Consultation on Patient Issues
Each day, on the front-lines, visiting health professionals encounter a wide range of patient issues. The combination of products and services you’ll find at Independent Mobility Solutions are unique in our area and represent a valuable resource for the visiting health professionals, caregivers and the patients they serve. As an A.T.S. with the Rehabilitation Engineers Society of North America, and 15 years in the industry, I have experience in a variety of issues frequently encountered when dealing with home care patients. I understand the difficulties of managing your time while going above and beyond the call of duty for your patients. To help solve your patient’s issues in a time efficient manner, I’ve provided some common issues:.

• Accessibility
• Mobility (manual or power)
• Home Safety/Accessibility Evaluation
• Wheelchair Seating & Positioning
• Wound Care
• Transfer Issues
• Home Remodeling for Handicapped Accessibility

For a consultation regarding any of the above issues please fill out the Request for Consultation form. I’ll follow-up with you by email or phone, whichever you prefer. During business hours, please feel free to call me anytime to discuss patient’s issues.

Home Safety
Prior to the PPS payment system enacted in the late 1990s, rehab departments in sub-acute centers were reimbursed for home visits to help prepare patients for discharge. This practice helped identify accessibility issues and other safety concerns. The new system puts the responsibility on the Visiting Health Professional to identify and attempt to rectify any issues. The problem with this approach is the lag time between a patient returning home and a VHP getting involved to resolve the issue. Accessibility issues can be major safety concern. Even though a patient has the ability to climb stairs does not mean it is safe to do so on a regular basis. Exercise is typically an activity performed in a safe and controlled manner. Walking up or down the stairs when necessary is not a safe or efficient way to exercise. The statistics below come from an article on the CDC web site regarding the cost of falls. The statistics provide a stark reminder of how many lives are seriously effected by accidents. Read the article here.

Home Safety Evaluations: If you feel the patient has trouble with access in/out or around the home, don’t hesitate to print the Home Safety Evaluation form and have the patient or caregiver fill it out, or you can fill it out online. I will review the form and call to discuss or set an appointment to do an on site survey.

• More than one third of adults 65 and older fall each year (Hornbrook et al.1994; Hausdorff et al.2001).
• Of those who fall, 20% to 30% suffer moderate to severe injuries that make it hard to get around or live alone and increase the chance of early death (Alexander et al. 1992).
• Older adults are hospitalized for fall-related State Programs injuries five times more often than they are for injuries from other causes (Alexander et al.1992).

Insurance Coverage & pricing information
for Accessibility & Mobility Products

One of the most frequently asked questions I receive relates to insurance coverage for accessibility and mobility products. The Insurance Coverage Chart provides information on additional product lines, insurance details, and private pay price points.

Accessibility Coverage Overview
As a rule the health insurance industry does not cover accessibility items. The reason is the massive cost associated with providing coverage of the accessibility as a concept. For example, if Medicare began covering straight run stair lifts, it would open them up to law suits by patients who need access but are unable to use a stair lift. Patients in power wheelchairs may argue that they’re being discriminated due to their condition. They would say the insurance company was not really providing a stair lift, but access to the patient’s home environment, therefore the insurance company should pay to have an elevator installed in their home and a vertical lift outside.

Occasion Liability Insurance will pay to purchase or rent a stairlift, such as in the case of an auto accident. The VA also covers stair lifts but they have a different process than the typical provider/claim way of doing business. The process takes time and the VA buys stair lifts directly from the manufacturer and uses contract installers.

Powered Mobility Coverage

Powered mobility is covered by most health insurance plans. However the consumer often misunderstands coverage rules. Medicare’s criteria for coverage can be thought of as an industry standard. Medicare will cover powered mobility for patients to use in their home environment. Patients must provide medical evidence that they are unable to propel a lightweight manual wheelchair to navigate within their home.