If a patient can achieve his or her highest level of independence, as a rehab clinician, I say let's go for it. To Medicare reviewers, too often they say stop at the prior level of function. So I often challenge the reviewer to explain this terminology.
You don't want to mess around with pneumococcal bacteria, which causes pneumonia, and even worse, sepsis and meningitis. That's why nursing home residents should receive two vaccinations: the pneumococcal polysaccharide vaccine (PPSV23) and the influenza vaccine.