I want to report multiple PT licenses. Should I?

I have been a PTA in Texas for 6 years. I have worked home health the past 4 years. 3 years in a smaller city and going on 6 months in Houston. I am really getting tired of these lazy PTs that come to home health to try to get away from actually working.

I have had a big problem working behind PTs that think an evaluation is talking with a patient for 5-10 minutes, taking vitals, and leaving having done nothing else. Sometimes they will maybe walk with them 50ft and then say that is enough. I know this because I ask patients what they were taught or ask what they did on the first visit. It is always the same, “oh nothing, we just talked. They said it was just the evaluation.” I know it could be said that a lot of patients don’t remember, but there are plenty of people I see that are clear minded, or have family/caregivers present all the time that are clear minded and can confirm nothing was done. It happens during reevaluations too. They say that the PT asks what I am doing, how it is going, if they want to continue, maybe walk a little bit, and that’s it. In and out in 10-15 minutes.

Sometimes this affects my work as a PTA. I go to see a patient that was not properly evaluated, and they are either way higher level than expected or lower than expected. This leads to unattainable goals or instant completion of goals on the first visit sometimes. One PT frequently puts the same values on all the test supposedly completed such as 57 second TUG, 30 second stand test x 2, and Tinetti score of 11/28 on almost every single patient. I’ll sometimes retest TUG and get like 10-20 seconds when it’s a higher level person. I describe these tests to patients and they say they did not perform them. I know the Tinetti can be for the most part completed without a patient knowing.

I frequently see "Generalized Weakness, Fall risk" as the diagnosis, and it tells me very little. I have had one patient that had that as the diagnosis on the PT evaluation and had really bad orthostatic hypotension. I found this out after walking with the patient and they almost passed out. Checked their BP and found it was like 60/40. I then looked at the OT evaluation afterwards and theirs had orthostatic hypotension as the dx.

Another patient had back surgery, another with hip surgery, and another that had brain surgery and all had "Generalized Weakness, Fall risk" as their dx. I find out about the surgeries by talking with the patient on my first visit, not by looking at the documented medical history on the PT evaluation because it isn’t there. You could say, well how does this change the treatment? If they have spinal precautions or hip precautions, that would be important to educate a patient on and avoid during treatment.

I had 1 patient with primary progressive MS that has been a hoyer lift patient the past 10 years. Flaccid RUE and RLE, 1 MMT in LLE, 4 MMT in LUE. The PT put standing goals, and said he had 3 MMT on LLE muscles in the evaluation. I found out he straight up copied word for word an evaluation done by another therapist 1 year ago. The first therapist was stupid to put standing goals and MMT grades 3 on the patients LLE, and the second was stupid to copy the previous evaluation and not do any evaluation of the patient himself. The patients wife is a smart retired nurse, and said that the patient has been the same for years with no sharp decline, no improvement, no change...She said he just came in talked and left.

I could list a lot more. I have brought this up to my company, and they “had a talk with them.” It’s the same story for each of them. They always say, “I’ve been staying the whole 45 minutes I promise. I don’t know how to prove it to you.” I know there is no minimum time for visits and it’s a company policy to stay 45 minutes, but 10-15 minutes can’t be ethical. The company says they talked with them about the documentation discrepancies, and the PTs say they will do better. I’ve waited over a month and no changes. Patients continue to complain that the visits are a waste of time because they don't do anything. I tell the patients to report them to my company, and sometimes they are like "well, I don't want to get anyone in trouble."

I actually got one of my patients to send me video from cameras in their home proving that one of the PTs only stayed 9 minutes. I haven’t done anything with the video yet or told the PT that I have it.

I really want to report these PTs because they aren’t doing anything for these patients, they are making my job harder and sometimes unsafe, and are getting paid well for a job they aren’t doing. I know so many PTs complain about pay, but they chose this job/career. If you think about it with documentation on a 9 minute visit, they are making like $75 for 20 minutes of “work” IF you consider what they are doing work. Maybe 30 minutes if you include driving.

22 Tex. Admin. Code § 322.4 - (b) Practicing in a manner detrimental to the public health and welfare may
include, but is not limited to, the following:(1) failing to document physical therapy services, inaccurately
recording, falsifying, or altering patient/client records

Do I have enough to report these PTs licenses? Could they investigate through the company and look at documentation? Copy paste evals and HUGE differences between evaluation and my first visit.