When Robert Mendia started his medical-equipment business in 1993, he didn’t dream it would turn out like it has—although he was certainly in the right place for dreaming.

Bayshore Dura Medical Equipent from left to right: Eileen Rakes, RN, director of clinical services; Raul Lopez, director of operations; Robert Mendia, CRTT, president; and Eric Barretto, general manager.

“I started off in my bedroom,” says Mendia, president of Dura Medical Equipment, which does business as Bayshore Dura Medical. “Half of it was my office, and the other half was my room.”

The company quickly outgrew its humble surroundings and now occupies 25,000 square feet in an industrial center in Miami Lakes, Fla, as well as three additional South Florida locations in Miami, Broward County, and West Palm Beach. Initially, however, Mendia had a more modest goal.

“I’m a respiratory therapist by trade, and I wanted to give therapy in people’s homes,” Mendia says. “The only way that the insurance companies would cover it would be through the equipment, so I started providing oxygen and nebulizers to patients in their homes. We started getting calls for other stuff, like wheelchairs and hospital beds, so we branched out and kept growing, and now we’re the biggest fee-for-service provider in South Florida.”

Special Service
Superior service proved the key to success, according to Mendia.

“From the very beginning, service was our No. 1 goal,” he says. “I always relied on our service to get us to the next level.”

Fulfilling customers’ needs quickly and efficiently is a big part of what sets the company apart, according to Mendia.

“The way we route and the way we dispatch our technicians, they’re always in a particular area of town,” he says. “That keeps someone within a few miles of a facility, or a patient’s home, or a doctor’s office, wherever we need to go throughout Dade County.”

Mendia says the commitment to customer service does not stop at 5 PM. “We have calls all hours of the night for any type of emergency, and we’ll go out and do them,” he says. “Other companies obviously have an on-call system, but that’s not the way we do things. If you contact us on-call, it is like regular business on Monday at 9 in the morning.”

Staff members receive education and supervision designed to ensure the best service for patients, Mendia says. “We have an educational person solely responsible for in-servicing staff members and following up every quarter to make sure all our technicians are trained in the same manner,” he says. “They’ll also go out with our technicians to patients’ homes to make sure that they’re using universal precautions, that they’re following the treatment plan, that they’re doing the right thing.”

Operations within the company also receive scrutiny, according to Mendia.

“We have a performance improvement manager who collects information,” he says. “Each department has steps they need to follow, and they have to score other departments that they work with. We aggregate all that information and review it quarterly. If we identify an undesirable trend, we can fine-tune it.”

A Bigger Slice of the Pie
As Dura Medical Equipment grew, it found itself going head-to-head with a larger provider, Bayshore Medical Equipment. “It was owned by three hospitals here in Florida,” Mendia says. “The hospitals were telling people they needed to use that company, but people still wanted to do business with us because our service was really, really good. They’ll call us and we’re out there just as fast as if you order a pizza from Domino’s.”

When Bayshore Medical Equipment’s owners decided to sell the company, Mendia saw an opportunity to expand. Despite his position as sole owner of Dura Medical Equipment, he consulted others before making a final decision.

“I have a group of staff members that sits down at a round table and makes decisions on the course of the company,” Mendia says. “We wanted to make sure we were buying a great company, and we wanted to make sure everything was out in the open.” Audits by an outside accountant and a medical-reimbursement specialist preceded the final transaction. Dura Medical Equipment took over its larger rival last year.

Mix and Match
To get the most value out of the acquisition, Mendia knew he could not take the purchased company’s clients for granted.

“A lot of times when another company comes in, the relationships disappear,” Mendia says. “When I acquired Bayshore, most of the staff members were retained, so we had familiar people to walk referrals through the new company and make sure they got things done. I wanted to make sure we let all the referral sources know we still do the same thing, and it’s only going to get better.”

Combining two companies’ records presented a challenge.

“They had a different software than we did, so we had to integrate all that,” Mendia says. “We didn’t want to just merge everything electronically because we didn’t want to copy anything over that was in error, so we had to go physically through all the charts. We had a group of staff members that would audit charts all day, reviewing them, making sure everything was in compliance. Also, our purchasing method was completely different. We basically cherry-picked and took the strengths of both companies.”

Keeping Score
Adding to the stress of managing a successful merger, the company faced a Joint Commission on Accreditation of Healthcare Organizations survey.

“We’d been accredited since 1997, and we’d never scored below a 97% and never gotten any Type I recommendations,” Mendia says. “Right when I was acquiring Bayshore Medical, we were given about 6 months [notice]. Bayshore had gone off accreditation because it knew it would sell and didn’t want to reapply. We all worked very, very hard to make sure we got everything completely up to speed.”

The effort apparently paid off.

“We just got surveyed in December of last year and we got 100%,” Mendia says. “As a matter of fact, the surveyor said he’d never seen any facility run like we run ours. Our warehouse was impeccable, he said.”

Growing Forward
The merger resulted in a significant expansion of services, Mendia says. “We have a staff of about 70 employees, and our revenues are in the $7 million range, expecting to grow more,” Mendia says. “We have a prescription-management department that talks to physicians to get prescriptions. Acquiring Bayshore, we were able to move into rehab. We’re now involved in sip-and-puff chairs and other very sophisticated chairs for adults and pediatrics.”

Respiratory therapy remains an important part of the business, befitting Mendia’s background. “I wanted to make sure that we had enough of the equipment and also the personnel to be able to facilitate a patient who goes home on a ventilator, a continuous positive airway pressure device, a bilevel positive airway pressure device, or anything like that,” Mendia says. “We currently have the largest clinical respiratory department in South Florida, in which we have a total of seven professionals between respiratory therapists and nurses.”

Medicare represents about 50% of the company’s business, Medicaid accounts for 20%, and managed care makes up the remainder, according to Mendia.

“We’re trying to get more managed care contracts,” he says. “We have the staff and the knowledge in order to do that right now. We’re also looking forward to expanding to Florida’s west coast.”

Judging from his track record, that is not an idle dream.

Keith Bush is a contributing writer for Dealer/Provider.