It is customary to teach the patient and/or a family member the skills required to
administer insulin injections safely and effectively. Once the patient or other nonmedical
person has mastered these skills, he is to all intents and purposes functioning as
a skilled person when administering or self-administering the injection. If a patient is unable
to learn these skills or is physically or mentally incapable of performing the service
for himself, e.g., he is blind, senile, or spastic, and there is no one else willing
and able to learn and perform the service for him, the administration of the injection
by a nurse constitutes a skilled nursing service.