Randy Lundi, RN, BSN, says it is fun to help people accomplish wound healing.

Decubiti Concepts in Painesville, Ohio, doesn’t provide a lot of things. It offers no walkers, wheelchairs, or commodes. It rarely sells a product, preferring to rent. It doesn’t even have a retail store or showroom.

What it does do, however, is supply support surfaces. And as wound and pressure sore experts, it is able to provide surfaces and services more cost-effectively than large, diversified HME providers, says president Randy Lundi, RN, BSN.

“We’re basically a local, entrepreneurial company competing with the national, larger vendors,” he says. “We provide therapeutic air mattresses to treat pressure sores and also provide products that prevent people from getting bed sores.”

For the last several years, Decubiti has provided support surfaces for, among other businesses, Medical Service Company, a large HME company in nearby Cleveland. “Lundi has the type of expertise that we don’t have,” says Joel D. Marx, president and CEO of Medical Service. “[Support surfaces] is a specialty or even a subspecialty.... This is where Randy impressed us. He knows what he’s doing, and he does a lot of it.”

Marx sees market specialization, such as that done by Lundi’s company, as a growing trend not limited to the support surfaces area. Doing everything for everybody, a concept widely promoted during the 1990s by most HME dealers, is no longer as necessary as once thought. He observes that truly successful companies, the ones that are growing fastest, have tended to specialize in specific areas. Five-year-old Decubiti Concepts was one of the first to see the support surfaces niche and capitalize on it.

Located 25 miles east of Cleveland, with just one part-time and four full-time employees performing administrative and service tasks, Decubiti is a small company. Lundi is the clinician and his role is key to his company’s success. The clinical component, he explains, means providing a service for clients and for customers, the client being the agency that calls with a customer referral, and the customer being the patient.

The clinical component is what drives product selection, adds Marx. “If we don’t have the clinical component, then one size fits all,” he says. “Randy helps us make the right choice for the right product. Often the referrals for products in that area are coming from social workers or nurses who are not always technically educated, are not specialty nurses.”

The simple request to do something for the wound—to get a low air loss surface—is too general in today’s market of multiple surface choices and an increasing menu of care plans. Fifteen years ago that was fine, says Marx, but today it is essential to specify more exactly.

Along with the clinical expertise that Lundi’s company brings to its clients, it offers a line of proprietary products called Stimulus Systems. Designed by Decubiti and manufactured by outside companies, the line includes mattress replacements and mattress overlays. The Stimulus family of products utilizes a technology called dynamic alternating therapy, Lundi explains.

“Dynamic alternating therapy is a treating concept that uses pressure for a therapeutic advantage and benefit. People say pressure is bad for skin, it breaks it down, which is why patients must be turned frequently. That’s all true,” he says. Lundi’s products, however, use pressure in a fashion that makes it a healing ally.

Decubiti Concept’s staff is small by design. From left, Don Phillips, Keith King (seated), Mike Miller, Randy Lundi, and Toni Heavner (seated).

By creating wide pressure gradients over a patient’s body, two things happen that are verifiably beneficial in a wound-healing process that uses dynamic alternating therapy. The first is to control the time of exposure to pressure. “Pressure in and of itself I can’t control. I can at best attempt to manage it. But the time element of pressure I can control, by alternating air chambers in an air mattress,” Lundi says.

Second, alternating pressures in the surface’s inflated air cells stimulates blood flow to the wound bed. This sort of technology is critical for the healing process, Lundi says.

To augment the Stimulus product line, Decubiti Concepts offers products from manufacturers around the country. As an example, the low air loss surface that Lundi uses comes from another company. Its addition allows Decubiti to present to its customers a comprehensive line of products and technologies.

Because dynamic alternating therapy is an accepted, proven therapy, reimbursement issues never become a huge problem and claim denials are few. The company has a Medicare reimbursement code for mattresses, which is a large part of Decubiti’s business.

Lundi’s success has a solid foundation. For 4 years, he was employed by a large national support surfaces company, and found he enjoyed providing a service for nurses and patients in the field. It was fulfilling and fun to help people accomplish wound healing, he says. The large-company experience gave him a background for the support surfaces segment of the health care industry, so when he was approached by a friend about going into business on his own, he felt comfortable. Add to that the skills he had picked up as a clinical nurse, and the entire package just clicked. “We felt it was something we could be successful at, and at the same time own our own business,” he says.

Does he see the specific niche that Decubiti Concepts filled as an industry trend? “I certainly hope not,” he jokes. “I think the critical issue in anything that we do, and it really doesn’t matter what business you’re in, is your willingness to be a servant to your referral source and to your patients.” He believes that 90% of the reason that customers choose Decubiti is because of the company’s commitment to service.

To confirm the feasibility of small businesses becoming tightly focused on the support surfaces niche, Lundi points to recent industry statistics. “By 2006, the business of renting therapeutic mattresses for wound healing is almost going to double,” he says. “That’s the market projection. So, if you put yourself in a good situation now, as we hope we have with Decubiti Concepts, we hope that we can continue to prove ourselves and grow our business accordingly.”

Business challenges include the temptation to be complacent. Being comfortable with a customer base is fine, but a referral base as well as competition will keep Decubiti on its toes, he says. Perhaps the biggest hurdle may be changes in the industry, which include Congressional budget battles and the possibility of national competitive bidding for HME. Lundi sees flexibility as one of his keys to survival.

On the horizon for Decubiti Concepts may be expansion into different geographies, as well as bringing new people into the company to support the service and clinical components. “We’ve always felt we had to be very good in our own backyard, and we’re still working to do that, because it’s a dynamic industry,” Lundi says. “There are more competitors coming into our type of business every day.”

His basic philosophy focuses on a simple belief. “You can’t control what your competition does, you can only control what you do,” he says. For someone with a firm toehold in such a specialized niche, it sounds like a plan.

Judy Wade is a contributing writer for Dealer/Provider.