received for professional services among themselves as they determine necessary to defray their joint operating expense. 12. Failing to adhere to the recognized standards of ethics of the physical therapy profession. 13. Charging unreasonable or fraudulent fees for services performed or not performed. 14. Making misleading, deceptive, untrue or fraudulent representations in violation of this chapter or in the practice of the profession. 15. Having been adjudged mentally incompetent by a court of competent jurisdiction. 16. Aiding or abetting a person who is not licensed in this state and who directly or indirectly performs activities requiring a license. 17. Failing to report to the board any direct knowledge of an unprofessional, incompetent or illegal act that appears to be in violation of this chapter or board rules. 18. Interfering with an investigation or disciplinary proceeding by failing to cooperate, by wilful misrepresentation of facts or by the use of threats or harassment against any patient or witness to prevent the patient or witness from providing evidence in a disciplinary proceeding or any legal action. 19. Failing to maintain patient confidentiality without prior written consent of the patient or unless otherwise required by law. 20. Failing to maintain adequate patient records. For the purposes of this paragraph, "adequate patient records" means legible records that comply with board rules and that contain at a minimum an evaluation of objective findings, a diagnosis, the plan of care, the treatment record, a discharge summary and sufficient information to identify the patient. 21. Promoting an unnecessary device, treatment intervention or service for the financial gain of the practitioner or of a third party. 22. Providing treatment intervention unwarranted by the condition of the patient or treatment beyond the point of reasonable benefit. 23. Failing to report to the board a name change or a change in business or home address within thirty days after that change. 24. Failing to complete continuing competence requirements as established by the board by rule. 25. Failing to demonstrate professional standards of care and training and education qualifications, as established by the board by rule, in the performance of dry needling when provided as a therapeutic modality. 32-2045. Investigative powers; emergency action A. To enforce this chapter the board may: 1. Receive complaints filed against licensees or certificate holders and conduct a timely investigation. 2. Conduct an investigation at any time and on its own initiative without receipt of a written complaint if the board has reason to believe that there may be a violation of this chapter. 3. Issue subpoenas to compel the attendance of any witness or the production of any documentation relative to a case. 4. Take emergency action ordering the summary suspension of a license or certificate or the restriction of the licensee's practice or certificate holder's employment pending proceedings by the board. 5. Require a licensee or certificate holder to be examined in order to determine the licensee's or certificate holder's mental, physical or professional competence to practice or work in the field of physical therapy. B. If the board finds that the information received in a complaint or an investigation is not of sufficient seriousness to merit direct action against the licensee or certificate holder it may take either of the following actions: 1. Dismiss the complaint if the board believes the information or complaint is without merit. 2. Issue an advisory letter. The issuance of an advisory letter is a nondisciplinary action to notify a licensee or certificate holder that, while there is not sufficient evidence to merit disciplinary action, the board believes that the licensee or certificate holder should be educated about the requirements of this chapter and board rules. An advisory letter is a public document and may be used in future disciplinary actions against a licensee or certificate holder. 3. Issue a nondisciplinary order requiring the licensee or certificate holder to complete a prescribed number of hours of continuing education in an area or areas prescribed by the board to provide the licensee or certificate holder with the necessary understanding of current standards, skills, procedures or treatment. C. The board shall notify a licensee or certificate holder of a complaint and the nature of the complaint within ninety days after receiving the complaint. D. Any person may submit a complaint regarding any licensee, certificate holder or other person potentially in violation of this chapter. Confidentiality shall be maintained subject to law. E. The board shall keep confidential all information relating to the receipt and investigation of complaints filed against licensees and certificate holders until the information becomes public record or as required by law. 32-2046. Informal and formal hearings A. The board may request an informal hearing with a licensee or any unlicensed person in order to further its investigation or to resolve a complaint. B. If at an informal hearing the board finds a violation of this chapter has occurred that constitutes grounds for disciplinary action, it may take any disciplinary actions prescribed in section 32-2047, paragraph 1, 2 or 6, except that a civil penalty may not exceed $500. C. If the results of an informal hearing indicate that suspension, revocation or a civil penalty might be in order, the board shall notify the subject of the investigation of the time and place for a hearing pursuant to title 41, chapter 6, article 10. D. In lieu of or in addition to an informal hearing as provided in subsection A of this section, the board may serve on a licensee a summons and complaint setting forth the grounds for disciplinary action and notice of a hearing to be held before the board at least thirty days after the date of the notice. The notice shall state the time and place of the hearing. E. A motion for rehearing or review of the board's decision in a disciplinary action shall be filed pursuant to title 41, chapter 6, article 10. F. The service of a summons and complaint and the service of a subpoena shall be as provided for service in civil cases. G. If a person disobeys a subpoena, the board may petition the superior court for an order requiring appearance or the production of documents. 32-2047. Disciplinary actions; penalties On proof that any grounds prescribed in section 32-2044 have been violated or that any requirements prescribed in section 32-2030 have been violated, the board may take the following disciplinary actions singly or in combination: 1. Issue a decree of censure. 2. Restrict a license or registration. The board may require a licensee or registrant to report regularly to the board on matters related to the grounds for the restricted license or registration. 3. Suspend a license or registration for a period prescribed by the board. 4. Revoke a license or registration. 5. Refuse to issue or renew a license or registration. 6. Impose a civil penalty of at least $250 but not more than $10,000 for each violation of this chapter. In addition, the board may assess and collect the reasonable costs incurred in a disciplinary hearing when action is taken against a person's license. 7. Accept a voluntary surrendering of a license or registration pursuant to an order of consent by the board. 32-2048. Unlawful practice; classification; injunctive relief; deposit of civil penalties A. It is unlawful for any person to practice or in any manner to claim to practice physical therapy or for a person to claim the designation of a physical therapist unless that person is licensed pursuant to this chapter. A person who engages in an activity requiring a license pursuant to this chapter or who uses any word, title or representation in violation of section 32-2042 that implies that the person is licensed to engage in the practice of physical therapy is guilty of a class 1 misdemeanor. B. The board may investigate any person to the extent necessary to determine if the person is engaged in the unlawful practice of physical therapy. If an investigation indicates that a person may be practicing physical therapy unlawfully, the board shall inform the person of the alleged violation. The board may refer the matter for prosecution regardless of whether the person ceases the unlawful practice of physical therapy. C. The board, through the appropriate county attorney or the office of the attorney general, may apply for injunctive relief in any court of competent jurisdiction to enjoin any person from committing any act in violation of this chapter. Injunction proceedings are in addition to, and not in lieu of, all penalties and other remedies prescribed in this chapter. D. The board shall deposit, pursuant to sections 35-146 and 35-147, all monies it collects from civil penalties pursuant to this chapter in the state general fund. 32-2049. Disclosure prohibition The board shall not disclose the identity of a person who provides information unless this information is essential to proceedings conducted pursuant to sections 32-2045 and 32-2046 or unless required by a court. 32-2050. Substance abuse recovery program In lieu of a disciplinary proceeding prescribed by this article, the board may allow a licensee to actively participate in a board-approved substance abuse recovery program if: 1. The board has evidence that the licensee is an impaired professional. 2. The licensee has not been convicted of a felony relating to a controlled substance in a court of law of the United States or any other territory or country. 3. The licensee enters into a written agreement with the board for a restricted license and complies with all of the terms of the agreement, including making satisfactory progress in the program and adhering to any limitations on the licensee's practice imposed by the board to protect the public. Failure to enter into such an agreement shall activate an immediate investigation and disciplinary proceedings by the board. 4. As part of the agreement established between the licensee and the board, the licensee signs a waiver allowing the substance abuse program to release information to the board if the licensee does not comply with the requirements of this section or is unable to practice with reasonable skill or safety. 32-2051. Rights of consumers A. The public has access to the following information: 1. A list of licensees and interim permit holders that includes the licensee's and interim permit holder's place of practice, license or interim permit number, date of license or interim permit expiration and status of license or interim permit. 2. A list of physical therapist assistants who are licensed in this state, including place of employment, license number, date of license expiration and status of license. 3. Public records. B. The home addresses and telephone numbers of physical therapists and physical therapist assistants are not public records and shall be kept confidential by the board unless they are the only addresses and telephone numbers of record. C. If a referring practitioner is deriving direct or indirect compensation from the referral to physical therapy, the physical therapist shall disclose this information in writing to the patient. D. A physical therapist shall disclose in writing to a patient any financial interest in products the physical therapist endorses and recommends to the patient and shall document this disclosure in the patient's record. E. A physical therapist shall ensure that each patient understands that the patient has freedom of choice in services and products. F. Information relating to the physical therapist-patient relationship is confidential and shall not be communicated to a third party who is not involved in that patient's care without the prior written consent of the patient. The physical therapist shall divulge to the board information it requires in connection with any investigation, public hearing or other proceeding. The physical therapist-patient privilege does not extend to cases in which the physical therapist has a duty to report information as required by law. The confidentiality requirements and privileges of this subsection also apply to physical therapist assistants. G. Each licensee shall display a copy of the license and current renewal verification in a location accessible to public view at the licensee's place of practice. If the licensee is unable to display the license or current renewal verification, the licensee must produce that documentation on request. H. The board shall keep all information relating to the receipt and investigation of complaints filed against a licensee confidential unless the information is disclosed in the course of the investigation or any subsequent proceeding or if that information is required to be disclosed by law. I. The following are confidential and are not available to the public: 1. Patient records, including clinical records, patient files and any report or oral statement relating to a diagnostic finding or treatment of a patient. 2. Any information from which a patient or a patient's family might be identified. 3. Information received and records or reports kept by the board as a result of an investigation made pursuant to this chapter. 32-2052. Judicial review Except as provided in section 41-1092.08, subsection H, final board decisions are subject to judicial review pursuant to title 12, chapter 7, article 6. 32-2053. Physical therapy licensure compact The physical therapy licensure compact is adopted and enacted into law as follows: Section 1 Purpose The purpose of this compact is to facilitate the interstate practice of physical therapy with the goal of improving public access to physical therapy services. The practice of physical therapy occurs in the state where the patient/client is located at the time of the patient/client encounter. This compact pr