After her removal from the hospital to a nursing home treatment with various drugs administered by injection was necessary. The court concluded that all evidence in the case indicated that Mrs. Sowell required the constant attention of skilled nurses and therefore reversed the Secretary's denial of benefits. Viewed together these cases point out that each case of this type must be decided on its own facts. The instant case is, on its facts, more nearly like the Johnson case.
The scope of our review is limited by 42 U.S.C.A. § 405(g) to a determination of whether the Secretary's determination that Mrs. Mutzig's post hospital care was custodial is supported by substantial evidence. The record reveals that the only services received by Mrs. Mutzig during her stay at St. John's were physical therapy and unskilled nursing care. The record is devoid of evidence which would indicate that Mrs. Mutzig had, as required under § 1395f(a)(2)(C), to be an inpatient in order to receive the needed physical therapy.
We conclude that physical therapy costs are not, under § 1395f(a)(2)(C), compensable when performed on an inpatient basis when the patient could receive such physical therapy at home. The act specifically allows for compensation for needed physical therapy on an at home basis, but only under specified circumstances, 42 U.S.C.A. § 1395x(p), which have not been met in this case.
The record clearly reveals that Mrs. Mutzig needed care, but it is equally clear that she did not require the continuous attention of professionals. She was confined to bed because of a broken leg. Her regaining her ability to walk was retarded by her age, 74 years, excessive weight, arthritis and poor motivation. She did require assistance for dressing and use of the bathroom. On the other hand, she could feed herself, was not mentally confused and received medicines only orally. She in brief required care but suffered no acute condition of a life-threatening nature.
On this record we must conclude that the Secretary's conclusion that Mrs. Mutzig's care at St. John's was custodial rather than services required to be given on an inpatient basis because of a need for continuous skilled nursing care is supported by substantial evidence.