Incurring the expense of ancillary services

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

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

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

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

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

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

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

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

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

I called that tech and visited him recently. He found my batteries severely depleted, regretted the trouble they caused and replaced them. He told me he was not trained to work on all power wheelchairs, so he would not be able to repair any other problem.

We both wonder if there is something else wrong besides the batteries. The battery chargers that come with new power chairs are not the best. In fact, I had to replace the one that came with my last power chair within six months.

At my previous facility the vendor kept my power chair running. Even before Ohio Medicaid's Ancillary Services law, that vendor utilized used parts for my chair when Medicaid would not pay. Many times they got no fee for a facility call to install my batteries. I went to them myself sometimes so they would not incur extra expense.

So now my chair is running. But I wonder if the facility will repair it if I have further trouble, especially if the joystick controller goes out, which can be a costly repair.

The Ohio Medicaid Ancillary Services Law was put in place to balance Ohio's budget. But to me it is an opportunity for facilities to become familiar with the wheelchair needs of their residents. Facilities could also form alliances with vendors or train their own employees to purchase or repair chairs at more reasonable prices. Perhaps this law could cause the cost of custom wheelchairs and their repair to go down.

I have read that some power chairs will be built more like those in the ’70s. Instead of being sleek, they will look more like a manual chair with a motor. The tech said, “The simpler the chair, the easier it is to repair.”

Even though my chair is working, I have been looking into the cost of a used battery charger. Being able to move on my own is quite important because it enhances my well-being. I will not give it up easily.

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