Ley de Servicios Básicos
16.- PROPIEDADES, PLANTAS Y EQUIPOS
TRANSFER TUB SEAT
November 15, 2015
MODELS/DESCRIPTION
Standard – G98309 and BE7200 Bariatric – Merit A312
Non-padded transfer bench
Extends over tub edge with two legs in the tub (with suction cups) and two legs out of the tub
Drainage holes to prevent leakage onto floor Reversible back to left or right side
SPECIFICATIONS
NOTE: Please lift the release tabs on the suction cup feet to release them from the surface of the tub. Not doing so can cause the suction cup to tear away from the leg of the transfer
seat.
ELIGIBILITY
Must meet general eligibility requirements
OPTIONS AVAILABLE
Leg extensions for G98309 and BE7200 models – height range approximately 22 – 27”
REQUISITIONING AUTHORITY Physiatrist
Licensed Occupational Therapists and/or Physical Therapists Home Care Nurse
FORMS
Special Needs Equipment Requisition
STATIONARY COMMODE
April 1, 2014
Standard Bariatric
MODELS/DESCRIPTION Standard - G30213-4
Bariatric 650# – Merit C315 Bariatric 850# – Merit C316
Welded chrome steel main frame
Fixed plastic armrests; bariatric has drop arms Plastic pail with lid
Standard model can be used with pail or over most standard height toilets
SPECIFICATIONS
Must meet general eligibility requirements OPTIONS AVAILABLE
• Splash guard
REQUISITIONING AUTHORITY Physiatrist
Licensed Occupational Therapists and/or Physical Therapists Home Care Nurse
FORMS
Special Needs Equipment Requisition
COMBINATION COMMODE
November 15, 2015
MODELS/DESCRIPTION Artisan Models
Standard – ATS-500A
Bariatric – available upon request
Commode with four small locking casters, padded seat cover, and pan
Arms drop down to facilitate transfers Can be used with pan or over most toilets SPECIFICATIONS
Must meet general eligibility requirements OPTIONS AVAILABLE
Height insert (2 or 3”) available for the ATS-500A model REQUISITIONING AUTHORITY
Physiatrist
Licensed Occupational Therapists and/or Physical Therapists Home Care Nurse
FORMS
Special Needs Equipment Requisition
CHILD’S COMMODE
April 1, 2014
MODELS/DESCRIPTION
Sammons Preston Model
Aluminum arms with white plastic seat and pail Adjustable hook and loop-chest strap
SPECIFICATIONS
Overall unit weight of 12 lbs.
Overall width of 18”
Width between arms is 14.5”
Overall depth of 19”
Height adjustable legs from 11”-14”
250 lbs. maximum weight capacity ELIGIBILITY
Must meet general eligibility requirements REQUISITIONING AUTHORITY
Physiatrist
Licensed Occupational Therapists and/or Physical Therapists Home Care Nurse
FORMS
Special Needs Equipment Requisition
BATH TUB LIFT
April 1, 2014
MODELS/DESCRIPTION Guardian Spa
SPECIFICATIONS
Recline in lowest position Weight capacity of 308 lbs.
Height range: Lowest 3”; Highest 16.5” (without 2.5” height adapter)
Size of base – 25” long x 13.5” wide Seat width of 16.5”
Battery powered hand control unit; provided with charger ELIGIBILITY
In addition to meeting general eligibility requirements, the client must meet one of the following for a duration of two months or more:
The client is unable to use any of the regular bath seats
independently because of transfer requirements, endurance, or support requirements.
The client is able to use a tub lift independently.
The client can physically use a bath seat but would not receive sufficient immersion in water required by conditions such as:
Perineal irritations
Frequent diarrhea or bladder problems Skin problems
The caregiver is unable to assist transfers safely with any of the other bath seats available.
The client cannot tolerate a shower or spray because of pulmonary conditions.
The client’s tub may not allow the use of any bath seats the client is capable of using.
A home assessment to ensure suitability is required.
This item requires scheduled maintenance.
REQUISITIONING AUTHORITY Physiatrist
Licensed Occupational Therapists and/or Physical Therapists ORDER DETAILS
Specify the criteria that apply FORMS
Special Needs Equipment Requisition
BATH TUB CLAMP
April 1, 2014
MODELS/DESCRIPTION G980006
SPECIFICATIONS Height of 13”
Adjust to fit tubs 2.75 – 6.25” thick ELIGIBILITY
Must meet general eligibility requirements Loan restricted to SHP, SIP, and FHB recipients REQUISITIONING AUTHORITY
Physiatrist
Licensed Occupational Therapists and/or Physical Therapists Home Care Nurse
FORMS
Special Needs Equipment Requisition
WALL BARS
April 1, 2014
MODELS/DESCRIPTION
Silver enamel with knurled grip SPECIFICATIONS
Available in 32” or 18”
ELIGIBILITY
Must meet general eligibility requirements Loan restricted to SHP, SIP, and FHB recipients REQUISITIONING AUTHORITY
Physiatrist
Licensed Occupational Therapists and/or Physical Therapists Home Care Nurse
ORDER DETAILS
Specify size required FORMS
Special Needs Equipment Requisition
UTILITY BATH SEAT WITH BACK
April 1, 2014
Standard Bariatric
MODELS/DESCRIPTION Standard – G30402
Bariatric – MDS89745AXW Plastic seat and removable back Metal legs with rubber tips
Fits inside tub SPECIFICATIONS
Must meet general eligibility requirements
Loan program restricted to SHP, SIP, and FHB recipients REQUISITIONING AUTHORITY
Physiatrist
Licensed Occupational Therapists and/or Physical Therapists Home Care Nurse
FORMS
Special Needs Equipment Requisition
UTILITY BATH SEAT WITHOUT BACK
April 1, 2014
Standard Bariatric
MODELS/DESCRIPTION Standard - G30403
Bariatric - MDS89740AXW
Plastic seat with metal legs with rubber tips Fits inside tub
SPECIFICATIONS
Must meet general eligibility requirements
Loan program restricted to SHP, SIP, and FHB recipients REQUISITIONING AUTHORITY
Physiatrist
Licensed Occupational Therapists and/or Physical Therapists Home Care Nurse
FORMS
Special Needs Equipment Requisition
RAISED TOILET SEAT
April 1, 2014
Standard MODELS/DESCRIPTION
Standard Round - 7014
Bariatric - Savannah 5670-06
Adjustable seat heights on standard model that can be tilted anteriorly or posteriorly
Standard model fits only on toilet seats with round bowl Bariatric model made of molded plastic
SPECIFICATIONS
Model Height Weight Capacity
7014 3- 6” 300 lbs.
Savannah 5670-06
4” 450 lbs.
ELIGIBILITY
Must meet general eligibility requirements Loan restricted to SHP, SIP, and FHB recipients REQUISITIONING AUTHORITY
Physiatrist
Licensed Occupational Therapist and/or Physical Therapist Home Care Nurse
FORMS
Special Needs Equipment Requisition
TOILET ARM REST SET
April 1, 2014
MODELS/DESCRIPTION Lumex 6460A
Two arms with mounting bracket that attaches to toilet seat bolts Aluminum legs with rubber feet
Plastic armrests SPECIFICATIONS
Height adjusts from 26”-31”
16.75” depth at the arms; 12” depth at the legs Width between arms adjusts from 18”-24”
250 lbs. maximum weight capacity ELIGIBILITY
Must meet general eligibility requirements
Loan is restricted to SHP, SIP, and FHB recipients REQUISITIONING AUTHORITY
Physiatrist
Licensed Occupational Therapists and/or Physical Therapists Home Care Nurse