I work out an outpatient I wound care clinic, located inside a hospital. KCI vacs are used on the inpatient side, I think they are rented.
The inpatient nurse normally orders a KCI vacs for home use. However, if the patient will be seeing us after discharge, I typically use another DME company.
Two common problems : 1) getting a good seal on a vac located near the anus. This can often be solved by creating a smaller "windowpane" or by using a hydrocolloid (Duoderm) on the edges.
2) untrained personnel applying the VAC improperly.
Change the cannister when almost full. Most patients can do this part themselves. Medicare only pays for 15 per month if I'm not mistaken.
Insurance vary from state to state. However, most VAC suppliers will release an indigent VAC; don't utilize KCI often but know they are generous with this, at least with our hospital.
Hope this helps!