Ancillary Supplies from Fresenius

[PrimeTimer]

Maybe we've been spoiled by having supplies delivered but my husband (the home hemo patient) was told by his nurse this week that with the exception of saline, we will have to pick up the ancillary supplies (gauze, tape, needles, etc) ourselves from the center because Fresenius is no longer going to have them delivered. That bums me out, to say the least. 

[cattlekid]

Hmmmm....wonder what the reasons are for the change?  Cost cutting, I'm sure.

I wonder what will happen if the center runs out?  Are you going to be rationed?  When I was on home hemo, Baxter (through DaVita) had crazy amounts of supplies listed for deliveries and I would have to call in and majorly cut down my supply deliveries or I would have been overrun and could have opened my own urgent care clinic.

[PrimeTimer]

No doubt that they will make it sound "convenient" for us by saying, "Oh, don't worry, your husband can pick up his supplies at his monthly appointments" when in reality, it will probably go something more like this: "Oh. Here's a box of gauze for now. You can come back next week to get the rest of your supplies when we get more in stock". This will mean more trips to the center (translation: gas, time, scheduling, phone calls, money, lifting boxes in/out of the car and bringing them indoors, etc...)  Perhaps after a month or two, I will check with our insurance company to see if they were made aware of this change and if they are paying less or more for the supplies to be delivered to the center opposed to our home. Of course, I doubt they will discuss any dollar amounts with me, as I am sure that is something negotiated and agreed upon between them and the center but, I will be curious to know if our insurance company will be made aware of this change in the convenience of doing "home" hemo and any increase/decrease in their and the center's costs or not. and the increase to OUR costs, which will not only include gas in the car but TIME is also very valuable. Or perhaps we've just been spoiled by home deliveries.

[noahvale]

*

[PrimeTimer]

Maybe we've been spoiled by having supplies delivered but my husband (the home hemo patient) was told by his nurse this week that with the exception of saline, we will have to pick up the ancillary supplies (gauze, tape, needles, etc) ourselves from the center because Fresenius is no longer going to have them delivered. That bums me out, to say the least. 

Your husband will need to be proactive.  3 days before his monthly appointment have him call and remind the home training coordinator/nurse when he'll be coming in.  Also, send an email/fax of the needed supplies for the month.  Once there, if told, "sorry we don't have everything in stock, come back in a few days for the rest" he's got to stand up for himself.  Let them know how much of an unneeded inconvenience it will be and that they should provide the same service as the home delivery company.  That's one of the selling points of home treatment.   

As for contacting his insurance company, give it a try.  However, I'm afraid you'll probably just be spinning your wheels.  But, ya never know!  Also, you can write a letter of complaint to the facility administrator with copies to the FMC regional director and your ESRD Network.

However, I hope the change goes smoothly. - NoahVale

Thanks, Noahvale. Yes, we are going to have to be proactive about this. I remember how they touted and signed my husband up for their "Ultracare" and "TOPS" programs (when I remind my husband "the patient" of that, he laughed and told me it was probably all just propaganda) and now I wonder if he's right. I assume that if we have to put in our supply request to the nurse, there is going to be a lot of back/forth and phone tag, because as it is now, any time we call we are told "she's busy with a patient". Not her fault tho...she's been very good to us but they overwhelm her with patients. She usually calls us back in an hour or two but if we have to go thru that every month for supplies, that's going to be awfully frustrating and time consuming. As for email, we asked her a long time ago about that but she said they (Fresenius) didn't allow the nurses to have email so unless that has changed, that option is out. As for the saline still being delivered, I pray it's not going to be via UPS. Even if we can arrange the delivery time, they only deliver to the door, they won't bring the boxes inside. Ah well...we shall see. But first things first, we are going to remind them about how Fresenius sold us on the convenience and benefits of doing "home" hemo, including their "Ultracare" and "TOPS" programs.

[Hootie]

We use davita and have a great relationship with home hemo nurse. I send her the list of supplies needed and when we meet with nephrologist monthly, she has the supplies on a cart ready to roll to car. There have been times where we ran out and she overnights emergency stuff. She will not overnight EPO as it has to be picked up. Communications is the key. Be aggressive in what you need. 

[PrimeTimer]

Thanks, Hootie. I agree, communication is key. And in this case, I fear there will be a lack of it due to the nurse being too busy. Since she (and the other nurses) at the center are always so busy with patients, I can't imagine them having the time to take phone calls or read emails to take supply requests AND THEN going to the supply room and filling everyone's supply requests while at the same time, seeing their daily onslaught of patients that are there for their monthly appointments and/or because they are having trouble with their catheter, fistula etc.....I mean, if they are too busy to come to the phone when we call, I don't think they are going to magically have time to be filling everybody's orders in a timely fashion ahead of time or even during a patient's monthly appointment.

[Simon Dog]

I assume that if we have to put in our supply request to the nurse, there is going to be a lot of back/forth and phone tag, because as it is now, any time we call we are told "she's busy with a patient"

I email the RN who is my handler, she orders the supplies, and the package shows up on my door about 3 days later.

THEN going to the supply room and filling everyone's supply requests

The RN orders my supplies (presumably via a web portal) from MMS Pharmacy for direct shipment to me.  The only supplies grabbed from the clinic are blood sample tubes, clamps and large syringes (60cc)

As for email, we asked her a long time ago about that but she said they (Fresenius) didn't allow the nurses to have email so unless that has changed, that option is out.

WTF?

The fresenius standard for emails is firstname.lastname@fmc-na.com.    If that doesn't work, email to clinic####@fmc.na (#### is your clinic number) and ask the message be forwarded to your RN.  If that fails, use the clinic fax number.   Carrier pigeon is not practical due to the diseases birds can carry and the medical nature of the facility.

I will check with our insurance company to see if they were made aware of this change and if they are paying less or more for the supplies to be delivered to the center opposed to our home.

Your insurance company is probably paying a negotiated "per treatment" price, and is not concerned with the details of how this is accomplished.

As for the saline still being delivered, I pray it's not going to be via UPS. Even if we can arrange the delivery time, they only deliver to the door, they won't bring the boxes inside.

Your prayers are not going to be answered.  But, you can order a few boxes at a time and don't have to play the "stock up" game with the bi-monthly deliveries formerly offered by TruBlue.

Hmmmm....wonder what the reasons are for the change?  Cost cutting, I'm sure.

I was told the reason was the $300 per trip delivery charge that FMC was charging itself.

[PrimeTimer]

Anyone able to pick up a whole box of Fistula needles from their Fresenius? Or do you now just get a few at a time? One time the nurse didn't know if we needed more needles or not so she jammed a few into a sharpes container and my husband brought them home in the trunk of the car. I don't think that is sanitary. For one thing, the lid to the container didn't fit because of the length of the packaged needles. We are soon going to be needing needles and I want to prepare. Sorry if this sounds like a stupid question.

[Vt Big Rig]

Anyone able to pick up a whole box of Fistula needles from their Fresenius? Or do you now just get a few at a time? One time the nurse didn't know if we needed more needles or not so she jammed a few into a sharpes container and my husband brought them home in the trunk of the car. I don't think that is sanitary. For one thing, the lid to the container didn't fit because of the length of the packaged needles. We are soon going to be needing needles and I want to prepare. Sorry if this sounds like a stupid question.

Ours are delivered with our "monthly" order! At clinic we get large syringes if we need some, alcohol pads, EPO, heparin, and lab tubes and material.

[Simon Dog]

The Fresenius clinic I use orders supplies for me from MMC Pharmacy in TN.   The fistula needles are ordered "by the needle", not "by the box".  The key is having your RN order a full box quantity (for JMS, this is 300 blunts or 250 sharps; it may vary for other brands).   The RN who takes care of me has no problem ordering full boxes for me.

It looks like I have the same setup that Vt Big Rig has with regard to supplies, except that I get alcohol pads in my order, not from the clinic.

The individual needle ordering is handy if you are using buttonholes and need a small supply of sharps on hand in case you have problems with your regular access location.

[PrimeTimer]

  Hubby came home with a full box of fistula needles all still inside their original box. (JMS Harmony)