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

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 ( 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.

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

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.

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!

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…

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.

[QUOTE=Anonymous;3607]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

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

can anyone advise best way to proceed? thanks!!

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.

Fresenius has a staff-assist program that they call “Ultracare at Home.” Here is a link to it: 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.

Hello I know of a HHD staffing in the grand rapids michigan area.

If you would like you can e-mail me at for more information we are not allowed to give certain information on the page.

That’s not exactly true, HomeDialysispartners. The problem I have is that you seem to be advertising a service that doesn’t yet exist–and that you don’t know how to set up. I’m afraid setting up a staff assisted home dialysis program isn’t something we can help you with. But I do want our visitors to know what is and isn’t really there, NOW, to help them.

Dori I understand your concern Iam not asking any one to help me step by step to setup a home staffing agency Iam doing exactly that I want input from others who have done the same and can help me avoid cerntian mistakes iam not tryin to mislead or offend any one at I want to know what the public wants and need. No Iam not up and running at this time but Iam here to answer any question any one have concerning my near future plans and take all suggestion. Thank you

[QUOTE=Anonymous;3607]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

Mr Harding I would like to learn more about this information

I’m glad you’re finding some help. It’s to everyone’s benefit if there are more options for patients.

Hi Dori I will be only offering a service (Partners ) Nurses and Tech I just want to let people know there so many different options I will work with home hemo programs to offer to everyone not just the young but to the eldery and people with certian conditions that can’t leave thier home this service will benefit all and promote growth in Home Hemo dialysis programs.

So if you have any thing that can help me make this happen quicker Iam listening.

Staff Assisted Hemodialysis does exist. I have been involved now with two companies housed in Texas that do exactly that. It is very specialized and the patients have to meet certain criteria to qualify, ie health situation and insurance qualification.

Hi Guest,
Yes, we know that staff-assisted hemodialysis does exist. There are companies that offer it now, and I’m aware of at least one of the ones in Texas, which has been around for a number of years now. The main criteria patients have to meet is a health plan other than Medicare, which unfortunately doesn’t pay for it.