Problem Solvers

Zeroing in on Mattress Quality

Reimbursement cuts have put pressure on support surface prices, but where does quality come into the equation? How can providers pick carefully?

Support surfaces have represented a bedrock business for many HME providers over the years, but funding pressures such as competitive bidding and ensuing increased competition have made it harder and harder to profitably provide therapeutic support surfaces.

So providers have had to look at price as a key element in trying to protect their profit margins, and that can potentially open up a can of worms, because then quality becomes an issue. Sure a support surface might meet a provider’s price point, but will it deliver the goods? For how long?

And that’s critical because at the end of the day, the provider must provide a therapeutic support surface that is going to generate a positive patient outcome. Moreover, even if the support surface initially delivers on its therapeutic benefits, will it continue to do so over the long haul?

That’s a legitimate question given than many therapeutic support surfaces are complex DME offerings that involve motors, which must run constantly or near constantly. The last thing the provider needs to do is roll a truck to the patient’s home to replace a motor — or entire support surface, for that matter — that has failed after only a few weeks in service.

And if product replacement becomes a frequent occurrence, the provider is not only in trouble with the patient, but it could be in trouble with the referral partner. If a physician or discharge planner learns that more than one patient has experienced problems with their support surface, that could be the end of the relationship with that provider.

“It makes our industry look bad,” says Ron Resnick, president and owner of Blue Chip Medical Products, a manufacturer of various therapeutic mattresses and wheelchair cushions. “It’s supposed to be durable medical equipment, not disposable medical equipment. … We still have to put out a quality product and be able to service it.”

What to Look For?

This means providers are in a tricky spot: they must run businesses profitably, they must ensure positive patient outcomes, and they must identify good quality support surfaces that are going to ensure they can accomplish both.

For starters, a big consideration is the mattresses motor. Group 2 support surfaces, such as low air-loss, alternating-pressure mattresses, involve blowers and pumps, and those devices have motors that must be dependable. They can product heat, and usually the hotter something runs, the quicker it can break down. The less a motor works, the quieter it will be and the cooler it will run. This will contribute to the devices longevity.

Another key consideration is standards adherence for factors such as fire safety and infection control. Mattresses must comply with the Consumer Products Safety Commission’s 16 CFR Part 1633 rule on mattress flammability. This standard requires the foam materials used in mattresses don’t burn too fast when exposed to open flame and result in a “smaller” fire size The same holds true for infection control in manufacturing. Resnick says that manufacturers must have certification that documents its products and practices adhere to Federal standards and requirements on control infectious materials and microbes.

“We manufacture here [in the United States],” Resnick explains in regards to ensuring the material it purchases for manufacturing complies with infection control standards. “We get bolts of material, we unwind them and put them on a tight winder. We inspect the materials; they go in a light box. We make sure it’s all quality goods. … We have to always certify that we meet infection control standards.

“The same thing goes for fire safety,” he adds. “I’d like to think everyone is compliant. I certainly hope so.”

But at the end of the day, how many providers are going to know what to look at when it comes to fabric or on the inside of a blower motor in order to know that it will last over the long-haul? Moreover, how they going to get access to that motor or that mattress in order to do their inspection?

“How do [providers know]?” Resnick asks. “They’re getting a product bundled, wrapped in a box. They don’t see it.”

But if the provider can get a look at component parts, it should inspect them and learn more about them. For instance, if the provider can see the blower it might be able to determine its origin. Often motors are third party items, which can be researched and priced out to determine which blowers are good quality.

Ultimately, Resnick advises that a provider really get to know a manufacturer before committing its capital to purchasing its mattresses. By learning more about that manufacturer’s processes and procedures the provider can get a much better sense of the quality going into the support surface.

“I can show you empirically how we comply. We send [our product] out to testing laboratories right here in Long Island. We certify everything, such as infection control. We have to, whether it’s a Federal government bid or not. I have no choice — and I also have to sleep at night.”

Final Considerations

Another important consideration is replacement parts, Resnick advises. Does the manufacturer have a solid supply of replacement parts for its mattresses and related equipment? What about for mattresses that it might someday phase out?

If there’s one piece of advice that Resnick says providers should use as their “prime directive” when it comes to assessing mattress quality, it is that you get what you pay for. The temptation might be to go with the lowest-cost option, but the concern is that what’s low-cost on the front end of that purchasing decision might wind up being very costly on the back end. Caveat emptor.

“At the end of the day, I lose a ton of business in the homecare industry, because they say, ‘Why am I going to pay you more money?’” He explains. “Why? Because my product is going to hold is going to hold up, and you’re not going to go out on a Sunday at 10 o’clock at night and change out something.”

This article originally appeared in the April 2016 issue of HME Business.

About the Author

David Kopf is the Executive Editor of HME Business and DME Pharmacy magazine. Follow him on Twitter at @postacutenews.

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