Staff Assisted HD

Has anyone had any luck in trying to make this option a choice for patients?? Pt outcomes would be so much better if there is a way to make this a reality.

QueenB, the challenge with staff assisted home HD in the U.S. is that a pilot study of it was done–in the 1980s, FORTY years ago–and there was some fraud. Medicare chose to end the pilot and never allow staff assistance for dialysis in the home! I call this “throwing out the baby with the bathwater.” It is beyond time for a new pilot of staff-assisted home HD, and I have reached out to Medicare to ask about it. I haven’t gotten any answers.

In the meantime, it’s important to know that the FDA approved solo home HD for capable people in 2017. So, many people whose only barrier to home HD was not having a care partner are now able to successfully do their own treatments. This is not a great solution for everyone, but it does help a lot of people.

People who have means can hire a technician or nurse to help with the treatments. That is not an option for everyone, but it helps a few.

Some clinics are training dialysis technicians to do SOME of the tasks in the home that would otherwise make home HD impossible. So, a tech might come and put away the supplies after they have been delivered, which helps those who don’t have the strength to move the boxes around. Things like that.

A few health plans cover staff assisted home HD, even though Medicare doesn’t.

The best way to make staff assisted home HD an option is for patients to advocate for it. You might reach out to Home Dialyzors United and see if this is a topic they have been working on. Perhaps you could help.

There are some dialysis companies that provide staff-assisted home dialysis for patients on HD. Some companies only offer it to residents of nursing homes vs. care in a patient’s private home. As Dori mentioned, there is no extra payment through Medicare for it, but some other insurers do cover it for their members and the VA may cover it for veterans eligible for care through the VA. The Home Dialysis Central Find a Clinic database lists clinics that may offer it. You can search that database at Clinic Search - Find a Clinic - Home Dialysis Central.

in 2017 I was involved in home dialysis in nursing homes in Huston TX. Where an Nx stage unit was put into two nursing homes, I would go into their facility and give pt dialysis. It was very useful i believe that they are still doing that today. You might be able to do this if there is a nursing home close to you

Thanks so much for the info!!

Thanks so much for your informative reply. I will look into all of this especially with the VA. It’s would be a much better option and improve overall pay outcomes overall.