From left: Paul, Nancy, and Larry Rice each brought personal experience in rehabilitation to their company.

Experience, it is often said, is the best teacher. It is not a bad business plan, either. When Paul Rice first met his future wife, Nancy, he was working as a rehabilitation therapist at a major medical group in Texas; Nancy was a severely injured patient. The rehabilitation process brought them together. And their union became the genesis of The Wheelchair Shop Inc, a Houston-based HME provider specializing in rehabilitation services and equipment.

Paul and Nancy Rice founded The Wheelchair Shop in 1992 after seeing and, yes, experiencing firsthand a dearth of reliable rehabilitation services in the area. To manage the start-up operation, the couple called on Paul’s brother, Larry, who also understood the world of physical rehabilitation in a very personal way: He lost the use of an arm in an accident as a young man.

“Paul loves doing rehab, and he founded the company on service,” Larry Rice says. “Nancy understood what it was like to not get good service, and I understood what it was like to fight with insurance companies, to not get things that you need. That has had a lot of influence on this company. We want to make sure that our clients don’t have that problem. We’ve been there.”

Community-minded thinking is key
“There” is a place many of the larger medical groups in Houston did not want to be in the early 1990s, according to Rice. “They were pulling out of rehab—they didn’t feel it was a profitable endeavor,” Rice says. The Wheelchair Shop stepped in to fill the void.

Ten years later, many of the bottom-line challenges that pushed those big players away from the rehab segment remain—in fact, they may loom larger. But The Wheelchair Shop has managed, nonetheless, to grow into a thriving independent HME provider, generating roughly $4 million annually—all from one location with a staff of 12.

While any company can deem itself a specialist and include the word in marketing materials, few actually stick to one thing, and most cannot help but dabble in other services or product lines in search of added revenue. That search, ironically, often introduces new inefficiencies, while distancing the company from its so-called “specialty.”

The Wheelchair Shop is no dabbler. From the day it opened, the company has never veered from its original focus on rehabilitation equipment and services, starting with an inventory that sticks to the basics—wheelchairs, lifters, shower chairs, beds—and favors quality over price. By establishing alliances with top medical equipment manufacturers, the company differentiates itself from many of the mom-and-pops and regional providers in the area.

“They don’t do what we do,” Rice says. “We set up the best piece of equipment possible. We know which ones are dependable and we demonstrate [that dependability] to therapists.”

Equally important is what the company does not offer, including oxygen and orthopedic soft goods, which might distract from the core mission. “We are not going to be all things to all people,” says Rice. “That is a whole different delivery system that we don’t understand, and it would take away from our main focus on rehab. We’ve developed some efficiencies in our delivery system that help us get the rehab equipment out there in a more profitable manner.”

That discipline extends from the showroom to the back office, where reimbursement issues take center stage. And in this area, the company is equally selective, dealing only with Medicaid and private insurers. It does not get involved with Medicare cases.

“We have not felt comfortable with Medicare because we’ve seen horror stories,” says Rice, who is, however, studying recent regulatory changes to determine if the Medicare process is becoming more amenable. “I want to make sure that if we are to tackle that, we have all our ducks in a row.”

Word-of-Mouth success
Sticking to its strengths, The Wheelchair Shop has built up a territory that is as broad as its inventory is targeted. The HME has more than 3,000 customers within a 600-mile radius around Houston, Rice estimates. Almost as impressive, this growth has been accomplished mostly through word of mouth.

The Wheelchair Shop receives about 20 referrals from therapists and physicians every few days, according to Rice. The number of unofficial referrals is not as easily tracked, but it is quantifiable and just as significant.

“It’s little John’s mom liked what we did, liked our approach, said ‘you should go to them,’” Rice says. “I think it’s because we take time out of this time-consuming process to talk to clients about their concerns. We are very personal. We’re not clinical in our behavior to clients.”

The Wheelchair Shop’s nonclinical approach extends to the environment it has created for its customers. “This is not a showroom with slate-gray walls. We designed the showroom for kids and parents, and we want people to want to hang around here.”

This year, the company wants even more people to “hang around” and is adopting a stronger marketing approach, which includes sponsoring an annual wheelchair basketball game.

“We’ve relied so much on our good deeds that we’ve not gone out in the past and said, ‘Hey, look at us,’” Rice says. “I’m spending more time talking to people [at state and local industry events], pounding our chest a little. I’ve found people who were looking for [a company like] us but hadn’t found us.”

ALL-AROUND HANDS
As The Wheelchair Shop grows, there are plans to add more people to its 12-person team. For now, the small workforce is able to serve its large customer base by functioning as an interconnected, interchangeable unit. “We have what we call ‘all-around hands,’” Rice says. “There is no one person who is just a technician, or strictly a salesperson. When you come to work at The Wheelchair Shop, I don’t care what your educational background is or where you’ve been before, you have to start in the back, repairing wheelchairs, until we’re comfortable that you can explain why we use this equipment, and you’re prepared to answer just about any question that a client or therapist can ask.”

Staff members also have to be prepared to return a phone call. A simple requirement, it would seem, but as anyone who has been stuck in limbo with a phone menu can attest, a courtesy not always practiced promptly in the hectic world of home care.

“I gained two customers the other day from two of our largest competitors,” Rice says. “They were very mad because they’d been waiting for 3 weeks for callbacks. And they kept getting a customer service rep that they never put a face to, who took a message or put them into voice mail.

“It’s easy to get me on the phone. I want that piece of equipment that has our name on it to stand for something. Every time they see that logo and our name, that means they get quality equipment, quality people, quality treatment.”

Whether painting its showroom walls something other than slate gray to create a more welcoming environment, or sponsoring a local basketball game, or simply returning a phone call today instead of tomorrow, The Wheelchair Shop always operates as a member of the community it serves. In return, it has been rewarded with a loyal and growing client base.

“Companies like us are better suited to provide this equipment than a nationally owned company because we understand our market area and we have to face our customers day to day in the community,” Rice says. “When we go home, we worry about that client and the next morning we’re coming back in, finding ways that we’re going to do this better....Sometimes I go to the grocery store and see one or two of my clients. If I do a poor job, how can I face them?”

Aaron R. Smith is a contributing writer for Dealer/Provider.