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Orthotists and Prosthetists Penalties and Sanctions

Texas Occupations Code, Chapter 605
16 Texas Administrative Code, Chapter 114

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Class A Violations

Penalty: Fine between $50 – $1,000

Failure to Notify Department Violations

Violation Texas Statutes
Failed to report to the Department violations of the Act or this chapter committed by a licensed assistant 16 TAC 114.27(c)(8)
Failed to notify Department of change in the accredited facility designation of the on-site practitioner(s) in charge name and license number within 30 days after the change 16 TAC 114.29(e)(1)(C);
16 TAC 114.70(b)
Failed to notify Department of change in the accredited facility designation of the on-site safety manager(s) name and license number within 30 days after the change 16 TAC 114.29(e)(3)(B);
16 TAC 114.70(b)
Failed to notify the Department of any change(s) of name or mailing address within 30 days after a change 16 TAC 114.70(b)

Posting and Public Information Violation

Violation Texas Statutes
Failed to publicly display the license certificate in the primary place of employment 16 TAC 114.21(e)(1)
Failed to carry the license or obtain duplicate licenses to be displayed at each location of employment when without a primary office or when employed at multiple locations 16 TAC 114.21(e)(2)
Displayed or carried a copy of a license instead of the original 16 TAC 114.21(e)(3)
Allowed license to be copied for a purpose other than for license verification 16 TAC 114.21(f)
Failed to sign, date and mark license copies with the word "COPY" across the document's face 16 TAC 114.21(f)
Failed to prominently display facility accreditation certificate in facility available for public inspection 16 TAC 114.29(f)(3)
Failed to prominently display consumer complaint notice sign in facility 16 TAC 114.29(f)(5);
16 TAC 114.70(d)
Failed to prominently display the license certificates of practitioners in facility available for public inspection 16 TAC 114.29(f)(8)
Failed to display a visible sign with facility hours of operation and, when appropriate, information regarding temporary closures 16 TAC 114.29(f)(9)

Advertising Without a License or Accreditation Violations

Violation Texas Statutes
Used terms or letters indicating directly or by implication that an orthotic or prosthetic service will be provided when not licensed or accredited Occupations Code 605.251;
Occupations Code 605.301(2)(c);
Occupations Code 605.351;
16 TAC 114.29(f)(6)
Advertised or otherwise held-out as able to practice orthotics or prosthetics without a license Occupations Code 605.251

Facility, Equipment and Sanitation Violations

Violation Texas Statutes
Failed to clean examination/treatment room(s) after each patient 16 TAC 114.29(j)(2)
Failed to have hand sanitizer/hand soap, hand towels or hand dryers available at the sinks for use by employees/patients 16 TAC 114.29(j)(3)
Failed to have exam tables covered in material for disposable one-time use or can be disinfected, replaced or cleaned after providing service to each patient 16 TAC 114.29(j)(4)
Failed to have gloves and disinfectants available in examination/treatment areas 16 TAC 114.29(j)(5)
Failed to keep the floors, walls, ceilings, shelves, furniture, furnishings and fixtures clean and in good repair or failed to repair or fill-in cracks or similar disrepair not readily accessible 16 TAC 114.29(j)(6)
Failed to keep plumbing fixtures clean or failed to repair any disrepair with plumbing not readily accessible 16 TAC 114.29(j)(7)
Failed to have suitable facility plumbing providing hot and cold running water at all times 16 TAC 114.29(j)(8)
Failed to provide at least one facility restroom 16 TAC 114.29(j)(9)
Facility being utilized for living or sleeping purposes or utilized for any other purpose tending to make the premises unsanitary, unsafe or endanger the public health and safety 16 TAC 114.29(j)(10)
Failed to separate the facility patient waiting areas from other areas 16 TAC 114.29(k)(1)
Failed to provide chairs with armrests or failed to provide chairs without armrests or wheels upon request 16 TAC 114.29(k)(2);
16 TAC 114.29(l)(3)
Failed to provide a facility telephone for patient use 16 TAC 114.29(k)(3)
Failed to provide private patient rooms 16 TAC 114.29(l)(1)
Failed to maintain facility machine use training records documenting staff training for each machine 16 TAC 114.29(m)(2)

Class B Violations

Penalty: Fine between $500 – $3,000 and/or up to 6-month probated suspension.

Health and Safety Violations

Violation Texas Statutes
Failed to wash hands with hand sanitizer/soap and water before providing service to client 16 TAC 114.29(j)(1)
Storing chemical supplies in restrooms or other areas accessible to the public 16 TAC 114.29(j)(9)
Failed to provide at least one set of parallel bars, wall-mounted mirror or mirror with base for patient facility ambulation trials 16 TAC 114.29(l)(2)
Failed to have facility equipment, tools, and materials for casting, measuring, fitting, repairs and adjustments of orthoses/prosthesis 16 TAC 114.29(o)(2)
Failed to have safety equipment, including safety glasses or goggles and dust masks for persons working in facility 16 TAC 114.29(m)(1)
Failed to provide proper facility machine use training 16 TAC 114.29(m)(2)
Failed to have safety guards on facility machines as required by the manufacturer 16 TAC 114.29(m)(3)

Administrative Violations Related to Assistants

Violation Texas Statutes
Failed to file with the Department a supervision agreement before the assistant clinical residency begins 16 TAC 114.27(b)(1)
Failed to provide the assistant clinical resident and Department with supervisor's written documentation on beginning, terminating or completing the assistant clinical residency 16 TAC 114.27(b)(3)
Failed to review and sign off on patient care notes made by assistant clinical resident by supervising practitioner within 10 days from the date the service was provided 16 TAC 114.27(b)(5);
16 TAC 114.27(c)(1)
Allowed the assistant clinical residency to begin with supervisor before approval from the Department 16 TAC 114.27(b)(2)

Administrative Violations

Violation Texas Statutes
Failure of an accredited facility to have a licensed practitioner in charge 16 TAC 114.29(e)(1)
Failed to have an accredited facility residency program director licensed in the same discipline in which the professional clinical residency is being conducted providing direct/indirect resident supervision 16 TAC 114.29(e)(2)
Failed to have one person designated facility safety manager to develop, carry out and monitor the facility safety program 16 TAC 114.29(e)(3);
16 TAC 114.29(j)(6)

Unlicensed Activity

Violation Texas Statutes
Practiced, attempted, offered to practice orthotics or prosthetics with an expired license 16 TAC 60.31(g);
16 TAC 114.40(f)(1);
16 TAC 114.40(f)(2);
16 TAC 114.90(c)(10)
Practiced, attempted, offered to practice orthotics or prosthetics patient care as an accredited facility with an expired license 16 TAC 60.31(g);
16 TAC 114.40(e)(5);
16 TAC 114.40(f)(1);
16 TAC 114.40(f)(3);
16 TAC 114.90(c)(10)

Class C Violations

Penalty: Fine between $1000 – $5,000 and/or 1-year probated suspension up to revocation.

Administrative Violations

Violation Texas Statutes
Altered a license or a copy of a license 16 TAC 114.21(g)
Failed to cooperate with the Department inspector in the performance of the inspection 16 TAC 114.29(i)(6)
Used or allowed a person to use a license or registration for any fraudulent, misleading or deceptive purpose 16 TAC 114.90(c)(4)
Failed or refused to provide acceptable documentation of continuing education records for renewal 16 TAC 114.90(b)(20)
Failed to cooperate with the Department during an investigation of a complaint by not furnishing required documentation or responding to a request for information or a subpoena issued by the Department 16 TAC 114.90(d)(21);
16 TAC 114.90(d)(27);
16 TAC 114.90(f)
Interfered with a department investigation or disciplinary proceeding by misrepresentation of facts, by threats, retaliation or harassment against anyone 16 TAC 114.90(d)(22)
Filed a complaint with the Department that is frivolous or made in bad faith 16 TAC 114.90(h)

Records Violations

Violation Texas Statutes
Failed to include accurate and current patient progress notes 16 TAC 114.29(m)(1)
Failed to keep patient records private 16 TAC 114.29(m)(2);
16 TAC 114.90(d)(13)
Made patient records available without the patient's signed consent or as permitted by law 16 TAC 114.29(m)(3)
Failed to maintain patient records for a minimum of five (5) years 16 TAC 114.29(m)(4)

Standard of Care Violations - Related to Supervision

Violation Texas Statutes
Provision of care by assistant clinical resident or licensed assistant without appropriate supervision 16 TAC 114.27(b)(4) and (9);
16 TAC 114.27(c)(6)
Provided patient care to orthotic/prosthetic patients including ancillary or assistant patient care services as a registered technician 16 TAC 114.28(d)
Licensed assistant provided ancillary patient care services in a discipline other than that of the supervisor's license Occupations Code 605.255(b);
16 TAC 114.27(c)(2);
16 TAC 114.27(c)(3);
16 TAC 114.27(c)(4)
Student registrant working without appropriate supervision Occupations Code 605.258(b)
Failed to supervise and be responsible for the acts/omissions of the licensed assistant by supervising practitioner 16 TAC 114.27(c)(5);
16 TAC 114.27(c)(7)
Failed to supervise a technician by a licensed prosthetist, orthotist, prosthetist/orthotist, prosthetist assistant, orthotist assistant, or prosthetist/orthotist assistant 16 TAC 114.28(a)
Practitioner in charge failed to supervise and maintain supervision of clinical or technical personnel 16 TAC 114.90(d)(8)
Practitioner in charge failed to provide facility on-site supervision 16 TAC 114.90(d)(8)

Standard of Care Violations - Related to Treatment

Violation Texas Statutes
Persistently or flagrantly over-treated a client or patient 16 TAC 114.90(c)(12)
Failed to maintain acceptable standards of prosthetics or orthotics practices set forth by department rules 16 TAC 114.90(d)(5)
Failed or unable to practice prosthetics/orthotics with reasonable skill and safety due to use of alcohol, drugs, chemicals or from mental or physical conditions 16 TAC 114.90(d)(6)
Treated or agreed to treat human ailments by means other than appropriate prosthetic/orthotic treatments 16 TAC 114.90(d)(7)
Provided prosthetic/orthotic services or products in a way that the person knows or should know violates the Act or chapter 16 TAC 114.90(d)(9)
Failed to assess and evaluate a patient's status 16 TAC 114.90(d)(10)
Provided or attempted to provide services for which the licensee lacks education or experience 16 TAC 114.90(d)(11)
Delegated functions to an individual lacking the ability, knowledge or license/registration to perform the functions 16 TAC 114.90(d)(12)
Failed to follow universal precautions or infection control standards as required by the Health & Safety Code 16 TAC 114.90(d)(18)
Fitted a prosthesis or orthosis without a prescription Occupations Code 605.2515;
16 TAC 114.90(d)(23)
Fitted a prosthesis or orthosis inaccurately or modifying the prescription without authorization 16 TAC 114.90(d)(24)
Performed an act or omission constituting gross neglect, such as conduct involving malice, willfulness or wanton and reckless disregard of others' rights Occupations Code 605.353(a)(4);
16 TAC 114.90(e)(1)
Performed an act or omission constituting malpractice by failing to perform services or provide products for which compensation has been received or failed to perform services or provide products with reasonable care, skill, expedience, and faithfulness Occupations Code 605.353(a)(4);
16 TAC 114.90(e)(2)(A)
Performed an act or omission constituting malpractice by failing to do that which a person or ordinary prudence would have done or would not have done under the same or similar circumstances Occupations Code 605.353(a)(4);
16 TAC 114.90(e)(2)(B)

Misrepresentation

Violation Texas Statutes
Failed to submit truthful continuing education documentation or information to the Department; committed fraud, misrepresentation, or concealment of a material fact with continuing education requirements Occupations Code 605.353(a)(2);
16 TAC 114.90(b)(2);
16 TAC 114.90(d)(19);
16 TAC 114.50(p)
Impersonated or acted as a proxy for a licensee or registrant at a continuing education activity Occupations Code 605.353(a)(2);
16 TAC 114.90(b)(4)
Used a proxy to participate in a continuing education activity Occupations Code 605.353(a)(2);
16 TAC 114.90(b)(5)
Provided false or misleading information to the Department regarding a Department inquiry Occupations Code 605.353(a)(2);
16 TAC 114.90(b)(6)
Placed or caused to be placed false, misleading or deceptive advertising Occupations Code 605.353(a)(2);
16 TAC 114.90(c)(1)
Made or allowed false, misleading or deceptive representations concerning services or products provided or to be provided. Occupations Code 605.353(a)(2);
16 TAC 114.90(c)(2)
Made or allowed false, misleading or deceptive representations on an employment application Occupations Code 605.353(a)(2);
16 TAC 114.90(c)(3)
Forged, altered or falsified a physician's or healthcare professional's order Occupations Code 605.353(a)(2);
16 TAC 114.90(c)(6)
Delivered prosthetic/orthotic services or products through means of misrepresentation, deception or subterfuge Occupations Code 605.353(a)(2);
16 TAC 114.90(c)(7)
Made, filed, or caused another person to make or file a report or record the licensee knows to be inaccurate, incomplete, false or illegal Occupations Code 605.353(a)(2)
16 TAC 114.90(c)(9)
Other fraud or deceit concerning services provided Occupations Code 605.353(a)(2);
16 TAC 114.90(c)(15)

Unlicensed Activity

Violation Texas Statutes
Knowingly employed or professionally associated with a person or entity providing orthotic or prosthetic services without the required license or accreditation Occupations Code 605.251;
16 TAC 114.90(c)(5)
Provided orthotic care in a facility not accredited in orthotics 16 TAC 114.90(d)(25)
Provided prosthetic care in a facility not accredited in prosthetics 16 TAC 114.90(d)(26)
Practiced, attempted to practice, or offered to practice orthotics/prosthetics, or acted as an assistant without a license Occupations Code 605.251;
16 TAC 114.90(c)(10)
Fabricated or assembled an orthosis or prosthesis without a prescription or device distributor license Occupations Code 605.2515
Practicing in a place other than an accredited facility or exempt facility 16 TAC 114.29(c)(1);
16 TAC 114.27(c)(9)
Operated an unaccredited facility 16 TAC 114.29(f)(1);
16 TAC 114.29(g);
16 TAC 114.90(c)(10);
16 TAC 114.90(d)(14);
16 TAC 114.90(d)(25) and (26)

Unprofessional or Unethical Conduct

Violation Texas Statutes
Persistently or flagrantly overcharged a client, patient or third party Occupations Code 605.353(a)(3);
16 TAC 114.90(c)(11)
Took, without authorization, patient medication, supplies, equipment or personal items Occupations Code 605.353(a)(3);
16 TAC 114.90(c)(14)
Accepted or paid, or agreed to pay or accept illegal remuneration for the securing or soliciting of patients Occupations Code 605.353(a)(3);
16 TAC 114.90(c)(8)
Discriminated based on race, color, national origin, religion, gender, age or disability in the practice of prosthetics/orthotics Occupations Code 605.353(a)(3);
16 TAC 114.90(d)(1)
Surrendered a license to avoid disciplinary action or prosecution Occupations Code 605.353(a)(3);
16 TAC 114.90(d)(2)
Licensee had previous disciplinary action Occupations Code 605.353(a)(3);
16 TAC 114.90(d)(3)
Engaged in conduct prohibited by state, federal or local law Occupations Code 605.353(a)(3);
16 TAC 114.90(d)(4)
Engaged in other unprofessional or unethical conduct Occupations Code 605.353(a)(3);
16 TAC 114.90(d)(29)
Assaulted or caused, permitted or allowed physical or emotional injury or impairment of dignity or safety to patient/client Occupations Code 605.353(a)(3);
16 TAC 114.90(d)(15)
Made abusive, harassing or seductive remarks to a patient, client or co-worker in the workplace Occupations Code 605.353(a)(3);
16 TAC 114.90(d)(16)
Engaged in sexual contact as defined by the Penal Code § 21.01 with a patient or client as the result of patient or client relationship Occupations Code 605.353(a)(3);
16 TAC 114.90(d)(17)

Class D Violations

Penalty: Fine od $5,000 and/or license revocation.

Violation Texas Statutes
Obtained or attempted to obtain a license by fraud, misrepresentation, or concealment of material fact 16 TAC 60.23(a)(1);
16 TAC 60.23(a)(2);
Occupations Code 605.353(a)(1);
16 TAC 114.90(b)(1);
16 TAC 114.90(b)(7)
Cheated on an examination 16 TAC 60.52(a)
Impersonate or act as a proxy for an examination candidate 16 TAC 114.90(b)(3);
Used a proxy to take an examination 16 TAC 114.20(b)(5)
Failed to comply with a previous order of the Commission or Executive Director 16 TAC 51.353(a);
16 TAC 114.90(c)(13);
16 TAC 114.90(d)(28)
Failed to pay the Department for a dishonored payment or processing fee 16 TAC 60.82;
16 TAC 51.210(c);
16 TAC 114.80(f)