Program payment will be made for the skilled nursing care the beneficiary receives,
      provided  all of the following conditions are met:
   
   
   
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            A.  
               The services are ordered by, and included in, the plan of treatment established by
                  the physician for the patient (see HI 00601.300), and
                
 
 
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            B.  
               The services are required on an intermittent basis (see HI 00601.330), and
                
 
 
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            C.  
               The services are performed by, or under the direct supervision of, a licensed nurse
                  to assure the safety of the patient and to achieve the medically desired result (see
                  HI 00601.380), and
                
 
 
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            D.  
               The services are reasonable and necessary to the treatment of an illness or injury
                  (see HI 00601.340).