A. Teaching and training activities

Teaching and training activities which require the skills or knowledge of a nurse constitute skilled nursing services. These include but are not limited to teaching or training the patient, a family member or others to:

1. Give an injection;

2. Irrigate a catheter;

3. Care for a colostomy or ileostomy;

4. Administer medical gases;

5. Prepare and follow a therapeutic diet;

6. Apply dressings to wounds involving prescription medications and aseptic techniques;

7. Carry out bladder training;

8. Carry out bowel training (only when bowel incontinency exists);

9. Perform activities of daily living (dressing, eating, personal hygiene, etc.) for themselves through use of special techniques and adaptive devices where they have suffered a loss of function;

10. Align and position a bed-bound patient;

11. Perform transfer activities, e.g., bed to chair or wheelchair, wheelchair to bathtub or toilet; and

12. Ambulate by means of crutches, walker, cane, etc.

In determining the reasonable and necessary number of teaching visits consideration is given to whether the home teaching constitutes a reinforcement of that provided in an institution or is the initial instruction received by the patient.