B. Consideration is given to both the inherent complexity of the service and the condition of the patient

In many instances a service is classified as a skilled nursing service on the basis of its complexity alone, e.g., intravenous and intramuscular injections or insertion of catheters. In others, the classification requires a consideration of both the nature of the services and the condition of the patient, i.e., in a given case the patient's condition may be such that a service which would normally be classified as unskilled can only be provided safely and effectively by a skilled individual. For example, in some situations a patient who has had rectal surgery may be given an enema safely and effectively only by a nurse.