[casluis]

We have been asked to stop giving out crutches to ED patients (because we cannot collect on the charges). We see 38,000 patients a year...many indigent. We do not have a DME license and the hospital is not interested in getting one.
What are other hospitals doing about this?

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[JillR]

I know of a hospital {not the one I work in} that refers people to the city fire department. This department gets used equiptment such as crutches, walkers, wheel chairs, ect by donations made from the public and rents this equiptment to the public for about 5 dollars for an allotted amount of time. It's great PR for the fire dept and it really cuts costs for the patients. It's a very successful program all around. Maybe someone could set something like this up where you live.

Cal, I understand the fiscal reasoning behind the crutches, but they certainly can't send someone out the door with a simple/nondisplaced fx without crutches..that's malpactice. How do they they justify fx sans crutches? The fire department deal sounds great. I always tell people not to throw the crutches out, either return them or donate them to Goodwill.

[casluis]

Thanks for your ideas...keep them coming.
We are looking at combination funding with vouchers to purchase from local vendors..we like the donation idea and are asking all local thrift shops to directly donate any crutches donated to them.

[ERNURSE4NOW]

SUGGESTION: SPEAK WITH LOCAL PHARMACY IN YOUR AREA..WE HAVE A FEW PHARMACY'S THAT RENT CRUTCHES FOR $5.00 DEPOSIT AND THE PATIENT GETS THE DEPOSIT BACK WHEN THEY RETURN THEM. ONE PHARMACY HAS RENTAL FOR FREE WITH PROPER I.D. (DRIVERS LICENSE).

[casluis]

Guess what? Our attorney(s) said it was in our best interest, from an Risk Management perspective, to continue to give crutches out and apply for a DME license...yeah! Just in time for the 11th hour.
The ED satff at my place is wonderful, though, willing to make it work!
Thanks for your input.

[SuburbanER]

In our ED, we used to direct local patients to go to the first aid squad in town to get crutches. However, if an orthopod prescribed crutches for a patient, we had to supply them. Due to an increased demand, we now provide crutches to any patient in which it is indicated.

[Sarah, RNBScN]

We give out crutches and so on...they have to pay before they leave and they are theres for keeps.

If they need to be taught how to use them, during M-F we send them to our Physio dept. After all, they are the experts.

[galenight]

We ran across the same thing Casluis. Our docs write a script for the crutches and the patient (and/or family) is responsible for getting it filled. We direct them to the DME places, some of which are "on call" 24 hours a day. I agree that there is a legal aspect to not giving them out, but we take them out by w/c which helps. I also think that patient need to take responsibility for themselves and their health care needs. If that means an inconveinent trip to another town for crutches, then so be it. Hospitals cannot continue to provide every service known to mankind for free. Everyone, hospitals included, have the right to make money. If we don't, we can't be there to help the people when they need us most.

[Rena RN 2003]

our supplier bills our patients directly. the receipt is stamped with the blue card info and the patient signs. a copy of the face sheet is retained with our copy and the patient is given the original in order to pay for them directly.