Licensed, registered, or certified as a physical therapist assistant, if applicable, by the state in which practicing, unless licensure does not apply and meets one of the following requirements: Graduated from a physical therapist assistant curriculum approved by the Commission on Accreditation in Physical Therapy Education of the American Physical Therapy Association; or if educated outside the United States or trained in the United States military, graduated from an education program determined to be substantially equivalent to physical therapist assistant entry level education in the United States by a credentials evaluation organization approved by the American Physical Therapy Association and; Passed a national examination for physical therapist assistants. Identifies and accesses appropriate external and internal resources to meet patient and/or family needs and to facilitate optimal patient outcomes while home care services are being provided, and for transfer and discharge processes.