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All other in-home care services listed below i.e., homemakerlpersonal care <br /> r services, housekeeping services, chore services and companion services must be <br /> provided by a licensed and/or State approved provider of service. <br /> 1. Skilled Nursing <br /> Skilled nursing care consists of those services which can only be performed <br /> by a licensed nurse (R.N., L.P.N. or LV.N.) to assure the safety of the <br /> participant and to achieve the medically desired result according to the <br /> physician's treatment plan. Other Medicare criteria such as the <br /> intermittent care and homebound requirements do not apply. See 24 CFR <br /> 409.42(b)(1)-(3). <br /> 2. Rehabilitation Nursing Services <br /> Rehabilitation nursing services are those services designed to assist in <br /> carrying out a physician's plan of treatment for rehabilitation. These <br /> services include skilled nursing services, i.e., those services that can only <br /> be performed by a licensed nurse, such as assistance in performing skilled <br /> therapy services and sk�led observation, maintenance and evaluation of <br /> - the need for modification of the treatment plan. These services must be <br /> performed by a registered nurse with specialized training in rehabilitation <br /> � services. <br /> 3. Therap,v Services <br /> Therapy services is treatment to restore, improve or maintain impaired <br /> functions, which is auned at increasing or maintaining the participant's <br /> ability to perform those tasks required for independent functioning. The <br /> services must be performed by a qualified speech, physical or occupational <br /> therapist or therapist assistant under the supervision of a qualified speech, <br /> physical or occupational therapist. � <br /> 4. Home Heaith Aide Services <br /> The primary functions of a home health aide are to perform therapeutic, <br /> supportive and/or compensatory health and personal care tasks and <br /> activities for participants in their homes. Home health aide services must <br /> be provided by a certified home health agency and assigned and <br /> performed under the supervision of a registered professional nurse or <br /> � � . <br /> ` III-4 <br />