Skilled service named — a covered procedure, observation & assessment of an unstable condition, teaching & training, or management & evaluation of the plan — described, not just “assessed.”
Licensed-level reasoning explicitly stated — why the service was not unskilled/custodial.
Daily basis shown — why the skilled need existed today (not “continues to need skilled care”).
Quantified response — numeric pre/post values against the ordered parameter or the specific prior value (never “baseline” alone).
Medical Necessity Sentence present — skilled service + licensed-level reason + measurable effect + the daily/SNF-level clause.
Maintenance note: if the resident has plateaued, the note proves the skill required to maintain or slow decline (Jimmo) — improvement is not required.
