The 2010 PPS Rule clarifies the rule that in the house health setting, management and evaluation of a patient care plan is considered a reasonable and necessary skilled service only when underlying conditions or complications are such that a registered nurse can ensure that essential non-skilled care is achieving its purpose. (42 C.F.R. 409.42(c)(1)(i))
Patient Education Services
The 2010 PPS Rule clarifies when patient education services constituted skilled services would be deemed to no longer be needed when it became apparent, after a reasonable period of time, that the patient, family, or caregiver would not be trained. Further teaching and training would cease to be reasonable and necessary in this case and would cease to be considered a skilled service. The services for teaching and training would be considered to be reasonable and necessary prior to the point that it became apparent that the teaching on training was unsuccessful.
