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Incurring the expense of ancillary services

October 10, 2011
by Kathleen Mears
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The other day, as I was being pushed to breakfast in my dead power chair, I wondered what was wrong with it and how much it would cost to be fixed. When I got this chair new from Medicaid in 2008, the vendor told me the nursing home would be responsible for repairing it. But I wondered how that process would work.

After getting my medicine I sat at the med cart waiting and wondering if the aides forgot my chair was not running. This is the first time in over a year they have had to push me. Being pushed makes me feel even more dependent.

The week before my chair broke down we discussed it at my care conference. The chair had been giving me trouble for a couple of months, but the administrator told me the facility was only responsible for repairing manual wheelchairs.

About a week after the care conference, the ombudsman emailed that under Ohio's Medicaid Ancillary Services Law enacted in 2009 facilities are required to repair residents' power chairs. The Ancillary Services Law reimburses facilities $3.91 a day (per resident) for: oxygen, custom wheelchairs, physical, occupational, speech therapy, ambulance, ambulette service and some over the counter drugs.

I have had power chairs for more than 25 years. When I first moved to a nursing home, Medicare would no longer pay for repairs, so I had to. For many years I lived where I was quite familiar with the wheelchair vendor. For the past year I have lived in a different area and have had to locate new vendors.

When my chair's batteries died this past May, I wondered whether the facility would replace them and how long that would take. So, when my sister found a vendor 20 miles away who would come to me and replace them, I decided to pay the $400 plus fee. The tech assured me that with a three-year warranty, I had no worries.

A month later the power in the joystick was inconsistent. When I called the tech, he told me he was not certified to work on my chair because it was classified as a “rehab chair.” I was disappointed because I had hoped he would be able to do repairs on my chair, if needed.

My chair problems got worse. It frequently stalled going up the ramp to my van. A couple of days we barely had enough power to make it back to the facility. Then, three weeks ago my chair stopped completely at a strip mall and we had to call the fire department to get me in the van. I knew my chair had to be repaired.

I went to a major Columbus, Ohio, vendor to have my chair checked out. The service manager found nothing wrong with the chair or the battery charger. But a voltage meter showed my battery had little power. He told me to go back to the tech who replaced the batteries in May and get new ones.

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Thanks Kathleen for highlighting how the little things do matter so much in our daily lives - and having a wheelchair our of action is a real bugger! But I love your tenacity. Keep well,
Ralph

Kathleen,

When I first began looking for a new power chair ("Rehab Chair") almost a year ago now the first one suggested during my formal "seating evaluation" that took place at a local hospital clinic just for that (making sure I got the right chair for all my needs) was the new "Invacare FDX" power chair. The latest Invacare chair on the market now. When my vendor delivered a brand-new INVACARE FDX power chair to my home last November I couldn't believe how "Mickey Mouse" it looked. Or more like you described... a manual wheelchair with batteries attached under a unit. The vendor let me keep the new demo of up to for several days to try it out. When I took it down the sidewalk or the road in front of my house it went CLINK, CLUNK, SQUEAK, PING, CLINK, etc. etc. the entire time. This would be like going to a new car dealer, taking their latest model for a test drive, and have their latest car on the market SOUND LIKE THAT! Needless to say, I was far from impressed. Especially having a chair for 12 years that is built solid.

I also got, from the vendor, that "It is easy to get parts for these chairs as they are interchangeable." Or something like that. But, wait a minute, I thought, why are they thinking about repairs FIRST when I want a chair to last a long time before needing any repairs whatsoever? I posed this very question to the vendor and he was not ready for a snappy comeback. The chairs spoke volumes pardon the pun!

I tried a couple of other "Rehab Chairs" after that made by QUANTUM. But they were just a step above the Invacare chairs. To make a long story short, I was just about to give up when I found a different vendor that told me about the latest model of the current chair I have (Permobil). Permobil chairs are built tough. They are not flimsy or "Mickey Mouse" in any way.

I now have a Permobil M 300 even though it has been a long journey to get what I needed. Learn "never to settle." :-). I think that a majority of those receiving new power chairs "easily settle" for what they are offered and/or given. For that very reason, the quality of chairs these days are definitely better than those from the 1970s or early 1980s but not by much! Everyone eligible for a power chair should be, or is, required to have a seating evaluation first. This way, they go over you from head to toe so when a power chair is ordered... every... little... "need" for the individual is itemized and written out for the insurance company. But after that, it is up to the consumer to ultimately choose the chair that is right for them. One may have to go through several models (demos) like I did before finding are getting what they need but that is the way that it SHOULD BE. Unlike vehicles, power chairs are a part of our body. Our "fit" to them, factoring in every facet of a person's lifestyle, should be straight on target.

All power chair users need to have a VOICE! Perhaps, through blogs and forums or communities like this... someday there may be a cumulative voice which holds more power.

Lori ~

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Kathleen Mears

www.ltlmagazine.com/blog/kathleen-mears

Kathleen Mears has been a nursing home resident in Ohio for 20 years. She is an incomplete...