North Dakota Administrative Code Title 55.5 - Occupational Therapy Practice, Board of
Overview of NDAC Title 55.5 – Occupational Therapy Practice
Title 55.5 governs the practice of occupational therapy (OT) in North Dakota, including:
Licensing and renewal of occupational therapists (OTs) and occupational therapy assistants (OTAs).
Scope of practice, including what services may be provided and how therapy is delivered.
Professional conduct and ethical obligations.
Disciplinary actions and penalties for violations.
The rules ensure public safety, ethical practice, and professional competence.
Case 1: Practicing Without a License
Scenario
An individual begins providing occupational therapy services at a local clinic without obtaining a license in North Dakota.
NDAC 55.5 Requirement
All OTs and OTAs must hold a valid North Dakota license before practicing.
Practicing without a license is strictly prohibited.
What Happens
A patient files a complaint with the Board.
Investigation confirms that the individual never applied for licensure.
Result
Individual is ordered to cease practice immediately.
Legal action may follow, including fines or criminal charges.
Future licensing application may be denied or conditioned.
Key Principle
Licensure ensures that only qualified professionals provide therapy, protecting patient safety.
Case 2: Scope of Practice Violation
Scenario
An OTA begins providing independent occupational therapy evaluations and treatment plans without OT supervision.
NDAC 55.5 Requirement
OTAs must practice under the supervision of a licensed OT, according to defined supervisory ratios and responsibilities.
OTAs cannot perform independent evaluation or develop treatment plans unsupervised.
What Happens
Clinic audit reveals several cases of unsupervised OTA evaluations.
Result
OTA receives a formal warning.
Clinic implements corrective measures, including proper supervision documentation.
Board may require additional training or probation.
Key Principle
The scope of practice rules protect patients from improper or unsafe care provided outside legal boundaries.
Case 3: Failure to Maintain Continuing Education
Scenario
An OT renews their license but fails to document the required 24 hours of continuing education in the previous two years.
NDAC 55.5 Requirement
Licensed OTs must complete continuing education to maintain competence.
Proof of completion is required at renewal.
What Happens
Renewal application is flagged for missing documentation.
Board requests verification of completed courses.
Result
License renewal is denied until CE requirements are met.
OT completes necessary courses and submits proof.
OT may be placed on temporary inactive status during compliance.
Key Principle
Continuing education ensures that OTs maintain current knowledge and skills.
Case 4: Unprofessional Conduct – Patient Neglect
Scenario
A licensed OT repeatedly misses scheduled therapy sessions for patients without documentation or rescheduling.
NDAC 55.5 Requirement
OTs must provide competent and ethical care.
Neglect or abandonment of patients constitutes unprofessional conduct.
What Happens
Complaints are filed by patients and families.
Board investigation confirms pattern of neglect.
Result
License is suspended or placed on probation.
OT must complete remedial training and improve documentation practices.
Key Principle
NDAC 55.5 enforces professional responsibility and patient safety.
Case 5: Fraudulent Documentation
Scenario
An OT falsifies patient records to justify billing for services that were never provided.
NDAC 55.5 Requirement
Accurate documentation is mandatory.
Fraud or misrepresentation in patient records is strictly prohibited.
What Happens
Audit of billing records uncovers discrepancies.
Board investigation confirms falsification.
Result
OT license may be revoked.
Civil or criminal penalties may apply.
Clinic implements safeguards to prevent recurrence.
Key Principle
Documentation integrity is critical for patient safety, insurance compliance, and public trust.
Case 6: Improper Delegation
Scenario
An OT delegates a complex intervention to a support personnel who is not trained or qualified to perform the task.
NDAC 55.5 Requirement
Delegation must only be to personnel qualified to perform the assigned tasks.
OT retains responsibility for patient care outcomes.
What Happens
Patient injury occurs.
Board investigation finds improper delegation.
Result
OT placed on probation and required to retrain on delegation standards.
Clinic must revise policies on supervision and delegation.
Key Principle
OTs are accountable for safe delegation and supervision of therapy tasks.
Case 7: Boundary Violations
Scenario
An OT develops a personal relationship with a patient that affects professional judgment.
NDAC 55.5 Requirement
OTs must maintain professional boundaries with patients.
Dual relationships that impair clinical judgment are prohibited.
What Happens
Complaint is filed by a patient family member.
Board investigation confirms boundary violation.
Result
OT receives disciplinary action, possibly including suspension, counseling, or mandatory ethics training.
Key Principle
Professional boundaries protect patient trust and safety.
Summary of Core Themes in NDAC Title 55.5 Cases
Licensure compliance – practicing without a license is prohibited.
Scope of practice – OTs and OTAs must work within legal and professional boundaries.
Continuing education – maintaining competence is mandatory.
Professional conduct – neglect, fraud, or unethical behavior triggers disciplinary action.
Documentation and record-keeping – accuracy is critical for legal and clinical accountability.
Supervision and delegation – proper oversight protects patients from harm.
Patient safety and boundaries – ethical care and professional relationships are enforced.
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