I’m sorry that you and your husband are not getting the support you need from your current dialysis clinic . Dialysis regulations require clinics to have sufficient staff to meet patients’ needs and patients need to have a way to reach a staff member when needed. The regulations mention a call service. Do you feel like you and/or your husband had sufficient training to do home dialysis with confidence? Did your clinic send you home with a training manual? Is that helpful?
Having a positive working relationship with the team, including the home training nurse, dietitian, social worker and physician is really important at all times, but especially when someone is new to home dialysis and may have questions or situations that arise that didn’t come up during training. Have you talked with the home training nurse and clinic manager about how you feel? Having a conversation like this can sometimes help to resolve problems.
There are a number of clinics throughout the country that offer PD. Patients can change from one clinic to another at any time. If your husband has an employer health plan that’s in-network and Medicare, there should be no problem with payment if he transfers. Billing for dialysis is done on a daily basis so you don’t have to wait until the end of a month to switch clinics.
Have you talked with the home training nurse and/or clinic manager at the clinic your husband would like to transfer to? I’d suggest making an appointment to do that and to talk with the medical director to make sure they will admit your husband before you let his current clinic know that he wants to transfer. Whenever a patient transfers, the new clinic always requests certain medical records from his old clinic and the old clinic must do that within 1 working day of the transfer by regulation. If he’s using a PD cycler, he may need to return the cycler to the old clinic and get one from the new clinic. The new clinic will want him to demonstrate he knows how to do PD and that clinic may have a slightly different way of doing things. More training may not be a bad thing and may help you feel more confident, Changing clinics and scheduling training before your husband goes back to work would make it easier.
I don’t believe changing clinics would affect your husband’s transplant status. I’d suggest that your husband check with the transplant program to make sure they know who to communicate with at the new clinic if your husband does change clinics. The regulations require dialysis and transplant patients to update each other on a patient’s status.