3. Documentation That Clearly Supports the Daily Nursing Skilled Services -
Nursing services are considered skilled when they are so inherently complex that they can be safely and effectively performed only by, or under the supervision of, a licensed nurse. Documentation supports coverage when an individualized assessment of the patient’s clinical condition demonstrates that the specialized judgment, knowledge, and skills of a licensed nurse are necessary. Care should be taken to complete a skilled note at least daily, focusing on the patient’s clinical needs, along with skilled assessment of clinical conditions and notation on the resident’s response to care delivery.