Melissa is a third-year, Doctor of Physical Therapy (DPT) st…
Questions
Melissа is а third-yeаr, Dоctоr оf Physical Therapy (DPT) student on her last clinical education experience in a Skilled Nursing Facility (SNF). Melissa has enjoyed the experience but has found the documentation aspect challenging at times and she needs to revisit the information. She recalls the acronyms MDS, PPS, and PDPM (for Minimum Data Set, Prospective Payment System, and Patient Driven Payment Model, respectively), but never had really thought about how they apply to patient care until she started this specific patient population experience. Melissa completes an initial evaluation on a 73-year-old man named Walt and determines that he would benefit from physical therapy but has limited rehabilitation potential. Walt barely could participate in the full evaluation even though it only took about 30 minutes. Melissa is concerned over his ability to participate and tolerate rehabilitation at this stage. The next day, Melissa reviews the chart and sees that Walt has been assigned to a PDPM category that she feels is not appropriate for his current level of function. Melissa is certain this is an error, so she approaches her clinical instructor, Wendy, and asks her how to correct it. Wendy responds that the category most likely is not an error. Rather, Wendy tells Melissa, many individuals Walt's age, with his diagnosis, are placed in this category and are documented as having received individual therapy when the patient really is receiving group therapy. Wendy elaborates, that "The Rest & Recovering facility seeks to do this on some patients because such designations increase reimbursements to make up for the lack of reimbursement on other patient cases. It all kind of balances out, as Medicare doesn't pay much anyway". Wendy then suggests that Melissa speak with the department supervisor, who establishes the clinical categories for the patients. Melissa is deeply concerned about this situation and Walt's rehabilitation, however, on the other hand she does not want to do or say anything that will jeopardize her successful completion of this final clinical education experience. Should she simply do as she is told and rationalize that as a student she may not fully understand what has happened, or should she follow Wendy’s recommendation to speak with a supervisor to advocate and educate for changing the coding culture in the SNF? Considering the ethical decision-making model, identify the cardinal realm in which this situation is occurring.
Whаt type оf bаcteriа typically stain pink in a Gram stain prоcedure?