Providers scramble for solutions as Medline bed recall disrupts market

YARMOUTH, Maine – Medline’s bed recall – and the company’s planned exit from the market – are rippling through the home medical equipment (HME) industry, leaving providers grappling with operational, financial and patient care challenges.

Medline has not disclosed how many products are affected, but the U.S. Food and Drug Administration lists 771,127 affected units.

Medline guidance creates uncertainty

The company’s shifting guidance has left some HME providers uncertain about how to respond. Most recently, on Oct. 26, Medline said customers can continue using Medline Brand beds, rails, mattresses and accessories in accordance with revised instructions.

“With this continual guidance, we haven't, as a company, made a firm decision as to exactly what we're going to do, because there seems to be all this conflicting information,” said Michael McDonald, president and owner of Weymouth, Mass.-based Clinical 1 Home Medical.

In the guidance, Medline also outlined two possible paths for affected beds: Customers may have certain existing beds repaired, or customers may receive a replacement or full or partial refund of the original purchase price.

For McDonald, that offered some relief.

“If we have to replace all the beds, which is what I (previously) thought, that is financially and operationally an absolute disaster,” he said.

Hospital bed supply crunch deepens

As providers that rely on Medline seek alternative manufacturers, the sudden shift in demand is putting pressure on hospital bed supplies across the industry.

“A month ago, we were on a three- to four-week backorder (with Drive Medical), and now it's getting even longer,” said Nikki Short, managing director for Austin Medical Supplies in Easton, Md. “Other suppliers in our region are completely out of beds. We're getting calls daily about the status of beds.”

Drive Medical says it has accelerated manufacturing, expanded distribution capabilities and increased inventory commitments to help ensure product availability. The company also expects additional inventory to become available beginning in mid-November, supported by a new distribution center in Savannah, Ga.

HME providers face tough choices

The shortage is already forcing providers to make difficult decisions about how to preserve available inventory.

Ryan Cordeiro, who is waiting for about 30 beds, says he’s triaging his current inventory, holding off on cash sales and prioritizing hospital discharges.

“I value them going home prior to a sale that I can get today,” said Cordeiro, COO of Springfield, Mass.-based Louis & Clark Medical Supply. “I need to keep my referrals happy and I have to make sure that people are safe in their own homes. So, I'm trying to juggle the moral dilemma and the operational dilemma.”

Cordeiro says he’s also contacted families of deceased patients to locate unused bed components.

Competitive bidding’s impact resurfaces

For provider Steve Ackerman, the current disruption highlights the longer-term consequences of Medicare’s competitive bidding program, which has significantly driven down reimbursement for beds.

His company, Spectrum Medical in Fairfax, Va., stopped carrying Medline beds six or seven years ago because of quality concerns and the volume of repairs required.

“Medline stepped in and did what any good business would do and filled a void for a price point for this bed,” said Ackerman, CEO. “Now, there are only maybe two or three players left that are big enough to fill this void. The question is, how quickly.”

Medicare policy questions loom

The Medline recall could also create policy complications. Many affected beds were obtained through Medicare’s capped rental program, while others were sold directly to consumers or facilities.

The situation may also raise questions around Medicare’s five-year replacement rule if patients need new beds before they would normally qualify for replacement equipment.

“It becomes a slippery slope as to who is responsible for what,” Ackerman said.