3. Complexity of service
The classification of a particular service as skilled is based on the technical or professional health training required to effectively perform or supervise the service. In many instances a service may be classified as a skilled service on the basis of the complexity alone, e.g., intravenous and intramuscular injections or insertion of catheters. On the other hand, a patient following instructions can normally take a daily vitamin pill. Consequently, the act of giving the vitamin pill to a patient who is too senile to take it himself is not a skilled service. Similarly, State law may require that all institutional patients receive medication only from a licensed nurse. This fact does not make administration of a medication a skilled nursing service if such medication can be prescribed for administration at home without the presence of a licensed nurse.