How to get a recliner

I have asked my primary physician (a Medicare HMO) and my clinic (DaVita) for a dialysis recliner, per Medicare requirements. No luck.yet.

Does anyone have ideas on how to obtain a recliner under Medicare HMO or via DaVita? I am in serious need of one. I have worn out two regular recliners dialyzing at home, five and six days per week, for five years. Springs and recliner mechanism are broken. Parts and service call cost more than price of recliner.

DaVita and physicians don’t seem to understand that I am entitled to a recliner (including delivery) under Medicare. I was wondering why this website doesn’t educate its partners (such as DaVita) on their responsibilities under Medicare. I went through the same problem getting other basic dialysis equipment.

Would appreciate any help. Thanks.

The Medicare Benefit Policy Manual states that Medicare covers a standard recliner (no bells and whistles) under the usual composite rate that the facility is paid per treatment. We have posted on our Medicare FAQs a question and answer about this topic. The Medicare manual doesn’t say that it will cover more than one per patient.

If your facility provided one recliner for you, you may need to buy additional recliners as you wear them out. I’d talk with sales reps who sell recliners to ask for one with a washable surface that is strong enough and durable enough to take someone of your height and weight sitting in it for as long and as often as you need it. You don’t have to recline all the time you’re on HD, but if you prefer this position, be sure to tell the sales rep this so he/she can be sure the reclining mechanism of any recliner you’re considering is strong enough to take that. If you can get a guarantee, I’d suggest you pay extra for that.

I have never received a recliner from a clinic. I have been wearing out my own personal recliners which I purchased myself. I am only requesting one recliner. I never stated in my post that the recliners I have been using were furnished by a clinic.

CarePlus, a Medicare HMO, has denied my request for a recliner stating that it is not covered under Medicare.

MMiller reports: My DaVita clinic delivered a like-new custom hemodialysis recliner to my home today. The lesson to be learned is to make the request directly to the clinic, regardless of what the Medicare HMO or your primary physician says. It is the clinic’s responsibility to provide home patients with recliners and other dialysis supplies, just as the clinic would provide them if you were dialyzing in-center. Don’t allow your clinic to discriminate against you because you are a home patient. Remember, the clinic doesn’t have to spend money on employees to serve your needs in the center since you are doing all the work at home.

I’m glad you were able to sort that out, Mmiller, and hope you like your new recliner! :slight_smile:

[LEFT]Dori and Beth:

This is the response from my DaVita@Home Clinic Administrator. I have never received a chair and I have been with the Clinic for over 2 years. I got this response after I forwarded Beth’s Medicare reference verbatim. How do I respond? Erich

We are never reimbursed for any of the items that we supply to you to allow you to dialyze at home. We are paid for the treatments, and now that there are 6 treatments/week, Medicare doesn’t cover all of those. We are still being reimbursed for the way hemodialysis has always been reimbursed- 3 treatments/week. The composite rate has been changed little throughout the years, as you are probably aware, and the cost of dialysis has steadily increased.

To date, we have supplied all the medically necessary equipment that we felt a patient needed to do his/treatments at home, safely and effectively.[/LEFT]

Erich, DaVita has the bucks. They and Fresenius try to run the entire dialysis industry in the US. Before the recent bills in the Senate and House, both were pushing for lower reimbursements than actually passed because they could absorb the costs while the smaller dialysis centers weren’t going to be able to.

You’re just going to have to press harder, or perhaps turn on your noted charm. They may be correct that they don’t get reimbursed specifically for any one piece of equipment or supply item, but they are supposed to cover all needed equipment and supplies through the composite rate.

Thanks, Rich.

Dori and Beth, this was my most recent reply from DaVita At Home. Does this sound right?

If a patient is unable to buy a recliner, we have provided a dialysis chair that has been used in one of our clinics. They are used, but we can do that for you. Let me know if this is what you want and I will have our biomed go the the wharehouse and select one to clean up.

My situation might have been different since I started HHD with the hospital. I actually was able to talk them into reimbursing me for the purchase of an absolutely wonderful, cushy, leather La-Z-Boy recliner. It even rocks, which isn’t supposed to be covered by Medicare. But Erich, you know me. I know how to play the game and pull strings, or twist them when necessary.

However, Wellbound supplies new recliners to pts after training. They’re clinic chairs, but still new. I’m going to start working on Wellbound to supply home-style recliners instead. I see no reason to turn your house into a spitting image of a center. I though the idea was to do ‘home’ hemo.

The idea of such a ‘rich’ company cleaning up a chair they deemed not good enough for one of their clinics is kind of repulsive to me. Don’t kid yourself, they’re making tons of money getting the composite rate and additional remittances from the secondary insurers. And don’t forget they probably charge insurers about $1350-1500 per treatment for those who haven’t been dialyzing for the 30-33 months (soon to be longer) that patients initially treat.

[LEFT]Well Rich, I took your advice and wrote:

A chair that isn’t good enough for a DaVita Clinic isn’t going to work for me. I would like a new chair. If you can’t get it for me, please give me the name of someone in DaVita who can.

I know DaVita wants to do Home Hemo right and not on the cheap. Home hemo patients deserve a comfortable chair to spend up to eighteen hours a week in. That is six more hours than a traditional patient in a DaVita Clinic.

I’m sure we can work this out and not by offering me a used chair that isn’t fit for a clinic.

Thank you. Erich

this was the response to it. Any other ideas?

I don’t think we are doing home hemo on the cheap. We have always worked with our patients to provide them what they needed, and you have been a great example of that. I am, quite frankly, surprised at how quickly you disregard that.

We are working hard to float the home hemodialysis boat, which is proving to be a very costly modality. Medicare rates don’t give us any wiggle room at all. You aren’t aware of our financials for this modality, but it sounds like you have made assumptions about it. You would be extremely surprised that they aren’t what you are thinking.

We make sure our patients have a comfortable recliner at there disposal. If they do not, we will, as I said, provide them with a used chair. To date, our patients have not had a problem with this. Home hemodialysis provides you, and all of our patients with a great deal. I am very proud or our programs, and the work that we do. Our patients frequently let us know that as well.

I am sorry that you feel that we aren’t doing an adequate job for you in this way. I am hopeful that you can look beyond your demand for a chair and realize that we have provided what we can, when we can.[/LEFT]

When you say like new, do you mean it was used but is in great shape? Erich

This was my response.

Dear ______

I’m a bit shocked by your email. I am patient with a need not a vendor. I don’t need to be aware of the financials of DaVita. I just need to be provided with optimum service to keep myself alive.

Beth Witten MSW ACSW LSCSW, Medical Education Institute, Inc. wrote:

The Medicare Benefit Policy Manual states that Medicare covers a standard recliner (no bells and whistles) under the usual composite rate that the facility is paid per treatment. We have posted on our Medicare FAQs a question and answer about this topic. The Medicare manual doesn’t say that it will cover more than one per patient.

A like new used chair would be fine, however you offered me:

a dialysis chair that has been used in one of our clinics. They are used. . … Let me know if this is what you want and I will have our biomed go the the warehouse and select one to clean up.

What would your response be if you were offered a used chair that is sitting in a warehouse that will need to be cleaned up by biomed professionals? I believe this conversation and its tone could have been averted if the chair that I requested was presented in way that sounded appealing and in a positive helpful light., e.g. we can provide a like new chair that is very comfortable for dialyzing eighteen hours a week.

Finally, I am offended. DaVita’s offer of home hemo is not giving me some sort of gift - provides you, and all of our patients with a great deal. Home hemo is what all capable dialysis patients deserve - to live a life of dignity and purpose. Please do not forget that. Home hemo is the right thing for a meaningful life. DaVita is not providing me a favor, it is providing a service that all capable dialysis patients have a right to have. And in doing so the society benefits tremendously.

I will not look beyond my request for a comfortable chair to dialyze up to eighteen hours a week. I don’t think you would either if you were in the same boat. I will however accept a like new used chair that has been thoroughly sanitized. When may I expect delivery.

Thank you for your compassionate understanding. Please call me at 517.648.7764 any additional discussion on this topic.

Warm regards,


This gives you a glimpse of how well DaVita is doing. There should be no excuses for being cheap and offerring a chair from the junk pile.

Hi Folks

Have we not talked on this before? Maybe my mind is gone, but I recall talking on how centers should all have a list of items that thy supply. I started in Exton (pa) Davita 'in center" and it was deplorable. The problem was that the Drs and nurses and soc.worker or the Davita people and worse the people on dialysis didn’t care. Most of people I talked with who were on dialysis were scare to "“rock the boat” due to the nurses and Drs, saying if you didn’t like it, go some where else. The Drs or nurses or techs that did care were scare for fear of job lose. They were company Drs and nurses etc.

The home training was very good and I did get everything I needed ,new chair etc. But at the time I went into home program I was covered under a group health plan. The problem with both centers was an outlook on Davita part that they came first and foremost. Anything else that took place outside of dialysis didn’t matter.

I’ve said all along it depends on the location of the center. If the center is in a well to do area where people have more money and can use the power that money brings , will get better tx and anything else they may need. If a person is connected with a medical person who knows the ropes and can play the game get better tx and anything else they want, from the time they want in center if they chose to be in center, to what ever home tx they want, I can’t image a Dr who has a son or other family treated the way poor blacks or spanish speaking folks are treated.

Is this a real picture of every Davita center, or FMC center,no it depends on location and the money who are in center or on a home program. Plus the one thing

Davita workers do not like in my own trip into Davita are questions.


Bob OBrien

I got quite lucky, I didn’t get a recliner either but the patient training next door gave me his… on the other hand clinic stated that most of the funds go to training itself and also depends on whether patient has extra insurance coverage, so I suppose those patients with better coverage are the luckier ones.