NAC: CHAPTER 640A - OCCUPATIONAL THERAPISTS

[Rev. 2/15/2010 10:45:59 AM]

This chapter of NAC has changes which have been adopted but have not been codified; you can see those changes by viewing the following regulation(s) on the Nevada Register of Administrative Regulations: R210-07

CHAPTER 640A - OCCUPATIONAL THERAPISTS

GENERAL PROVISIONS

640A.010 “Board” defined.

640A.015 “Provisional licensee” defined.

LICENSING

640A.020 Eligibility to apply for license; examination and interview of applicants.

640A.030 Application for license.

640A.040 Applicant for license who is educated, licensed or registered in another country.

640A.050 Expiration, renewal and reinstatement of license.

640A.060 Licensing of person whose license has been expired or inactive for 5 years or more.

640A.062 Temporary licensing.

640A.065 Provisional licensing.

640A.070 Continuing education: Generally.

640A.080 Continuing education: Approval of credit.

640A.090 Continuing education: Approval of credit for attending or giving presentation.

640A.100 Continuing education: Information required to obtain credit.

640A.110 Display, alteration and reproduction of license.

640A.120 Change of name after issuance of license; replacement of lost license.

640A.130 Notification of addresses of licensee; mailing of notice to licensee.

640A.140 Annual list of licensees.

640A.150 Inclusion of license number on or with documents submitted to board.

640A.160 Fees.

STANDARDS OF PRACTICE

640A.200 Use of professional title.

640A.205 Adoption by reference of code of ethics and standards of practice.

640A.210 Prohibitions: Use of license; misrepresentations.

640A.220 Professional responsibility regarding patients.

640A.230 Scope of services with and without referral of patient by licensed provider of health care.

640A.250 Practice by occupational therapy assistant or provisional licensee.

640A.260 Supervision and employment of occupational therapy assistant: Verification; notice of termination.

640A.265 Delegation of duties to occupational therapy assistants and unlicensed persons; limitations.

640A.267 Delegation of duties to student or provisional licensee; limitations.

640A.270 Delegation of duties to occupational therapy aide or technician; limitations.

640A.275 Supervision of occupational therapy aide or technician: “Directly supervise” interpreted.

640A.280 Termination or interruption of treatment.

640A.290 Records of patients: Maintenance; release; falsification; review before signing.

640A.300 Fees and billing.

640A.310 Advertising.

640A.320 Conduct of programs of research.

DISCIPLINARY ACTION

640A.350 Procedure for institution of disciplinary action; grounds; presence of supervising occupational therapist required at proceedings.

640A.361 Unprofessional conduct: Imposition of conditions on use of license.

PROCEEDINGS BEFORE BOARD

640A.400 Action by board on its own motion; petition for adoption, amendment or repeal of regulation or for hearing.

640A.410 Fees and expenses of witnesses.

GENERAL PROVISIONS

NAC 640A.010 “Board” defined. As used in this chapter, unless the context otherwise requires, “board” means the board of occupational therapy.

(Supplied in codification)

NAC 640A.015 “Provisional licensee” defined. (NRS 640A.110) As used in NAC 640A.015 to 640A.160, inclusive, unless the context otherwise requires, “provisional licensee” means the holder of a provisional license as an occupational therapist or occupational therapy assistant issued by the board pursuant to NAC 640A.065.

(Added to NAC by Bd. of Occupational Therapy by R179-01, eff. 9-20-2002)

LICENSING

NAC 640A.020 Eligibility to apply for license; examination and interview of applicants. (NRS 640A.110)

1. To be eligible to apply for licensure as an occupational therapist or occupational therapy assistant, an applicant must have graduated from an educational program that:

(a) Is accredited by an accrediting service approved by the board; and

(b) Includes a fieldwork program.

2. The board will use an examination provided by an agency approved by the board in the examination of an applicant for a license as an occupational therapist or occupational therapy assistant. The applicant must achieve a passing score on the examination before he will be licensed.

3. Oral interviews will be held at such times and places as the board designates, taking into consideration the number of applicants and the location of the applicants.

4. To be eligible for an interview, an applicant must file a completed application with the executive secretary of the board at least 30 days before the date of the examination.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A by R083-99, 9-27-99)

NAC 640A.030 Application for license. (NRS 640A.110, 640A.140)

1. Each completed application for a license as an occupational therapist or occupational therapy assistant must:

(a) Include at least three professional references;

(b) Be accompanied by the appropriate fee; and

2. Each applicant must request:

(a) That the school of occupational therapy where the applicant received his degree mail the applicant’s transcript directly to the board; and

(b) That an agency approved by the board to certify a person as an “occupational therapist registered” or “certified occupational therapy assistant” mail verification of certification directly to the board.

The applicant must use the forms provided by the board in its licensure packet to request that his transcript and verification of certification be mailed directly to the board.

3. If an applicant licensed in another state or territory is applying for a license in this state, he must attach a copy of his current license from the other state or territory.

4. If an applicant’s name has been changed since attending school, the applicant must submit proof of name change to the board.

5. Each applicant for licensure as an occupational therapy assistant or temporary occupational therapist must use the form provided by the board in its licensure packet to submit verification of his employment and supervision by a licensed occupational therapist.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A 5-23-95; R083-99, 9-27-99; R179-01, 9-20-2002)

NAC 640A.040 Applicant for license who is educated, licensed or registered in another country. (NRS 640A.110)

1. An applicant for licensure who has graduated from a school in another country must:

(a) Take and pass an examination provided by an agency approved by the board that demonstrates that the applicant’s education is equivalent to a bachelor’s degree in occupational therapy; and

(b) Submit to the board an application with accompanying documentation that complies with NAC 640A.030.

2. An applicant for licensure who is licensed or registered in another country must submit documentation, satisfactory to the board, which verifies his licensure or registration.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A 5-23-95; R083-99, 9-27-99)

NAC 640A.050 Expiration, renewal and reinstatement of license. (NRS 640A.110, 640A.180)

1. A license issued by the board to an occupational therapist or occupational therapy assistant expires on June 30 of each year. The board will prorate the fee for a license which is issued for less than 12 months.

2. To renew such a license, the licensee must submit to the board:

(a) An application for renewal;

(b) Except as otherwise provided in subsection 3 of NAC 640A.070, proof of his completion of the continuing education required by the board pursuant to NAC 640A.070; and

3. The board will deem any application for renewal as late if it is not received by the board on or before the date upon which the license expires. If the application for renewal is not received on or before the 31st day after the date upon which the license expired, the licensee must apply for reinstatement of the expired license.

4. To reinstate a license which has been expired or inactive for more than 90 days but less than 5 years, the applicant must:

(a) Make current the information on his original application by showing his employment since the date of his original application and revising the other information in the original application to make it current;

(b) If he is licensed as an occupational therapy assistant, submit verification of his current employment and supervision by a licensed occupational therapist on a form approved by the board;

(c) Provide documentation that he is certified as an “occupational therapist registered” or “certified occupational therapy assistant” by an agency approved by the board;

(d) Submit to the board proof of the completion of at least 10 hours of continuing education as specified in NAC 640A.080 within the 12 months immediately preceding his application for reinstatement;

(e) Submit any additional information requested by the board;

(f ) Pay the appropriate fee; and

(g) Meet with the board if it so requests.

5. As used in this section, the term “license” does not include a provisional license or a temporary license.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A by R083-99, 9-27-99; R179-01, 9-20-2002)

NAC 640A.060 Licensing of person whose license has been expired or inactive for 5 years or more. (NRS 640A.110)

1. Except as otherwise provided in subsection 2, if a person whose license as an occupational therapist or occupational therapy assistant has been expired or inactive for 5 years or more wishes to reinstate his license, he must:

(a) Reapply for a license as if he were a new applicant and retake and pass an examination provided by an agency approved by the board; or

(b) Provide documentation that he is certified pursuant to subsection 1 of NRS 640A.160.

2. A person whose license as an occupational therapist or occupational therapy assistant has been expired or inactive for 5 years and who has not met the requirements of subsection 1, may reinstate his license if he:

(a) Applies for and obtains from the board a temporary license;

(b) Practices under the general supervision of a licensed occupational therapist for at least 640 hours within no more than 10 continuous months;

(c) Submits to the board a letter from the supervising licensed occupational therapist attesting that the applicant is competent in occupational therapy and has completed the practice required by paragraph (b);

(d) Submits to the board proof of the completion of at least 10 hours of continuing education as specified in NAC 640A.080 within the 12 months immediately preceding his application for a license; and

(e) Reapplies for a license as if he were a new applicant.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A by R083-99, 9-27-99)

NAC 640A.062 Temporary licensing. (NRS 640A.110, 640A.170)

1. A person who holds a license as an occupational therapist or occupational therapy assistant issued in another state or territory may apply to the board for a temporary license to practice in this state.

2. To obtain a temporary license, an applicant must, at least 30 days before his first day of work, submit to the board:

(a) An application with accompanying documentation that complies with NAC 640A.030; and

(b) The appropriate fee.

3. A temporary license expires 6 months after the date on which it is issued or renewed.

4. A temporary license may be renewed not more than once.

5. To renew such a license, the holder must submit to the board:

(a) A request for renewal; and

(b) The applicable fee.

6. The holder of a temporary license may convert the temporary license to a regular license if:

(a) The holder submits to the board:

(1) A request for conversion; and

(2) The appropriate fee; and

(b) The board receives, directly from an agency approved by the board to certify a person as an “occupational therapist registered” or “certified occupational therapy assistant,” written verification of the certification of the holder.

(Added to NAC by Bd. of Occupational Therapy, eff. 5-23-95; A by R083-99, 9-27-99; R179-01, 9-20-2002)

NAC 640A.065 Provisional licensing. (NRS 640.110)

1. A person who is otherwise eligible to apply for licensure as an occupational therapist or occupational therapy assistant, but has not achieved a passing score on the examination as required by subsection 2 of NAC 640A.020, may apply to the board for a provisional license.

2. To obtain a provisional license, an applicant must, at least 30 days before his first day of work, submit to the board:

(a) An application with accompanying documentation that complies with NAC 640A.030; and

(b) The appropriate fee.

3. An applicant who is unable to provide a transcript as required by paragraph (a) of subsection 2 of NAC 640A.030 shall be deemed to have complied with that paragraph if an appropriate officer of the school of occupational therapy where the applicant studied submits directly to the board a statement that the applicant has completed all requirements for graduation from an educational program in occupational therapy.

4. An applicant who is unable to provide the verification of certification as required by paragraph (b) of subsection 2 of NAC 640A.030 shall be deemed to have complied with that paragraph if he submits to the board written verification, from an agency approved by the board to provide an examination for licensure as an occupational therapist or occupational therapy assistant, that the applicant:

(a) Is scheduled to take the examination at a stated date and place; and

(b) Has requested the agency to transmit, directly to the board, the applicant’s scores on the examination when the scores become available.

5. A provisional license expires 6 months after the date on which it is issued or renewed.

6. A provisional license may be renewed not more than once.

7. To renew such a license, the provisional licensee must submit to the board:

(a) A request for renewal;

(b) The appropriate fee; and

(c) Written verification, from an agency approved by the board to provide an examination for licensure as an occupational therapist or occupational therapy assistant, that the provisional licensee:

(1) Is scheduled to take the examination at a stated date and place; and

(2) Has requested the agency to transmit, directly to the board, the provisional licensee’s scores on the examination when the scores become available.

8. A provisional licensee may convert his provisional license to a regular license if:

(a) The provisional licensee submits to the board:

(1) A request for conversion; and

(2) The appropriate fee; and

(Added to NAC by Bd. of Occupational Therapy by R179-01, eff. 9-20-2002)

NAC 640A.070 Continuing education: Generally. (NRS 640A.110)

1. Except as otherwise provided in subsection 3, an occupational therapist or occupational therapy assistant shall complete, to the satisfaction of the board, at least 10 hours of continuing education as specified in NAC 640A.080 within the year immediately preceding his request for renewal of his license.

2. If the licensee obtains more than 10 hours of continuing education in a year, he may request that the board carry over a maximum of 10 hours to apply towards completion of his requirement for continuing education for the following year. Proof of the completion of the requirement for continuing education must be submitted with an application for renewal of a license in the year in which the credit is earned.

3. Upon request, the board will, if deemed appropriate by the board:

(a) Reduce the number of hours of continuing education required for the renewal of a license of an applicant who obtains his initial license and renews that license in a period of less than 12 months;

(b) Extend the period in which a licensee must obtain the continuing education required for renewal; or

4. A licensee who seeks a reduction of the number of hours of continuing education required, an extension of time to obtain continuing education or a waiver pursuant to subsection 3, must petition the board to grant his request at least 30 days before the date on which his license must be renewed. The licensee must submit with the petition proof, satisfactory to the board, that he was unable to obtain the continuing education because of circumstances which were beyond his control.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A by R083-99, 9-27-99)

NAC 640A.080 Continuing education: Approval of credit. (NRS 640A.110)

1. The board will approve credit for continuing education as follows:

(a) One hour of credit will be approved for each hour spent attending a workshop, course, conference or seminar;

(b) One hour of credit will be approved for each hour spent giving a presentation at a workshop, course, conference or seminar; and

(c) The amount of credit for authoring a publication will be determined upon receipt and evaluation by the board of the information required to be submitted to it pursuant to NAC 640A.100.

2. The board will consider the written request of a licensee that it approve credit for any continuing education that is not specified in subsection 1 if the request is submitted to the board at least 30 days before the license of the licensee expires.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A by R083-99, 9-27-99)

NAC 640A.090 Continuing education: Approval of credit for attending or giving presentation. (NRS 640A.110)

1. A licensee may request approval of credit for continuing education from the board before attending or giving a presentation at a program of continuing education. The request must be accompanied by the applicable information and documentation listed in NAC 640A.100.

2. The board will inform a licensee of the approval or denial of credit within 30 days after the next meeting of the board following the receipt of the request.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A by R083-99, 9-27-99)

NAC 640A.100 Continuing education: Information required to obtain credit. (NRS 640A.110)

1. To obtain credit for attending a program of continuing education, a licensee must submit to the board:

(a) The name of the sponsor of the program;

(b) The name of the program;

(d) Biographical information regarding the instructor of the program;

(e) The inclusive dates of attendance; and

(f ) A brief summary of the information he learned and how he will use that information in his practice.

2. To obtain credit for giving a presentation at a program of continuing education, a licensee must submit to the board:

(a) The title of the presentation;

(b) The name of the sponsor of the presentation;

(d) The number of hours of the presentation;

(e) The source for the information conveyed in the presentation;

(f ) The inclusive dates of the presentation;

(g) A list of all the persons who attended the presentation; and

(h) A brief summary of the presentation and the information that a person who attended the presentation was expected to learn.

3. To obtain credit for authoring a publication, the licensee must submit to the board:

(a) A copy of the published material; and

(b) The title, publisher and date of publication of the published material.

4. If the credit is for a course of study, training or performing an educational activity which is not specified in NAC 640A.080:

(a) A description of the subject matter studied, the training received or the educational activity performed;

(b) A schedule of the time spent studying, training or performing; and

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A by R083-99, 9-27-99)

NAC 640A.110 Display, alteration and reproduction of license.

1. A licensee shall display his current license in a prominent location which is accessible to the public in the principal location of his practice.

2. A licensee shall not:

(a) Alter his license; or

(b) Except as otherwise provided in this subsection, make a reproduction of his license.

A licensee may make a reproduction of his license to keep in his files or to provide to institutions such as educational institutions.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92)

NAC 640A.120 Change of name after issuance of license; replacement of lost license.

1. If an occupational therapist or an occupational therapy assistant changes his name after his license is issued, he must submit, within 30 days after the change, proof satisfactory to the board that his name was legally changed. If the change of name resulted from marriage or a court decree, a copy of the marriage certificate or court decree must be submitted to the board.

2. An occupational therapist or occupational therapy assistant who has lost his license may request in writing from the board a duplicate license. The board will issue a duplicate license upon payment of the appropriate fee.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92)

NAC 640A.130 Notification of addresses of licensee; mailing of notice to licensee.

1. Each licensee shall file his current residential address and business address with the board.

2. A licensee shall notify the board of any change in his residential address or business address within 30 days after the change.

3. If the board is required by law or the provisions of this chapter to deliver any notice by mail to a licensee, the notice will be mailed to the last residential address of the licensee which was filed with the board in accordance with this section.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92)

NAC 640A.140 Annual list of licensees.

1. The board will prepare and maintain an annual list of persons licensed by the board.

2. A copy of the list of licensees may be obtained from the board upon written application accompanied by the cost of reproduction as determined by the board.

3. The board will provide a copy of its list of licensees to the commissioner of insurance without charge.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92)

NAC 640A.150 Inclusion of license number on or with documents submitted to board. The license number assigned to the licensee by the board must accompany or be written upon every document which he submits to the board.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92)

NAC 640A.160 Fees. (NRS 640A.110, 640A.190) The following fees are established:

1. For an occupational therapist:
(a) Initial application for a license................................................................................	$250
(b) Processing of initial license.....................................................................................	150
(c) Annual renewal of a license.....................................................................................	175
(d) Late renewal of a license..........................................................................................	290
(e) Application for a temporary or provisional license.................................................	100
(f ) Renewal of a temporary or provisional license.......................................................	100
(g) Reinstatement of an expired license........................................................................	350
(h) Inactive license.........................................................................................................	150
(i) Reinstatement of an inactive license........................................................................	100
2. For an occupational therapy assistant:
(a) Initial application for a license................................................................................	$175
(b) Processing of initial license.....................................................................................	100
(c) Annual renewal of a license.....................................................................................	125
(d) Late renewal of a license..........................................................................................	230
(e) Application for a temporary or provisional license.................................................	75
(f ) Renewal of a temporary or provisional license.......................................................	75
(g) Reinstatement of an expired license........................................................................	250
(h) Inactive license.........................................................................................................	100
(i) Reinstatement of an inactive license........................................................................	90
3. General:
(a) Change of name on a license....................................................................................	$50
(b) Duplicate of lost license...........................................................................................	50

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A 5-23-95; R083-99, 9-27-99; R179-01, 9-20-2002)

STANDARDS OF PRACTICE

NAC 640A.200 Use of professional title.

1. An occupational therapist shall, in all appropriate professional circumstances, refer to himself as an occupational therapist registered/licensed and may refer to himself using corresponding initials for the words.

2. An occupational therapy assistant shall, in all appropriate professional circumstances, refer to himself as a certified occupational therapy assistant/licensed and may refer to himself using corresponding initials for the words.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92)

NAC 640A.205 Adoption by reference of code of ethics and standards of practice. (NRS 640A.110)

1. The board hereby adopts by reference:

(a) The Occupational Therapy Code of Ethics approved by the representative assembly of the American Occupational Therapy Association in 2000; and

(b) The Standards of Practice for Occupational Therapy approved by the representative assembly of the American Occupational Therapy Association in 1998.

2. A copy of the Occupational Therapy Code of Ethics or the Standards of Practice for Occupational Therapy may be obtained, free of charge, from the executive director of the board, P.O. Box 70220, Reno, Nevada 89570-0220.

(Added to NAC by Bd. of Occupational Therapy by R083-99, eff. 9-27-99; A by R179-01, 9-20-2002)

NAC 640A.210 Prohibitions: Use of license; misrepresentations.

1. A licensee shall not use his license to:

(a) Support any claim, promise or guaranty concerning the success of the treatment he administers; or

(b) Imply that he has competence in a profession other than the practice of occupational therapy.

2. A licensee shall not misrepresent:

(a) His professional qualifications;

(b) His affiliations;

(d) The licenses or professional qualifications of:

(1) The institutions or organizations with which he is associated; or

(2) Any person whom he supervises in the course of his professional duties.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92)

NAC 640A.220 Professional responsibility regarding patients. (NRS 640A.110) A licensee:

1. Shall treat a patient with professional skill and competence.

2. Shall not practice, condone, facilitate or collaborate in any type of discrimination toward a patient based on the patient’s:

(a) Race;

(b) Color;

(d) Age;

(e) Religion;

(f ) National origin;

(g) Mental or physical disability; or

(h) Sexual orientation.

3. Shall not misrepresent to a patient the efficacy of his treatment of the patient or the results to be achieved by a course of treatment of occupational therapy.

4. Shall inform his patient of any risk to the patient that may be associated with the proposed treatment of occupational therapy.

5. Shall seek the advice and counsel of colleagues and supervisors whenever such a consultation is in the best interest of the patient.

6. Shall not engage in sexual activities with a patient. The board will presume that there is a violation of this subsection if the sexual relationship and activity begins during the course of treatment of the patient or within 6 months after the termination of the professional relationship with the patient.

7. Shall not suggest to a patient who is referred to him by one provider of health care that he seek the treatment of another provider of health care. If there is no referring provider of health care or if the patient does not wish to return to the referring provider of health care, a list containing the names of providers of health care may be offered to the patient by the licensee. If possible, such a list must contain the names of at least two providers of health care.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A by R083-99, 9-27-99)

NAC 640A.230 Scope of services with and without referral of patient by licensed provider of health care. (NRS 640A.110)

1. An occupational therapist may practice occupational therapy on a patient for specific medical conditions if the patient has been referred to the occupational therapist by a provider of health care licensed to practice in this state.

2. An occupational therapist may, without referral, provide occupational therapy services, including, without limitation, evaluation, planning and implementing a program of treatment, monitoring services and consultation for a person whose ability to perform the tasks of daily living is impaired by:

(a) Developmental deficiencies;

(b) The aging process;

(d) Sensory impairment;

(e) Psychological or social dysfunction; or

(f ) Other conditions.

3. An occupational therapist may provide the occupational therapy services listed in subsection 2 in a nonmedical setting, including, without limitation, a residential setting, an educational setting, a vocational setting, a recreational setting, or a center that provides for the care of adults or children during the day.

4. As used in this section:

(a) “Consultation” includes working with providers of health care and other persons involved in the care of a patient to provide advice and services.

(b) “Monitoring services” includes those services which are characterized by regular contact at least once per month to:

(1) Check or regulate adaptive and positioning equipment to ensure its proper use; or

(2) Assess the level of skills of a patient, including, without limitation, the adaptive skills of the patient.

(c) “Specific medical conditions” includes those conditions of acute trauma, infection, disease, aging or postsurgical status where custom requires the involvement of a provider of health care.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A by R083-99, 9-27-99)

NAC 640A.250 Practice by occupational therapy assistant or provisional licensee. (NRS 640A.110)

1. An occupational therapy assistant or a provisional licensee shall not practice occupational therapy without the general supervision of an occupational therapist. Immediate physical presence or constant presence on the premises where the occupational therapy assistant or provisional licensee is practicing is not required of the supervising occupational therapist. To provide satisfactory general supervision, the occupational therapist shall:

(a) Provide an initial plan of treatment or program of intervention, and any subsequent changes to the initial plan or program, for patients assigned to the occupational therapy assistant or provisional licensee.

(b) Not less than 1 hour for each 40 hours of work performed by the occupational therapy assistant or provisional licensee and, in any event, not less than 1 hour each month, engage in:

(1) Clinical observation of the occupational therapy assistant or provisional licensee; or

(2) Direct communication with the occupational therapy assistant or provisional licensee. The mode and frequency of that communication is dependent upon the setting for the practice of the occupational therapy assistant or provisional licensee. Direct communication may consist of, without limitation:

(I) Direct or joint treatment of a patient;

(II) Personal supervision of the occupational therapy assistant or provisional licensee while providing services;

(III) Conversation, in person or by telephone;

(IV) Exchange of written comments;

(V) Review of patient records; or

(VI) Conferences, or other face-to-face meetings.

(c) Establish the caseload of the occupational therapy assistant or provisional licensee based on the competency of the occupational therapy assistant or provisional licensee as determined by the supervising occupational therapist.

(d) Review all written documentation prepared by the occupational therapy assistant or provisional licensee during the course of treatment of a patient. The completion of this review by the occupational therapist may be evidenced by:

(1) Preparation of a separate progress note; or

(2) The occupational therapist signing and dating the document prepared by the occupational therapy assistant or provisional licensee.

2. The supervising occupational therapist and the occupational therapy assistant or provisional licensee shall jointly:

(a) Document the supervision required pursuant to this section by preparing, without limitation:

(1) Daily or weekly schedules;

(2) Logs of supervision; and

(3) Patient records.

(b) Ensure that each record regarding a patient treated by the occupational therapy assistant or provisional licensee is signed, dated and reviewed by the occupational therapy assistant or provisional licensee and the supervising occupational therapist. In reviewing the record, the occupational therapist and the occupational therapy assistant or provisional licensee shall verify, without limitation:

(1) The accuracy of the record; and

(2) That there is continuity in the services received by the patient pursuant to the plan of treatment or program of intervention.

3. An occupational therapy assistant or provisional licensee, acting jointly with a supervising occupational therapist, may:

(a) Prepare and disseminate any written or oral reports;

(b) Write the final evaluation and discharge summary of a patient; and

(c) Unless the treatment is terminated by a patient or his provider of health care, determine when to terminate treatment.

4. An occupational therapy assistant or provisional licensee shall document all treatment provided to a patient by the occupational therapy assistant or provisional licensee.

5. A supervising occupational therapist shall not delegate responsibilities to an occupational therapy assistant or provisional licensee which are beyond the scope of the training of the occupational therapy assistant or provisional licensee.

6. The provisions of this section do not prohibit an occupational therapy assistant or provisional licensee from responding to acute changes in a patient’s condition that warrant immediate assistance or treatment.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A 5-23-95; R083-99, 9-27-99; R179-01, 9-20-2002)

NAC 640A.260 Supervision and employment of occupational therapy assistant: Verification; notice of termination.

1. An occupational therapy assistant shall submit verification of his employment and supervision by a licensed occupational therapist to the board within 30 days after a change in his employment or supervision. The verification must be submitted on a form approved by the board.

2. An occupational therapist who is licensed by the board shall notify the board within 30 days after the termination of his supervision of an occupational therapy assistant.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92)

NAC 640A.265 Delegation of duties to occupational therapy assistants and unlicensed persons; limitations. (NRS 640A.110)

1. An occupational therapist shall supervise any program of treatment which is delegated to an occupational therapy assistant.

2. Only an occupational therapist may:

(a) Interpret the record of a patient who is referred to the occupational therapist by a provider of health care;

(b) Interpret the evaluation of a patient and identify any problem of the patient;

(c) Develop a plan of care for a patient based upon the initial evaluation of the patient, which includes the goal of the treatment of the patient;

(d) Determine the appropriate portion of the program of treatment and evaluation to be delegated to an occupational therapy assistant;

(e) Delegate the treatment to be administered by the occupational therapy assistant;

(f ) Instruct the occupational therapy assistant regarding:

(1) The specific program of treatment of a patient;

(2) Any precaution to be taken to protect a patient;

(3) Any special problem of a patient;

(4) Any procedure which should not be administered to a patient; and

(5) Any other information required to treat a patient;

(g) Review the program of treatment of a patient in a timely manner;

(h) Record the goal of treatment of a patient; and

(i) Revise the plan of care when indicated.

3. Except as otherwise provided in NAC 640A.267, a licensee shall not knowingly delegate to a person who is less qualified than the licensee any program of treatment which requires the skill, common knowledge and judgment of the licensee.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A by R179-01, 9-20-2002)

NAC 640A.267 Delegation of duties to student or provisional licensee; limitations. (NRS 640A.110) An occupational therapist who is supervising a:

1. Student participating in the supervised experience required by NRS 640A.120; or

2. Provisional licensee,

may delegate duties to the student or provisional licensee if the occupational therapist determines, before he delegates a duty, that the student or provisional licensee possesses the necessary knowledge, competence, training and skills to perform the duty.

(Added to NAC by Bd. of Occupational Therapy, eff. 5-23-96; A by R179-01, 9-20-2002)

NAC 640A.270 Delegation of duties to occupational therapy aide or technician; limitations. (NRS 640A.110, 640A.230)

1. A person may assist a licensed occupational therapist as an occupational therapy aide or technician. Such an occupational therapy aide or technician is not required to be licensed pursuant to the provisions of chapter 640A of NRS or possess the professional or advanced training in basic anatomical, biological, psychological or social sciences which are required for the practice of occupational therapy.

2. Except as otherwise provided in subsection 3, a licensed occupational therapist may delegate duties to an occupational therapy aide or technician if he determines, before he delegates a duty, that the aide or technician possesses the necessary knowledge, competence, training and skills to perform the duty. The duties which may be delegated to an occupational therapy aide or technician include, but are not limited to, the:

(a) Routine maintenance of a department;

(b) Transportation of a patient;

(d) Preparation of treatment equipment for a therapy session with a patient;

(e) Attendance to the personal needs of a patient during treatment;

(f ) Assistance in the construction of adaptive equipment and splints; and

(g) Performance of clerical, secretarial and administrative duties.

3. A licensed occupational therapist may not delegate a duty to an occupational therapy aide or technician if the duty requires the aide or technician to make independent evaluations, assessments or recommendations. The duties which may not be delegated to an aide or technician include, but are not limited to, the:

(a) Interpretation of the record of a patient referred to an occupational therapist;

(b) Interpretation of prescriptions for a patient;

(d) Recordation of the treatment or progress of a patient;

(e) Duties described in subsection 3 of NAC 640A.265; and

(f ) Performance of any duty which requires the aide or technician to act independently or without the supervision of a licensed occupational therapist during a therapy session with a patient.

4. An occupational therapist who delegates a duty to an aide or technician:

(a) Shall directly supervise the aide or technician in accordance with the provisions of NAC 640A.275; and

(b) Is professionally responsible for the duty performed by the aide or technician.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A 5-23-96; R179-01, 9-20-2002)

NAC 640A.275 Supervision of occupational therapy aide or technician: “Directly supervise” interpreted. As used in NRS 640A.230, the board interprets the term “directly supervise” to mean supervision of an occupational therapy aide or technician by a licensed occupational therapist who:

1. Is physically present on the premises at all times when the aide or technician is working with patients;

2. Provides personal instruction to the aide or technician on a regular basis;

3. Personally evaluates the work of the aide or technician on a regular basis; and

4. Sets forth detailed statements of the duties and responsibilities of the aide or technician.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A 5-23-96)—(Substituted in revision for NAC 640A.360)

NAC 640A.280 Termination or interruption of treatment. A licensee:

1. Shall terminate his treatment of a patient and his professional relationship with a patient when the treatment and relationship are no longer required or no longer serve the needs of the patient.

2. Shall not withdraw his treatment of a patient precipitously and shall minimize any related adverse effects on the patient.

3. Who anticipates the termination or interruption of treatment of a patient shall:

(a) Notify the patient promptly of the termination or interruption of the treatment;

(b) Seek the transfer or referral of the patient to another occupational therapist for treatment; or

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92)

NAC 640A.290 Records of patients: Maintenance; release; falsification; review before signing. (NRS 640A.110)

1. A licensee shall maintain in a secure and confidential manner any record of a patient which shows a medical problem of the patient or the scope of the treatment of the patient administered by the licensee.

2. Except as otherwise provided by law, a licensee shall not release a record of a patient which is confidential, or any information contained therein, except:

(a) With the written consent of the patient;

(b) In response to a subpoena issued by the board;

(d) When there exists a clear and immediate danger to the patient, another person or to society. If there exists such a danger, a disclosure may be made to an appropriate member of the patient’s family, to another provider of health care or to an appropriate agent of a law enforcement agency or other agency of the Federal Government, the state or one of its political subdivisions when acting in his official capacity.

3. A licensee shall not falsify a record of health care of a patient to indicate:

(a) The presence of the licensee at a time when he is not in attendance treating a patient; or

(b) That therapeutic procedures were performed by the licensee which he has not performed.

4. A licensee shall not sign a record of health care of a patient unless the licensee has reviewed the record. The review of the record must include, without limitation, verification of:

(a) The accuracy of the record; and

(b) Continuity in the services received by the patient pursuant to the plan of treatment or program of intervention.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A by R083-99, 9-27-99)

NAC 640A.300 Fees and billing. A licensee shall:

1. Make arrangements for the payment of fees for the treatment at the beginning of the therapeutic relationship with a patient.

2. Charge for his treatment an amount which represents a reasonable fee for the treatment.

3. Refrain from any misleading or deceptive billing practice.

4. Make billing information available to the patient upon the request of the patient.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92)

NAC 640A.310 Advertising. A licensee shall not advertise treatment by the use of occupational therapy or equipment used in the practice of occupational therapy in such a manner that the advertising:

1. Contains a testimonial or endorsement by another person;

2. Implies that the occupational therapist has skill which is superior to that of another occupational therapist;

3. Holds the occupational therapist out as a specialist unless the licensee is certified as a specialist by an organization recognized by the board;

4. Makes any false claim about the efficacy or value of the treatment the licensee administers; or

5. Is false, deceptive or misleading in regard to the fee which is charged or the terms of any credit for the treatment administered.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92)

NAC 640A.320 Conduct of programs of research.

1. A licensee shall obtain the voluntary and informed consent of a prospective participant in a program of research before engaging in the program of research.

2. A licensee shall not penalize a person for his refusal to participate in a program of research.

3. A licensee engaging in a program of research shall:

(a) Protect a participant in the program from any unwarranted occupational or mental discomfort, distress or harm;

(b) Treat information obtained from a participant or learned about a participant through the program as confidential information; and

(c) Take credit only for the work he is actually doing in the program and give credit to another person for any contribution made by that person to the program of research.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92)

DISCIPLINARY ACTION

NAC 640A.350 Procedure for institution of disciplinary action; grounds; presence of supervising occupational therapist required at proceedings. (NRS 640A.110)

1. To institute disciplinary action against an occupational therapist or occupational therapy assistant, a written complaint, specifying the charges, must be filed with the board on its own motion, or by a member of the board or another person who is aware of an act or circumstance constituting a ground for disciplinary action pursuant to this section or NRS 640A.200. The complaint must be signed by the person filing it.

2. In addition to those acts specified in subsection 3 of NRS 640A.200, the following acts, among others, constitute “unprofessional conduct”:

(a) Engaging in the practice of occupational therapy when unable to do so with reasonable skill and safety to patients because of the licensee’s use of alcohol or any controlled substance, or because of any mental or physical condition or illness suffered by the licensee;

(b) Being guilty of negligence in the performance of occupational therapy;

(d) Failing to report or otherwise concealing information related to a violation of NRS 640A.200 or this chapter which could result in harm to the public health and welfare;

(e) Intentionally making or filing a false or misleading report;

(f ) Failing to file a report which is required by law or a third person or intentionally obstructing or attempting to obstruct another person from filing such a report;

(g) Intentionally harassing, abusing or intimidating a patient, employer, employee, colleague or other person, either physically or verbally, including, but not limited to, sexual harassment, abuse or intimidation;

(h) Failing to notify the board of disciplinary action imposed upon the licensee or applicant for licensure by a regulatory authority in another jurisdiction in which the licensee or applicant currently holds or held a license;

(i) Intentionally divulging, without the consent of the patient, information gained within the context of the professional relationship with the patient;

( j) Failing to obtain the informed consent of a patient before engaging in scientific research involving the patient;

(k) Violating a provision of the Occupational Therapy Code of Ethics or the Standards of Practice for Occupational Therapy;

(l) Referring or appearing to refer a patient to a third person to receive a fee or other consideration from the third person;

(m) Recommending or prescribing therapeutic devices or modalities sold by a third person to receive a fee or other consideration from the third person;

(n) Advertising in a manner that tends to deceive or mislead the public;

(o) Making false statements, providing false information or omitting pertinent information in connection with an application for licensure or renewal of a license; or

(p) Misrepresenting or falsifying credentials, including, but not limited to, those relating to education, training, experience and areas of competency.

3. If a complaint is filed against an occupational therapy assistant, any supervising occupational therapist who signed, dated or reviewed a record regarding a patient treated by the occupational therapy assistant shall accompany the occupational therapy assistant to any proceedings before the board concerning the complaint.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92; A 5-23-96; R083-99, 9-27-99)

NAC 640A.361 Unprofessional conduct: Imposition of conditions on use of license. (NRS 640A.110) If the board determines that an occupational therapist or occupational therapy assistant is guilty of unprofessional conduct pursuant to NRS 640A.200 and does not suspend or revoke his license, the board will impose, as it deems appropriate, one or more of the following conditions on the use of that license:

1. The acceptance of a public or private reprimand administered by the board;

2. Probation for a specified period or until further order of the board;

3. Restrictions or limitations on the scope of the licensee’s practice;

4. The successful completion of a program of remedial education or treatment approved by the board;

5. Supervision of the professional work of the licensee by a person approved by the board;

6. The repayment to a patient of all money collected by the licensee in connection with the unprofessional conduct;

7. The successful completion of a physical or mental examination or an examination testing the competence of the licensee; or

8. Such other disciplinary action as the board considers necessary and appropriate.

(Added to NAC by Bd. of Occupational Therapy, eff. 5-23-96; A by R083-99, 9-27-99)

PROCEEDINGS BEFORE BOARD

NAC 640A.400 Action by board on its own motion; petition for adoption, amendment or repeal of regulation or for hearing.

1. The board may act on its own motion. Any other request for the adoption, amendment or repeal of a regulation of the board or for a formal hearing by the board must be submitted to the board as a petition.

2. Any interested person may submit a petition to the board for the adoption, amendment or repeal of a regulation of the board or for a formal hearing by the board.

3. The petition must be in writing and addressed to the chairman of the board.

4. An original and two legible copies of the petition must be filed with the board. The board may, when appropriate, direct that a copy of each petition be made available to any other person who the board determines may be affected by the petition.

5. The petition must contain:

(a) The full name and mailing address of the petitioner;

(b) If the adoption of a new regulation is proposed, the body or substance of the proposed regulation and the supporting facts and arguments;

(c) If the amendment or repeal of an existing regulation is proposed, the NAC citation of the regulation and the supporting facts and arguments;

(d) If a formal hearing by the board is requested, the relevant facts which support the request; and

(e) A statement that the petition is made in accordance with the applicable provisions of the NRS.

6. The petition must be signed by the petitioner. The signature constitutes a representation by the signer that:

(a) He has read the petition;

(b) To the best of his knowledge, information and belief, the statements made therein are true; and

7. Upon receipt of such a petition, the board will, if necessary, request the petitioner to clarify the request.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92)

NAC 640A.410 Fees and expenses of witnesses. A witness who participates in a proceeding held by the board is entitled to receive fees and reimbursement for mileage in the same amounts and under the same conditions as for witnesses in the courts of this state.

(Added to NAC by Bd. of Occupational Therapy, eff. 12-23-92)