Disciplinary Actions, Civil Penalties, Assessment Of Costs, And

SCREENING PANELS. (1) Upon a finding by the Board that a physical therapist or physical therapist assistant has violated any provision of the T.C.A. §§ 63-13-101, et seq., or the rules promulgated thereto, the Board may impose any of the following actions separately or in any combination deemed appropriate to the offense. (a) Letter of Warning and/or Letter of Concern – This is a written action issued by the Board’s consultant to the physical therapist and/or physical therapist assistant for minor or near infractions. It is informal and advisory in nature and does not constitute a formal disciplinary action. However, if the Board takes this action at a contested case hearing through the issuance of a final order, it shall be considered an adverse act by the Board and reportable to the National Practitioner Databank and/or similar agency. (b) Formal Censure or Reprimand – This is a written action issued to a physical therapist or physical therapist assistant for one time and less severe violations. It is a formal disciplinary action. (c) Probation – This is a formal disciplinary action which places a physical therapist or physical therapist assistant on close scrutiny for a fixed period of time. This action may be combined with conditions which must be met before probation will be lifted and/or which restrict the individual’s activities during the probationary period. (d) Licensure Suspension – This is a formal disciplinary action which suspends an individual’s right to practice for a fixed period of time. It contemplates the reentry of the individual into the practice under the license previously issued. (e) Licensure Revocation – This is the most severe form of disciplinary action which removes an individual from the practice of the profession and terminates the licensure previously issued. If revoked, it relegates the violator to the status he possessed prior to application for licensure. However, the Board may, in its discretion, allow the reinstatement of a revoked license upon conditions and after a period of time it deems appropriate. No petition for reinstatement and no new application for licensure from a person whose license was revoked shall be considered prior to the expiration of at least one (1) year unless otherwise stated in the Board’s revocation order. (f) Conditions – Any action deemed appropriate by the Board to be required of a disciplined licensee in any of the following circumstances: 1. During any period of probation, suspension; or 2. During any period of revocation after which the licensee may petition for an order of compliance to reinstate the revoked license; or 3. As a prerequisite to the lifting of probation or suspension or as a prerequisite to the reinstatement of a revoked license; or 4. As a stand-alone requirement(s) in any disciplinary order. (2) Order of Compliance – This procedure is a necessary adjunct to each previously issued disciplinary order containing probation, suspension or other condition limiting the licensee’s ability to practice. An order of compliance is available only when a petitioner has completely complied with the conditions of a previously issued disciplinary order, including payment of civil penalties, completion of continuing education courses, or payment of administrative costs. If all conditions of the ordered discipline have been satisfied, or if no conditions have GENERAL RULES GOVERNING THE PRACTICE OF PHYSICAL THERAPY CHAPTER 1150-01 been placed on the license in addition to probation or suspension, the Board may consider a petition at its last meeting before the expiration of any such discipline. The Board, at its discretion, may require the petitioner to appear before granting such order. No discipline issued by the Board shall be lifted until the licensee petitions for and receives such order from the Board, which shall only be effective the original date the discipline was to expire, and in no event effective earlier than the date of petition, pursuant to this paragraph. (a) The Board will entertain petitions for an Order of Compliance as a supplement to a previously issued order upon strict compliance with the procedures set forth in subparagraph (b) in only the following three (3) circumstances: 1. When the petitioner can prove compliance with all the terms of the previously issued order and is seeking to have an order issued reflecting that compliance; or 2. When the petitioner can prove compliance with all the terms of the previously issued order and is seeking to have an order issued lifting a previously ordered suspension or probation; or 3. When the petitioner can prove compliance with all the terms of the previously issued order and is seeking to have an order issued reinstating a license previously revoked. (b) Procedures 1. The petitioner shall submit a Petition for Order of Compliance, as contained in subparagraph (c), to the Board’s Administrative Office that shall contain all of the following: (i) A copy of the previously issued order; and (ii) A statement of which provision of subparagraph (a) the petitioner is relying upon as a basis for the requested order; and (iii) A copy of all documents that prove compliance with all the terms or conditions of the previously issued order. If proof of compliance requires testimony of an individual(s), including that of the petitioner, the petitioner must submit signed statements from every individual the petitioner intends to rely upon attesting, under oath, to the compliance. The Board’s consultant and administrative staff, in their discretion, may require such signed statements to be notarized. No documentation or testimony other than that submitted will be considered in making an initial determination on, or a final order in response to, the petition. 2. The Board authorizes its consultant and administrative staff to make an initial determination on the petition and take one of the following actions: (i) Certify compliance and have the matter scheduled for presentation to the Board as an uncontested matter; or (ii) Deny the petition, after consultation with legal staff, if compliance with all of the provisions of the previous order is not proven and notify the petitioner of what provisions remain to be fulfilled and/or what proof of compliance was either not sufficient or not submitted. GENERAL RULES GOVERNING THE PRACTICE OF PHYSICAL THERAPY CHAPTER 1150-01 3. If the petition is presented to the Board the petitioner may not submit any additional documentation or testimony other than that contained in the petition as originally submitted. 4. If the Board finds that the petitioner has complied with all the terms of the previous order an Order of Compliance shall be issued. 5. If the petition is denied either initially by staff or after presentation to the Board and the petitioner believes compliance with the order has been sufficiently proven the petitioner may, as authorized by law, file a petition for a declaratory order pursuant to the provisions of T.C.A. § 4-5-223 and Rule 1200-10-01-.11. (c) Form Petition Petition for Order of Compliance Board of Physical Therapy Petitioner’s Name: Petitioner’s Mailing Address: Petitioner’s E-Mail Address: Telephone Number: Attorney for Petitioner: Attorney’s Mailing Address: Attorney’s E-Mail Address: Telephone Number: The petitioner respectfully represents, as substantiated by the attached documentation, that all provisions of the attached disciplinary order have been complied with and I am respectfully requesting: (circle one) 1. An order issued reflecting that compliance; or 2. An order issued reflecting that compliance and lifting a previously ordered suspension or probation; or 3. An order issued reflecting that compliance and reinstating a license previously revoked. Note – You must enclose all documents necessary to prove your request including a copy of the original order. If any of the proof you are relying upon to show compliance is the testimony of any individual, including yourself, you must enclose signed statements from every individual you intend to rely upon attesting, under oath, to the compliance. The Board’s consultant and administrative staff, in their discretion, may require such signed statements to be notarized. No documentation or testimony other than that submitted will be considered in making an initial determination on, or a final order in response to, this petition. GENERAL RULES GOVERNING THE PRACTICE OF PHYSICAL THERAPY CHAPTER 1150-01 Respectfully submitted this the ____ day of , 20_____. Petitioner’s Signature (3) Order Modifications – This procedure is not intended to allow anyone under a previously issued disciplinary order, including an unlicensed practice civil penalty order, to modify any findings of fact, conclusions of law, or the reasons for the decision contained in the order. It is also not intended to allow a petition for a lesser disciplinary action, or civil penalty other than the one(s) previously ordered. All such provisions of Board orders were subject to reconsideration and appeal under the provisions of the Uniform Administrative Procedures Act (T.C.A. §§ 4-5-301, et seq.). This procedure is not available as a substitute for reconsideration and/or appeal and is only available after all reconsideration and appeal rights have been either exhausted or not timely pursued. It is also not available for those who have accepted and been issued a reprimand. (a) The Board will entertain petitions for modification of the disciplinary portion of previously issued orders upon strict compliance with the procedures set forth in subparagraph (b) only when the petitioner can prove that compliance with any one or more of the conditions or terms of the discipline previously ordered is impossible. For purposes of this rule the term “impossible” does not mean that compliance is inconvenient or impractical for personal, financial, scheduling or other reasons. (b) Procedures 1. The petitioner shall submit a written and signed Petition for Order Modification on the form contained in subparagraph (c) to the Board’s Administrative Office that shall contain all of the following: (i) A copy of the previously issued order; and (ii) A statement of why the petitioner believes it is impossible to comply with the order as issued; and (iii) A copy of all documents that proves that compliance is impossible. If proof of impossibility of compliance requires testimony of an individual(s), including that of the petitioner, the petitioner must submit signed and notarized statements from every individual the petitioner intends to rely upon attesting, under oath, to the reasons why compliance is impossible. No documentation or testimony other than that submitted will be considered in making an initial determination on, or a final order in response to, the petition. 2. The Board authorizes its consultant and administrative staff to make an initial determination on the petition and take one of the following actions: (i) Certify impossibility of compliance and forward the petition to the Office of General Counsel for presentation to the Board as an uncontested matter; or (ii) Deny the petition, after consultation with legal staff, if impossibility of compliance with the provisions of the previous order is not proven and notify the petitioner of what proof of impossibility of compliance was either not sufficient or not submitted. GENERAL RULES GOVERNING THE PRACTICE OF PHYSICAL THERAPY CHAPTER 1150-01 3. If the petition is presented to the Board the petitioner may not submit any additional documentation or testimony other than that contained in the petition as originally submitted. 4. If the petition is granted a new order shall be issued reflecting the modifications authorized by the Board that it deemed appropriate and necessary in relation to the violations found in the previous order. 5. If the petition is denied either initially by staff or after presentation to the Board and the petitioner believes impossibility of compliance with the order has been sufficiently proven the petitioner may, as authorized by law, file a petition for a declaratory order pursuant to the provisions of T.C.A. § 4-5-223 and Rule 1200- 10-01-.11. (c) Form Petition Petition for Order Modification Board of Physical Therapy Petitioner’s Name: Petitioner’s Mailing Address: Petitioner’s E-Mail Address: Telephone Number: Attorney for Petitioner: Attorney’s Mailing Address: Attorney’s E-Mail Address: Telephone Number: The petitioner respectfully represents that for the following reasons, as substantiated by the attached documentation, the identified provisions of the attached disciplinary order are impossible for me to comply with: Note – You must enclose all documents necessary to prove your request including a copy of the original order. If any of the proof you are relying upon to show impossibility is the testimony of any individual, including yourself, you must enclose signed and notarized statements from every individual you intend to rely upon attesting, under oath, to the reasons why compliance is impossible. No documentation or testimony other than that submitted will be considered in making an initial determination on, or a final order in response to, this petition. GENERAL RULES GOVERNING THE PRACTICE OF PHYSICAL THERAPY CHAPTER 1150-01 Respectfully submitted this the ____ day of , 20____. Petitioner’s Signature (4) Civil Penalties (a) Purpose – The purpose of this rule is to set out a schedule designating the minimum and maximum civil penalties which may be assessed. (b) Schedule of Civil Penalties 1. A Type A Civil Penalty may be imposed whenever the Board finds a person who is required to be licensed, certified, permitted or authorized by the Board, guilty of a willful and knowing violation of the Practice Act, or regulations promulgated pursuant thereto, to such an extent that there is, or is likely to be, an imminent, substantial threat to the health, safety and welfare of an individual patient or the public. For purposes of this section, willfully and knowingly practicing as a physical therapist or physical therapist assistant without a permit, license, certification, or other authorization from the Board is one of the violations of the Physical Therapy Practice Act for which a Type A Civil Penalty is assessable. 2. A Type B Civil Penalty may be imposed whenever the Board finds the person required to be licensed, certified, permitted, or authorized by the Board guilty of a violation of the Physical Therapy Practice Act or regulations promulgated pursuant thereto in such a manner as to impact directly on the care of patients or the public. 3. A Type C Civil Penalty may be imposed whenever the Board finds the person required to be licensed, certified, permitted, or authorized by the Board guilty of a violation of the Physical Therapy Practice Act or regulations promulgated pursuant thereto, which are neither directly detrimental to patients or the public, nor directly impact their care, but have only an indirect relationship to patient care or the public. (c) Amount of Civil Penalties 1. Type A Civil Penalties shall be assessed in the amount of not less than $500 nor more than $1,000. 2. Type B Civil Penalties may be assessed in the amount of not less than $100 and not more than $500. 3. Type C Civil Penalties may be assessed in the amount of not less than $50 and not more than $100. (d) Procedures for Assessing Civil Penalties 1. The Division of Health Related Boards may initiate a civil penalty assessment by filing a Memorandum of Assessment of Civil Penalty. The Division shall state in the memorandum the facts and law upon which it relies in alleging a violation, the proposed amount of the civil penalty and the basis for such penalty. The Division may incorporate the Memorandum of Assessment of Civil Penalty with a Notice of Charges which may be issued attendant thereto. GENERAL RULES GOVERNING THE PRACTICE OF PHYSICAL THERAPY CHAPTER 1150-01 2. Civil penalties may also be initiated and assessed by the Board during consideration of any Notice of Charges. In addition, the Board may, upon good cause shown, assess a type and amount of civil penalty which was not recommended by the Division. 3. In assessing the civil penalties pursuant to these rules the Board may consider the following factors: (i) Whether the amount imposed will be a substantial economic deterrent to the violator; (ii) The circumstances leading to the violation; (iii) The severity of the violation and the risk of harm to the public; and (iv) The economic benefits gained by the violator as a result of non- compliance; and (v) The interest of the public. 4. All proceedings for the assessment of civil penalties shall be governed by the contested case provisions of Title 4, Chapter 5, Tennessee Code Annotated. (5) Assessment of costs in disciplinary proceedings shall be as set forth in T.C.A. §§ 63-1-144 and 63-13-313. (6) Reconsiderations and Stays – The Board authorizes the member who chaired the Board for a contested case to be the agency member to make the decisions authorized pursuant to Rule 1360-04-01-.18 regarding petitions for reconsiderations and stays in that case. (7) Screening Panels – Any screening panel(s) established pursuant to Tennessee Code Annotated § 63-1-138: (a) Shall have concurrent authority with the Board members and any individual Physical Therapist or Physical Therapist Assistant designated by the Board pursuant to paragraph (6) of Rule 1150-01-.19, to do the acts enumerated in paragraph (6) of Rule 1150-01-.19 subject to the conditions contained therein. 1. A screening panel(s) comprised of two (2) or more persons shall elect a chairperson prior to convening to conduct business. 2. A screening panel(s) comprised of two (2) or more persons is required to conduct the informal hearings authorized in subparagraph (b) immediately below. (b) After completion of an investigation by the Division, may upon request of either the state, or the licensee who is the subject of an investigation but only with the agreement of the state, or upon agreement of both the licensee and the state, conduct a non- binding informal hearing and make recommendations as a result thereof as to what, if any, terms of settlement of any potential disciplinary action are appropriate. 1. Neither the Rules of Civil Procedure, the Rules of Evidence, nor Contested Case Procedural Rules under the Administrative Procedures Act shall apply in informal hearings before the screening panel(s). However, Rule 31 of the Rules of the Tennessee Supreme Court may serve as general guidance as to the principles of mediation and alternative dispute resolution. GENERAL RULES GOVERNING THE PRACTICE OF PHYSICAL THERAPY CHAPTER 1150-01 (i) Evidence may be presented or received in any manner and in whatever order agreed upon by the parties. (ii) In the absence of an agreement of the parties the screening panel chairperson shall determine the manner and order of presentation of evidence. 2. A licensee who is the subject of an investigation being considered by a screening panel cannot be compelled to participate in any informal hearing. 3. Proposed settlements reached as a result of any informal hearing will not become binding and final unless they are: (i) Approved by a majority of the members of the screening panel which issued them; and (ii) Agreed to by both the Department of Health, by and through its attorney(s), and the licensee; and (iii) Subsequently presented to and ratified by the Board. 4. The activities of the screening panels and any mediation or arbitration sessions shall not be construed as meetings of an agency for purposes of the open meetings act and shall remain confidential. The members of the screening panels, mediators and arbitrators have a deliberative privilege and the same immunity as provided by law for the boards, and are not subject to deposition or subpoena to testify regarding any matter or issue raised in any contested case, criminal prosecution or civil lawsuit which may result from or be incident to cases processed before them.