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UKM1 — UKM1 TASK 1: HEALTHCARE ORGANIZATION ANALYSIS

 

HEALTHCARE POLICY AND ECONOMICS — D223

PRFA — UKM1

 

 

TASK OVERVIEW SUBMISSIONS EVALUATION REPORT 

 

 

COMPETENCIES

738.6.1 : Determining Factors of Value Based and Equitable Patient-Centered Care

The learner integrates principles of organizational ethics to improve healthcare quality for individuals, families, and their communities. 

 

738.6.2 : Data Use for Informed Decision Making in Healthcare Delivery

The learner identifies how financial data, business-related data, and information sources inform decisions that influence healthcare.

 

738.6.3 : Determining Factors of Value Based and Equitable Patient-Centered Care

The learner compares healthcare financial models to facilitate value-based care and fiscally responsible and equitable patient-centered care.

 

INTRODUCTION

Nursing has a pivotal role in shaping policies and implementing practices to improve patient outcomes. Increasingly, healthcare is being reimbursed based on outcomes, including patient satisfaction and quality of care. Healthcare professionals are being held accountable for the care provided and the patient outcomes achieved. In this changing environment, nurses should have an awareness of financial implications, share in the decision-making process, and leverage data through participation in continuous improvement processes.

 

For this task, you will examine the payment model of a healthcare organization and compare it with the principles of value-based care.

 

You will consider the organizational ethics that are reflected in the financial structure of the organization and discuss data that informs this financial structure. You will compare this organization to another organization and consider which organization is most aligned with value-based care principles. You will discuss the role of nursing in the fiscal responsibility of the value-based care model.

 

Your goal for this task is to clearly and concisely present a recommendation that analyzes the alignment of the financial structure within a healthcare organization to value-based healthcare and analyzes the role of nursing in value-based healthcare, using convincing evidence to promote the necessity for change.

 

 

REQUIREMENTS

Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. The originality report that is provided when you submit your task can be used as a guide.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

Tasks may not be submitted as cloud links, such as links to Google Docs, Google Slides, OneDrive, etc., unless specified in the task requirements. All other submissions must be file types that are uploaded and submitted as attachments (e.g., .docx, .pdf, .ppt).

 

A.  Examine a healthcare organization that has significance to you, using the American Hospital Directory (AHD) website found in the Web Links section, and complete the following:

1.  Identify the healthcare organization you selected from the AHD by name and location.

2.  Explain why you chose the healthcare organization in part A1 and any significance the organization has to you, including specific examples.

3.  Describe (suggested length 1-2 paragraphs) the healthcare organization from A1 and the “type of facility” it is, according to AHD website, and the types of services this kind of facility typically provides.

a.  Explain what the “type of control”, according to AHD website, means for this healthcare organization identified in part A1 and how it informs the services typically provided at this healthcare organization.

4.  Discuss the total performance score (TPS) Quality Score for the healthcare organization from part A1, and identify the four domains of the TPS.

a.  Identify one credible additional source of quality data on healthcare organizations.

5.  Discuss two organizational ethics that are reflected in the type of facility and the type of control listed for this organization, including specific examples.

6.  Discuss the nurse’s role in fiscal responsibility for this type of organization related to value-based care, including specific examples.

7.  Describe one healthcare organizational change that could improve the delivery of value-based healthcare for the healthcare organization from part A1.
 

B.  Compare the financial structure of the healthcare organization you discussed in part A with another organization listed on the AHD website that is within the same or an adjacent state, including specific examples from each healthcare organization.

1.  Discuss which healthcare organization from part B is more aligned with value-based healthcare, including one scholarly evidence source published within the last five years to support the discussion.

2.  Discuss which healthcare organization from part B is more supportive of equitable patient-centered care, including one scholarly evidence source published within the last five years to support the discussion.

3.  Discuss one financial and one quality data source that could inform organizational transformation in any healthcare organization.
 

C.  Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
 

D.  Demonstrate professional communication in the content and presentation of your submission.

 

 

File Restrictions

 

File name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg, wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z
 

 

RUBRIC

A1:HEALTHCARE ORGANIZATION SIGNIFICANCE

 

NOT EVIDENT

The submission does not identify a healthcare facility.

APPROACHING COMPETENCE

The submission is missing the healthcare facility’s name or location, or the organization is not selected from the AHD website.

COMPETENT

The submission identifies the healthcare facility by the organization’s name and location, and the organization is selected from the AHD website.

A2:SIGNIFICANCE OF FACILITY

 

NOT EVIDENT

The submission does not explain why the healthcare organization identified in part A1 was chosen.

APPROACHING COMPETENCE

The submission does not explain the significance the organization has to the learner, or the submission is not supported with specific examples.

COMPETENT

The submission explains why the healthcare organization identified in part A1 was chosen and any significance it has to the learner, and the submission is supported with specific examples.

A3:TYPE OF FACILITY

 

NOT EVIDENT

A description of the organization from part A1 is not provided.

APPROACHING COMPETENCE

The submission does not accurately describe the organization identified in part A1 or does not include the “type of facility” it is. Or the description does not accurately include the types of services typically provided at this kind of organization.

COMPETENT

The submission accurately describes the organization identified in part A1, including the “type of facility” it is and the types of services typically provided at this kind of organization.

A3A:TYPE OF CONTROL

 

NOT EVIDENT

The submission does not explain the “type of control” for the healthcare organization identified in part A1.

APPROACHING COMPETENCE

The submission does not provide a logical explanation of what “type of control” means for the healthcare organization identified in part A1. Or the submission does not logically explain how the “type of control” informs the services typically provided at this healthcare organization.

COMPETENT

The submission provides a logical explanation of what “type of control” means for the healthcare organization identified in part A1 and how the specific “type of control” informs the services typically provided at this healthcare organization.

A4:TOTAL PERFORMANCE SCORE

 

NOT EVIDENT

The submission does not discuss the TPS Quality Score or identify any domains of the TPS for the healthcare organization from part A1.

APPROACHING COMPETENCE

The submission does not logically discuss the organization’s TPS Quality Score or what this score means for the healthcare organization from part A1. Or the submission does not correctly identify 1 or more of the 4 domains of the TPS.

COMPETENT

The submission logically discusses the organization’s TPS Quality Score and what this score means for the healthcare organization from part A1. The submission correctly identifies each of the 4 domains of the TPS.

A4A:SOURCE OF QUALITY DATA

 

NOT EVIDENT

The submission does not identify 1 additional source of quality data on healthcare organizations.

APPROACHING COMPETENCE

The submission identifies 1 additional source of quality data on healthcare organizations, but the chosen source is not credible.

COMPETENT

The submission identifies 1 credible additional source of quality data on healthcare organizations.

A5:ORGANIZATIONAL ETHICS

 

NOT EVIDENT

The submission does not discuss any organizational ethics reflected in the “type of facility” and “type of control” listed for the chosen organization.

APPROACHING COMPETENCE

The submission discusses only 1 of the organizational ethics, or 1 or both of the ethics are not reflected in the “type of facility” or “type of control” listed for this organization. Or 1 or both ethics discussed are not plausible. Or the discussion does not provide specific examples of how both ethics are reflected in the organization.

COMPETENT

The submission discusses 2 plausible organizational ethics that are reflected in the type of facility and type of control listed for the chosen organization. Both ethics are plausible, and the discussion provides specific examples of how both ethics are reflected in the organization.

A6:NURSING ROLE IN VALUE-BASED CARE

 

NOT EVIDENT

The submission does not discuss the nurse’s role in fiscal responsibility.

APPROACHING COMPETENCE

The submission does not present a logical discussion of the nurse’s role in fiscal responsibility for this type of organization. Or the nursing role discussed is not related to value-based care, or the discussion does not provide specific examples.

COMPETENT

The submission presents a logical discussion of the nurse’s role in fiscal responsibility for this type of organization as related to value-based care, and the discussion provides specific examples.

A7:ORGANIZATIONAL CHANGE FOR VALUE-BASED HEALTHCARE

 

NOT EVIDENT

A description of 1 healthcare organizational change that could improve the delivery of value-based healthcare is not provided.

APPROACHING COMPETENCE

The description of 1 healthcare organizational change that could improve the delivery of value-based healthcare is irrelevant or implausible for the healthcare organization from part A1.

COMPETENT

The description of 1 healthcare organizational change that could improve the delivery of value-based healthcare for the healthcare organization from part A1 is relevant and plausible.

B:COMPARE FINANCIAL STRUCTURES

 

NOT EVIDENT

A comparison of the financial structures of the healthcare organization from part A and another organization is not provided.

APPROACHING COMPETENCE

The comparison of the financial structures of the organization discussed in part A and a second healthcare organization is inaccurate or illogical. Or the comparison does not include the name or location of the second healthcare organization, or the location is not within the same or an adjacent state. Or the comparison does not include specific examples from each healthcare organization’s financial structure.

COMPETENT

The comparison of the financial structures of the organization discussed in part A and a second healthcare organization is accurate and logical. The comparison includes the name and location of the second healthcare organization, and the organization is in the same or an adjacent state. The comparison includes specific examples from each healthcare organization’s financial structure.

B1:ALIGNMENT WITH VALUE-BASED HEALTHCARE

 

NOT EVIDENT

A discussion of which healthcare organization from part B is more aligned with value-based healthcare is not provided.

APPROACHING COMPETENCE

The submission does not present a logical discussion of which healthcare organization from part B is more aligned with value-based healthcare, or the discussion does not provide relevant supporting details. Or the discussion is not supported with 1 scholarly evidence source that was published within the last 5 years.

COMPETENT

The submission presents a logical discussion of which healthcare organization from part B is more aligned with value-based healthcare, with relevant supporting details. The discussion is supported with 1 scholarly evidence source that was published within the last 5 years.

B2:EQUITABLE PATIENT-CENTERED CARE

 

NOT EVIDENT

A discussion of which healthcare organization is more supportive of equitable patient-centered care is not provided.

APPROACHING COMPETENCE

The submission does not present a logical discussion of which healthcare organization from part B is more supportive of equitable patient-centered care, or the discussion does not provide relevant supporting details. Or the discussion is not supported with 1 scholarly evidence source that was published within the last 5 years.

COMPETENT

The submission presents a logical discussion of which healthcare organization from part B is more supportive of equitable patient-centered care, with relevant supporting details. The discussion is supported with 1 scholarly evidence source that was published within the last 5 years.

B3:SOURCES TO INFORM ORGANIZATIONAL TRANSFORMATION

 

NOT EVIDENT

The submission discusses neither 1 financial nor 1 quality data source.

APPROACHING COMPETENCE

The submission does not discuss both 1 financial and 1 quality data source. Or 1 or more of the data sources are implausible or irrelevant to informing organizational transformation in a healthcare organization.

COMPETENT

The submission discusses 1 plausible financial and 1 plausible quality data source that are relevant to informing organizational transformation in a healthcare setting.

C:APA SOURCES

 

NOT EVIDENT

The submission does not include in-text citations and references according to APA style for content that is quoted, paraphrased, or summarized.

APPROACHING COMPETENCE

The submission includes in-text citations and references for content that is quoted, paraphrased, or summarized but does not demonstrate a consistent application of APA style.

COMPETENT

The submission includes in-text citations and references for content that is quoted, paraphrased, or summarized and demonstrates a consistent application of APA style.

D:PROFESSIONAL COMMUNICATION

 

NOT EVIDENT

Content is unstructured, is disjointed, or contains pervasive errors in mechanics, usage, or grammar. Vocabulary or tone is unprofessional or distracts from the topic.

APPROACHING COMPETENCE

Content is poorly organized, is difficult to follow, or contains errors in mechanics, usage, or grammar that cause confusion. Terminology is misused or ineffective.

COMPETENT

Content reflects attention to detail, is organized, and focuses on the main ideas as prescribed in the task or chosen by the learner. Terminology is pertinent, is used correctly, and effectively conveys the intended meaning. Mechanics, usage, and grammar promote accurate interpretation and understanding.

Please indicate 

It seems the primary problem in Task 1 is that you have not specifically identified the facility. Make sure you explain the location and specific details of which NYU Langone hospital you are using. For example, if you mean NYU Langone Tisch Hospital in Manhattan, please include the full name and location.

 

My submission 

 

Question  A1

• The healthcare organization I have selected is named NYU Langone Hospitals and it is located in New York. NYU Langone Hospitals is a teaching hospital that is also a general medical and surgical facility (Fulton).

Question A2

• I selected NYU Langone Hospitals since it is the hospital where I was born and also where my father works. This organization is important to me since it has offered exceptional treatment to me throughout my life.

Question A3

• NYU Langone Hospitals is a general medical and surgical institution as well as a teaching hospital. NYU Langone Hospitals is a not-for-profit institution. This signifies it is not owned by a for-profit corporation. Because the hospital is not driven by profit, this sort of oversight influences the services normally given at NYU Langone Hospitals. Instead, the hospital is driven by the desire to provide great patient care. The nurse’s job in NYU Langone Hospitals fiscal responsibility is to guarantee that the hospital provides high-quality treatment at a fair cost. • The nurse may do this by ensuring that the hospital employs evidence-based practices and encouraging cost-effective treatment. Adoption of electronic health records is one healthcare organizational reform that might enhance the delivery of value-based healthcare at NYU Langone Hospitals (EHRs). EHRs are electronic versions of a patient’s medical records. They are available to all members of the healthcare team and may assist to enhance communication and care coordination. EHRs may also assist to lower healthcare costs by eliminating duplicate testing and treatments.• Adoption of electronic health records (EHRs) will enhance NYU Langone Hospitals’ delivery of value-based healthcare in various ways. For starters, EHRs would increase communication and care coordination among members of the healthcare team. This would result in improved patient outcomes and shorter hospital stays. Second, EHRs would save healthcare costs by avoiding redundant testing and treatments. This would liberate resources that might be utilized to care for more people. Finally, by giving a more full picture of each patient’s medical history, EHRs would enhance treatment quality.• NYU Langone Hospitals is a non-profit hospital. This means that it is not owned by a for-profit company. This type of control informs the services typically provided at NYU Langone Hospitals because the hospital is not motivated by profit. Instead, the hospital is motivated by providing excellent patient care. The nurse’s role in fiscal responsibility for NYU Langone Hospitals is to ensure that the hospital is providing high-quality care at a reasonable cost.• The nurse can do this by ensuring that the hospital is using evidence-based practices and by promoting cost-effective care. One healthcare organizational change that could improve the delivery of value-based healthcare for NYU Langone Hospitals is the adoption of “electronic health records”. “EHRs are a digital version of a patient’s medical record”. They can be accessed by all members of the healthcare team and can help to improve communication and coordination of care. EHRs can also help to reduce the cost of care by preventing duplicate tests and procedures.

Question A4

• NYU Langone Hospitals has a total performance score (TPS) Quality Score of 3.75. This rating is determined on four factors: safety, efficacy, punctuality, and efficiency. “The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a reliable source of quality healthcare data”. The HCAHPS is a nationwide, standardized assessment of patients’ experiences in hospitals. This information may be used to compare the quality of treatment at various hospitals.• The HCAHPS is used by Medicare and other entities to assess hospital performance. Researchers also use it to analyze the quality of treatment delivered by hospitals and how well they comply to particular criteria. Each hospital may receive additional scores from other sources, such as patient satisfaction surveys or other rating systems, in addition to the HCAHPS score from Medicare.• “The HCAHPS is a national, standardized survey of patients’ perspectives of their hospital experience”. “The HCAHPS has been used for over a decade to measure the quality of health care delivered in hospitals and other healthcare facilities”.• The results from this survey provide information about the quality of care patients receive at each hospital, as well as information about how satisfied they feel with the care they received while they were there. The results of HCAHPS are released publicly on a quarterly basis and include national data on patient satisfaction, quality of care measures and other results related to patient safety.

Question A5

•  The hospital is a place where people come to be cared for. It is the duty of the hospital to provide the highest quality of care, but it also has an ethical responsibility to treat all patients equally. This means that there must be equal access to health care regardless of race, ethnicity, gender or socioeconomic status(Mackey).• The type of control listed for NYU Langone Hospitals are patient centered care and equity. Patient centered care requires that all decisions about patients be made with the patient’s best interests in mind. This means that patients should have input into their treatment plans and any decisions made by staff or other professionals will be based on their preferences.• Another ethical concept that assures that all patients get the same level of treatment regardless of race, ethnicity, gender, or socioeconomic background is equity. This implies that all patients have equal access to medical services such as specialists, laboratory tests, and x-rays without having to pay more than other patients who do not need these services as urgently as someone who does.

Question A6

•  The nurse’s role in fiscal responsibility for NYU Langone Hospitals is to ensure that the hospital is providing high-quality care at a reasonable cost. The nurse can do this by ensuring that the hospital is using evidence-based practices and by promoting cost-effective care. Evidence-based practice is the use of current research to improve patient care. This means that nurses must not only be familiar with current research, but they must be able to apply it to their practice. Nurses should also be aware of any changes in treatment or policy that could affect patients’ experience at NYU Langone Hospitals. • Cost-effective care refers to the highest quality care that is most affordable. This may mean providing less treatment or services than other hospitals, but it does not necessarily mean providing less expensive services or treatments. The nurse should be familiar with all options for delivering care at NYU Langone Hospitals, such as different forms of therapy and medications available for specific conditions. The nurse should also be aware of any changes in reimbursement from Medicare or private insurance companies that might affect costs at NYU Langone Hospitals.

Question A7

• One healthcare organizational change that could improve the delivery of value-based healthcare for NYU Langone Hospitals is the adoption of “electronic health records (EHRs)”. They can be accessed by all members of the healthcare team and can help to improve communication and coordination of care. EHRs can also help to reduce the cost of care by preventing duplicate tests and procedures.• In order to implement EHRs, the organization must first determine how it will be used in its daily operations. It is important for NYU Langone Hospitals to understand what types of information are necessary for patients and their families, as well as how this data will be shared with other providers. After determining these parameters, an implementation plan should be created that outlines how these goals will be achieved.• EHRs can also help to reduce the cost of care by preventing duplicate tests and procedures. If a patient has had two different tests or procedures, one in New York and one in Los Angeles, they may have paid double for both of them. By using an EHR, it is possible to have that patient’s records sent from one location to another so that only one set of records needs to be drawn up and sent. This will save time and money for everyone involved in providing care for that patient.

B. 

Question B1

• The healthcare organization that is more aligned with value-based healthcare is NYU Langone Hospitals. NYU Langone Hospitals is a non-profit hospital that is motivated by providing excellent patient care, rather than by profit. This aligns with the value-based healthcare principle of putting the patient first. In addition, NYU Langone Hospitals has adopted an evidence-based approach to medicine. They use clinical trials and other scientific studies to determine which treatments are most effective, and then implement them into their practice. This aligns with the value-based healthcare principle of using science to guide decision making and improve patient outcomes.• Lastly, NYU Langone Hospitals has implemented a “pay for performance” system where they pay hospitals based on how many patients they help get back on their feet after an illness or injury. This aligns with the value-based healthcare principle of rewarding those who provide high quality care at low cost and incentivizing others to improve their performance as well. Overall, NYU Langone Hospitals demonstrates an alignment with the current trend in healthcare towards value-based care because they place emphasis on improving patient outcomes through research and evidence based medicine instead of focusing solely on making money.

Question B2

• NYU Langone Hospital is a teaching hospital that teaches and trains future physicians and other healthcare workers. NYU Langone Medical School, NYU Langone’s medical school, provides free health care to its students via its student health insurance plan. “This accords with the equity concept of ensuring that all patients get the same quality of treatment”, “regardless of their color”, “ethnicity”, “gender or socioeconomic background”.• NYU Langone Hospitals is a healthcare institution that is more supportive of fair patient-centered treatment. NYU Langone Hospitals is a teaching hospital that teaches and trains future physicians and other healthcare workers. This is consistent with the equity concept of ensuring that all patients, regardless of race, ethnicity, gender, or socioeconomic background, get the same quality of treatment. NYU Langone Hospital also provides its staff with free health insurance and has a scheme in place to provide coverage for low-income persons who are uninsured or underinsured.

Question B3

•  One financial data source that could inform organizational transformation in any healthcare organization is the cost of care. This data can help to inform decision makers about which care practices are cost-effective and which are not. • The cost of care is an important financial data source because it can be used to determine how much money hospitals should be spending on various procedures or treatments, as well as how much they should be spending on certain medical supplies or medications. It also helps organizations determine whether they should increase or decrease the number of employees who work in departments such as administration or finance so that these employees can spend more time focusing on their own jobs instead of working on other tasks that don’t directly contribute to improving patient outcomes.

 

 

 

REFERENCES.

Fulton, B. D. (2017). Health care market concentration trends in the United States: evidence and policy responses. Health Affairs, 36(9), 1530-1538.

Scott, W. R., Ruef, M., Mendel, P. J., & Caronna, C. A. (2000). Institutional change and healthcare organizations: From professional dominance to managed care. University of Chicago Press.

Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing, 33(1), 51-55.

 

 

 

 

 

Recommendation 

 

 

 

A1. Healthcare Organization Significance

 

Approaching Competence

 

 

Approaching CompetenceThe submission is missing the healthcare facility’s name or location, or the organization is not selected from the AHD website.

 

EVALUATOR COMMENTS: ATTEMPT 1

The submission describes NYU Langone Hospital in New York. However, there are multiple NYU Langone hospitals listed in New York in the American Hospital Directory (AHD) and it is not clear which hospital is the focus. Please clarify the specific location of the selected facility.

 

A2. Significance of Facility

 

Approaching Competence

 

 

Approaching CompetenceThe submission does not explain the significance the organization has to the learner, or the submission is not supported with specific examples.

 

EVALUATOR COMMENTS: ATTEMPT 1

The essay notes that NYU Langone Hospital was selected because the nurse was born at the facility. However, the discussion does not clearly identify a facility listed in the AHD. Once the specific facility is clearly identified, please discuss the reason it was chosen and the significance using specific examples.

 

A3. Type of Facility

 

Approaching Competence

 

 

Approaching CompetenceThe submission does not accurately describe the organization identified in part A1 or does not include the “type of facility” it is. Or the description does not accurately include the types of services typically provided at this kind of organization.

 

EVALUATOR COMMENTS: ATTEMPT 1

The essay discusses that the selected hospital’s type of facility is a teaching hospital. However, the discussion does not clearly identify a facility listed in the AHD, the type of facility, and the type of services provided. Once the specific facility is clearly identified, please describe the type of facility as noted in the AHD and the types of services typically provided.

 

A3a. Type of Control

 

Approaching Competence

 

 

Approaching CompetenceThe submission does not provide a logical explanation of what “type of control” means for the healthcare organization identified in part A1. Or the submission does not logically explain how the “type of control” informs the services typically provided at this healthcare organization.

 

EVALUATOR COMMENTS: ATTEMPT 1

The discussion describes the non-profit control of the facility, which influences the services provided. However, the discussion does not clearly identify a facility listed in the AHD. Once the specific facility is clearly identified, please discuss the type of control for the facility and how it informs the services provided.

 

A4. Total Performance Score

 

Approaching Competence

 

 

Approaching CompetenceThe submission does not logically discuss the organization’s TPS Quality Score or what this score means for the healthcare organization from part A1. Or the submission does not correctly identify 1 or more of the 4 domains of the TPS.

 

EVALUATOR COMMENTS: ATTEMPT 1

The submission states that the TPS score is 3.75, which is determined by safety, efficacy, punctuality, and efficiency. However, the submission does not clearly identify a facility listed in the AHD. In addition, the essay does not discuss what the TPS score means for the facility and it does not accurately identify the four domains of the TPS score. Once a specific facility is identified, please state the correct TPS score for the facility, what it means for the facility, and accurately identify the four domains of the TPS.

 

A4a. Source of Quality Data

 

Competent

 

 

A5. Organizational Ethics

 

Approaching Competence

 

 

Approaching CompetenceThe submission discusses only 1 of the organizational ethics, or 1 orboth of the ethics are not reflected in the “type of facility” or “type of control” listed for this organization. Or 1 or both ethics discussed are not plausible. Or the discussion does n

 

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