Massachusetts regulations on MT documentation

A board covering matters of regulation and requirements as well as discussion regarding the bodywork and related professions. Wow! Now that's a lot of discussion!

Moderators: Talenyn, JLWmassage

Massachusetts regulations on MT documentation

Postby joshuatenpenny on Fri Sep 05, 2008 8:53 am

From 269 CMR 5.00: Code Of Professional Ethics & Standards Of Professional Practice

5.03 Standards for Documentation.

(1) The Massage Therapist and client shall agree upon the purpose of the Massage session;

(2) No documentation is required if the Massage session is for general relaxation, given during sports or other kind of events, or given during a public demonstration as in chair Massage, unless the client is under 18 years of age. If the client is less than 18 years of age, the therapist must obtain written permission of either a parent or a guardian for the minor client's receipt of Massage therapy;

(3) If a written plan of treatment is requested or required, the client file shall include the following documentation:

(a) The initial evaluation, which shall include:
1. The client's name, age, and gender;
2. Date of the session;
3. Pertinent medical history, including, but not limited to:

a. Client sensitivities and allergies;

b. Medical diagnoses, if available, and the source of the diagnosis;

c. Contraindications; and

d. Medications as disclosed by the client.

(b) Progress notes signed by a Massage Therapist rendering the Massage therapy, which shall include:

1. Subjective information, including the area of complaint as stated by the client and the date of onset;

2. Objective information, including any observations and objective testing, if applicable;

3. Ongoing assessments, if applicable;

4. Actions taken by the Massage Therapist;

5. Client response to Massage therapy treatment.

(c) A plan of treatment, if applicable, consisting of:

1. Goals or desired outcome of the treatment;

2. Modalities to be rendered;

3. Frequency and duration of treatment;

4. Referral to other professionals, if indicated; and

5. Client self-help education and instruction.
joshuatenpenny
Registered Member
 
Posts: 54
Joined: Thu Aug 21, 2008 2:20 am
Location: Massachusetts - Westminster

Postby cstbrian on Sat Sep 06, 2008 4:30 am

I'm from Mass also ...

Did you have a question or comment regarding documentation requirements?
Brian

"Life isn't about finding yourself ... life is about creating yourself." George Bernard Shaw
"When we try to control that which is out of our control, we become an incredibly anxiety prone society." Dr. John Upledger
User avatar
cstbrian
Registered Member
 
Posts: 569
Joined: Wed Oct 17, 2007 7:12 am
Location: Northampton, MA

Postby joshuatenpenny on Sat Sep 06, 2008 4:56 am

Oh! When I pasted in the regs I must have deleted my actual message.

I hadn't noticed this part of the new regs. At first I thought it was interesting that they would require SOAP notes, but then I saw that they say "if a written plan of treatment is requested or required". I can't imagine a client requesting it, and if it is up to your discretion whether or not the charting is required... then what is this really saying? "If you write progress notes, they must follow SOAP format"?

I was particularly concerned about the intake section, because I don't ask for a full list of medications. I ask if the person is on certain sorts of medications (pain relievers, anti-inflammatories, sedatives...) but I feel that the full list of medications is more information than it is within my scope of practice to evaluate. But there is that "as disclosed by the client" line, so perhaps adding "or other medications that might affect your treatment." to my question would be sufficient.

-- Joshua
joshuatenpenny
Registered Member
 
Posts: 54
Joined: Thu Aug 21, 2008 2:20 am
Location: Massachusetts - Westminster

Postby cicerone on Sat Sep 06, 2008 8:36 am

The way I'm reading this is that documentation is required unless you are at a sporting event, a promotional event or "just" doing Swedish (relaxation) massage.

The request might come from an athlete during the sporting event, it might even come from that "just relaxation" client if they are using insurance, but it isn't otherwise discretional.

The wording troubles me. How will you know if relaxation massage is contraindicated if you don't have an intake form? That is the information included in 3(a) of the exerpt. Is ruling on the "initial evaluation" covered seperately?
cicerone
Registered Member
 
Posts: 149
Joined: Mon Aug 11, 2008 12:08 pm
Location: NC

Postby cstbrian on Sun Sep 07, 2008 5:32 am

joshuatenpenny wrote:At first I thought it was interesting that they would require SOAP notes, but then I saw that they say "if a written plan of treatment is requested or required". I can't imagine a client requesting it, and if it is up to your discretion whether or not the charting is required... then what is this really saying? "If you write progress notes, they must follow SOAP format"?


I have discussed this with other MTs when we first read the new laws. I don't see it as a client requesting the info as much as a doctor, insurance company, or lawyer requesting client charts. If you are writing notes on a client, then yes, they need to be SOAP notes. If it is just a 'relaxation' session then your notes would say '60-minute, full body, relaxation swedish/deep tissue massage' (or something like that).

If the client comes in with any 'complaint(s)' and you are going to do therapeutic work, you must pull out your SOAP notes.

joshuatenpenny wrote:I was particularly concerned about the intake section, because I don't ask for a full list of medications. I ask if the person is on certain sorts of medications (pain relievers, anti-inflammatories, sedatives...) but I feel that the full list of medications is more information than it is within my scope of practice to evaluate. But there is that "as disclosed by the client" line, so perhaps adding "or other medications that might affect your treatment." to my question would be sufficient.


I don't feel it is out of our scope to know all the medications a client is taking. We must know if there is anything that would contraindicate massage or perhaps create a caution for massage. We are not 'evaluating' their meds, but we'd better know what effects they have on the body. I have a 'massage and medication' book in my office and will refer to it right in front of the client if there is a med I want to check. It is for the safety of the client. We are not advising in any way.

Plus, from my point of view, if anything were to happen to a client on my table I would want the intake to be as complete as possible to give to the EMTs/Paramedics who arrived to help me out. Again, it's for the safety of the client to have this info.

cicerone wrote:The wording troubles me. How will you know if relaxation massage is contraindicated if you don't have an intake form? That is the information included in 3(a) of the exerpt. Is ruling on the "initial evaluation" covered seperately?


"Initial Evaluation' is not covered separately. The wording is a bit troublesome. I feel (personal opinion here) that it was worded this way for the spas/clinics/therapists who do strictly 'relaxation' massage with no specific work. I can see where it might not be required to keep notes for relaxation work, but I feel it is in the best interest of the therapist to keep some notes.

I feel an intake should ALWAYS be filled out and even if not gone over one-on-one in detail, should be kept as a consent from the client and documentation of their level of health to receive massage. This will cover the therapist if anything were to go wrong. Can you imagine being called to court for 'injuring' someone and saying 'I don't have any notes or info about this client, it's not required of me by law.' True, it's not required. But a therapist with good notes and a good intake would easily show his/her professionalism, level of comprehension of the work, and would be judged on a very different level than the therapist not keeping any records.

Just my thoughts ...
Brian

"Life isn't about finding yourself ... life is about creating yourself." George Bernard Shaw
"When we try to control that which is out of our control, we become an incredibly anxiety prone society." Dr. John Upledger
User avatar
cstbrian
Registered Member
 
Posts: 569
Joined: Wed Oct 17, 2007 7:12 am
Location: Northampton, MA

Postby riversinger on Sun Sep 07, 2008 9:39 am

Brian,

Would you mind providing the name of the massage & medication book info, so that everyone who is interested can check it out ?

Thank you,
Deb/riversinger
The song of the spirit is as the song
of the river, on a journey back to source.
riversinger
Moderator
 
Posts: 1310
Joined: Tue Mar 29, 2005 3:18 pm
Location: Bucks County, PA

Postby cicerone on Sun Sep 07, 2008 11:12 am

riversinger wrote:name of the massage & medication book info...


The one required for our curriculumn was/is Massage Therapy & Medications by Randal S. Persad, Dip.Pharm., R.M.T.
cicerone
Registered Member
 
Posts: 149
Joined: Mon Aug 11, 2008 12:08 pm
Location: NC

Re: Massachusetts regulations on MT documentation

Postby JLWmassage on Wed Apr 20, 2011 7:38 am

A new bill is in the senate, that would change the scope of practice and up the hours to 900. Check out the grandfathering language.

SECTION 1. Section 227 of chapter 112 of the General Laws, as appearing in the 2008 Official Edition, is hereby amended by striking out lines 18 through 21 and inserting in place thereof the following sentence: -

Massage therapy shall include the prescription of stretching techniques and exercises but shall specifically not include diagnoses, the prescribing of drugs or medicines, spinal or other joint manipulations or any services or procedures for which a license to practice medicine, chiropractic, occupational therapy or podiatry is required by law.

SECTION 2. Section 229 of chapter 112 of the General Laws, as appearing in the 2008 Official Edition, is hereby amended by striking out subsection (a)(5) and inserting in place thereof the following subsection: -

(a)(5) he shall have successfully completed a course of study consisting of at least 900 classroom hours at an accredited massage school which shall consist of 200 hours of anatomy, physiology, and pathology, 150 hours of kinesiology and/or mycology, 50 hours in the subject of hygiene, first aid, CPR, HIV including the instruction of infection control procedures, 180 hours of general theory and applications of massage therapy, 200 hours of additional instruction including a minimum of 75 hours of ethics, law, and business practices, and 120 hours of actual hands-on practical massage therapy in a clinic or other supervised setting;

SECTION 3, Said section 229 of said chapter 112 of the General Laws, as so appearing, is hereby further amended by adding after subsection (c), the following subsection:-

(d) The board shall renew existing practitioners who, within a twelve month period following the effective date of this section have done one of the following: (1) completed 150 hours of continuing education as prescribed by the board; (2) passed the nation certification board for therapeutic massage and bodywork (NCBTMB) certification examination; or (3) is able to demonstrate that the applicant has been in active continuous practice of massage therapy for at least five years immediately preceding the effective date of this section
User avatar
JLWmassage
Moderator
 
Posts: 1598
Joined: Thu Jan 13, 2005 2:45 pm
Location: West Boylston, Ma

Re: Massachusetts regulations on MT documentation

Postby JLWmassage on Wed Apr 20, 2011 8:43 am

User avatar
JLWmassage
Moderator
 
Posts: 1598
Joined: Thu Jan 13, 2005 2:45 pm
Location: West Boylston, Ma


Return to County, State & Country Requirements, Legislation and Politics

Who is online

Users browsing this forum: No registered users and 1 guest

cron