Condition of participation: Skilled professional services.

Skilled professional services include skilled nursing services, physical therapy, speech-language pathology services, and occupational therapy, as specified in § 409.44 of this chapter, and physician or allowed practitioner and medical social work services as specified in § 409.45 of this chapter. Skilled professionals who provide services to HHA patients directly or under arrangement must participate in the coordination of care. (a) Standard: Provision of services by skilled professionals. Skilled professional services are authorized, delivered, and supervised only by health care professionals who meet the appropriate qualifications specified under § 484.115 and who practice according to the HHA's policies and procedures. (b) Standard: Responsibilities of skilled professionals. Skilled professionals must assume responsibility for, but not be restricted to, the following: (1) Ongoing interdisciplinary assessment of the patient; (2) Development and evaluation of the plan of care in partnership with the patient, representative (if any), and caregiver(s); (3) Providing services that are ordered by the physician or allowed practitioner as indicated in the plan of care; (4) Patient, caregiver, and family counseling; (5) Patient and caregiver education; (6) Preparing clinical notes; (7) Communication with all physicians involved in the plan of care and other health care practitioners (as appropriate) related to the current plan of care; (8) Participation in the HHA's QAPI program; and (9) Participation in HHA-sponsored in-service training. (c) Supervision of skilled professional assistants. (1) Nursing services are provided under the supervision of a registered nurse that meets the requirements of § 484.115(k). (2) Rehabilitative therapy services are provided under the supervision of an occupational therapist or physical therapist that meets the requirements of § 484.115(f) or (h), respectively. (3) Medical social services are provided under the supervision of a social worker that meets the requirements of § 484.115(m). [82 FR 4578, Jan. 13, 2017, as amended at 85 FR 27628, May 8, 2020]