---
kind: "section"
citation: "42 C.F.R. § 484.75"
title: "42"
number: "484.75"
heading: "Condition of participation: Skilled professional services."
url: "https://uscodex.org/cfr/42/484.75"
---

# §484.75. 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](/cfr/42/409.44.md) of this chapter, and physician or allowed practitioner and medical social work services as specified in [§ 409.45](/cfr/42/409.45.md) 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](/cfr/42/484.115.md) 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)](/cfr/42/484.115.md?p=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)](/cfr/42/484.115.md?p=f) or [(h)](/cfr/42/484.115.md?p=h), respectively.
  - (3) Medical social services are provided under the supervision of a social worker that meets the requirements of [§ 484.115(m)](/cfr/42/484.115.md?p=m).

## Notes

### Amendments

[82 FR 4578, Jan. 13, 2017, as amended at 85 FR 27628, May 8, 2020]

### Source

Source: 82 FR 4578, Jan. 13, 2017, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302 and 1395hh.

### Source

Source: 54 FR 33367, Aug. 14, 1989, unless otherwise noted.

### Amendments

[82 FR 4578, Jan. 13, 2017, as amended at 85 FR 27628, May 8, 2020]