Handouts are here! Click on this link. - Selman-Holman & Associates

4/20/2009
Skilled nursing or physical therapy visits for
management and evaluation of the
beneficiary’s c<strong>are</strong> plan <strong>are</strong> reasonable and
necessary w<strong>here</strong> underlying conditions or
complications require that only a registered
nurse or physical therapist can ensure that
essential non skilled c<strong>are</strong> is achieving its
purpose.
Palmetto
Management and evaluation of a patient’s c<strong>are</strong> plan.
Skilled nursing visits for management and
evaluation of the patient’s c<strong>are</strong> plan <strong>are</strong> also
reasonable and necessary w<strong>here</strong> underlying
conditions or complications require that only a
registered nurse can ensure that essential non-skilled
c<strong>are</strong> is achieving its purpose. To be reasonable and
necessary the complexity of the necessary unskilled
services that <strong>are</strong> a necessary part of the medical
treatment must require the involvement of licensed
nurses to promote the patient’s recovery and medical
safety in view of the patient’s overall condition.
UGS
To justify Management and Evaluation the
beneficiary’s c<strong>are</strong> plan has to be complex.
1. Management of the unskilled services being
provided
2. Evaluation of the effectiveness of the unskilled
services,
3. Oversight to avoid complications
The unskilled services must be part of the
medical treatment plan
4