TO meet the criteria for MED A you need to have a daily skilled need but also need to 
be able to say that this is the most practicable place for patient to be.In the case 
of wound care,we often send patients home with a daily dressing because they may have 
a daily need but in certain situations,the VNA can handle it at home so the SNF is not 
the most practicable place to be.A patient going to Florida on vacation would lead me 
as a medical reviewer to ask,Why do they need to stay in a SNF,why can't they be at 
home and have the VNA.

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