Anyone Else Have Issues With Davita?

[BattleScars]

Last summer I got fed up with how things were going with my treatment at a CAPD unit that is located at a hospital in Boston so I left and went to Davita. Now I'm really starting to regret ever leaving that hospital unit. I had issues there but nothing compared to the issues I'm having at Davita. This is tough to explain but I'll do my best to try and lay it all out for those of you who might not be familiar with the medical tape fiasco I went through a few months back.

I started my PD treatments with Davita in early September. The PD nurse explained that she was going to order me a bunch of supplies and to let her know if I was missing anything or wasn't using anything she ordered. I was wondering why she never asked me what I normally use considering I had already been doing PD for 2 years but after that didn't give it much though. My first order was bizarre. She ordered 70 boxes of each solution. I have a spare bedroom but I almost ran out of space. I had never seen anything close to this size of a delivery. I also got an assortment of things I didn't need and/or would never use. I actually ended up throwing out a bunch of stuff because I was tired of the clutter. One thing she didn't order me was the medical tape I use. There is only one type that works for me because others either don't stick or rip my skin and another one I'm allergic to. My previous Rx had always allowed me to order 6 rolls of this tape and that was always just about right for one month. I didn't panic because I had a few spare rolls so I thought it would all get sorted out. Well now it's January and it STILL hasn't been resolved! Not only that this entire tape fiasco has created so much drama and grief I'm ready to leave Davita!

 I first mentioned the tape situation to my PD nurse in late September. She said she would put the tape on my Rx. When my next order showed up in October I got a small box from UPS and I assumed my tape was in that box so I set it aside. By this time I was on my last roll of tape. I know now I should have peaked inside that box but I didn't until it was too late. I ran out of tape on a Saturday and I go to open the box and wouldn't you know it, no tape! I had to use tape that didn't work for me. I called my PD nurse and left her a polite message explaining the situation and letting her know I could come by the clinic Monday and pick up a couple of rolls of tape. That Monday I got no call back from her. After trying to reach her a couple times I gave up and spoke to someone in the dialysis unit. At this point I still was very calm, I assumed I could just drop by and pick up the tape. It was then that I was told Davita does not carry extra tape and I would have to contact Baxter. Baxter told me it would take 14 days! I looked online to see about just purchasing the tape myself and it cost $70 for a case (6 rolls) so there was no way I was going to do that.

Later that day I get a call from my PD nurse yelling and screaming at me because I "went above her" and I called her on na Saturday and she had "real emergencies" she was dealing with. She was completely freaking out on me. I got angry at this point and told her I wanted to see about finding a new nurse and she went off on me saying "after all the personal favors I've done for you and I've bent over backwards.." I was like what personal favors are you talking about? She goes on to tell me that she helped get my hemoglobin up and helped me get my meds. I said, "That's your job!!!!"Anyways that conversation did not end well.

After that I called Davita guest services to see about getting this resolved. After that my PD nurse finally ordered me one roll of tape! I called Baxter and was told I was only allowed one roll of tape per month. They finally called my PD nurse and she authorized 4 rolls but she won't budge. Now I am running out again at the end of every month. I have called Davita and they don't even care. Worst yet my PD nurse refuses to set up any appointments with me. Last month I went in to see my neph and my neph asked me where my labs were and I told her my PD nurse never called or attempted to set up an appt with me. That's when my PD nurse chimes in and claims to have called me several times and I never answered. That BS! I never had one missed call from her. And even if this were true what she was saying then why didn't she mail off a letter to get a hold of me? I know and she knows she's lying. Now she's even more angry I complained about her and she's retaliating against me. This I have no doubt.

In the meantime I haven't had an EPO injection in 3 months and I'm feeling really weak. I have asked over and over again to be transferred to another clinic because I don't feel safe with her as my nurse and they keep saying they will but haven't. But they have no problem sending ME threatening certified letters. I got one 3 weeks ago telling me I had an appt on Christmas Eve at 4pm to discuss my treatment plan. I called them and told them I was going to be with my family and we would have to reschedule that until after Christmas. I didn't hear back until I received a threatening letter saying I wasn't following the rules I signed saying I would keep all my appts! It was also saying no matter what I would have contact with the nurse I can't deal with because she provides coverage to all local clinics.

I called Davita again today and again I'm being made out to be the problem. Everything keeps getting turned around on me. They also NEVER call me. They just keep sending me certified letters in a lazy attempt to cover their own butts. They won't work with me at all and seem completely inflexible. They expect me to just drop whatever I'm doing and meet their demands. And worst yet, I still have NO DAMN TAPE!

I have never seen this before. I want out. I feel like giving up. To me this is the worst part of dialysis, it's their way or the highway. I can't safely tape my transfer set unless I fork over $70 out of my own pocket. If I don't comply with their unreasonable demands I won't be allowed to continue dialysis with them. Does anyone know a clinic in the Boston area where I can get treatment that isn't Davita and uses Baxter? I'm willing to even drive all the way out to Worcester if need be or up to NH. 

[BattleScars]

I also want to add one more thing. Everything with Davita seems to be about money so maybe that's why I can't get more than 4 rolls of tape but I have private insurance that we pay a lot of money for. Davita looked into Fedexing me some tape and they claim it would cost them over $200 to ship one roll of tape. I know that's a lie or they are the most inefficient company on this planet. They make the government look super efficient. I really can't wrap my head around this tape issue. It seems so simple to solve but at this point I really do believe this nurse is just trying to screw with me.

[noahvale]

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[Simon Dog]

Why is "uses Baxter" a requirement?  If you are flexible on that point, the Fresenius clinics present an additional option.

[Shaks24]

Its funny. The item I use the most of seems to be nonsterile 2x2 gauze. Use it for exit site care and doing sanitizing in set up. On my last order I asked for 2 packs and they said they could do only 1. Tape on the other hand no problem. Will ship all I want. I am with Fresenius. I guess they all got little quirks.

[obsidianom]

Why do you use non sterile guaze for exit site and sterile work?? We use only sterile 4 by 4 s and 2 by 2s .  Its safer.

[Simon Dog]

Why do you use non sterile guaze for exit site and sterile work?? We use only sterile 4 by 4 s and 2 by 2s .  Its safer.

The Fresenius standard is non-sterile.  In-center, they tape non-sterile directly on the exit site with no antibiotic.    I can order WAY more non-sterile than I need with my monthly FMC order, but only one box of sterile.    I haven't been worrying about it since I always put a dab of bactriban that soaks the side of the gauze that contacts my skin.  Fresenius uses only sterile when dealing with catheter exit sites.

The amount of stuff you can order from Fresenius is set by your nurse.    If you order more, and ask, the customer service team will contact the RN who handles your case for approval.  I never did this with gauze as my Rx limits me to 3 packs, however, I didn't have transducer protectors on my Rx, but ordered them - the RN got a call, approved it, and they showed up with the rest of the stuff.   

My RX allows me to order twice as many line sets as dialyzers.    I will know why this is the case when someone explains why hotdogs come 10 to a pack and buns 8 to a pack.   I also have some nonsense on my "authorized list" - I am required to use 14moh calibration solution and allocated 1 bottle a month.  BUT.... I am also authorized for 2 bottles of 12.5moh calibration solution I have been told not to use.

Tape on the other hand no problem. Will ship all I want.

There is a limit - you just haven't seen it.  Ask your RN to give you a copy of your Rx. for both the prescription and anciallary items (separate forms).   It will list the maximum you can order of each item as well as the quantity on your initial order.

[Shaks24]

I was trained to do catheter exit site daily care with non-sterile 2x2s. Each day after shower I dab dry with 2x2 then use another 2x2 to dab exit site with Gentimicin cream. Then tape a 2x2 over exit site. Thats how I was trained and after about 5 months have had no issues. While the exit site was still healing I dabbed with a disinfectant prior to the Gentimicin cream. They said I could stop that after it healed well. I also spray my shower head twice a month with bleach water.

[Bungarian]

...

[BattleScars]

Why is "uses Baxter" a requirement?  If you are flexible on that point, the Fresenius clinics present an additional option.

I guess it's not a requirement. I'm just unfamiliar with Fresnius and my only experience was an awkward one when I had to use it in the ER. I found the setup very confusing and much more complicated than Baxter. I'm open to Fresnius if I can get away from Davita. 

[BattleScars]

You can contact the ERSD Network of New England to file a grievance and ask for their help in resolving the issues you have with the clinic.  ESRD Networks are contracted by Medicare and its functions include overseeing quality of care in dialysis facilities and assisting patients with facility grievances.

General info about the ESRD Network of New England - http://networkofnewengland.org/

Info on filing a complaint - http://networkofnewengland.org/wp-content/uploads/2013/01/Do-you-have-a-concern-2008-MA-poster.pdf

Grievance Policy
PURPOSE
The purpose of this policy is to protect patient rights and to establish a process for the resolution of Grievances. The Network encourages open communication between local providers of ESRD healthcare services (dialysis and kidney transplant) and CKD / ESRD patients. Effective communication; as presented in the Decreasing Patient Provider Conflict (DPC) Toolkit, combined with patient education are keys to the avoidance of complaints in the ESRD setting. In the event that resolution of problems cannot be reached at the provider level, the Network serves as an objective arbiter of Grievances under authority of Centers for Medicare and Medicaid Services (CMS) federal contract.

The Network cannot and will not retaliate, discriminate against, intimidate, coerce or otherwise reprise patients or patient advocates who file Grievances.


Also, if your private/group insurance company is still primary, you might want to call Davita's guest services again and gently remind them of that fact.  The company does not want to lose the income you bring in.

As far as where to go outside of the Boston area for care, contact the Kidney Transplant/Dialysis Association (www.ktda.org).  It's a volunteer patient/family member organization that has been around for over 40 years in the New England area.  I'm sure they can help you with finding a center that better meets your needs.  However, a change of center will probably also require a change in nephrologist.

I wish you the best. ~ NoahVale

Thanks for all the info. I'm gonna follow up with this since I'm getting nowhere with Davita.

[Simon Dog]

The Fresenius standard is non-sterile.  In-center, they tape non-sterile directly on the exit site with no antibiotic.

Ooops, a correction is due.  Fresenius uses only sterile for PD; non-sterile for HD would coverage.