How to Keep Your Equipment Clean

Guest blog post by Bob Vogel

One of the perks of being a journalist is having the opportunity to attend many wheelchair events — like the Abilities Expo. One of the things that puzzles me — you may have noticed it, too — are wheelchair users who have a disconnect between how they dress and how they care for their mobility equipment. I could never figure out how somebody takes the time to be clean and dress well, but neglects cleaning their chair. A quick reminder — spending a few minutes wiping down your chair with a damp cloth or having your personal care attendant clean it for you — does wonders for your appearance.

People DO notice whether your chair is clean — or not. My wife — now ex-wife, good friend — said one of the things she noticed about me when we first dating was that I kept my chair clean. To her, this is a sign of self-confidence and comfort with my disability. She found this attractive.

Even more important than keeping your chair clean is making sure to keep your cushion clean! Keeping a cushion clean is something I rarely hear mentioned, but it is important — a cushion can get pretty funky if you don’t clean it now and then. We get used to our own odor, so if our cushion starts smelling rank, we probably won’t notice it. However, other people do notice the odor. To make matters worse, it is unlikely that even your close friends and family will tell you because there doesn’t seem to be a polite way to say it. Here is a hint — if people seem to give you a lot more personal space than everybody else, you may want to do some cushion cleaning.

The first step in avoiding cushion odor is to wash your cushion cover on a regular basis. After all, we change our underwear every day — I hope. I have two cushion covers and I change mine every couple of days. Standard size ROHO cushion covers can be purchased at authorized online retailers or The ROHO Store. Cushion covers can also be purchased at your local DME dealer. I find washing the covers on the “gentle” cycle and hang drying them helps them last much longer.

To purchase a cover for a custom size ROHO cushion, call customer service at 800-851-3449. The average cost of a custom cushion cover is around $70. Be sure to have the serial number of your cushion handy when you call. It’s printed on the white tag on the bottom of the cushion.

The next step to avoiding cushion odor is cleaning your cushion on a regular basis. With a ROHO cushion this is a quick and easy process. I give my cushion a quick clean every week or two when I’m in the bath or shower. I grab my cushion (still inflated with the valve closed) remove the cover and take it into the tub or shower with me. I clean it with a washcloth and soap — I use Irish Spring — by gently scrubbing around all the air cells, rinse thoroughly, especially around each cell and then towel dry around each cell. The process takes about 3–5 minutes total.

In-depth cleaning instructions can be found on The ROHO Group’s website at Cleaning and Disinfecting ROHO^® DRY FLOATATION^® Products.

For stubborn odors, like dreaded bladder or bowel accidents, go to the section on deodorizing under Cleaning and Disinfecting ROHO® DRY FLOATATION® Products.

Here are the directions:

• Deflate the cushion and close the valve(s). Make a mixture of one tablespoon of baking soda per quart of water (25 gm/l) or a solution of 1 part vinegar in 10 parts water — make enough to soak the cushion in deep wash basin.
• Soak the cushion in the basin for several hours, rinse and let dry. For really stubborn odors you may need to repeat the process.

I find using some type of weight — I use a small barbell — keeps the cushion immersed in the solution. It helps if you have an extra cushion — see “How Often Should You Replace Your Cushion?” — to sit on while the other one is being cleaned.

Remember to keep your mobility equipment clean. Here is to hoping that a significant other — or potential significant other — notices the effort!

 

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Bob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog.

 

Why You Need to Ask for Your Cushion by Name

Guest blog post by Bob Vogel

In my experience with DME (durable medical equipment) dealers, competition leads to quality. I was injured in 1985 — a T10 complete paraplegic — my first cushion and wheelchair were covered by Medicaid and provided by a local DME dealer. In the 90’s I worked as a sales rep for a wheelchair manufacturer, selling to and working with DME dealers. After that I worked as a sales rep for a DME dealer.

In my experience, a good DME dealer has the knowledge and takes the time to properly fit and provide the best cushion, wheelchair, etc., to meet their client’s needs. DME dealers strive to provide the best service and best products to meet our needs because it’s the right thing to do, and because it’s good business. We have the power to take our business to another DME dealer and word of mouth — good or bad — is powerful when it comes to business.

Unfortunately, because of competitive bidding, this paradigm is changing. The CMS (Centers for Medicare and Medicaid Services) competitive bidding program has DME dealers bidding to see who can provide equipment in a certain category for the lowest price — for you and I this category complex rehab, from cushions  and wheelchair backs to manual chairs and high-end power chairs. Round I of competitive bidding is already in place in 9 regions. Round II of competitive bidding is looming on the near horizon with 91 regions including the largest cities in the country.

Under competitive bidding, instead of Medicare beneficiaries having five to ten Medicare providers to choose from that compete based on the quality of the products and service they provide, we may only have one in our region — eliminating the competition and the need to provide quality products and service. Have a local DME dealer who didn’t win the bid that you have been going to for years? Tough. Don’t like the way the winning bid DME dealer does business? Tough. It’s not just Medicare — Medicaid and many private insurance companies have track records of following the Medicare competitive bidding guidelines.

The way competitive bidding is set-up encourages DME dealers that are only concerned with profit to underbid DME dealers that are truly concerned with providing the right product for their client. As an example, let’s take a look at a common type of cushion. Let’s say your skin and seating requires a ROHO^® HIGH PROFILE^® Single Compartment Cushion — the government HCPCS (Healthcare Common Procedure Coding System) code for this type of cushion is E2622. Now let’s say there is a dealer who is only in it for profit, winning the bid, and becoming the only game in town. Medicare’s Pricing, Data Analysis and Coding (PDAC) for E2622 includes 915 different cushions. According to this data, every cushion on the list will protect your skin just the same. If dealer only who is in it for profit carefully goes through the list they will find some real “bargains,” including a layered foam cushion with a 1/4″ gel cover that retails for $39. But hey, it fits into the code so it “should” protect your skin just like a ROHO HIGH PROFILE Single Compartment Cushion — right? Wrong!

When I left rehab in 1985, my therapist sent me home on a memory-foam cushion saying it “should” protect my skin just as well as the ROHO HIGH PROFILE Single Compartment Cushion I had requested. Despite regular weight shifts, I developed a tiny pressure ulcer within 3 months. Regular mirror-skin checks enabled me to catch it right away — I got the ROHO Cushion and was able to heal at home, feeling like I had dodged a bullet.

A dealer only interested in profit could submit a lowball bid of say $250 for this category — win the bid and start shoving $39 cushions under clients while collecting $250 per cushion from Medicare.

This is why it is vital that you, working with your clinician, request the exact cushion that you need on a doctor’s prescription/documentation. Because even if you are in an area that already has competitive bidding, there is a clause in competitive bidding that says if a doctor’s prescription specifies the make, model and product, then the winning bidder — the DME dealer — has to provide that cushion, or find another winning bidder DME dealer that will provide the cushion. As competitive bidding looms, it is more important than ever for each of us to advocate for our proper seating. Make sure your prescription includes exactly what your seating needs are, for example ROHO® HIGH PROFILE® Single Compartment Cushion (4″). Make sure the size of the cushion needed is included on the prescription, for example 16″ x 16″.

In addition, there is still time to phone, email, or write your representative and senators and tell them you do not want competitive bidding. Explain that while competitive bidding may save money in the short term, the wrong cushion risks life threatening pressure ulcers that will cost taxpayers in excess of $50,000 per occurrence in hospitalization alone.

So what can you do to change the outcome?
1. Send letters to your representative and senators. It’s OK if you don’t know what to write, we have a letter already written and all you have to do is fill in the blanks.
2. Go to competitivebiddingconcerns.com and fill out a form to record your personal struggles with getting mobility equipment.

To view the list mentioned in this blog, go to the Medicare Pricing, Data Analysis and Coding list (PDAC) https://www.dmepdac.com/dmecsapp/do/search. Next, scroll down to the green bar that says “Search DMEPOS Product Classification List.” Under the green bar to the right, type in E2622 and click on the purple GO button and all 915 cushions that meet the criteria for this code will appear.

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Bob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog.

The ROHO Group Adds New Wheelchair Cushion to Product Line™ — PostureLITE Cushion by ROHO®

BELLEVILLE, Ill., (September 1, 2011) — The ROHO Group, manufacturer and distributor of support surface products for medical and consumer applications, adds a new wheelchair cushion, the PostureLITE™ Cushion by ROHO^®, to its product mix.

PostureLITE is a self-adjusting air and foam wheelchair cushion that gently contours to the individual to redistribute force. The new cushion is designed for individuals who may require basic skin protection and weigh less than 350 pounds. PostureLITE’s preset air and foam design offers a perimeter air expansion chamber that easily adapts to an individual’s body shape to provide comfortable suspension and skin protection. Its closed system design, using a combination of air and foam, provides fail-safe support that does not need adjustment.

“PostureLITE will complement The ROHO Group’s already extensive selection of seating support surfaces and offer individuals outstanding comfort, skin protection and best of all, simplicity,” said Lisa Blackmore, the Director of Marketing Communications for The ROHO Group.

PostureLITE comes in three sizes and fits wheelchair widths of 15–20 inches. Weighing only approximately 1.5 pounds (0.6 kilograms), the cushion is lightweight, cost-effective and easy to use and transport. The cover is made of breathable fluid- and flame-resistant polyurethane-coated polyester with DEHP and BPA-free PVC non-skid bottom material. The foam core is made of polyurethane foam encased in DEHP and BPA-free PVC. PostureLITE is US Medicare E2601 code verified as a general use wheelchair cushion.

Specializing in shape fitting technology^®, The ROHO Group manufactures and distributes a variety of standard and custom-size wheelchair cushions and accessories, back systems, powered and non-powered support surfaces and the full line of XSENSOR^® Pressure Mapping Systems. For more information, visit The ROHO Group’s website at www.therohogroup.com or contact customer service at (800) 851-3449.

# # #

For more information, contact:
Danielle Boenisch
eMarketing & Support Surface Coordinator
The ROHO Group
danielleb@therohogroup.com
TheROHOGroup.com
Blog.TheROHOGroup.com
Learn about ROHO: http://www.therohogroup.com/corporate/about.jsp
Twitter.com/TheROHOGroup
LinkedIn.com/companies/The-ROHO-Group
Facebook.com/TheROHOGroup

Introducing new ROHO® SOFFLEX® 2 Mattress Overlay System

The ROHO Group, manufacturer of support surface products for medical and consumer applications, is introducing a new non-powered ROHO^® SOFFLEX^® 2 Mattress Overlay System, designed for individuals who require skin protection.

The SOFFLEX 2 Mattress Overlay System provides the same effective ROHO^® Shape Fitting Technology^® pressure redistribution known throughout the industry. The SOFFLEX 2 is designed to meet the needs of individuals who require skin/soft tissue protection or other medical needs. It has three sections to conform to the individual’s body shape, size and needs. The three non-powered sections easily snap together to form a complete mattress overlay.

“SOFFLEX 2 represents the first of a new generation of support surfaces coming from ROHO that use new materials science to provide the same ROHO^® quality,” Sr. VP of Sales and Business Development, Pat Chelf said.

Made from flame-retardant polyurethane, the new SOFFLEX 2 only weighs 6.5 pounds (2.9 kilograms) and is 36 inches (91.5 centimeters) wide by 81.75 inches (207.5 centimeters) long by 3.5 inches (9 centimeters) tall.

The SOFFLEX 2 comes with a hand inflation pump, operating instructions and a repair kit. It also has two cover options: ROHO^® Reusable Mattress Overlay System Cover or ROHO^® Mattress Overlay Enclosure Cover. The SOFFLEX 2 has an 18-month limited warranty and has a Medicare Part B HCPCS code of E0371 Group II Support Surfaces.

The ROHO Group specializes in Shape Fitting Technology^®, manufacturing cushioning and mattress products for medical applications as well as for recreational and commercial vehicle use. For more information, visit The ROHO Group’s website at www.therohogroup.com or contact customer service at (800) 851-3449 in the US, or at (618) 277-9150 if outside the US.

For more information, contact:
Danielle Boenisch
eMarketing Assistant
The ROHO Group, Inc.
1-800-851-3449, ext. 2220
danielleb@therohogroup.com
TheROHOStore.com
Blog.TheROHOGroup.com
Learn about ROHO: http://www.therohogroup.com/corporate/about.jsp
Twitter.com/TheROHOGroup
LinkedIn.com/companies/The-ROHO-Group
Facebook.com/TheROHOGroup

Why is there such a price difference between medical & consumer products?

Why do medical products cost more than consumer products, even though they may appear to be similar?

Ultimately, the cost to bring a medical product to market and the ongoing costs to produce and sell medical products are much higher than they are for a consumer product. Here are a few things to consider regarding the price differences:

• In order for products to qualify as medical products via Medicare (and most U.S. payers) they must meet specified criteria associated with performance, durability and safety.
• There are considerably more regulatory rules and oversight to comply with in producing and distributing medical products than with producing and distributing consumer products, including substantial testing, documentation and record retention.
• To be considered a “medical product” a product needs to make claims associated with their use in relationship to a medical condition/situation. These claims need to be back up with testing, studies and documentation.
• The expenses associated with legal fees, protection of intellectual property, liability insurance, etc. are all considerably higher for “medical” products.
• There is considerably more cost and time associated with managing a sale transaction through third party payers like Medicare, Medicaid or private insurance. For example:
  • When someone buys a consumer product they pay for the product before they get to take it with them. For medical sales this rarely occurs. Rather, the product is normally delivered before payment (or even any guarantee of payment). In the case of Medicare, the provider cannot obtain any prior authorization and only has an expectation (hope) of payment based on the rules as they interpret them. Before they actually get paid they must compile all of the proper documentation and submit the claim… hoping that Medicare will agree and pay. This can take weeks if not months. Then, if they do get paid they may have to start the process over again with a secondary payer.
  • If the primary payer doesn’t agree to pay, the process can become very long and costly, including appeals, more documentation, etc.
  • If the provider never gets paid the best-case scenario for them is that they can get the product back. However, they must weigh this against the impact that it will have on their reputation. In addition, even if they do get the product back it is no longer “new” and cannot be sold as such.
  • Further, payers like Medicare reserve the right to do post-payment audits for several years after the transaction is completed. In those audits if they determine that payment was made inappropriately they will insist on a refund of the payment (at the very least).
  • Beneficiaries are suppose to pay any portion of the co-insurance that is not covered by their insurance, but many don’t leaving the provider with nothing but bad choices including writing the balance off as bad debt or continuing to try and collect the debt while racking up more and more expenses in doing so.

Bottom line, products designed for consumer purposes are not the same as those designed to address medical needs, and the expenses associated with developing, producing and selling medical products are all considerably higher than they are for similar consumer products.

Finally, please take into consideration that the amount that most payers (Medicare, Medicaid and third-party payers) are allowing for medical products continues to be cut more and more, even though the cost of producing these products continues to increase (raw materials, utilities, freight charges, etc.). Costs also continue to increase as manufacturing and provider companies strive to provide their employees with reasonable salaries and benefits. In ROHO’s case, we’re proud to say that our products are made in the U.S. in our Belleville, Illinois facility; but there’s extra cost associated with that decision…and we believe extra quality too!

These are just some of the things to consider regarding the price difference between medical and consumer products. Is there anything else that you would add to the list? Do you disagree with any of the things listed? We’d love to hear your feedback!

(This has been modified from an e-mail written by Dave McCausland, Sr. VP of Planning & Government Affairs)

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