Hello, I am looking for a home dialysis company for a patient of mine. He is “cleared” to go home except we need to set up home dialysis (zip code 01867)
Is there any company near us that can help? Fresenius says it will take a while even to check out the private home to see if dialysis is a possibility. We are able to hire a private dialysis nurse so training should not be an issue.
We could also go to a facility but getting ambulance service from a private home to the local dialysis center has been difficult–they will only pick up from a facility.
Your thoughts would be appreciated.
Thank you.
Donna
The Medicare website has a database called Dialysis Facility Compare. It can be found at Medicare.gov. Search for Dialysis and insert the zip code or city and look under Service for clinics that offer the type of dialysis you want. I assume this is either home hemodialysis or peritoneal dialysis. The database auto-defaults to a distance of 25 miles, but you can expand the distance if needed. You can also look at the number of stars for quality and patient experience. There are 44 clinics within 25 miles. Of this 32 offer peritoneal dialysis (PD) and 20 offer home hemodialysis (HHD) looking at each option separately. Some clinics are owned by Fresenius, but others have different ownership. NOTE: It is possible that some clinics are approved for PD or home dialysis, but may not currently provide that option. The medical director has to agree to admit a patient for in-center or home dialysis. In some cases, a medical director may choose not to admit a patient s/he believes is too unstable to do dialysis in a clinic or at home.
So far as transportation to a dialysis clinic, Medicare will cover ambulance transportation to/from a home to a dialysis clinic IF the patient meets very specific criteria demonstrating medical necessity and if other means of transportation would endanger the patient’s health. The Medicare website at https://www.medicare.gov/coverage/ambulance-services doesn’t list the criteria, but does say transportation to/from a clinic from home may be covered.
Thanks Beth. I will continue my search for home hemodialysis and see what I can find. Although what you say about transportation is true it is only true up to a point. Medicare may be willing to pay but private ambulance companies are saying that they will not pick up a “carry out” from a private home, only from a. facility. Therefore, the patient must commit to a LTC facility, or stop life-sustaining dialysis, or find a home hemodialysis set-up (which can take weeks). I can’t believe it is true but have called MANY private ambulance companies and Medicare and all say the same. This is a huge issue in the Boston area. Thanks for your thoughts and info. Donna
The reason ambulance companies may be wary about transporting dialysis patients from home to dialysis is that there has been fraud and abuse in ambulance transportation of dialysis patients. In 2015 there was an Office of the Inspector General report about that - https://oig.hhs.gov/oei/reports/oei-09-12-00351.pdf.
That said, if a dialysis patient /he should not be denied medically justified services that meet Medicare’s criteria. If your patient meets those criteria, you might want to contact the CMS Regional Office in Boston to make sure they’re aware that ambulance providers are refusing to transport people on dialysis who meet Medicare criteria and that they have notified all the ambulance providers that transport from home to dialysis clinic is reimbursable for patients who meet their criteria. Here’s information on ambulance contacts at CMS Regional Offices, including Boston. It was created in 2019 so the listed contact may or may not be correct. If not, the local phone number for the Boston CMS Regional Office is (617) 565-1188. Ask for the contact for ambulance issues.
Hello, I am on home dialysis, PD, after 4 months on hemo. All my treatments are through DAVITA which is nationwide and international, so you should be able to find one. We are surprised that your patient did not get any help from wherever he/she was getting dialysis. Sounds like that company is just plain lazy, I was admitted to Del Webb Sun City West hospital in May 2019 where i spent a month on hiemo. The hospital found me a dialysis center BEFORE i was released, and my treatments were through the South West Kidney Institute and Davita. I was in a Davita Hemo center from 5 months and was put on PD Home dialysis frrom there. Been on home PD dialysis for over a year now.
The real question is what is the patient’s medical status? I’ve had difficulty helping those find a dialysis clinic when they have a trach or require mechanical ventilation. Outpatient dialysis clinics often say they have insufficient numbers of trained staff to handle respiratory care required for trachs or vents in-center and they may be reluctant to admit these patients for home dialysis because they believe the patient will be too unstable to do dialysis at home. I’ve been trying to work with dialysis corporations to address these concerns.