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Resident had hospital stay and upon return was covered for presumption of care. After the 5-days we continued to cover this resident for very unstable blood sugars. We are continuing to skill her due to many physician order changes and fluctuating blood sugars. The problem with this resident is that she is free to leave her floor of residence and often is downstairs at the vending machines, thus abusing those blood sugars. Is it OK to continue to skill this person or does the noncompliant behavior nullify Medicare? I was going on the thought that she could not manage her care at home, without skilled care. At least we constantly monitor so I felt the coverage was justified.
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