February 2014 • Vol. 13 No. 2

mobilitymgmt.com

Serving the Seating & Mobility Professional

www.OttobockUSMobility.com

The newest member of the Kimba family — Kimba Kruze — weighs as little as 25 lbs and folds into a compact package for easy transport. But this stroller is no lightweight when it comes to performance. RESNA crash tested for safety, the Kimba Kruze easily accommodates passengers weighing up to 165 lbs and provides a secure ride through a five-point padded harness. A variety of handy accessories add to the stroller’s versatile value. Call us at 800 328 4058 to see for yourself.

Live Your Life With Kimba® Kruze

(US) 866-800-2002(Canada) 888-570-1113

quantumrehab.com

“In between my college

classes, I lift four days a week to keep getting

stronger. My goal is to become a disability rights

lawyer to ensure all people get the medical

equipment they require. Sometimes a person will

look at me and ask me if I’m really disabled. I say,

‘You tell me.’ That’s my Edge.”

Scan to watch Kiel Eigen’sQ6 Edge® video.

youtube.com/QuantumRehabOfficial SponsorOfficial Sponsor facebook.com/QuantumRehab

4 mobilitymgmt.comfebruary 2014 | mobilitymanagement

february

Mobility Management (ISSN 1558-6731) is published monthly by 1105 Media, Inc., 9201 Oakdale Avenue, Ste. 101, Chatsworth, CA 91311. Periodicals postage paid at Chatsworth, CA 91311-9998, and at additional mailing offi ces. Complimentary subscriptions are sent to qualifying subscribers. Annual subscription rates payable in U.S. funds for non-qualifi ed subscribers are: U.S. $119.00, International $189.00. Subscription inquiries, back issue requests, and address changes: Mail to: Mobility Management, P.O. Box 2166, Skokie, IL 60076-7866, email MOBmag@1105service.com or call (847) 763-9688. POSTMASTER: Send address changes to Mobility Management, P.O. Box 2166, Skokie, IL 60076-7866. Canada Publications Mail Agreement No: 40612608. Return Undeliverable Canadian Addresses to Circulation Dept. or XPO Returns: P.O. Box 201, Richmond Hill, ON L4B 4R5, Canada.

© Copyright 2014 by 1105 Media, Inc. All rights reserved. Printed in the U.S.A. Reproductions in whole or part prohibited except by written permission. Mail requests to “Permissions Editor,” c/o Mobility Management, 14901 Quorum Dr, Ste. 425, Dallas, TX 75254

The information in this magazine has not undergone any formal testing by 1105 Media, Inc. and is distributed without any warranty expressed or implied. Implementation or use of any information contained herein is the reader’s sole responsibility. While the information has been reviewed for accuracy, there is no guarantee that the same or similar results may be achieved in all environments. Technical inaccuracies may result from printing errors and/or new developments in the industry.

Corporate Headquarters: 1105 Media9201 Oakdale Ave. Ste 101 Chatsworth, CA 91311www.1105media.com

Media Kits: Direct your Media Kit requests to Lynda Brown, 972-687-6781 (phone), 972-687-6769 (fax), lbrown@1105media.com

Reprints: For single article reprints (in minimum quantities of 250-500), e-prints, plaques and posters contact:PARS InternationalPhone: 212-221-9595E-mail: 1105reprints@parsintl.comwww.magreprints.com/QuickQuote.asp

This publication’s subscriber list, as well as other lists from 1105 Media, Inc., is available for rental. For more information, please contact our list manager, Jane Long, Merit Direct. Phone: 913-685-1301; e-mail: jlong@meritdirect.com; Web: www.meritdirect.com/1105

On the CoverUnderstanding tilt requires more than just knowing best-practice numbers.Cover by Dudley Wakamatsu.

16 cover featureTilt by the Numbers

Tilting in a wheelchair to provide weight shifting is a proven method of pressure relief

— but it has to be done correctly. Creating a successful tilt regimen requires more than

just knowing the best-practice numbers; it requires teamwork and communication on

the part of both ATP and consumer.

22 Automotive Accessibility: What’s Up the Road for 2014?

The adaptive automotive technology segment — aka, the mobility industry — is

seeing changes both internally (new players) and in Washington (a push for new poli-

cies). Here’s what dealers and manufacturers have to look forward to this year.

volume 13 • number 2

What’s New Online: MobilityMgmt.com & TheMobilityProject.comMake the most of your Mobility Management magazine

subscription by taking advantage of additional resources on

MobilityMgmt.com. Check out the availability of our latest

educational Webinars: Past Webcasts are archived and can

be viewed 24/7 after registration. Also use MobilityMgmt.

com to subscribe to eMobility, our free newsletter that

keeps you up to date on industry, assistive technology and

funding/policy news between MM issues.

8 Editor’s Note

9 MMBeat

24 Marketplace: Accessibility

28 Product Revue

29 Ad Index

30 CMS Update More K0823 Widespread

Review Results Are In

February 2014 • Vol. 13 No. 2

mobilitymgmt.com

Serving the Seating & Mobility Professional

contents

DESIGNSFREEDOM

SINCE 1981

Hybrid Platform

Lift

HPl

Mobility Cham

AUTO LIFTS STAIR LIFTS VERTICAL PLATFORM LIFTS INCLINE LIFTS POOL LIFTS

Universal Scooter Lift

Profile MWD Lift

AL600

AL100

AL580XL

Universal Mobility BundleScooter & Micro Lift

ampions

S CONTACT A HARMAR PRODUCT SPECIALIST 866-351-2776 WWW.HARMAR.COM

Pickup 350 HD

Harmar builds the leading solutions in scooter, power chair, and wheelchair transportation. With our comprehensive product line, dealers are prepared to meet a full range of customer needs. Plus, progressive sales tools and resources put dealers on the path to success. Because champions are made, not born.For information, contact a Harmar product specialist 866-351-2776

AL435

AL835

ALL NEW! AL915 Bundle

Pi k 350 HD

3-Axis Inside

Lift

Universal Mobility Bundle

8 mobilitymgmt.comfebruary 2014 | mobilitymanagement

Last month marked my 12th anniversary with Mobility Management, going all the way back to our spring 2002 launch.

Because of that — and because February is the month that we set aside for recognizing things we love, and because sometimes you just gotta throw out some good energy so all the bad news doesn’t drown you — I’m using this month’s space for a rather arbitrary and nowhere near complete list of what I love about this industry, about your industry.

% I love this industry’s bountiful heart. Countless people working in mobility, seating and accessibility started here because someone they cared about needed an innovation that would help them get out of bed, help them meet friends on the playground, or help them get to grandkids’ soccer games. You have never forgotten why you started here, and you still get your greatest kicks from aff ecting individual lives. In MMBeat this month, we recognize a handful of recent good deeds: Manufacturers, organizations, providers and ATPs putting aside profi t margins and harried schedules for a little while to pull together and make something great happen.

% I love innovation. It’s how the industry started, and it’s heartening to see that despite all the funding cutbacks, the red tape, the agencies that so often seem to be letting benefi ciaries down, products are still being improved. Upgraded. Redesigned. Invented. Take a look at Product Revue (page 28) to see what industry veterans are up to, and also at pages 10-11 to see some mobility concepts a little more outside the box.

% I love pressure relief. One of the fi rst educational sessions I ever attended was given by Tina Roesler, and it was on pressure sores. I saw those PowerPoint slides of stage 3 and 4 ulcers and was hooked. Pressure mapping? Weight shifts? Cushions and backs? Elevating legrests? If it relieves pressure, I love it.

% So naturally, I also love tilt. Power and manual. (I’m sure it’s sheer coincidence that our cover feature this month is “Tilt by the Numbers,” starting on page 16!)

% I love cars. I originally came from the automotive industry, and since I’m from California as well, in my head I can’t separate independence from horsepower. See page 22.

% I love WC-anything, of course. WC19 is cool, WC20 is awesome, and I can’t wait to start talking about WC18, coming up next year. (Again, see page 28!)

% I love universal design and accessibility. C’mon, I’m 5' tall. How much of my kitchen shelving do you think I can reach?

% I love ultralights, which get more gorgeous all the time. I see those curves and stances, and I think elegance. Or Ferrari. Who says clinical effi ciency and performance can’t also look great? Not ultralight manufacturers!

% I love power chairs and their electronics. Some of it is over my head, but I see how these sleek machines can be driven via, like, a fi ngertip and I think, magic.

% I love early intervention. The right technology in the hands of the right clinicians and ATPs can result in a kid attaining independent mobility right on time. Enough said.

% I love buckles and ankle huggers and armrest pads, and all the components that form something much greater than the sum of their parts. I really love how much engineering attention and design detail these “little” parts receive from their devoted makers.

% I love dynamic seating. I especially appreciate it after I’ve stepped off a plane. % And speaking of planes, I love the chocolate in Canada. Next month’s issue is our International

Seating Symposium special, bringing together all these great things and many more in one edition as we head to Vancouver. ●

Laurie Watanabe, Editorlwatanabe@1105media.com

Editor Laurie Watanabe (949) 265-1573

Associate Editor Cindy Horbrook (972) 687-6573

Group Publisher Karen Cavallo (760) 610-0800

Group Art Director Dudley Wakamatsu

Director, David Seymour Print & Online Production

Production Coordinator Charles Johnson

Director of Online Marlin Mowatt Product Development

National Sales Manager Caroline Stover (323) 605-4398

SECURITY, SAFETY & HEALTH GROUP

President & Group Publisher Kevin O’Grady

Group Publisher Karen Cavallo

Group Circulation Director Margaret Perry

Group Marketing Manager Susan May

President & Neal Vitale Chief Executive Offi cer

Senior Vice President & Richard Vitale Chief Financial Offi cer

Executive Vice President Michael J. Valenti

Vice President, Christopher M. Coates Finance & Administration

Vice President, Erik A. Lindgren Information Technology & Application Development

Vice President, David F. Myers Event Operations

Chairman of the Board Jeff rey S. Klein

REACHING THE STAFF

Staff may be reached via e-mail, telephone, fax, or mail. A list of editors and contact information is also available online at mobilitymgmt.com.

E-mail: To e-mail any member of the staff , please use the following form: FirstinitialLastname@1105media.com

Dallas Offi ce (weekdays 8 a.m. - 5 p.m. CT)Telephone 972-687-6700; Fax 866-779-909514901 Quorum Drive, Suite 425, Dallas, TX 75254

Corporate Offi ce (weekdays, 8:30 a.m.-5:30 p.m. PT) Telephone 818-814-5200; Fax 818-734-1522

9201 Oakdale Avenue, Suite 101, Chatsworth, CA 91311

mobilitymgmt.com

Volume 13, No. 2

FEBRUARY 2014

editor’s note

What I in Th is Industry (& Why)

mobilitymgmt.com 9 mobilitymanagement | february 2014

mm beat

Numotion Announces Latest Rehab Business Acquisitions

Numotion continues to grow, as the nationwide provider announced its latest acquisitions of complex rehab technology businesses.

Numotion has acquired the custom mobility division of Barnes Healthcare Services, which has offi ces in Alabama, Florida and Georgia, and serves pediatric and adult clients with complex seating & positioning needs.

In announcing the acquisition, Barnes Healthcare CEO Charlie Barnes III said, “Barnes Healthcare Services has been providing various healthcare services to customers in the southeast region for more than 104 years. Th e sale of our custom mobility division allows us to position ourselves for the future and focus on other service lines, including pharmacy, respiratory services, nutrition and medical supplies, as well as develop programs that align with the current and future healthcare environments.”

“We are excited about the professional team at Barnes joining Numotion, as they have a strong reputation in customer service,” Numotion’s regional VP Bill Boyce said in the news statement. “Th e

Having already announced a new Canadian sales partnership in September, TiLite has unveiled additional sales representation

deals that it says will expand its sales agreements with ROHO Inc., Target Medical and Permobil.

In September, TiLite announced that its ultralightweight manual wheelchairs would be represented by Permobil in Canada. Th e latest announcement, released at the end of October, said that Permobil will be representing TiLite in Florida and Puerto Rico, as well.

ROHO Inc. will represent TiLite in Illinois and most of Wisconsin, the announcement added. ROHO has been repre-senting TiLite in Michigan and will continue to do so.

Target Medical — which already represents TiLite in Ohio, Indiana, Kentucky, Pennsylvania and West Virginia — will now

TiLite Expands Sales Rep Agreements

additionally sell TiLite products in Tennessee and Mississippi.MSL Associates will continue to represent TiLite in North

Carolina and South Carolina. Th e new sales representation agreements began Dec. 1.“We are excited to extend our partnerships with these top players

in our industry,” said TiLite CEO David Lippes in the announce-ment. “Each has proven their dedication to TiLite’s vision that what matters most is the outstanding wheelchair experience we deliver to the people we serve. Permobil, ROHO and Target Medical will now play larger roles in delivering the most advanced and best-performing manual mobility product line in the world.”

TiLite, headquartered in Pasco, Wash., manufactures ultralight-weight, custom-fi tted aluminum and titanium manual wheelchairs for active adult and pediatric consumers. ●

addition of Barnes’ seven locations in Georgia and Florida greatly expands our coverage and improves access to complex rehab tech-nology to residents throughout the region.”

Numotion announced in late December that it had also acquired the Myrtle Beach rehab division of Southeastern Health Plus in Murrells Inlet, S.C.

“Th e sale of our rehab division allows us to focus almost exclusively on our orthotics and prosthetics business, which we plan to expand into other states,” Southeastern Health Plus CEO Ralph Lombardo said in an announcement about the acquisition.

Southeastern Health Plus has additional locations in St. Matthews and Summerville, S.C. Th e company also sells accessibility products, a range of DME and adaptive automotive equipment.

Neill Rowland, a regional VP for Numotion, said the latest Southeastern Health Plus acquisition “allows Numotion to expand its complex mobility business throughout the state and provides greater access to rehab equipment to residents needing these products and services.” ●

10 mobilitymgmt.comfebruary 2014 | mobilitymanagement

mm beat

Japanese power wheel-chair manufacturer WHILL is

preparing to deliver its fi rst chairs in the second quarter of 2014 and has opened up its Web site to accept pre-orders and $500 deposits.

Headquartered in Tokyo, WHILL’s American offi ce is in Menlo Park, Calif., and its Web site — whill.jp — said the manufacturer plans to hand deliver its fi rst 50 American production units to consumers in California in the April-June timeframe.

Consumers are being invited to order a WHILL by placing a down payment of $500. Th e WHILL’s retail price is expected to be $9,500.

A Retail PurchaseAtsushi Mizushima, WHILL’s director of product development, confi rmed to Mobility Management that the current power chair model does not have a HCPCS code and is not eligible for Medicare reimburse-ment — though Mizushima didn’t rule out that possibility for the future.

“We aspire to get over the stigma attached to wheelchairs and desire to make people on mobility devices happy just because they are on the mobility devices,” Mizushima said, in explaining the lack of HCPCS code. “As such, we don’t want to make it perceived as or be a ‘medical device,’ but we want to make it a personal mobility device that even non-disabled people want to ride, so that the users of our device can be proud of the device they are using.”

He added that WHILL is “defi nitely considering a Medicare-eligible model in the future," but isn't ready to set a timeframe for it.

Th e WHILL made its American debut in November at the Abilities

WHILL Sets Power Chair Pricing for 2014 Launch

An Abilities Expo attendee takes a seat in the new WHILL power chair. Photo courtesy WHILL Inc.

Expo consumer event in San Jose, Calif., and Mizushima said the manufacturer “received so many good reactions" from event attendees.

Th e manufacturer also attended the famous Consumer Electronics Show (CES) in Las Vegas in January.

A New DesignJapanese engineers previously with consumer electronics fi rms such as Olympus and Sony designed the WHILL, which has four wheels but can turn in its own space thanks to front wheels that move in multiple directions in a fashion similar to a ball bearing.

Consumers steer using the levers — which also act as armrests — that extend diagonally from the sides of the chair. Th e armrests move out of the way during transfers or to enable its user to roll under a table. Consumers can steer with either their left or right hands.

WHILL’s Web site says about driving via armrest, “Control is very intuitive, just like an ordinary joystick.”

Th e WHILL has a top speed of 6 mph and a user weight capacity of 300 lbs. Its team says it can navigate 10° slopes, weighs 176 lbs., and can climb obstacles up to 3" high.

Th e WHILL measures 23.6" wide and 32.5" long. Its seat width is 17.7x17.7".

The First 50 WHILLsTh e manufacturer will start distributing WHILL units in its home state of California in April through June, Mizushima says.

“We’d like to see and interact closer with our early adopters so that we can improve our product further, take responsibility of main-tenance and support, and understand how the maintenance and support would work,” he notes in explaining why distribution will start in California.

Th ose fi rst 50 units will be delivered by the manufacturer itself. WHILL is considering a diff erent distribution method for subsequent units. Mizushima says, “While we’ve been talking with some candi-dates, nothing is decided regarding this.”

WHILL is aiming to deliver chairs to consumers in other states as well as Japan in late 2014, Mizushima adds. ●

mobilitymgmt.com 11 mobilitymanagement | february 2014

mm beat

Seeing Power Chairs Through Diff erent Eyes

Ziesel Off -Road Vehicle Is Joystick DrivenAustrians know a thing or two about snow — navigating

through it, working with it, having fun in it. Maybe that heritage led to the development of the Ziesel, an “off-road driving machine” that looks strikingly like a power wheelchair and is driven via joystick.

But its manufacturer makes no mention of medical necessity or clinical benefits in discussing the Ziesel — which, incidentally, means “ground squirrel” in German. Instead, the manufacturer — Mattro Mobility Revolutions GmbH — focuses on the Ziesel’s ability to drive in all sorts of terrain… though snowy landscapes seem to get the most attention.

In lauding Ziesel’s abilities, its Web site (derziesel.com/wordpress/?lang=en) describes “unlimited freedom: Ski slope, toboggan run, ski touring areas, cross-country skiing tracks, the Ziesel takes you through them all.”

The Web site shows the Ziesel performing tasks ranging from patrolling snowy hills to pulling a plow on a farm, in addition to carrying users to picturesque, sunny seashores.

Internally, Ziesel’s Web site says the vehicle has “2x PMS elec-tric disc motors” and produces more than 368 ft.-lbs. of torque. The vehicle’s top speed is faster than 21 mph. The frame is made of tubular steel, and yes: That’s a rollbar on top.

Not surprisingly, all this outdoor ability doesn’t necessarily translate to indoor accessibility. The Ziesel is more than 5 feet tall, more than 47 inches wide, more than 51 inches long and weighs more than 540 lbs. including batteries.

All that power doesn’t come cheaply, either. Online science publication Gizmag.com, which filed the story in its “Health & Wellbeing” section, reports that the Ziesel retails for about $29,000 in American dollars. That doesn’t include the cost of shipping it

Ziesel can do the tasks of a snowmo-bile, but more closely resembles an all-terrain power wheelchair. Photos courtesy Mattro Mobility Revolutions

And Yet Another Take on the Power Chair…Unlike Austrian-born Ziesel, which doesn’t call itself a mobility

vehicle, the new UNiMO, from Japanese manufacturer Nano Optonics Energy, is being called a power wheelchair. The UNiMO’s Adventure model is a track-driven all-terrain power chair, while the UNiMO Grace (pictured in the screen capture) looks like something from the bridge of the Starship Enterprise. UNiMO is an abbreviation of “Unique Mobility,” and Gizmag.com described the Grace as having “clean, minimalist Apple-esque lines” as well as having a much lower retail price point than Ziesel. The chairs were reportedly in production late last year. Check out the

designs for yourself at nano-opt.jp/UNIMO_en/unimo_en.html. ●

from Austria to your local ski slope.

Mattro Mobility Revolutions says it specializes in the “development of future transportation concepts with alternative powertrains.” The company plans to ship its first production run — a total of 20 Ziesel units — this month and said back in November that it had nearly sold out. This month, Mattro Mobility also plans to invite potential investors and distributors to visit and test drive Ziesel personally. ●

— Laurie Watanabe

12 mobilitymgmt.comfebruary 2014 | mobilitymanagement

mm beat

Th ird Certifi cationAudit Approval

DelayedApproval of Invacare Corp.’s third and fi nal certifi cation audit, owed to the U.S. Food & Drug Administration (FDA) as part

of the ongoing FDA consent decree that halted production of manual and power wheelchairs and components in Elyria, Ohio, has been delayed, the seating, mobility and DME manufacturer has announced.

Th e third-party expert conducting the audit met with Invacare representatives on Dec. 20 and informed them that “some additional work is required in a few particular areas before the fi nal certifi cation report can be provided to the United States FDA,” Invacare said in a Dec. 23 news release.

Invacare described the third audit as “a comprehensive review of the company’s compliance with the FDA’s Quality System Regulation (QSR) at the impacted Elyria facilities.”

A New Complaint Handling SystemInvacare added that the third-party auditor’s remaining concerns center on the manufacturer’s new system for handling incoming complaints and Invacare’s risk review processes.

“As part of the mediation, the company conducted a comprehensive overhaul of its complaint handling system,” Invacare said in a state-ment. “Th is change has led to an increase in the backlog of complaints, as the updated procedure now requires the funneling of all sources of complaint data through one system. Th e launch of this new process initially outpaced the company’s ability to add and train new asso-ciates to thoroughly address and conduct standard investigations of complaint data.”

Th e backlog of complaints and “the complexity associated with [Invacare’s] highly confi gurable medical devices” made it diffi cult for Invacare to investigate and resolve complaints in a timely manner and to demonstrate that it was consistently using the new risk-review process, Invacare said.

In its December 23 announcement, Invacare said the new complaint handling system “has been operating for several months, and the company has been closing signifi cantly more complaints than are opened. Th e company has added additional contractors to further expedite clearing the backlog in order to achieve and demonstrate sustainable improvement.”

The Timeline Going ForwardIn earlier announcements, Invacare said it was hoping to get approval

of the third certifi cation audit in November 2013.Invacare now expects the third-party auditor to return in February

to examine the quality system again.Aft er the third certifi cation report is approved and submitted to the

FDA, the agency will conduct its own investigation, which could be the fi nal step before Invacare is able to return to normal operations.

Invacare executives signed the FDA’s consent decree in December 2012. In a Dec. 20, 2012, news announcement, the FDA said its inspections of Invacare “have documented violations of FDA’s Quality System regulations, along with failures to properly report adverse events to the agency.”

Th e consent decree prevented Invacare from designing, manu-facturing and distributing manual and power wheelchairs and components.

In July, Invacare announced that the second certifi cation report had been approved. Th at allowed Invacare to “resume design activi-ties on the critical new product development projects that will help us regain our custom power wheelchair marketshare when we exit the injunctive phase of the consent decree,” said Invacare CEO/President Gerald B. Blouch.

In May, Invacare said its fi rst certifi cation report had been approved, which regarded “qualifi cation and validation documentation for equipment and processes at the Taylor Street manufacturing facility.” Th e approval permitted the Taylor Street facility “to resume manu-facturing and distributing parts, components, accessories and subas-semblies to Invacare facilities other than the Taylor Street or corpo-rate facilities, for further manufacturing or to provide service related to medical devices manufactured at those other Invacare facilities.”

In its Dec. 23 announcement, Invacare said it could not predict when the third certifi cation report would be completed.

“While we are disappointed that the fi nal certifi cation report is not ready to be fi led, we have made signifi cant progress in our quality systems improvements over the past two years,” Blouch said in the news release. “Notwithstanding our extension of the timeline resulting from the complexities of this process, the fact remains that our associates have done an incredible amount of work. We remain fully committed to meeting the expectations of our third-party auditor and ultimately the FDA so we can return to full operations at our corporate and Taylor Street manufacturing facilities.” ●

Invacare Update:

mobilitymgmt.com 13 mobilitymanagement | february 2014

mm beat

BOC Announces New Executive Committee & Board ChairpersonThe Board of Certifi cation/Accreditation (BOC) has announced a

new chairperson and a new executive committee.James L. Hewlett took over the position as the board’s chair on

Jan. 1, following two terms as its vice chair. Hewlett has also served as member-at-large and has been a BOC-certifi ed orthotist since 1997. He fi rst joined the board in 2008.

“Jim will fi ll the role well,” said John P. Kenney, who completed his two terms as BOC’s board chair. “As vice chair, he already has played an important part in BOC’s strategic direction, and he brings vast experience in orthotics, prosthetics and durable medical equipment.”

In addition to Kenney, who becomes immediate past chair, the new executive committee is composed of R. Jeff rey Hedges, vice chair; William J. Powers, secretary; James Newberry Jr., treasurer; and Mark L. Parris, member-at-large.

A Closer Look: Invacare’s New Complaint Handling SystemWhile Invacare Corp.’s consent decree with the U.S. Food &

Drug Administration is an ongoing situation composed of many diff erent components, the focus of the third certifi cation audit is the manufacturer’s new system for handling and inte-grating complaints from customers.

Lara Mahoney, Invacare’s director of investor relations & corpo-rate communications, told Mobility Management, “We met with that third-party expert on Dec. 20 and did get a status report on the third-party certifi cation audit. We’ve made signifi cant progress, but there were a few areas of the quality system where they said we have to do more work, and that was in both our complaint and risk review process.”

The new system is a complex one that handles all complaints, no matter how they were received.

“We used to receive complaint data through a variety of areas,” Mahoney says. “Someone would call into customer service, or [the complaint] might come in through the sales force, through returns, through technical service. Now with our new system, we can better track complaints and trend the data to keep better track of that. It all goes through one complaint handling system. So all of these diff erent sources of data are now funneling through one system.”

The system handles all complaints, regardless of the product category — from general DME to respiratory to mobility and

James L. Hewlett

complex rehab technology — involved. “We started [the new complaint handling] process and that’s

where we weren’t able to add enough associates for what started coming through one singular system,” Mahoney explains. “So we’re adding and training associates to help fi nish the backlog, and we’re to the point where we’re closing out more complaints than are opened. But we just need to work through that process a little further to meet the third party’s expectations.”

The third-party expert is also looking for proof that the new system will work as a long-term solution.

“We have to manage the backlog, prove that we have this sustainable system, that it’s eff ective,” Mahoney says. “We’re moving forward. We’re committed to compliance, we’re getting this right, it’s just going to take some more time.”

While Invacare doesn’t yet know when it will be back to busi-ness as usual — after the third certifi cation audit is approved, the FDA will still need to conduct its inspection and give its fi nal approval — Mahoney says the changes that have taken place since the consent decree was signed in December 2012 will ulti-mately pay off .

“All the improvements that we’re making to our quality system, they’re going to make us a better company,” she notes. “These are good, strong improvements we’ve been making. It’s not just to get through the consent decree. It’s to continue going forward. ●

In accepting his new position, Hewlett said in the news announcement, “I am humbled and excited by my colleagues’ confi dence in me, and I recognize the responsibility of leading this important organization through a challenging climate. I look forward to advancing BOC’s mission to assure patients, physicians, professional organizations, the public at large, and government agencies of the competence, professionalism and safe-practice environments of BOC-certifi ed professionals and BOC-accredited facilities.”

BOC (bocusa.org), based in Owings Mills, Md., is a not-for-profi t agency that provides credentials in the fi elds of orthotics, prosthetics and DME. ●

14 mobilitymgmt.comfebruary 2014 | mobilitymanagement

mm beat

New Solutionsto Distribute PG Drives Technology

PG Drives has named New Solutions its primary North American distributor for aft ermarket mobility controllers.

In a news announcement, New Solutions called the new partnership “great news for everyone.”

“Th is association allows New Solutions to supply PGDT products along with its 3,500 other products in its quest to be the true ‘one-stop shop’ for all wheelchair and scooter parts.”

In addition, the new agreement gives providers a new way to handle repairs: “Shops can now send in parts to get repaired by the manufacturer through New Solutions,” the news announce-ment said. “What this means is that DME repair shops can now buy parts, electronic components and make repairs to their customers’ equipment, all through New Solutions.”

Curtiss-Wright announced in November 2012 that it had acquired PG Drives. ●

Permobil attached a special appreciation card to the joystick of every chair it shipped to consumers in the month of December. The card was signed by the Permobil employee who built the chair — and consumers who return their cards by May 1, 2014, can choose a free self-levelling cupholder, a $50 Amazon gift card, or a $50 restaurant gift card courtesy of Permobil “just because your business is such a great gift to us,” as the appreciation card said. Remind consumers who received Permobil chairs in December that it’s not too late to receive their gifts. Permobil Marketing Manager Barry Steelman said 2013 was the third year for this

appreciation program… Author, activist and motivational speaker Spencer West has joined Sunrise Medical Canada’s roster of Quickie Ambassadors. West, who had both legs amputated at the pelvis at age 5, climbed Mount Kilimanjaro using his hands and wheelchair in 2012 and raised nearly $500,000 along the way to benefi t Free the Children… AliMed has released its 2014-2015 Rehabilitation, Orthopedics & Skilled Nursing Sourcebook, which includes DME, orthopedic products, wheel-chair cushions and positioning products, among other items. It’s free to clinical and administrative staff at qualifi ed facilities: To

briefl y…

Reminder: It’s not too late for your new Permobil users to collect their holiday gifts!

inquire about your copy, visit alimed.com or call (800) 225-2610… Gary Cox, CEO of PMDRX, has announced his candidacy for state representative, district 30, in Arizona. “I decided to run because I believe there are many issues in the state of Arizona that are not getting addressed in our current legislature,” Cox says. In his position paper, Cox expresses opposition to the Aff ordable Care Act and concern over “Arizona’s Health Care Cost Containment System with the various health plan subcontractors that the state contracts with for the provision of health care coverage. Many of those plans are literally reaping millions of dollars in profi ts at the expense of their contracted physicians, hospitals, medical suppliers, etc., due to the numerous reimbursement loopholes they take advantage of to avoid the payment of legitimate claims.” Cox is planning to run as a Republican candidate in the August primary; the general election is in November… Get ready, curling (and sledge hockey and skiing and biathlon) fans! The Paralympic Games in Sochi, Russia, kick off on March 7. In the United States, a press release from NBC says it will air 50 hours of Paralympics coverage via NBC and NBCSN, its sports network. The Canadian Paralympic Committee has Paralympic Games broadcast rights for Canada and is partnering with Sportsnet, Yahoo Canada Sports and other media outlets to broadcast 65 hours of coverage and off er up to 350 hours of coverage through digital streaming. ●

mobilitymgmt.com 15 mobilitymanagement | february 2014

News outlets are quick to pick up any healthcare story loaded with buzz phrases like “Medicare fraud” or “wasted tax dollars,”

but seem far less interested in the humanitarian work being done by industry professionals.

For instance, Sunrise Medical’s ongoing Propel Donation Program awards seating & mobility assistance to consumers who might not be able to acquire the technology on their own. Kristyn Campbell, Sunrise’s marketing manager, says Propel Donation program committee members review applications once a quarter and select one or more consumers to receive product donations.

“Once our recipients have been selected, we work with their local supplier and ATP to custom confi gure the product that best comple-ments and enhances the lifestyle of that individual,” Campbell says.

Among the latest Propel Donation Program recipients is Brandon Holiday, who helps people with disabilities to express their competitive fi re via adaptive sports. Holiday — a below-the-knee amputee with systematic lupus and

Addison’s disease — had a Quickie 2 ultralight chair, but couldn’t get his seating components funded.

With the support of Curtis Boyer, ATP, from Numotion’s Hatfi eld, Pa., offi ce, Holiday was supplied a JAY Lite cushion and solid

insert for added stability, plus a JAY J3 back with posterior and lateral thoracic support.

Th e Propel Donation Program also recently awarded a Quickie Q7 and a QM-710 to the Dogsong Animal Training & Behavior program in Dillon, Colo. Th e chairs will be used to help service dogs in training become accustomed to wheels, handrims and motors. Trainer Lyn Manton Krueger

points out, “It is critical that the dog is comfortable doing all their tasks with their handler in the chair.”

When the VGM Group heard of a Grinch-like crime — a trailer carrying sports wheelchairs stolen from a Cedar Rapids YMCA parking lot the week before Christmas — its employees sprang into action. Replacing the chairs, which belonged to the Iowa Chariots

Creating Personal Mobility Victories:

Th e Industry Gives Back

mm beat

Do you have your own story of how your mobility or complex rehab technology business or organization is giving back? Send it (and high-resolution photos, if available) to the editor: lwatanabe@hmemediagroup.com.

sports program, would cost $40,000 to $50,000, so VGM associates paid $10 each for the privilege of wearing jeans to work the week of Dec. 30. Th e dollars collected were matched by VGM Group and by Van Miller, the organization’s founder.

U.S. Rehab, VGM’s complex rehab division, also contributed to the fund, and U.S. Rehab President Greg Packer worked with manu-facturers associated with VGM to replace the chairs. Th e chairs are serviced by JVA Mobility in VGM’s hometown of Waterloo, Iowa.

And the industry’s recent good deeds extend well beyond North American boundaries. Convaid announced in late October that it had donated four pallets of lightweight wheelchairs and compo-nents to UCP Wheels for Humanity, an organization that distributes chairs to children and adults in developing countries. UCP Wheels for Humanity Executive Director Michael Allen said in the news announcement, “We are so grateful for this gift and our long-standing partnership with Convaid. Th eir contributions over the years have allowed us to provide mobility to thousands of children in need around the world, making opportunities like school participation and community engagement available to them for the fi rst time.”

Closer to home, Convaid was a sponsor at November’s International Rett Syndrome Foundation’s annual Strollathon fund-raiser in Th e Woodlands, Texas. Convaid donated a new wheel-chair, complete with customization, to the Strollathon raffl e, and Convaid volunteers performed free seating & positioning adjustments for event participants who brought along their Convaid chairs.

Bruno Independent Living Aids helped make a Christmas wish come true for a young baseball fan with cerebral palsy. Sam Wedig, 10, is devoted to the Iowa Cubs, the Chicago Cubs’ Triple-A minor league team. Sam’s aunt called a Des Moines, Iowa, radio station that was granting holiday wishes and explained that Sam and his grand-parents, who are raising him, needed a way to transport the power chair that Sam had received through Iowa Medicaid and Advanced Rehab Technologies, a provider in Urbandale, Iowa.

Th e folks at Advanced Rehab Technologies contacted Bruno, who heard Sam’s story and donated a Joey platform lift to use with Sam’s grandparents’ 2009 Dodge Caravan. Th e Advanced Rehab Technologies crew donated its installation time free of charge.

Now that Sam has a ride, he’s preparing to throw out the fi rst pitch at an Iowa Cubs game this season. ●

16 mobilitymgmt.comfebruary 2014 | mobilitymanagement

On the surface, a tilt regimen for pressure relief can seem like a mathematical equation: How many degrees? For how many

minutes? How many times a day? To offl oad how much weight?But complicating this numbers game is the human factor: Th at

every client’s skin health and breakdown risk is diff erent, impacted by diff erent circumstances, such as nutrition, age, moisture, heat, sensa-tion or lack thereof. Th at each client has a diagnosis, but that each client is unique within that diagnosis. Th at each client has diff erent seating equipment in addition to the tilt system: diff erent backrests and seat cushions, diff erent legrests, perhaps a recline system as well.

And of course, the human factor culminates in diff erent personali-ties, lifestyles and behaviors. In fact, perhaps the only thing an ATP or seating clinician can count on is that a client will not perfectly adhere to best practice standards regarding how much to tilt, how oft en and how long.

Th at leaves seating professionals with the challenge of helping clients to develop weight-shift strategies that will work clinically as well as within the framework of everyday life.

Tilt Best-Practice StandardsTilt recommendations vary somewhat from entity to entity, but the

numbers from the commonly referenced Consortium of Spinal Cord Medicine, administered by Paralyzed Veterans of America (PVA), advises that wheelchair users activate their tilt systems every 15 to 30 minutes and remain in the tilted position at least one minute — which equates to tilting two to four times an hour.

Chris Maurer, MPT, ATP, at the seating & mobility clinic at Shepherd Center in Atlanta, calls those recommendations “a base-line.” While Maurer acknowledges that there’s no guarantee that tilting two to four times an hour will absolutely prevent all skin break-down, she says for new patients in a rehab facility setting, “We start everybody off on that. It gives them somewhere to start.”

She also acknowledges, “When they go home, we know they don’t consistently do that. Aft er they go home and everything settles down, I think the individual fi nds their own frequency at which they need to tilt to keep their skin healthy” — with further recognition, of course, that “some people do it correctly, and some people come back for skin surgery.”

Maggie Love, OTR, clinical education specialist for Permobil, calls the PVA guidelines “a great place to start.” But she adds, “Other factors need to be considered when developing a comprehensive skin-management program. Clients that have partial to full sensation may

Combining Best Practices with Best Strategies to Create Real-Life Pressure Relief

Seating & Positioning Series

By Laurie Watanabe

mobilitymgmt.com 17 mobilitymanagement | february 2014

be less prone to skin breakdown because they will naturally shift their weight while uncomfortable. Younger clients with new injuries are less prone to skin breakdown. As the individual ages and the gluteal tissue atrophies, there is greater risk for skin breakdown.”

A Matter of DegreesTh e other critical factor for pressure relief is the number of degrees that the wheelchair user tilts back.

In a research paper called “Use of Power Tilt Systems in Everyday Life” — published in Disability and Rehabilitation: Assistive Technology in January 2009 — authors Sharon Eve Sonenblum, Stephen Sprigle and Chris Maurer examined how and why consumers used tilt, and whether or not they used tilt to perform pressure-relieving weight shift s. Instrumentation attached to the power chairs recorded how oft en consumers tilted, how many degrees they tilted, and for how long.

Th e authors divided the amounts of tilt used by consumers into four categories: small (0° to 14°), medium (15° to 29°), large (30° to 44°) and extreme (greater than 45°).

One of the conclusions: “Although people used the [tilt] system frequently, so they were moving it a lot, it was seldom used for performing greater than 30° tilts,” Maurer says. Typically, she adds, tilts greater than 30° are considered pressure-relieving tilts.

“In a study prior to [the 2009 one], we looked at how does pressure change with increasing angles of tilt, and it turned out to be a linear relationship,” Maurer says. “Basically the farther you tilt, the more pressure off your seated area occurs. So basically to get the best benefi t out of a tilt system as far as pressure relief is concerned, you need to tilt as far as the system goes. Your pressures continue to go down the farther the system goes, so you need to maximize your tilt.”

Th e 2009 study that used instrumentation to measure amounts of tilt, Maurer adds, “showed that pretty much nobody did that.”

Th e report did note that consumers used tilt frequently.“Even subjects who spent 90 percent of their days in small tilt angles

used the tilt feature at least once per hour,” Maurer says. Th ose partic-ipants routinely sat in a tilted position, but “still moved the system in and out of it, whatever degree they chose.”

Could using tilt to make those frequent if small adjustments in positioning be similar to the type of constant shift ing and fi dgeting that able-bodied people do while sitting in offi ce chairs, for instance?

Sharon Sonenblum, Ph.D., senior research engineer at the Center for Assistive Technology & Environmental Access, Georgia Tech, thinks that’s an apt metaphor.

“It has always been our belief that in general, activity is good,” she says. Sonenblum and Sprigle authored another tilt-related study in 2011,

published in the Journal of Tissue Viability, called, “Th e Impact of Tilting on Blood Flow and Localized Tissue Loading.” Sonenblum says the research “looked at how the buttocks respond to tilts, and found that even when you do a small movement, the blood fl ow to the region increases. So there are physiological benefi ts to the small move-ments. And our current ongoing work is looking at whether people who move — i.e., shift , fi dget — more frequently have fewer pressure

ulcers than people who don’t move that much, in addition to studying their actual pressure reliefs.

“We weren’t made to sit stationary.”

Why Don’t Consumers Tilt Enough?Th e 2009 study on how and why consumers use their tilt systems uncovered some interesting information on why clients might not be as compliant as their clinicians would like them to be.

For instance, consumers cited a number of reasons for using tilt.“Most subjects reported using their tilt for physiological reasons,”

Maurer says. “A lot of people did it to address comfort or discomfort, rest and relaxation, functional independence and for posture.”

Some participants also specifi cally said they tilted to perform pres-sure relief. But Maurer says, “Th e subjects who reported pressure relief as a purpose for tilting didn’t perform more pressure-relieving tilts — those greater than 30° — or spend more time in larger or extreme tilts than anybody else. Th ey were saying they were doing it for pressure relief, but compared to the others, they didn’t spend any more time in greater amounts of tilt.”

Why not? Th e answers are complicated, can be unique to the indi-vidual consumer, and can range from a lack of knowledge about the seating & mobility system to discomfort in social situations.

Equipment wise, Maurer says, “A lot of people I fi nd are very scared of using the full range of the tilt: ‘I can’t go this far back, I’m going to slide right out of my chair.’ It’s scary to them that they can’t move their bodies: If the chair starts to tip, there’s nothing they can do about it. I think what’s important to have happen is to have the system delivered in a setting where a therapist and a supplier are together so the thera-pist can reiterate the need for the weight shift and its eff ect on the skin, and they can actually show the patient, bring them through the full range of tilt and prove to them that the chair isn’t going to fall over.”

Maurer says she’s tilted clients back, and then “I’ll hang on the back of the chair to show them: ‘Look, I’m sitting on the back of the chair with you in it and it’s still not going anywhere.’ Just to ease their fear that the chair is going to fl ip over on them.”

Perceived Compliance with TiltOther clients may believe they are achieving pressure-relieving tilts when they actually aren’t.

“Oft en, patients believe they are being compliant with the tilt regimen when they are not tilting enough to cause tissue reperfusion,” Love says. “It may not be as cut and dried as that, though. I think some-times patients believe that while 45° to 50° of tilt is the best, some tilt must be ‘pretty good.’ However, the research and pressure mapping are showing that is not the case. Th is is where the pressure mapping system puts a visual to the therapist’s words and can be a benefi cial educational

Typically, tilts greater than 30° are

considered pressure-relieving tilts

18 mobilitymgmt.comfebruary 2014 | mobilitymanagement

Seating & Positioning Series

Tilt vs. Life: Real-World Tips“Real life interferes.”

That’s the opinion of Chris Maurer, MPT, ATP, who works in the seating & mobility clinic at Shepherd Center in Atlanta, regarding why so many wheelchair users don’t use their tilt systems as often as they should to perform weight shifts.

“Most spinal cord injury systems do educate people about skin issues,” Maurer says. “They have ugly pictures and all sorts of things to scare people into doing their weight shifts. I also think that when they go home, real life interferes. You go back to work, you’re watching TV, you’re talking to people, and you forget to [perform weight shifts] two to four times an hour.”

The most eff ective way to change a client’s actions for the better might not be showing more pictures of stage 4 pressure sores, but rather looking for ways to work weight shifting into the client’s day.

Some tips: ● TV commercial = Time to tilt: “Do a weight shift during every

commercial,” Maurer suggests. “At the end of a half-hour show, weight shift.” The idea is to pair weight shifting with an activity that happens regularly, so that weight shifting becomes easier to remember.

● Privacy, please: Helping clients to create a way to tilt away from

tool. Pressure mapping was very helpful biofeedback for the clients to see that tilting 25-30° was not an adequate pressure relief.”

Other clients may have trouble achieving enough tilt to provide pressure relief because they typically sit with their systems tilted to begin with.

“You’re limited with how far the system tilts back,” Maurer says. “Th e system is only tilting to 50-55° degrees, probably. Th ere are many people that sit at 25° to 30° degrees of tilt, and that’s their constant. So tilting back only gets them another 15° to 20°. People who sit in that mid range of tilt don’t get much more by going further back.”

And that 15-20° isn’t enough tilt to attain the amount of tilt needed to perform the pressure relief that clinicians are aiming for.

For those clients, Maurer says, “We tend to tell them, ‘You’ve got to go back, and you also have to come all the way up. Because then you have more degrees going forward, and that also changes pressure from where you were. At that point they’re sitting on their sacrum, so they’ve got to sit up for a short period of time as well as go fully back. Th e whole concept is that you’ve got to move your position in which-ever direction you need to go depending on how you typically sit to change the pressure off that particular spot.”

Speaking of tilting all the way back: Maurer suggests making sure that clients realize how much tilt their systems off er. In the 2009 study, “the perception of tilt angle was oft en misconceived. Th ey thought they were all the way back, but they weren’t. Th ey said, ‘Th is is my fully tilted chair,’ and then you’d press the button and they’d keep going back further. So they think they’re all the way there, but they’re not.”

Adding recline to the system can be another way to achieve pres-sure relief, Love says: “Research is also showing that 25-35° of tilt plus 120° of recline is the optimal pressure-relieving position — especially

for patients with a spinal cord injury, as these individuals pressure map diff erently than control subjects, and put more pressure on the IT [ischial tuberosity] areas (Jan et al., 2013; Park & Jang, 2011).”

Elevating legrests (ELRs), Love adds, can also help to achieve optimal weight shift s for pressure relief. “Research has shown that using tilt in conjunction with recline and ELRs provides a better pres-sure shift than any of the power seat functions alone,” she explains.

When Life Gets in the WaySome of those scenarios — not knowing how much tilt a system off ers or being afraid that a fully tilted power chair will tip over — can be solved through demonstrations and education. Unfortunately, that’s not always the case.

“If was just an education issue, this would be an easily solved problem!” Love says. “A good portion of clients know they are not as compliant as they should be and still fail to follow the guidelines due to the same reasons some people don’t stick to their diets, or diabetics don’t check their blood sugar, etc. It’s a lifestyle change. Perhaps there are a portion of clients who also don’t believe that skin breakdown will happen to them: ‘I’m healthy and I move around a lot’ or ‘I’ve had a spinal cord injury for years and have never done pressure shift s as oft en as you have told me to.’ Th e reasons for non-compliance are very individual, and one needs to get to know the client in order to deter-mine the reasons… in order to come up with solutions.”

Maurer points out that when properly and fully executed, “Tilt is a non-functional position. It highlights their disability, so they don’t want to. A lot of business workers are in meetings where they’re not going to pull back from their table and tilt no matter what I say.”

Th erefore, outside-the-box thinking on the part of the ATP and

curious eyes could make them more willing to perform weight shifts. Maurer says she’s worked with a businesswoman “who is in an offi ce by herself, and she’s still self conscious. I said, ‘Just shut the door so you can do it without worrying about people watching you tilt back.”

● “I’m just stretching”: Maggie Love, OTR, clinical education specialist with Permobil, suggests teaching clients to perform other types of weight shifts that they can use if they feel uncomfortable tilting in public, such as “leaning forward on a desk while doing computer/school work. ‘Stretching’ while leaning to each side was another weight shift that many of my clients felt was more socially acceptable in a public setting.”

● Incorporate technology: Love points out that weight-shift reminders via cell phone, watch or timer “are noticed immediately by the user, but not overly distracting in a public situation.” And don’t overlook the potential value of old-school technology, either. “I even had a client achieve success by using a clicker to log how many weight shifts she performed each day,” Love says. “She was shocked to discover she only performed three weight shifts that fi rst day.” ●

Tilt by the Numbers

Help Your ClientsTransition to a Wheelchair

Free Video from Curtis InstrumentsNot long ago, Conway Policastro, an associate of Curtis Instruments, faced the difficult process of obtaining a wheelchair. We witnessed the complexities he and his family faced in confronting this major lifestyle change, and recognized that many people are in similar situations.

With our years of experience in medical mobility, we knew the Curtis team could help. Together, our ATP-certified mobility expert and our in-house communication agency produced a non-commercial public service video. It offers a step-by-step overview of the wheelchair provisioning process and is filled with valuable information. The honest, heartfelt advice from Conway, a recent wheelchair user, helps guide first-time wheelchair users through the emotional challenges.

To see the video go to

http://tinyurl.com/wheelchairtransition

To download the supporting document describingthe provisioning process go to

http://tinyurl.com/mobilitypdf

Curtis Instruments, Inc. does not build wheelchairs or power chairs and does not market products to wheelchair users.

20 mobilitymgmt.comfebruary 2014 | mobilitymanagement

clinician can be helpful.“Standing can be very benefi cial to decreasing the risk of pres-

sure ulcers — and an integrated system that allows the user to stand without transferring out of the system can increase compliance,” Love says. “Standing is a very functional weight shift , in addition to having many other medical benefi ts, and may be perceived as more socially acceptable.”

Th e assistive technology providers can help to remove potential tilt barriers by making sure clients remain in control of the system throughout the tilt range. Th at’s especially a concern for clients who become progressively weaker and fi nd it harder and harder to reposi-tion their arms on wheelchair armrests.

“Make sure they can access their tilt buttons through the full range of tilt,” she says. “A lot of people who are weak lose contact with the switch when they’re tilted all the way back, so they’re scared and they can’t reach the switch to come back up. Th ey limit how far back they go so they can reach the switch.”

Aiming for Long-Term SolutionsUsing tilt to its maximum eff ectiveness requires a high level of educa-tion — and resolve — from everyone on the seating & mobility team, especially the client.

“It can be tempting to constantly harp on our patients to stick with the established PVA pressure ulcer guidelines,” Love says. “However, it is important to empower the individual to take control of their skin management, which can be an important step in long-term success.

“In addition, it is oft en more helpful to establish yourself as an advocate for the patient and encourage open and honest communica-tion about skin management solutions. I almost think of the weight shift program as similar to a diet. We all know that we should eat healthy, small portions throughout the day as well as regularly exer-cise — however, we don’t always do this. We get tired, social obliga-tions get in the way, etc. Th e most successful lifestyle changes are ones that are incorporated seamlessly in our daily lives — made convenient with minimal barriers.”

Sonenblum suggests taking time to train new tilt users: for example, “Make sure the client knows that a full tilt feels like [and] that they are comfortable, not afraid that the chair will tip over.”

And even those frequent less-than-extreme tilts can be encouraged, she says.

“Of course, there’s value in recommending that people move around between pressure reliefs. When they are not tilting all the way back, lots of small movements might help.” ●

Seating & Positioning Series

Tilt by the Numbers

www.Qstraint.com/DiOR

Experience the power of combining the advanced QLK-150 docking station with DiOR – the Drive-in Occupant Restraint system.

Adding the DiOR to a QLK system delivers a new level of safety, security, independence and convenience. DiOR’s pivoting arms move forward as you enter with your power chair, providing you with the right lap belt angles every time.

DiOR is the first and only crash tested occupant belt for docking systems.

www.Qstraint.com/QLK-150

22 mobilitymgmt.comfebruary 2014 | mobilitymanagement

Here’s a number for you: 1.2 billion. Th at’s the number of media impressions that National Mobility Awareness Month made

in 2012, according to Dave Hubbard, CEO/executive director of the National Mobility Equipment Dealers Association (NMEDA).

Th at incredible number is also indicative of the inroads made by the automotive mobility industry in the mainstream media and the minds of the mainstream public, many of whom undoubtedly didn’t know that adaptive automotive equipment even existed beforehand.

National Mobility Awareness Month — again scheduled for May, with associated activities starting in February — is probably the best known and most widely publicized of NMEDA’s projects, but it’s just one of many priorities for the organization this year.

Grass-Roots SuccessTh e culmination of National Mobility Awareness Month is the announcement of consumers who have been elected, through public voting, to receive free mobility vehicles customized to their needs.

Th e contest invites consumers to submit their personal stories and to explain how a new mobility vehicle would impact their lives. Families, friends and entire communities have rallied around contest participants to drum up support and votes.

Th e Awareness Month campaign won a regional marketing award in Florida and won an honorable mention for Integrated Communications Campaigns from the American Society of Association Executives.

Educating Both Consumers & Policy Makers Will Remain a Top Priority in 2014

Automotive Access Special

By Laurie Watanabe

mobilitymgmt.com 23 mobilitymanagement | february 2014

As for those 1.2 billion impressions from a contest that was held for just the second time last year, Hubbard says, “It is amazing, consid-ering it was a grass-roots PR campaign that started as a social media eff ort. We’re really proud of the eff ort, and it seems to be generating more and more awareness for the solutions that are available out there and where to buy them. We hope that it generates positive awareness for NMEDA and its members.”

Th at awareness is critical. Behind the contest’s entertainment value and good-natured competition is the very real fact that too many people with mobility disabilities, their families and caregivers remain unaware of adaptive automotive solutions and the professionals who specialize in them.

Th e program is now in its third year, and Hubbard has noticed a change in entrants’ approaches.

In its inaugural year, he recalls, “We got a lot of ‘I need, I need, I need.’ But the second year, they caught onto the idea that we were looking for the inspirational stories. It is a question of need in a lot of cases, but it’s also a question of ‘What are you doing in your life to be inspiring to other people with disabilities or other people who need help?’”

Industry-Wide DonationsIn return, the mobility industry has come together to donate equip-ment and expertise to ensure that the winners receive vehicles that are individually customized to their particular needs.

While the automotive manufacturers — such as Chrysler and Toyota, who have already agreed to donate new vehicles for the 2014 contest — oft en get the most attention for their contributions, Hubbard points out that many other sponsors also donate products to make customizations possible.

“Our own manufacturers — Braun, VMI, some of the smaller ones like Q’Straint and Drive-Master — they’ve all stepped up and donated products to this,” Hubbard says. “Th e way it works is that we have a van donated and we get a conversion donated. And then the smaller manu-

facturers, like Sure Grip, MPS Hand Controls, Drive-Master, donate all the parts. Th ey’ve all stepped up, and NMEDA coordinates it.”

One vehicle winner last year was from Canada, making the Mobility Awareness Month program a genuinely international aff air.

Even contestants who don’t win a vehicle can gain valuable atten-tion through their campaigning eff orts.

“Local news programming or newspapers and media are picking up on the heroes who are campaigning,” Hubbard says. “Th e whole point is that you’ve got people out there with disabilities who are campaigning for votes and getting people to vote. And in their campaigns, social media is out there, and the media is tracking what’s going on. A lot of these stories are being picked up locally.

“A lot of times the local community will get involved to support this hero, and it just begins to mushroom. Th e really beautiful thing from our standpoint is it generates awareness for mobility solutions and comes back to that age-old problem in our industry: that people just don’t know what’s available.”

Educating Policy-MakersNMEDA’s 2014 educational plans don’t end with consumers and caregivers. Hubbard says the organization will continue to spread the word about the value of the technology and its professionals to policy-makers, as well.

“Our government relations eff orts this past year have focused on Congress and the VA (Veterans Aff airs),” he notes. “We’ve been trying to get the VA to establish criteria for selecting mobility dealers; they don’t have anything in place right now. Th ey can send [a veteran in need of mobility equipment] to anybody, whether they’re qualifi ed or not. And we’ve got veterans that don’t even know there’s a [mobility equipment] grant program out there for them.”

NMEDA is also working to teach the value of its members’ experi-ence and expertise to other funding sources.

“We’ve been trying to focus on getting ourselves introduced or

Seniors in the Spotlight for 2014 Mobility Contest The free vehicle giveaway is the high point of

the mobility industry’s National Mobility Awareness Month project, with entire communities rallying around their local heroes in hopes of voting them to victory. In late February, the mobilityaware-nessmonth.com Web site will start accepting contest submissions, with winners announced in May.

But there are changes to the contest for 2014, says Dave Hubbard, CEO/executive director of the National Mobility Equipment Dealers Association (NMEDA).

“This year we have three categories: people with disabilities, caregivers — they can talk about people they care for — and seniors,” Hubbard says. “We want to make sure that seniors get an even play in this because we realize that while seniors these days are technically adept and know about Twitter and Facebook, they may

not have the social networks that young people do. So we want to be sure that it’s fair and that they have an equal shot."

Making seniors aware of mobility equipment is a prime NMEDA goal, Hubbard says, since seniors often don’t get the sort of assistive technology education that’s provided by rehab hospitals or clinics that specialize in mobility-related conditions like spinal cord injury.

“If you’re aging into a disability, you probably have no idea what’s available to help you out there,” Hubbard points out.

The industry supports the contest by donating vehicles, conver-sions, customized adaptive equipment and related installation services to the winners. Hubbard says Chrysler and Toyota have already committed to donating vehicles for the contest. ●

24 mobilitymgmt.comfebruary 2014 | mobilitymanagement

automotive accessibility

Spirit APSThe Adjustable Positioning System (APS) car seat can accommodate both little kids (from 25 lbs.) and big kids (up to 130 lbs. and 5'6" in height). Its low-profi le sides make transfers easier, and the Spirit APS can be outfi tted with positioning options such as swing-away adjustable trunk supports, hip supports and an abductor. The multiple accessories grow with the child.

Columbia Medical(800) 454-6612columbiamedical.com

TrekAway Lift sThe TrekAway Independence series off ers fully automatic lifts with simple, nearly eff ortless operation and a 350-lb. lifting capacity (400-lb. option available). SmartPoint technology enables the lift to fold out of the way when operated. The TrekAway series includes a wide range of accessories so consumers can customize their lifts to meet their particular transportation needs.

Prairie View Industries(800) 554-7267pviramps.com

IDS LEESSThis modifi ed electric steering system reduces the eff ort needed to operate an OEM electronic power steering system. Via the LEESS system, the eff ort required can be set from zero to the factory standard amount. LEESS includes a built-in backup system and dual battery. The system continues to provide reduced-eff ort steering even after a loss of ignition or total engine failure. The system can be returned to the OEM settings with the push of a button.

Drive-Master Co. Inc.(973) 808-9709drive-master.com

mar

ketp

lace

reintroduced to a number of the state [vocational] rehabilitation departments, and talking to them about what our dealers do and the fact that they’re audited every year against a given set of criteria,” Hubbard says. “We’re basically asking [the departments] to make it easy on themselves and choose NMEDA dealers to do their work.”

One of the legislative items on NMEDA’s watchlist concerns auto-motive franchise laws, Hubbard adds.

“We’ve got a couple of state legislative eff orts going on with respect to licensing mobility dealers in states where the states have held up franchising laws that might — they have not yet, let’s make that clear — but could in fact prohibit the sale of mobility vehicles from mobility dealers because they don’t have a new car franchise license with their OEM,” he says. “It’s just a gap in the law, so wherever that exists we go in and correct that situation. We’ve been successful in about seven states, so that’s good.”

NMEDA and its members also expect to continue sharing a general message about the organization’s criteria and the special skills that a NMEDA mobility dealer has.

NMEDA’s Quality Assurance Program (QAP), originally an optional upgrade for organization members, became mandatory in 2011.

Asked if the new QAP standard has had a positive eff ect, Hubbard says, “It’s helped a lot. We don’t have a dual standard at NMEDA anymore. When we go in and talk to Congress or make [Capitol] Hill visits, we can say unequivocally, ‘Th is is what our members stand for’: the training, the facilities that they have to have, and so forth. And it helps us in that we don’t have to try to service two diff erent statuses of members. We’re able to tighten up the QAP program, make it stronger and more defi nitive, which gives you a stronger platform to stand on when you’re talking to government offi cials or telling somebody that they need to put criteria in place — and if it’s not QAP, it should be very similar to QAP.”

Given that a mobility dealer is called upon to do comprehensive mobility assessments, anticipate clients’ clinical progressions, stay up to date on the latest equipment applications, work with referral and funding sources, collaborate with driver rehabilitation specialists, and install and service a wide range of products — Hubbard believes that the QAP actually comprises the most basic standards.

“To me, it really is the minimum requirements for getting into business as a mobility dealer. It is the highest standard in the industry, but it is still a minimum standard of what a dealer should be doing.” ●

Automotive Access Special

Making Inroads

mobilitymgmt.com 25 mobilitymanagement | february 2014

Pathfi nderThe newest lift in the Aqua Creek family, the Pathfi nder can support 300 lbs. and is the company’s most aff ordable ADA-compliant lift. The sleek, compact design was created to fi t any commercial or residential pool deck and to blend right into the environment. The stainless steel construction and white powder-coated fi nish make Pathfi nder a durable solution. Path-fi nder weighs 120 lbs. and stands 48.25" tall.

Aqua Creek Products(406) 549-0769aquacreek.com

No-Drill Grab BarThanks to their patented mounting hardware, these grab bars don’t require drilling or profes-sional assistance to install in minutes. The grab bars come complete with all necessary attach-ment materials and can be added to almost any room in the house to improve safety and security. Limited lifetime warranty.

Drive Medical(877) 224-0946drivemedical.com

Omni Transfer SystemAble to perform multiple functions in the home, the Omni system can be used as a bed-side commode, an over-the-toilet commode, a roll-in shower chair and a bath slider. The tub base transfer frame folds for easy storage, and the Slider Safe Auto-Stop Safety System prevents the chair from coming off the base. Custom tub lengths are available. Caregivers can upgrade to the next size of the Omni for a fraction of the cost of a new system.

Columbia Medical(800) 454-6612columbiamedical.com

Milford Person Lift With a lifting capacity of 300 lbs., the Milford Person Lift off ers a highly adaptable and versa-tile way to transfer consumers from wheelchair to vehicle. The lift is designed to be quick and easy for consumers to operate. The Smartbase option can be used in traveling situations to take the Milford lift along for the ride.

Pride Mobility Products(800) 800-8586pridemobility.com

Recaro Monza RehaDesigned to provide superb positioning in the car for kids with special needs, the Monza Reha booster seat features adjustable lateral sup-ports and a full-range positioning harness. The popular swivel base makes it easy for parents to transfer children in and out of the seat. The lightweight (12-lb.) seat is also easy to move from vehicle to vehicle as needed. With weight capacities of 33.1 to 110.2 lbs, and with back heights of 23.6" to 30.3".

Thomashilfen(866) 870-2122thomashilfen.us

QRT-360 RetractorQ’Straint’s new QRT-360 is a four-point, heavy-duty, fully automatic retractable tie-down system that has performed successfully in a 30-mph frontal crash of a WC19 power wheelchair and lapbelt in a motor vehicle. The shorter retractor footprint allows more fl exibility in vehicle anchor points to better accommodate larger chairs. The QRT-360 meets RESNA’s higher-strength WC18 requirements that will take eff ect in December 2015.

Q’Straint(800) 987-9987qstraint.com

automotive accessibility

home & environmental accessibility

marketplace

marketplace

26 mobilitymgmt.comfebruary 2014 | mobilitymanagement

home & environmental accessibility

Helix Curved Stairlift Going up! This next-generation stairlift features an ultra-smooth ride and quiet operation. The new True-Curve rail was designed to provide smoother transitions and tighter bends so it can mount more closely to the wall. The ergonomic seat has a standard manual swivel feature and fl ip-back arms for easy transfers. The simple-to-connect rails and lighter chassis will be welcomed by dealers doing the installations.

Harmar(800) 833-0478harmar.com

Rio Bath Lift The Rio’s modern design features an aluminum frame and smooth surfaces that are easy to keep clean. Its small footprint makes the bath lift easy to move from place to place and convenient to store when it’s not in use. The installation requires no tools, and the Rio can be assembled by the end user or caregiver.

Invacare Corp.(800) 333-6900invacare.com

VPL Express DeckDesigned to help easily complete vertical plat-form lift (VPL) installations, the new VPL Express Deck off ers an attractive and universal solution that requires no construction or building per-mit. The deck features a standard 5x5' landing area and adjusts for rises up to 4'. Units can be combined to create a larger deck. The deck is all aluminum with powder-coated handrails. Its universal design allows VPL handrails, doors and steps to be positioned on any side.

Harmar(800) 833-0478harmar.com

mar

ketp

lace

• • • • •

mobilitymgmt.com 27 mobilitymanagement | february 2014

Advance Bath ChairAvailable in four sizes, the Advance can ac-commodate consumers up to 159 lbs. The removable cover is washable, and the Advance features a lap belt and adjustable lateral guides made of mesh material. Options include an abduction belt, a headrest and a shower trolley. A standard adjustable frame provides multiple positioning options. The seat cover is available in six colors (we’re a fan of the pink!).

Ottobock(800) 328-4058ottobockus.com

Serta Perfect Lift ChairConsumers will recognize the Serta name, and this lift chair has plenty of special features — including premium Cool Action Gel Memory Foam for cooling comfort and support — to live up to that reputation. The chair boasts a premium Dacron top layer and Pirelli webbing for comfort that’s personalized, plus individually wrapped coil springs and a No-Sag spring base.

Pride Mobility Products(800) 800-8586pridemobility.com

C500 VS StanderWhen reaching a top shelf requires a diff erent and higher perspective, Permobil’s C500 VS standing power chair delivers. In addition to its standing function, this chair off ers power tilt (0-25°), power recline (90-175°), 10" seat elevator, and power elevating legrests (90-175°) that function independently of tilt/recline. Con-sumers can drive up to 1.5 mph while standing (with a top speed of 5 to 6.5 mph while seated). The C500 VS has a 265-lb. weight capacity.

Permobil(800) 736-0925permobil.com

home & environmental accessibilitym

arketplace

28 mobilitymgmt.comfebruary 2014 | mobilitymanagement

6-Inch CastersNow available for the M300 and M400 power bases: 6" casters to provide tighter front-legrest positioning and improved maneuverabil-ity, since the chair can maneuver with its legs at 90° angles. Permobil reports minimal loss in climbing performance vs. the larger 8" casters, which also remain available. The 6" casters can be ordered as a custom-ization for the M300 HD (heavy-duty) power base.

Permobil (800) 736-0925permobil.com

Glide Suspension ForkAs wheelchairs roll forward, their front wheels are the fi rst to meet the bumps in their way. The Glide is designed to maximize vibration dampening in both horizontal and vertical directions, thus minimizing vibration transfer to the consumer. The Glide is available in dual and single-sided fork designs and comes in three diff erent durometers (elas-tomer hardnesses) based on rider weight. Currently available on new TiLite chairs — Out-Front is seeking more OEM partners — the Glide was invented and tested by Human Engineering Research Laboratories, a joint venture of the University of Pittsburgh and the VA Pittsburgh Healthcare System.

Out-Front(480) 833-1829out-front.com

Folding Steel WalkerBenefi tting from steel’s strength and durability but while maintain-ing the lightweight convenience found in aluminum models, this walker features easy push-button folding, newly designed rear glide caps for smooth sliding over most surfaces, vinyl contoured hand grips and 5" wheels. Height adjustable so consumers can choose the most comfortable confi guration.

Drive Medical (516) 998-4600drivemedical.com

Vertical Platform Lift sThis new indoor/outdoor line of vertical platform lifts can provide direct access to almost any area in a home and can be adjusted to the height required by the wheelchair user. The lifts have an easy-to-use control paddle and key lock for safe and reliable operation. Standard features include 42" high solid side panels, automatic folding access ramp, emergency stop switch, non-skid platform and ramp, and powder-coated fi nish with weather-sealed controls.

Butler Mobility (888) 847-0804butlermobility.com

product revue

TRAAs the newest member of TiLite’s titanium chair line, the TRA takes the TR — the manufacturer’s fl agship — and adds the benefi ts of full adjustability. Features include a dual-tube frame geometry that stiff ens the chair and transfers more of each push stroke directly to the forward motion of the chair. The TRA is also “TiFit,” a made-to-measure wheeled prosthetic built to fi t just one person. Choices of colors, wheels, handrims, tires, wheel locks, tattoos, etc., ensure that each TRA is as unique as its owner.

TiLite (800) 545-2266tilite.com

mobilitymgmt.com 29 mobilitymanagement | february 2014

ad index

Alumiramp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Aqua Creek Products . . . . . . . . . . . . . . . . . . . . . . . .27

Columbia Medical . . . . . . . . . . . . . . . . . . . . . . . . . .26

Curtis Instruments . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Freedom Designs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Harmar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6, 7

Open Sesame . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Ottobock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Permobil . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32

Pride Mobility Products/Quantum Rehab . . . . . 3

Q’Straint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21

SKYLINK Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

Group Publisher Karen Cavallo(760) 610-0800

Nat’l Sales Manager Caroline Stover(323) 605-4398

Sales Assistant Lynda Brown(972) 687-6710

Advertising Fax (866) 779-9095

advertisers’ index Company Name Page # Company Name Page #

mob

ility management

editorial advisory board

editorial advisory board MM Editorial Advisory Board Josh Anderson TiLite

Pat Boardman Consultant

Lois Brown National Seating & Mobility

Jay Doherty Quantum Rehab

Rick Graver Medtech Services

Ryan Hagy Numotion Rita Hostak Sunrise Medical

Julie Jackson Invacare Corp.

Karen Lundquist Ottobock

Joe McKnight Aero Mobility

Amy Morgan Permobil

Julie Piriano Pride Mobility Products/ Quantum Rehab

Lauren Rosen St. Joseph’s Children Hospital of Tampa

Jean Sayre Comfort Company

Mark Smith Wheelchairjunkie.com

Stephanie Tanguay Motion Concepts

Cody Verrett ROVI

Company Name Page # Company Name Page #

accessibility marketplace

Aqua Creek Products. . . . . . . . . . . . . . . . . . . . . . 25

Columbia Medical. . . . . . . . . . . . . . . . . . . . . .24, 25

Drive-Master Co. Inc. . . . . . . . . . . . . . . . . . . . . . . 24

Drive Medical. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Harmar. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Invacare Corp.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Ottobock. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Permobil. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Prairie View Industries. . . . . . . . . . . . . . . . . . . . . 24

Pride Mobility Products . . . . . . . . . . . . . . . .25, 27

Q’Straint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Thomashilfen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Company Name Page # Company Name Page #

product revue

Butler Mobility. . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

Drive Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

Out-Front . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

Permobil . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

TiLite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

30 mobilitymgmt.comfebruary 2014 | mobilitymanagement

National NHIC Corp. has released the results of a widespread prepayment review for Medicare consumer power chair claims processed in the third quarter of 2013.

The review is for Group 2 power wheelchairs in the K0823 HCPCS code, defi ned as having captain’s-style seating and a user weight capacity up to and including 300 lbs.

For the July 1-Sept. 30 review period, NHIC, the Jurisdiction A DME MAC, examined 333 claims submitted by 132 diff erent suppliers, who were issued Additional Documentation Requests (ADR).

For 79 of the claims, NHIC said it did not receive the required additional documentation.

Of the 254 claims for which suppliers did provide additional documentation, NHIC said 98 claims were allowed, and 156 claims were denied.

“The total denied allowance amount — dollar amount of allowable charges for services determined to be billed in error — divided by the total allowance amount of services medically reviewed resulted in an overall charge denial rate of 52.8 percent,” NHIC said in a Dec. 27 bulletin.

A Decline from Previous QuartersThe 52.8-percent charge denial rate was a sharp decline from previous quarters’ rates. The second-quarter 2013 denial rate was 82.8 percent; the rate for the fi rst quarter of 2013 was 86.6 percent.

NHIC Reports Q3 Power Chair Review Results

briefl y…Attention, funding specialists: Th e next time you’re electroni-cally billing a HCPCS code with a narrative description that indicates “not otherwise clas-sifi ed” (NOC), unlisted or nonspecifi ed, the DME MACs are reminding you that you must include “in the SV101-7 segment for HIPAA 5010A1 claims, a concise description of the NOC code” or else the claim will be rejected by the CEDI. In loop 2400, segment NTE01 of the ANSI X12N, version 5010A1 (electronic claim) or item 19 (paper claim), you’ll also need to provide a concise description of the item being billed; the manu-facturer’s name; the product name and number; the model number and serial number; the MSRP or MSP acronym, plus the manufacturer’s suggested retail price (or “No MSRP,” if the price isn’t available). You don’t have much room — only 80 character spaces — in the line note, so get ready to do your best abbreviating… A new Medicare Learning Network (MLN) “MLN Matters” paper has been released on the upcoming tran-sitions of dozens of DME and complex rehab technology items from the routinely purchased category to the capped-rental category. Th e change takes eff ect April 1 for items that are not part of the Medicare competi-tive bidding program; the items involved in round 2 or the round 1 recompete will transition to the capped-rental category at later dates. To access the MLN Matters paper, type “MLN Matters 8566” into a browser and click on the corresponding cms.gov link. Fift y wheelchair and wheelchair-related HCPCS codes, including adult tilt-in-space chairs and pediatric bases, are impacted by the change. ●

Th e most common reason for denials was one or more issues with the face-to-face exam

cms update

scooter) and missing documentation, including missing physician signatures, signature dates or date stamps.

The second-most commonly seen errors involved issues with the Licensed Certifi ed Medical Professional (LCMP) examination (e.g., the LCMP exam was missing the physician’s agreement or disagreement with the OT or PT evaluation). Detailed product description errors were seen in 20.1 percent of denied claims, while 19.3 percent of denied claims had seven-element order problems, and 13.4 percent of denied claims had problems with home assessments.

“Based on the results of this prepayment review, DME MAC A will continue to review claims billed with HCPCS K0823,” NHIC stated.

More than One ErrorNHIC provided examples of actual claim denials from third-quarter 2013 and noted that some denied claims contained more than one error.

For instance, in the fi rst example provided, NHIC said the claim’s seven-element order didn’t include the length of time that the power chair would be needed and was missing the date of the face-to-face examination.

Also: “The seven-element order and face-to-face examination did not include confi rma-tion that the supplier received a copy of these documents within the 45 days of the comple-tion of the face-to-face examination as veri-fi ed with a date stamp or the equivalent from the supplier,” NHIC said. “The documentation submitted did not contain a detailed product description or proof of delivery.”

Other examples also showed that claims contained multiple errors that ranged from missing confi rmations that documents were received within the prescribed 45 days after the face-to-face exam to the fact that the face-to-face exam “was completed on a supplier-generated form with insuffi cient information regarding the benefi ciary’s specifi c mobility limitations to support medical necessity for [the] power wheelchair.” ●

NHIC said the most common reason for denials was one or more issues with the face-to-face examination. That problem was present in 56.3 percent of claims that were denied.

Specifi c face-to-face exam problems included a failure to demonstrate medical necessity for the power chair (e.g., documentation did not rule out lesser types of mobility equipment, such as a cane, walker or

mobilitymgmt.comIntroducing the NEW

Now there are more reasons than ever to visit your favorite mobility website!

The C500 Corpus® 3G is designed for the collage of life… busy streets, meetings, lunches, entertainment and nightlife. With its independent suspension, the powerful C500 provides a smooth ride over a variety of terrains from sidewalks to grassy parks, while the Corpus 3G seating system offers the ultimate in comfort for your exciting lifestyle.

Permobil.com