CMS says very clearly that “skilled nursing and skilled therapy services in the Skilled Nursing Facility (SNF), Home Health (HH), and Outpatient Therapy (OPT) settings does not turn on the presence or absence of a beneficiary’s potential for improvement, but rather on the beneficiary’s need for skilled care.” Providers or Insurers that say differently are simply wrong. Use CMS’ own words, right from the CMS Jimmo Settlement page.