What changed

• Specific findings — the glucose against the ordered parameter, the technique observation, the foot exam, the monofilament score.
• Skill-justification clause — the subtle changes the nurse monitored that a layperson could not detect.
• Daily / SNF-level clause — why skilled monitoring was required today and at SNF level.
• MDS + care-plan linkage — the items the note supports and the goal it advances.