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  1. #1
    Anonymous Guest

    Default Staff Assisted Home Dialysis

    I am finding very little information on this topic, the networks, state departments and other contacts have been of little help. It appears that once home dialysis turns into "staff assisted", all of the regulations change. Is there anyone out there that has gone down this road before that can give some advise?
    Thanks, Melanie

  2. #2
    Join Date
    06-25-04
    Location
    Kansas
    Posts
    1,769

    Default Staff-assisted Home Dialysis

    Years ago a number of dialysis providers offered staff-assisted home dialysis. Medicare used to pay enough for dialysis to cover this service under a reimbursement system called "target rate reimbursement." Since the composite rate was introduced in the early 1980's, the amount Medicare pays no longer is enough for most clinics to pay for staff to help with home dialysis. I have heard that some dialysis providers have found a way to offer it. One I've seen displaying at national meetings is Quality Dialysis in Stafford, TX. You can find this clinic on the Home Dialysis Central database. I don't know if this dialysis provider offers this service to any patient no matter what their insurance they have or whether they limit this service to those with commercial insurance or who pay privately. I have known patients at several dialysis clinics who have had home hemo helpers that they paid to help them since Medicare doesn't pay for them.

    Some companies offer staff-assisted home dialysis but they are listed with Medicare as durable medical equipment (DME) providers. They be set up with Medicare as Method II suppliers. If they are Method II suppliers, they may get a higher rate of reimbursement than a dialysis clinic that gets paid under the composite rate. I don't think Method II suppliers operate under the regulations that govern dialysis clinics and Networks may not know they exist. Here are some DME providers that may offer staff-assisted home dialysis:
    * Dialysis at Home - Boston, MA
    * Dialysis Care Associates - Walpole, MA
    * Koffel Medical - Libertyville, IL
    * Orion Medical Enterprises - N Miami Beach, FL
    You can find contact information for these companies on the Medicare website (www.medicare.gov). Look at the provider listing. Choose to search by name and enter the name of the company. Select the state and choose "durable medical equipment" as the type of provider. This should give you the name, address, and contact numbers for the provider. Some also have their own websites.

    People occasionally contact us asking about staff-assisted home programs in their area. If anyone knows of dialysis or DME providers that offer staff-assisted home dialysis and how to contact them, please let us know.
    Beth Witten MSW ACSW LSCSW
    Medical Education Institute, Inc.

  3. #3
    Anonymous Guest

    Default STAFF ASSISTED HOME DIALYSIS

    We have successfully negotiated benefit exceptions in order to pay for home hemodialysis caregivers. I would be happy to share how to go about this process if you want to email me with information on how to contact you.

    Elton Harding
    PRESIDENT
    DIALYSIS CARE ASSOCIATES
    eharding@dialysiscare.org

  4. #4
    Unregistered Guest

    Default Staff Assisted Home Dialysis

    I just happend to read this in a search. Staff assisted home dialysis is still around. I do not know why more people do not use it or it is not listed as a home treatment but it is great! I live in Texas and Quality Dialysis is my service provider.

  5. #5
    Unregistered Guest

    Default staff assisted home dialysis

    Hello - I just found this forum. I think staff assisted home dialysis is what I need for my mother. She wants to do home hemo dialysis but is a widow living alone so doesn't have a "partner". I do not live close enough to do the treatments. I had hoped there were agencies that provided trained staff to come in and do the treatments at her home. I have found very little info on this and even the people at DaVita acted like this just wasn't done. She has excellent private insurance in addition to her Medicare so I think it might be covered. If anyone can offer help or information I would truly appreciate it. She lives in the Grand Rapids, Michigan area. Thank you!

  6. #6
    Join Date
    06-06-06
    Location
    London, UK
    Posts
    159

    Default

    Interesting thread, I'm posting under a recipients point of view eg the patient. My mother is carer, & a pensioner.

    Although UK laws are very different her claim for a carer's "allowance" as it's called here, would forfeit her claim (eg payments of) to a state pension.. Anyone come across similar situations

    I didn't realise staff assisted Home haemo existed. Even a respite service that didn't involve a patient going into a unit would be beneficial..
    TheFlyingKidney!
    "Dialysis! What is this? The dark ages!
    L. 'Bones' McCoy, ST"
    Anyone else got a blog?
    http://www.facebook.com/TheFlyingKidney

  7. #7
    Unregistered Guest

    Angry none

    In response to Staff-Assisted Hemodialysis, I know that staff assisted works much better for most patients on Hemodialysis. I don't understand how CMS thinks that a person trained for two - six weeks per year can be safe for the patient. If you read the Regs its seems to be all about the patients well-being. Then a person who does not have near the experience of even a PCT, can push meds and conduct the treatment. Can someone please explain the logic here?
    If patients wish to receive Staff-Assisted Home Hemodialysis, they should be able to choose this type of treatment at home. Medicare does not cover this, but some private insurance carriers may. CMS and State regulators need to reevaluate Staff-Assisted Home Hemodialysis because it is a necessary type of modality that some patients NEED.

  8. #8
    Unregistered Guest

    Default staff assisted at home hemodialysis

    Quote Originally Posted by Anonymous View Post
    We have successfully negotiated benefit exceptions in order to pay for home hemodialysis caregivers. I would be happy to share how to go about this process if you want to email me with information on how to contact you.

    Elton Harding
    PRESIDENT
    DIALYSIS CARE ASSOCIATES
    eharding@dialysiscare.org
    My mom would like to switch to in home dialysis from
    m in center. She is on Medicare and lives in NJ. Is there any possibility of
    getting a dialysis staff assistant to help? thanks. (she also has aarp
    medigap).

    can anyone advise best way to proceed? thanks!!

  9. #9
    Join Date
    06-25-04
    Location
    Kansas
    Posts
    1,769

    Default

    You might want to check on the "Find a clinic near you" database from the Home Dialysis Central homepage for staff-assisted home dialysis facilities in NJ and nearby states (depending on where in NJ your mother lives). There are no clinics in NJ, but 3 clinics in NY (White Plains, Hawthorne, and Brooklyn) that do.

    Medicare and most Medicare supplements will not cover staff assisted home dialysis and most patients pay for it out-of-pocket. However, some Medicaid agencies and some long-term care policies may provide this level of home support.
    Beth Witten MSW ACSW LSCSW
    Medical Education Institute, Inc.

  10. #10
    Join Date
    08-17-04
    Posts
    2,147

    Default

    Fresenius has a staff-assist program that they call "Ultracare at Home." Here is a link to it: https://www.ultracare-dialysis.com/e....asp?pid=s0814. I suspect that this is available to folks with the right insurance, and I don't know if a Medigap policy would cover it, but it's worth checking out.

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