Map which Chapter 8 bases apply, then show the need is daily and can be met only in a SNF (the practical-matter test). This is what a coverage reviewer looks for on a Part A day.
Observation & assessment of an unstable condition
Assessing uncontrolled or changing pain — including in residents who cannot self-report — and monitoring opioid effects require RN judgment.
Management & evaluation of the plan
Evaluating and adjusting the pain plan and coordinating with the provider are skilled activities needed as long as pain is unstable.
