case study

Write a 1,050- to-1,400 word paper that includes the following:

  • Answer the discussion questions located at the end of the case you selected.
  • Include what therapeutic approach you would apply in this case, and explain why you chose it.
  • Describe the ethical issues you may encounter, as well as how you intend to approach them.

Format your paper consistent with APA guidelines.

Lydia graduated at the top of her class from Anystate University. Following graduation, she started her career as a coder, in what was then known as Medical Records at Rosewood General Hospital. She successfully passed the Registered Records Administrator exam and, in a few years, was promoted to the position of Assistant Director of Medical Records. Later that year, Lydia met Theodore, and they were married the following year. Lydia continued in her position as Assistant Director of Medical Records at Rosewood for three more years until Theodore was transferred to a position in another state. Lydia resigned her position and relocated with Theodore and their two-year-old daughter.

Lydia had no trouble finding employment after the move. She accepted a position as Lead Coder at Greenlawn Hospital. While working at this facility, Lydia appreciated significant professional growth; she was promoted to Assistant Director and, eventually, Interim Director of Medical Records at Greenlawn. During her term as Interim Director of Medical Records, the American Medical Records Association changed to the American Health Information Management Association (AHIMA). Lydia took steps to change the name of the Medical Records department at Greenlawn to Health Information Services. Lydia also delivered twins during her time serving as Director at Greenlawn.

The Health Information Management career field underwent numerous changes, and Lydia attended continuing education seminars to ensure she was up-to-date in her knowledge of the dynamic rules and regulations related to PPS, the Health Insurance Portability and Accountability Act, corporate compliance, and other new issues that popped up along the way. Administration at Greenlawn Hospital eventually offered Lydia the position of becoming the permanent Director of Health Information Services, which she gladly accepted. However, during this very busy time in her life, between her growing family and keeping up with her career, Lydia failed to keep up her credentials through AHIMA. At one point, Lydia made a point of investigating what she would need to do to get her credentials reinstated, but this reinstatement was certainly not a priority in her life at the time.

Lydia kept in close contact with her classmates from Anystate University, which soon proved to be beneficial to her. Theodore was transferred once again, meaning another relocation for the family. Luckily, one of Lydia’s close friends from school, Fernando, was Director of Health Information Management at Springfield Memorial Hospital, and he was looking for a Coding Manager. As soon as Fernando received news of Lydia moving to his area, he told her about the position and said that it would be hers if she was interested. Back in their college days, Lydia frequently tutored Fernando in coding, so he was confident enough of her abilities that he did not require her to take a coding test prior to employment. Fernando also knew about Lydia’s continuous employment in the Health Information Management field and that she consistently attended continuing education seminars, so the thought of verifying her credentials did not cross his mind because Springfield Memorial Hospital did not require their coders to hold credentials.

Lydia continued to work at Springfield Memorial, and prior to a Joint Commission survey, the issue of her lapsed credentials surfaced. She discussed the process of reinstatement through AHIMA with Fernando, but because it was not required for her position, it was not addressed as an urgent issue. Lydia had become busy outside of work dealing with her children, who had become teenagers, and divorcing Theodore, who had left her for another woman.

Lydia looked for additional part-time work to pay her growing list of monthly bills. She taught medical terminology at a local community college. Another of her old college friends, Matilda, was director of a Commission on Accreditation for Health Informatics and Information Management (CAHIIM)-accredited Health Information Management program at another local college. Matilda was in desperate need of additional adjunct faculty and had talked to Lydia over lunch one day about the possibility of teaching nights. Lydia really needed additional money, so she eagerly accepted the position. Matilda, like Fernando, was aware of Lydia’s career achievements and her frequent attendance of continuing education activities. Matilda hired Lydia, whose resume indicated she held the Registered Health Information Administrator (RHIA) credential.

The following semester, Matilda started gathering data for an upcoming CAHIIM site survey and had requested the required information related to her faculty members’ continuing education activities. Lydia provided Matilda with copies of certificates to provide appropriate evidence of her attendance at seminars, which provided significantly more than the required number of continuing education credits for maintenance of the RHIA credential. Matilda also requested a copy of Lydia’s RHIA certificate. However, Lydia explained that most of her professional documents were still packed in boxes from her move back to the state, plus she was also in the process of packing her belongings to put the house that she owned with Theodore up for sale. Matilda accepted the excuse and figured the document really was not that important to the CAHIIM surveyors because they could easily obtain the document from AHIMA if necessary.

The CAHIIM surveyors arrived, did their preliminary review of data, met with Matilda, and then met with the students and individual instructors. During her meeting with the surveyors, Matilda could not say enough about how Lydia was one of her best instructors, and they were impressed at the experience she had to share with the students. The surveyors received equally positive comments about Lydia from the students they interviewed.

At the end of the site survey, Matilda met with the survey team and was astounded to learn from them that Lydia did not hold any AHIMA credentials. They did reinforce the fact that her extensive experience, especially in the coding arena, qualified her to teach medical terminology and coding. However, the surveyors explained that Lydia would not be qualified to teach any other courses specific to health information management until she successfully had her credentials reinstated through AHIMA, which she indicated to the surveyors that she was completely willing to do. The surveyors explained to Matilda that because Lydia was qualified to teach some of the courses, they would not officially document the issue, but they wanted to make her aware of the situation.

  • . Should Matilda or Fernando have been aware of Lydia’s credential status?
  • 2. Should Matilda inform her organization’s administration of Lydia’s credential status? Why or why not?
  • 3. Matilda and Fernando are close friends. Matilda suspects that Fernando may not be aware of Lydia’s credential status. Should she alert him of the issue as a colleague? Why or why not?
  • 4. How should Matilda respond to Lydia following the survey?
  • 5. What legal and ethical issues are addressed in this case?
  • 6. Using the case method, evaluate possible actions that should be taken and determine the best option.
 
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