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Compliance for Physical Therapy… the required evil that everyone with a physical therapy practice wants to avoid.  What does this mean for your practice and why should you care?

Why You Need Compliance for Physical Therapy Practices

What does this mean for your practice and why should you care?  In a broad sense it means that there are requirements you need to ensure both your practice and your staff are aware of, have documented, and are following daily.  The caring part is a bit more straightforward; compliance is required by law and can carry both civil and/or criminal penalties for non-compliance.   So, unless you are fond of fines or jail, let’s take a quick look at some of the key compliance components for your practice.

HIPAA, The Privacy and Security Rules

The most well-known compliance component is HIPAA, the privacy and security rules that most everyone is familiar with. HIPAA/HITECH requires the security of protected health information (PHI) both in paper and electronic formats.  Additionally, approximately 2/3 of the requirements involve having documented policies and procedures for how your practice handles PHI.  Do you have written out policies and procedures that your staff has been trained on?  Would your staff know where these are located if someone asked?  Does your staff know the 18 PHI identifiers?  If you cannot answer yes to these questions you may need to update/revise your existing HIPAA compliance program.

Other Laws and Requirements

True or False?  If we are compliant with HIPAA there are no other regulations we need to focus on?  Unfortunately, false; just being HIPAA compliant is not enough.  There are other laws and requirements that also apply to your practice.  The Fair Labor Standards Act, Fair Credit Reporting Act, Civil Rights Act, and Age Discrimination Employment Act at the federal level along with numerous state, county, and city laws govern how you employ, pay, provide benefits for, and even background check or drug test your staff.  One of the most confusing issues is the classification of staff as exempt or non-exempt.  Failure to properly classify an employee could lead to fines, payment of back pay and/or an EEOC compliant.  The Department of Labor provides guidance if you need a quick review .  The Occupational Safety and Health Administration (OSHA) governs how you ensure your staff is safe at work.  Their requirements include such things as requiring Safety Data Sheets and pictogram labels for hazardous chemicals (including Tide Pods), eye wash stations and sharps containers.  The American with Disabilities Act (ADA) has requirements that impact both employees and patients of your practice from both an employment, facility and language accessibility standpoint.

Policies & Procedures are a Must

Sadly, the list continues if you participate in Medicare, Medicaid, or any private payer for reimbursement.  Each payer has their own list of requirements and compliance expectations.  Compliance with all laws, standards, and/or regulations is mandatory.  A critical first step to ensuring your practice is on the right path is to have written policies and procedures that detail how you do work and that cover all the requirements.

According to the APTA:

The policy and procedure manual plays an important role in every business and organization, and physical therapy is no exception. The development and enforcement of policies and procedures is an important responsibility of physical therapist (PT) managers.

A well-written and comprehensive manual communicates to both internal and external stakeholders the rules, regulations, and processes that govern an entity. Policy and procedure manuals are integral to the orientation and training of new and current staff; ensuring compliance with laws, regulations, and accrediting organizations; and promoting consistency, safety, and best practices.

A poorly developed manual, conversely, fosters confusion and inconsistency, increasing the risk that laws, regulations, and health and safety standards will be violated. Even worse, an inadequate manual can heighten the risk of injury or harm to patients and employees, and place the organization at risk for lawsuits and other damages. Taking the time to carefully and accurately develop and maintain policies and procedures, therefore, is an important investment for all managers. 

Once you have these in place train your staff and have them acknowledge the information.  Ongoing hold staff to the standards, audit to check for compliance, and provide education to ensure all compliance requirements continue to be met.  Compliance is never ending.  Annual updates, new information, and changes to laws require practice owners to keep informed to keep compliant.  Start the New Year off stress free by ensuring your practice is compliant!

Business & Clinical Management Services (BCMS) is an outpatient rehab consulting firm that provides the keys to unlocking the compliance regulatory vault.  For more information about our services, contact Alicia N. Mahoney at  or schedule time for a free compliance program overview.