?skill for nephrostomy tube

[Cathy Bruce]

We have a resident with long-term useage of a nephrostomy tube due to failed stents to keep one kidney draining.  She has chronic UTI’s and has had multiple hospitalizations for UTI and urosepsis.  Is being followed by nephrology and urology.  Nursing is flushing the nephrostomy tube q shift.  We cut her from Medicare Part A when therapy discontinued due to lack of progress.  Now she has a UTI again.  Should we put her back on Med A due to acute infection and need for ongoing monitoring and assessment? Should she be considered “skilled” long term like you skill continuous peg tube feeding residents, who never requalify for a Med A stay?    Any feedback would be appreciated.   Thanks.