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.

1. (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.

2. (b) Standard: Responsibilities of skilled professionals. Skilled professionals must assume responsibility for, but not be restricted to, the following:

   1. (1) Ongoing interdisciplinary assessment of the patient;
   2. (2) Development and evaluation of the plan of care in partnership with the patient, representative (if any), and caregiver(s);
   3. (3) Providing services that are ordered by the physician or allowed practitioner as indicated in the plan of care;
   4. (4) Patient, caregiver, and family counseling;
   5. (5) Patient and caregiver education;
   6. (6) Preparing clinical notes;
   7. (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. (8) Participation in the HHA's QAPI program; and
   9. (9) Participation in HHA-sponsored in-service training.

3. (c) Supervision of skilled professional assistants.

   1. (1) Nursing services are provided under the supervision of a registered nurse that meets the requirements of § 484.115(k).
   2. (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. (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]