Medicare Supplies

[spejsa]

I don't know if anybody will have an answer on this one but here goes. I am working for a home health agency that sees a lot of Medicare patients. I have run into having issues with stocking enough supplies in my car and thought about something. I interviewed a few months ago at a different home health agency and the manager there stated that we didn't "stock cars" with that agency as supplies would always be at a patient's home. They were shipped to them? Does anybody know about this. I am having issues with having every single supply in my car. I wonder why more of these people do not have supplies set up in their homes? Thanks!

[caliotter3]

They don't have supplies in their homes because their nurses have stocked cars I would expect. My agencies do not provide supplies to nurses, they tell us that all supplies are in the home and that is true. The doctor writes the order, "prescription", and the DME company establishes the account with the family and sends everything to the house.

[nurse42long, RN]

I thought that the Home Care Agency was supposed to provide supplies to Medicare patients. That they should not be getting from a DME company. I'm talking about wound care, Foley's, etc. not beds, walkers. Our Medicaid patients have to get their supplies from a DME but Medicare is billed from the HHC Agency for supplies. Therefore I keep supplies in my car for needs that I might run into rather than driving back to office to pick up. Private insurances differ of course but Medicare has always stated that Home Care provide supplies pertinent to needs. I could be wrong but I've seen it this way in several agencies in different states.

[annaedRN, RN]

if you work for a Medicare-certified home health care agency providing skilled nursing visits (intermittent visits not private duty nursing) then yes, you are responsible for supplies. My agency orders and keeps supplies in house...some agencies have gone to contracting with a supplier to send those supplies directly to the patient's home. I'm not sure how that works for stocking the nurses bag - is the same supplier able to send things to the agency/nurse directly? Not sure. I know with the company/supplier we use - if I need to take something from my bag for a pt then the supplier will send us the "card stock" back if we order it, but it is the agency's financial responsibility if it is a Medicare pt. But like I said, I initially stock my bag from the agency supplies. Your DON should know...how are the other nurses handling it?

[spejsa]

Well, it is a mess... I guess the other nurses just have all the supplies in their cars. Since I am new to this I have had issues with knowing exactly what to have in the car. And the woman who works in the office and order supplies is not doing a good job. I had to buy a thermometer cuz there weren't any in the supply room. And, as far as I have seen, there are not a lot of supplies. I can put in an order to the woman who orders supplies and will do that tomorrow. If anybody has ideas on what to order, let me know. Thanks!

[AnnemRN]

Well, it is a mess... I guess the other nurses just have all the supplies in their cars. Since I am new to this I have had issues with knowing exactly what to have in the car. And the woman who works in the office and order supplies is not doing a good job. I had to buy a thermometer cuz there weren't any in the supply room. And, as far as I have seen, there are not a lot of supplies. I can put in an order to the woman who orders supplies and will do that tomorrow. If anybody has ideas on what to order, let me know. Thanks!

Even though my agency contracts with a supplier, we have to have car stock available. For example,there are times when an established patient develops a wound - the wound care can't wait 2 days until the supplies arrive.

In my car stock, I have multiple 4x4's, 2x2's, ABD pads, kerlix, conform, tape, hydrocolloids, wound gel, adaptic, xeroform, saline, staple/suture removal kits & steri strips, foley catheters in different sizes with insertion kits and drainage bags. I also have venipuncture supplies, although this list is not all inclusive I hope it helps.

[berube]

keep some small bottle of normal saline so you can always do a NS wet to dry until you get your supplies.

start out with a small stock, one way of learning what to keep in your trunk is to run out of it just one time. i also keep extra bottles of hand sanitizer, irrigation kits, PICC dressing kits (just a few tips)

[Lacie, BSN, RN]

We have an entire room filled with supplies, the field nurses stop in to stock with what they need on a weekly basis or as needed and keep extra in thier trunk supplies.We have a pharmacy deliver anything related to picc lines to the patients home otherwise everything else comes out of our office. Only time we use DME is for equipment such as walkers, beds, etc. Even in those cases we just send the request then the DME will obtain the order from the MD. I must be in the lucky office as I never get complaints from my team of not enough supplies or of them not being available. Only thing I have had to supply myself was my stethoscope and b/p cuff.

[ProBeeRN, BSN, RN]

We contract with Medline (http://www.medline.com) for all Medicare patients and the supplies are shipped to the home directly. We are able to get some stuff to keep in our cars (gauze, saline, syringes, tape) - but even things like kerlix, abds, and especially hydrocolloids, hydrogel, etc., all need to be ordered. It's a "cost saving" thing so that these supplies don't go to our non-Medicare patients who are supposed to get their own from a DME company. They're available at the office in small numbers, but they are LOCKED UP and we have to give the patients Medicare numbers to bring them to the home. Honestly, it can be a real challenge getting supplies for the non-covered patients. I end up keeping a "private stock" in my car of leftover supplies from discharged patients, etc. for emergencies.

[AnnemRN]

We contract with Medline (www.medline.com) for all Medicare patients and the supplies are shipped to the home directly. We are able to get some stuff to keep in our cars (gauze, saline, syringes, tape) - but even things like kerlix, abds, and especially hydrocolloids, hydrogel, etc., all need to be ordered. It's a "cost saving" thing so that these supplies don't go to our non-Medicare patients who are supposed to get their own from a DME company. They're available at the office in small numbers, but they are LOCKED UP and we have to give the patients Medicare numbers to bring them to the home. Honestly, it can be a real challenge getting supplies for the non-covered patients. I end up keeping a "private stock" in my car of leftover supplies from discharged patients, etc. for emergencies.

We use Medline too, but I find the quality of the products inferior to other brands. Our agency does not carry many of the products we need either - I've had to get really creative to get by until the drop shipment arrives.