ORTHOTICS AND PROSTHETICS (OPS) Class A: $50 up to $1,000. Failure to Notify Department Violations

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ORTHOTICS AND PROSTHETICS (OPS) Texas Occupations Code, Chapter 605 16 Texas Administrative Code, Chapter 114 Class A: $50 up to $1,000 Failure to Notify Department Violations Failed to report to the Department violations of the Act or this 114.27(c)(8) chapter committed by a licensed assistant Failed to notify Department of change in the accredited facility 114.29(e)(1)(C); designation of the on-site practitioner(s) in charge name and 114.70(b) license number within 30 days after the change Failed to notify Department of change in the accredited facility 114.29(e)(3)(B); designation of the on-site safety manager(s) name and license 114.70(b) number within 30 days after the change Failed to notify the Department of any change(s) of name or 114.70(b) mailing address within 30 days after a change Posting and Public Information Violation Failed to publicly display the license certificate in the primary place 114.21(e)(1) of employment Failed to carry the license or obtain duplicate licenses to be 114.21(e)(2) displayed at each location of employment when without a primary office or when employed at multiple locations Displayed or carried a copy of a license instead of the original 114.21(e)(3) Allowed license to be copied for a purpose other than for license 114.21(f) verification Failed to sign, date and mark license copies with the word COPY 114.21(f) across the document s face Failed to prominently display facility accreditation certificate in 114.29(f)(3) facility available for public inspection

Failed to prominently display consumer complaint notice sign in 114.29(f)(5); 114.70(d) facility Failed to prominently display the license certificates of practitioners 114.29(f)(8) in facility available for public inspection Failed to display a visible sign with facility hours of operation and, 114.29(f)(9) when appropriate, information regarding temporary closures Advertising Without a License or Accreditation Violations Used terms or letters indicating directly or by implication that an 605.251; 605.301(2)(c); orthotic or prosthetic service will be provided when not licensed 605.351; 114.29(f)(6) or accredited Advertised or otherwise held-out as able to practice orthotics or 605.251 prosthetics without a license Facility, Equipment and Sanitation Violations Failed to clean examination/treatment room(s) after each patient 114.29(j)(2) Failed to have hand sanitizer/hand soap, hand towels or hand 114.29(j)(3) dryers available at the sinks for use by employees/patients Failed to have exam tables covered in material for disposable one- 114.29(j)(4) time use or can be disinfected, replaced or cleaned after providing service to each patient Failed to have gloves and disinfectants available in 114.29(j)(5) examination/treatment areas Failed to keep the floors, walls, ceilings, shelves, furniture, 114.29(j)(6) furnishings and fixtures clean and in good repair or failed to repair or fill-in cracks or similar disrepair not readily accessible Failed to keep plumbing fixtures clean or failed to repair any 114.29(j)(7) disrepair with plumbing not readily accessible Failed to have suitable facility plumbing providing hot and cold 114.29(j)(8) running water at all times Failed to provide at least one facility restroom 114.29(j)(9) Facility being utilized for living or sleeping purposes or utilized 114.29(j)(10) for any other purpose tending to make the premises unsanitary, unsafe or endanger the public health and safety

Failed to separate the facility patient waiting areas from other 114.29(k)(1) areas Failed to provide chairs with armrests or failed to provide chairs 114.29(k)(2); without armrests or wheels upon request 114.29(l)(3) Failed to provide a facility telephone for patient use 114.29(k)(3) Failed to provide private patient rooms 114.29(l)(1) Failed to maintain facility machine use training records 114.29(m)(2) documenting staff training for each machine Class B: $500 to $3,000 and/or up to 6-month probated suspension Health and Safety Violations Failed to wash hands with hand sanitizer/soap and water before 114.29(j)(1) providing service to client Storing chemical supplies in restrooms or other areas accessible to 114.29(j)(9) the public Failed to provide at least one set of parallel bars, wall-mounted 114.29(l)(2) mirror or mirror with base for patient facility ambulation trials Failed to have facility equipment, tools, and materials for casting, 114.29(o)(2) measuring, fitting, repairs and adjustments of orthoses/prosthesis Failed to have safety equipment, including safety glasses or goggles 114.29(m)(1) and dust masks for persons working in facility Failed to provide proper facility machine use training 114.29(m)(2) Failed to have safety guards on facility machines as required by the 114.29(m)(3) manufacturer Administrative Violations Related to Assistants Failed to file with the Department a supervision agreement before 114.27(b)(1) the assistant clinical residency begins

Failed to provide the assistant clinical resident and Department with 114.27(b)(3) supervisor s written documentation on beginning, terminating or completing the assistant clinical residency Failed to review and sign off on patient care notes made by assistant 114.27(b)(5); clinical resident by supervising practitioner within 10 days from the 114.27(c)(1) date the service was provided Allowed the assistant clinical residency to begin with supervisor 114.27(b)(2) before approval from the Department Administrative Violations Failure of an accredited facility to have a licensed practitioner in 114.29(e)(1) charge Failed to have an accredited facility residency program director 114.29(e)(2) licensed in the same discipline in which the professional clinical residency is being conducted providing direct/indirect resident supervision Failed to have one person designated facility safety manager to 114.29(e)(3); develop, carry out and monitor the facility safety program 114.29(j)(6) Unlicensed Activity Practiced, attempted, offered to practice orthotics or prosthetics 60.31(g); 114.40(f)(1); with an expired license 114.40(f)(2); 114.90(c)(10) Practiced, attempted, offered to practice orthotics or prosthetics 60.31(g);114.40(e)(5); patient care as an accredited facility with an expired license 114.40(f)(1); 114.40(f)(3); 114.90(c)(10) Class C: $1000 to $5,000 and/or 1-year probated suspension up to revocation Administrative Violations Altered a license or a copy of a license 114.21(g) Failed to cooperate with the Department inspector in the 114.29(i)(6) performance of the inspection

Used or allowed a person to use a license or registration for any 114.90(c)(4) fraudulent, misleading or deceptive purpose Failed or refused to provide acceptable documentation of 114.90(b)(20) continuing education records for renewal Failed to cooperate with the Department during an investigation of 114.90(d)(21); a complaint by not furnishing required documentation or responding 114.90(d)(27); 114.90(f) to a request for information or a subpoena issued by the Department Interfered with a department investigation or disciplinary 114.90(d)(22) proceeding by misrepresentation of facts, by threats, retaliation or harassment against anyone Filed a complaint with the Department that is frivolous or made in 114.90(h) bad faith Records Violations Failed to include accurate and current patient progress notes 114.29(n)(1) Failed to keep patient records private 114.29(n)(2); 114.90(d)(13) Made patient records available without the patient s signed consent 114.29(n)(3) or as permitted by law Failed to maintain patient records for a minimum of five (5) years 114.29(n)(4) Standard of Care Violations Related to Supervision Provision of care by assistant clinical resident or licensed assistant 114.27(b)(4) and (9); without appropriate supervision 114.27(c)(6) Provided patient care to orthotic/prosthetic patients including 114.28(d) ancillary or assistant patient care services as a registered technician Licensed assistant provided ancillary patient care services in a 605.255(b); discipline other than that of the supervisor s license 114.27(c)(2); 114.27(c)(3); 114.27(c)(4) Student registrant working without appropriate supervision Failed to supervise and be responsible for the acts/omissions of the licensed assistant by supervising practitioner 605.258(b) 114.27(c)(5); 114.27(c)(7)

Failed to supervise a technician by a licensed prosthetist, orthotist, 114.28(a) prosthetist/orthotist, prosthetist assistant, orthotist assistant, or prosthetist/orthotist assistant Practitioner in charge failed to supervise and maintain supervision 114.90(d)(8) of clinical or technical personnel Practitioner in charge failed to provide facility on-site supervision 114.90(d)(8) Standard of Care Violations Related to Treatment Persistently or flagrantly over-treated a client or patient 114.90(c)(12) Failed to maintain acceptable standards of prosthetics or orthotics 114.90(d)(5) practices set forth by department rules Failed or unable to practice prosthetics/orthotics with reasonable 114.90(d)(6) skill and safety due to use of alcohol, drugs, chemicals or from mental or physical conditions Treated or agreed to treat human ailments by means other than 114.90(d)(7) appropriate prosthetic/orthotic treatments Provided prosthetic/orthotic services or products in a way that the 114.90(d)(9) person knows or should know violates the Act or chapter Failed to assess and evaluate a patient s status 114.90(d)(10) Provided or attempted to provide services for which the licensee 114.90(d)(11) lacks education or experience Delegated functions to an individual lacking the ability, knowledge 114.90(d)(12) or license/registration to perform the functions Failed to follow universal precautions or infection control standards 114.90(d)(18) as required by the Health & Safety Code Fitted a prosthesis or orthosis without a prescription 605.2515; 114.90(d)(23) Fitted a prosthesis or orthosis inaccurately or modifying the 114.90(d)(24) prescription without authorization Performed an act or omission constituting gross neglect, such as 605.353(a)(4); conduct involving malice, willfulness or wanton and reckless 114.90(e)(1) disregard of others rights Performed an act or omission constituting malpractice by failing to 605.353(a)(4); perform services or provide products for which compensation has 114.90(e)(2)(A) been received or failed to perform services or provide products with reasonable care, skill, expedience, and faithfulness

Performed an act or omission constituting malpractice by failing to 605.353(a)(4); do that which a person or ordinary prudence would have done or 114.90(e)(2)(B) would not have done under the same or similar circumstances Misrepresentation Failed to submit truthful continuing education documentation or 605.353(a)(2); information to the Department; committed fraud, misrepresentation, 114.90(b)(2); or concealment of a material fact with continuing education 114.90(d)(19); requirements 114.50(p) Impersonated or acted as a proxy for a licensee or registrant at a 605.353(a)(2); continuing education activity 114.90(b)(4) Used a proxy to participate in a continuing education activity 605.353(a)(2); 114.90(b)(5) Provided false or misleading information to the Department 605.353(a)(2); regarding a Department inquiry 114.90(b)(6) Placed or caused to be placed false, misleading or deceptive 605.353(a)(2); advertising 114.90(c)(1) Made or allowed false, misleading or deceptive representations 605.353(a)(2); concerning services or products provided or to be provided. 114.90(c)(2) Made or allowed false, misleading or deceptive representations on 605.353(a)(2); an employment application 114.90(c)(3) Forged, altered or falsified a physician s or healthcare 605.353(a)(2); professional s order 114.90(c)(6) Delivered prosthetic/orthotic services or products through means of 605.353(a)(2); misrepresentation, deception or subterfuge 114.90(c)(7) Made, filed, or caused another person to make or file a report or 605.353(a)(2) record the licensee knows to be inaccurate, incomplete, false or 114.90(c)(9) illegal Other fraud or deceit concerning services provided 605.353(a)(2); 114.90(c)(15)

Unlicensed Activity Knowingly employed or professionally associated with a person or 605.251; entity providing orthotic or prosthetic services without the required 114.90(c)(5) license or accreditation Provided orthotic care in a facility not accredited in orthotics 114.90(d)(25) Provided prosthetic care in a facility not accredited in prosthetics 114.90(d)(26) Practiced, attempted to practice, or offered to practice 605.251; orthotics/prosthetics, or acted as an assistant without a license 114.90(c)(10) Fabricated or assembled an orthosis or prosthesis without a 605.2515 prescription or device distributor license Practicing in a place other than an accredited facility or exempt 114.29(c)(1); facility 114.27(c)(9) Operated an unaccredited facility 114.29(f)(1); 114.29(g); 114.90(c)(10); 114.90(d)(14); 114.90(d)(25) and (26) Unprofessional or Unethical Conduct Persistently or flagrantly overcharged a client, patient or third 605.353(a)(3) party 114.90(c)(11) Took, without authorization, patient medication, supplies, 605.353(a)(3) equipment or personal items 114.90(c)(14) Accepted or paid, or agreed to pay or accept illegal remuneration 605.353(a)(3) for the securing or soliciting of patients 114.90(c)(8) Discriminated based on race, color, national origin, religion, 605.353(a)(3) gender, age or disability in the practice of prosthetics/orthotics 114.90(d)(1) Surrendered a license to avoid disciplinary action or prosecution 605.353(a)(3) 114.90(d)(2) Licensee had previous disciplinary action 605.353(a)(3) 114.90(d)(3) Engaged in conduct prohibited by state, federal or local law 605.353(a)(3) 114.90(d)(4)

Engaged in other unprofessional or unethical conduct 605.353(a)(3) 114.90(d)(29) Assaulted or caused, permitted or allowed physical or emotional 605.353(a)(3) injury or impairment of dignity or safety to patient/client 114.90(d)(15) Made abusive, harassing or seductive remarks to a patient, client 605.353(a)(3) or co-worker in the workplace 114.90(d)(16) Engaged in sexual contact as defined by the Penal Code 21.01 605.353(a)(3) with a patient or client as the result of patient or client relationship 114.90(d)(17) Class D: $5,000 and/or Revocation Obtained or attempted to obtain a license by fraud, 60.23(a)(1); 60.23(a)(2); misrepresentation, or concealment of material fact 605.353(a)(1); 114.90(b)(1); 114.90(b)(7) Cheated on an examination 60.52(a) Impersonate or act as a proxy for an examination candidate 114.90(b)(3); Used a proxy to take an examination 114.20(b)(5) Failed to comply with a previous order of the Commission or 51.353(a); Executive Director 114.90(c)(13); 114.90(d)(28) Failed to pay the Department for a dishonored payment or 60.82; 51.210(c); processing fee 114.80(f)