I was just looking for a phone number or address to file a complaint with Medicare for the deficient wheelchair Medstar Surgical provided me with and came across Medicare's definition of abuse:
Abuse occurs when doctors or suppliers don’t follow good medical practices...
Sound familiar anyone? Sounds a lot like the care I am getting from St. Charles too.
Monday, April 18, 2011
Medstar Surgical Piloting a Ship of Fools and St. Charles Hospital is On Board!
After waiting ten months for my new wheelchair, six months longer than Medstar promised, I finally got my new wheelchair last week. Finally, I can enjoy the new chair, right? NO FUCKING WAY!
It seems nobody at Medstar or the wheelchair clinic at St. Charles Hospital bothered to consider seat height. The new chair is more than three inches higher than my old chair. Since I can't walk or even stand, I must transfer by sliding across my chair on or off the bed, toilet or recliner. An additional three inches above my existing chair might as well be on the roof!
How could this have been avoided? First, we will go with the obvious - St. Charles' wheelchair clinic did an extensive evaluation of my needs ten months ago. Surely seat height was considered. Or was it?
Medstar could have figured it out when they did a home evaluation. Unfortunately, the home evaluation amounted to measuring a few doorways. If Medstar was more concerned with patient care than pushing another $25,000 wheelchair out the door, maybe they would have measured the height of my bed and toilet.
Maybe if Gail Ferrentino-Walsh of Medstar and Rudy Rogers, Pride Manufacturing's representative, made good on the offer of a loaner chair back in the fall, I could have discovered the problem for them, months before the chair was even ordered.
Maybe if Medstar provided me with the documentation I requested, this could have been avoided. But, of course, they refused.
Or maybe it is contained in my medical records at St. Charles' wheelchair clinic? I requested my records seven weeks ago, but I have heard nothing from Laura Beck, St. Charles Director of Outpatient Rehab. Another opportunity to get it right was missed.
What facts are Medstar Surgical and St. Charles Hospital hiding? Why is it so hard to get information from them? With just a modicum of transparency, most of the problems they created could have been avoided. Or is honesty bad for business?
My most recent letter to Medstar and St. Charles follows:
Marc E. Charest
256 Sebonac Road
Southampton, NY 11968
April 18, 2011
Mr. Gerry Dickerson Director of Rehab
Medstar Surgical and Breathing
15-40 128th Street
College Point, NY 11356
(and)
Ms. Laura Beck, Director of Outpatient Rehab
St. Charles Hospital
200 Belle Terre Road
Port Jefferson, NY 11777
Re: New wheelchair.
Dear Sir & Madame,
Six months after it’s expected arrival, I finally got my wheelchair at the St. Charles wheelchair clinic on April 11. Upon arriving home, I was shocked to realize this new chair was unusable - it is more than three inches higher than my existing chair. FYI- my current chair, a Permobil, has all the same power functions as the new chair, so a suitable power chair can be built. The new chair also lacks the removable abductor bolsters discussed at my evaluation.
After Pride Manufacturing’s rep Rudy tried lowering my chair Friday April 15, I decided to give it another chance over the weekend. Rudy was only able to lower it about three-quarters of an inch.
The excessive height of the new chair makes it impossible for me to transfer from the toilet to the chair. Sunday morning, while home alone, it took me 15 minutes to get into the wheelchair from the toilet. In the process I pulled a muscle in my lower back. My toilet is two and a half inches higher than a standard toilet already, and it would have to be raised an additional three inches to make transfers safe.
Transferring from my bed to the chair is marginally easier, but I expect that would also be a source of pulled muscles in the future. Raising my bed or toilet enough to match the chair’s height would make them too high for my feet to reach the ground comfortably. That would also make it impossible for me to get dressed or do exercises and physical therapy at my bed.
Compared with all the detailed information collected during my evaluation at the wheelchair clinic, the cursory home evaluation done by Medstar involved measuring door widths only. The person doing the home evaluation had a tape measure. What would have been the difficulty in doing a comprehensive home evaluation?
Both of your corporations failed to consider the elemental issue of seating height. After waiting an incredible ten months, six months past Medstar’s salesperson’s estimate of October 2010, I am now no closer to a useable power chair than I was in June 2010 when this comedy of errors began. How much longer will it take before I get the chair I need? When will someone, anyone, step up and make this right?
Mr. Dickerson- no more emails. I expect you to respond with a phone call or in writing. Please stop hiding behind “policy” and blaming Medstar’s continuing failures on “difficulties with Medicare”.
Ms. Beck- On February 28 I received a call from you promising help. After I wrote another letter and left two messages for you, I have still not heard from you.
One or both of your organizations created a problem that could easily have been avoided. I recommend you confer with each other before responding. In your response, I need to know how you will expeditiously provide me with an adequate wheelchair that finally meets my needs. I am unwilling to waste an untold number of months waiting due to your mistakes.
Sincerely,
Marc Charest
c.c.
US Rep. Timothy Bishop
Ms. Kim Smith, Attorney
Pride Manufacturing
It seems nobody at Medstar or the wheelchair clinic at St. Charles Hospital bothered to consider seat height. The new chair is more than three inches higher than my old chair. Since I can't walk or even stand, I must transfer by sliding across my chair on or off the bed, toilet or recliner. An additional three inches above my existing chair might as well be on the roof!
How could this have been avoided? First, we will go with the obvious - St. Charles' wheelchair clinic did an extensive evaluation of my needs ten months ago. Surely seat height was considered. Or was it?
Medstar could have figured it out when they did a home evaluation. Unfortunately, the home evaluation amounted to measuring a few doorways. If Medstar was more concerned with patient care than pushing another $25,000 wheelchair out the door, maybe they would have measured the height of my bed and toilet.
Maybe if Gail Ferrentino-Walsh of Medstar and Rudy Rogers, Pride Manufacturing's representative, made good on the offer of a loaner chair back in the fall, I could have discovered the problem for them, months before the chair was even ordered.
Maybe if Medstar provided me with the documentation I requested, this could have been avoided. But, of course, they refused.
Or maybe it is contained in my medical records at St. Charles' wheelchair clinic? I requested my records seven weeks ago, but I have heard nothing from Laura Beck, St. Charles Director of Outpatient Rehab. Another opportunity to get it right was missed.
What facts are Medstar Surgical and St. Charles Hospital hiding? Why is it so hard to get information from them? With just a modicum of transparency, most of the problems they created could have been avoided. Or is honesty bad for business?
My most recent letter to Medstar and St. Charles follows:
Marc E. Charest
256 Sebonac Road
Southampton, NY 11968
April 18, 2011
Mr. Gerry Dickerson Director of Rehab
Medstar Surgical and Breathing
15-40 128th Street
College Point, NY 11356
(and)
Ms. Laura Beck, Director of Outpatient Rehab
St. Charles Hospital
200 Belle Terre Road
Port Jefferson, NY 11777
Re: New wheelchair.
Dear Sir & Madame,
Six months after it’s expected arrival, I finally got my wheelchair at the St. Charles wheelchair clinic on April 11. Upon arriving home, I was shocked to realize this new chair was unusable - it is more than three inches higher than my existing chair. FYI- my current chair, a Permobil, has all the same power functions as the new chair, so a suitable power chair can be built. The new chair also lacks the removable abductor bolsters discussed at my evaluation.
After Pride Manufacturing’s rep Rudy tried lowering my chair Friday April 15, I decided to give it another chance over the weekend. Rudy was only able to lower it about three-quarters of an inch.
The excessive height of the new chair makes it impossible for me to transfer from the toilet to the chair. Sunday morning, while home alone, it took me 15 minutes to get into the wheelchair from the toilet. In the process I pulled a muscle in my lower back. My toilet is two and a half inches higher than a standard toilet already, and it would have to be raised an additional three inches to make transfers safe.
Transferring from my bed to the chair is marginally easier, but I expect that would also be a source of pulled muscles in the future. Raising my bed or toilet enough to match the chair’s height would make them too high for my feet to reach the ground comfortably. That would also make it impossible for me to get dressed or do exercises and physical therapy at my bed.
Compared with all the detailed information collected during my evaluation at the wheelchair clinic, the cursory home evaluation done by Medstar involved measuring door widths only. The person doing the home evaluation had a tape measure. What would have been the difficulty in doing a comprehensive home evaluation?
Both of your corporations failed to consider the elemental issue of seating height. After waiting an incredible ten months, six months past Medstar’s salesperson’s estimate of October 2010, I am now no closer to a useable power chair than I was in June 2010 when this comedy of errors began. How much longer will it take before I get the chair I need? When will someone, anyone, step up and make this right?
Mr. Dickerson- no more emails. I expect you to respond with a phone call or in writing. Please stop hiding behind “policy” and blaming Medstar’s continuing failures on “difficulties with Medicare”.
Ms. Beck- On February 28 I received a call from you promising help. After I wrote another letter and left two messages for you, I have still not heard from you.
One or both of your organizations created a problem that could easily have been avoided. I recommend you confer with each other before responding. In your response, I need to know how you will expeditiously provide me with an adequate wheelchair that finally meets my needs. I am unwilling to waste an untold number of months waiting due to your mistakes.
Sincerely,
Marc Charest
c.c.
US Rep. Timothy Bishop
Ms. Kim Smith, Attorney
Pride Manufacturing
Wednesday, March 16, 2011
What Medstar Surgical Fails to Acknowledge
Gerry, your attempts to explain the overwhelming problems with documentation issues with Medicare are not in vain. I understand them. The "small delay" you identified spanned more than five months! Gail Ferrentino-Walsh said the chair would be ready by October 2010. The lies began in September, as Gail's assistant, Janine Radice, told me on numerous occasions application had been made to Medicare. THE TRUTH IS, YOUR EMPLOYEES LIED REPEATEDLY OVER THE COURSE OF SEVERAL MONTHS! It was only after I threatened legal action while on the phone with Janine was any action taken. You took Gail and Janine off my case because even you could not trust them to act. How on earth is that the fault of Medicare issues?
Is there anyone at Medstar Surgical honest enough to take responsibility for the mistakes your company has made? Or are you callous enough to ignore the fact a disabled man has to bear the burden of your misdeeds?
Still no further word from St. Charles Hospital.
Is there anyone at Medstar Surgical honest enough to take responsibility for the mistakes your company has made? Or are you callous enough to ignore the fact a disabled man has to bear the burden of your misdeeds?
Still no further word from St. Charles Hospital.
Medstar Surgical's Response
March 16, 2011
Mr. Marc Charest
256 Sebonac Road
Southhampton, NY 11968
Re: Wheelchair processed under the Medicare Program
Mr. Charest,
We have tried, in vain, to explain to you the overwhelming problems with the documentation issues with the Medicare Program in the procurement of a powered mobility device.
People just like you all over the country struggle everyday, sometimes for much longer periods of time than you, to get a new power mobility intervention.
We want you to have your chair. We are completely aware of the difference a properly designed device can have in your quality of life. The documentation burden put on suppliers, physicians and clinicians can, and has, caused untenable delays in the service delivery process. The problem remains with the system. Until that is corrected delays will continue.
Medstar identified a gap in our process tracking that caused a small delay and corrected it. We do not now, nor have we ever, been involved in lies or deceit, with you or any other entity we deal with.
The system that was approved by the ADMC process will result in a “no cost” to you. You have Medicare primary and Medicaid secondary to cover those costs
The power base, the power independent tilt, headrest and back that were specified in clinic are covered and approved.
The seat elevator, discussed in clinic, is never a covered item under Medicare. Now that we have the Medicare determination, we have submitted to Medicaid for a determination. Private payment is the only way for this to be included on your chair in the event of a denial from Medicaid
Items that were, or may be not covered, and there for not paid by your insurance can only be provided on a private pay basis. Items not covered or paid for privately will not be included on the new power chair.
We have the affirmative ADMC approval for your chair. Further processing is on hold until you decide the next course of action. As a point of information, to long of a delay in final delivery will render the ADMC approval invalid.
Gerry Dickerson
VP Rehab Technology
Medstar Surgical, Inc.
College Point, NY 11356
Mr. Marc Charest
256 Sebonac Road
Southhampton, NY 11968
Re: Wheelchair processed under the Medicare Program
Mr. Charest,
We have tried, in vain, to explain to you the overwhelming problems with the documentation issues with the Medicare Program in the procurement of a powered mobility device.
People just like you all over the country struggle everyday, sometimes for much longer periods of time than you, to get a new power mobility intervention.
We want you to have your chair. We are completely aware of the difference a properly designed device can have in your quality of life. The documentation burden put on suppliers, physicians and clinicians can, and has, caused untenable delays in the service delivery process. The problem remains with the system. Until that is corrected delays will continue.
Medstar identified a gap in our process tracking that caused a small delay and corrected it. We do not now, nor have we ever, been involved in lies or deceit, with you or any other entity we deal with.
The system that was approved by the ADMC process will result in a “no cost” to you. You have Medicare primary and Medicaid secondary to cover those costs
The power base, the power independent tilt, headrest and back that were specified in clinic are covered and approved.
The seat elevator, discussed in clinic, is never a covered item under Medicare. Now that we have the Medicare determination, we have submitted to Medicaid for a determination. Private payment is the only way for this to be included on your chair in the event of a denial from Medicaid
Items that were, or may be not covered, and there for not paid by your insurance can only be provided on a private pay basis. Items not covered or paid for privately will not be included on the new power chair.
We have the affirmative ADMC approval for your chair. Further processing is on hold until you decide the next course of action. As a point of information, to long of a delay in final delivery will render the ADMC approval invalid.
Gerry Dickerson
VP Rehab Technology
Medstar Surgical, Inc.
College Point, NY 11356
Thursday, March 10, 2011
Letter to Medstar Surgical and St. Charles Hospital
Marc E. Charest
256 Sebonac Road
Southampton, NY 11968
631-259-3828
March 9, 2011
Mr. Zeb Pirzada, CEO
Medstar Surgical and Breathing
15-40 128th Street
College Point, NY 11356
and
Mr. James O’Connor, CEO
St. Charles Hospital
200 Belle Terre Road
Port Jefferson, NY 11777
Re: New wheelchair.
Dear Sirs,
This week, the wheelchair I have been waiting nine months for has finally been approved. The delays were caused by errors, inaction or outright deceit by one or both of your corporations. I have been endeavoring for months simply trying to get someone to provide proper patient care. I have been more than flexible in trying to work with everyone.
The entire purpose of obtaining a new wheelchair was to provide a chair with better back and head support. My current chair is inadequate in this regard. I have endured several months of unnecessary neck and back pain while waiting for the chair that was promised to me by October 2010.
After again consulting with my attorney, I am offering a proposal to resolve this issue once and for all.
First, Medstar and St. Charles will provide, at no cost to me, the wheelchair as approved by Medicare.
Second, in addition to the power options discussed at the wheelchair clinic, I request the seatback also be motorized. In the nine months since my evaluation at the wheelchair clinic, my hands have weakened and I will be unable to operate the seatback angle manually in the very near future. The cost for this will also be borne by your corporations.
I will not compromise on the above proposal. Throughout this ordeal I have been offered nothing but excuses, finger-pointing and platitudes. As I have stated to several people involved, I will not back down.
If the above proposal is not accepted, I fully intend on filing suit to recover treble damages for the costs I have incurred repairing my old wheelchair and any out of pocket costs for my new wheelchair. I estimate this will amount to about $25,000. In addition, I will be seeking compensation for pain and suffering since October 2010 caused by the extended use of the inadequate chair I am using. I have no estimate for that.
I am eager to put this problem behind me, as my only desire is to be comfortable and independent in a wheelchair that works for me. Given all that has transpired and all I have endured, this is a more than reasonable proposal.
I look forward to your response.
Sincerely,
Marc Charest
256 Sebonac Road
Southampton, NY 11968
631-259-3828
March 9, 2011
Mr. Zeb Pirzada, CEO
Medstar Surgical and Breathing
15-40 128th Street
College Point, NY 11356
and
Mr. James O’Connor, CEO
St. Charles Hospital
200 Belle Terre Road
Port Jefferson, NY 11777
Re: New wheelchair.
Dear Sirs,
This week, the wheelchair I have been waiting nine months for has finally been approved. The delays were caused by errors, inaction or outright deceit by one or both of your corporations. I have been endeavoring for months simply trying to get someone to provide proper patient care. I have been more than flexible in trying to work with everyone.
The entire purpose of obtaining a new wheelchair was to provide a chair with better back and head support. My current chair is inadequate in this regard. I have endured several months of unnecessary neck and back pain while waiting for the chair that was promised to me by October 2010.
After again consulting with my attorney, I am offering a proposal to resolve this issue once and for all.
First, Medstar and St. Charles will provide, at no cost to me, the wheelchair as approved by Medicare.
Second, in addition to the power options discussed at the wheelchair clinic, I request the seatback also be motorized. In the nine months since my evaluation at the wheelchair clinic, my hands have weakened and I will be unable to operate the seatback angle manually in the very near future. The cost for this will also be borne by your corporations.
I will not compromise on the above proposal. Throughout this ordeal I have been offered nothing but excuses, finger-pointing and platitudes. As I have stated to several people involved, I will not back down.
If the above proposal is not accepted, I fully intend on filing suit to recover treble damages for the costs I have incurred repairing my old wheelchair and any out of pocket costs for my new wheelchair. I estimate this will amount to about $25,000. In addition, I will be seeking compensation for pain and suffering since October 2010 caused by the extended use of the inadequate chair I am using. I have no estimate for that.
I am eager to put this problem behind me, as my only desire is to be comfortable and independent in a wheelchair that works for me. Given all that has transpired and all I have endured, this is a more than reasonable proposal.
I look forward to your response.
Sincerely,
Marc Charest
What are Medstar Surgical and St. Charles Hospital thinking?
While getting my old wheelchair repaired last week, I spoke with the vendor regarding a new chair. I learned several surprising facts.
First, if I change vendors, I'll need a new evaluation from the wheelchair clinic. No vendor will accept a nine month old evaluation. I had to wait three months to get an appointment at the wheelchair clinic last year. That would put me in June, an entire year after I started this whole fiasco. And then the paperwork starts all over again!
Second, Medicare won't accept an evaluation more than three months old. So how the hell did Medstar Surgical get my nine month old information approved? Were these the dates Medstar and St. Charles' wheelchair clinic have been talking about recently with me on the phone? Have my medical records been changed to cover their asses?
Most frustrating through all this is dealing with the daily back and neck pain I have. The whole purpose of getting a new wheelchair was to have a chair that provided better back and head support. Nine months later, I'm still in the same crappy chair.
Could I have gone with another vendor at any time? Of course. But every time I called Medstar or St. Charles, I was told the paperwork was almost done and delivery was imminent. Changing vendors would waste time as far as I knew. They all did a spectacular job of stringing me along.
Medstar Surgical continues to fail to take responsibility for it's fraudulent actions in supplying my wheelchair. I suspect there will be more to the story too, once I see my full medical record and what was submitted to Medicare.
St. Charles Hospital I believe fails to see it's culpability in the substandard care I have received through the wheelchair clinic. Allowing the antics of Medstar to occur under their watch is foolhardy at best.
First, if I change vendors, I'll need a new evaluation from the wheelchair clinic. No vendor will accept a nine month old evaluation. I had to wait three months to get an appointment at the wheelchair clinic last year. That would put me in June, an entire year after I started this whole fiasco. And then the paperwork starts all over again!
Second, Medicare won't accept an evaluation more than three months old. So how the hell did Medstar Surgical get my nine month old information approved? Were these the dates Medstar and St. Charles' wheelchair clinic have been talking about recently with me on the phone? Have my medical records been changed to cover their asses?
Most frustrating through all this is dealing with the daily back and neck pain I have. The whole purpose of getting a new wheelchair was to have a chair that provided better back and head support. Nine months later, I'm still in the same crappy chair.
Could I have gone with another vendor at any time? Of course. But every time I called Medstar or St. Charles, I was told the paperwork was almost done and delivery was imminent. Changing vendors would waste time as far as I knew. They all did a spectacular job of stringing me along.
Medstar Surgical continues to fail to take responsibility for it's fraudulent actions in supplying my wheelchair. I suspect there will be more to the story too, once I see my full medical record and what was submitted to Medicare.
St. Charles Hospital I believe fails to see it's culpability in the substandard care I have received through the wheelchair clinic. Allowing the antics of Medstar to occur under their watch is foolhardy at best.
What is Medstar Surgical Hiding?
After my letters of February 25, I got a positive response from St. Charles Hospital. I spoke with Laura Beck, director of Patient Care Services (631-476-5606). She was very apologetic about what transpired and promised to help me get what I needed from Medstar. Amazingly however, I haven’t heard from her since.
Medstar, naturally, was absolutely no help. Gerry Dickerson is refusing to release any information regarding my file, claiming it contains proprietary information. How correspondence regarding my medical file could hurt Medstar is beyond me. What are they hiding?
The weekly updates promised by Zeb Pirzada, president of Medstar Surgical, never materialized either.
Medstar, naturally, was absolutely no help. Gerry Dickerson is refusing to release any information regarding my file, claiming it contains proprietary information. How correspondence regarding my medical file could hurt Medstar is beyond me. What are they hiding?
The weekly updates promised by Zeb Pirzada, president of Medstar Surgical, never materialized either.
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