10 Tips for Opening a Durable Medical Equipment Loan Program

Have you ever considered starting your own durable medical equipment loan program but you aren’t sure where to start? We’re featuring two OTs who have done just this and will show you how. Huge thanks to Hannah Wieger, OTR/L and Melissa Kimmerling, OTR/L for showing us the ins and outs of DME loan programs with this guest post!

Occupational therapists are experts in adapting the environment to meet our clients’ needs when short- or long-term impairments threaten the safety of occupational performance. These modifications often involve recommending durable medical equipment (DME). Within the interdisciplinary team, OTs are uniquely skilled to allow patients to become more independent through the recommendation of and fitting for medical equipment.

The following challenges are often faced when attempting to acquire medical equipment for our patients:

• Lack of reimbursement for these items due to payment restrictions from Medicare, Medicaid, and private insurance alike
• Cost of healthcare often places clients in a position where there is little to no money available for the purchase of non-covered adaptive devices
• The situation that led to the hospitalization was often unexpected, putting the client in an even more challenging financial position
• Letters of medical necessity are time consuming and ever changing

Bottom Line: Let’s create more equipment loan programs where this equipment can be reused, recycled and cost nothing for our clients to utilize.

The Methodist Health System in Omaha, Nebraska decided to do just that. After five years of operation, the Durable Medical Equipment Loan Program has saved more than $50,000 in medical equipment costs for the year 2020. The Methodist Equipment Loan Program has produced effective outcomes for our clients and health system through collaboration with the affiliate college, meeting one of AOTA 2025’s pillars to improve occupational therapy in the future (AOTA, 2019).

Whether you have interest in saving the world from medical equipment waste, or just want to be able to help your client’s family struggling financially with the healthcare process, you may want to consider opening a durable medical equipment loan program of your own.

If so, here are 10 steps we recommend to help you get your DME loan program started. Be sure to read through to the end for resources to help get your program off the ground!

1. Start With Why

When the Methodist Equipment Loan Program was developed, the idea was presented at a state association sponsored CEU by another OT living in a rural community. This OT had recently published an article in OT Practice (Lord & Sheehan, 2015), in which the goal of this program was to save CMS dollars on medical equipment through recycling used DME. When my colleagues and I attended the CEU, we immediately thought of our hospital’s Charitable Care Foundation that supports our health system’s clients in financial need by purchasing medical equipment for their transition home.

The amount of money being spent by our health system to support medical equipment has been reduced by 80% after starting a DME loan program. Maybe you’d like to save money being spent on medical equipment? Or perhaps your clients do not have access to equipment.

We suggest designing a formal or informal needs assessment to determine your why and identify the seed you can grow your program from. You may want to consider – Who are your recipients? Who are you marketing to? Who do you need to brainstorm with? What medical equipment is most needed in your area and amongst your clients?

2. Develop a Partnership

Support and teamwork are key to allow you to build your DME loan program and run the program smoothly. There are a number of healthcare workers independently collecting, storing and giving away medical equipment in their own time, but without support and collaboration the amount of people who benefit is small.

Focusing on your mission and the results of your needs assessment, contact community partners who may share those same goals or benefit from free medical equipment and begin collaborating. There are volunteers in your community interested in the benefits of a DME loan program that will help you grow and run the program. Consider developing a partnership with your local OT school, charitable organization, healthcare agencies, church groups, and so many other possibilities.

3. Allocate a Space

Remember that your space can be temporary at first! Once the program gets running, equipment can always be moved to a larger location if data supports the impact and necessity of the program’s growth. Many colleagues in the “reuse and recycle” network begin running their DME loan program out of their garage or an underutilized shed.

There are likely many organizations you can partner with in your community who have extra closet space who may be willing to help you get this idea off the ground. Consider nursing facilities, independent/assisted living facilities, storage units, churches, or even unused patient rooms at your place of employment. The space you allocate to store equipment will influence how large of a scale an equipment drive can be.

4. Host an Equipment Drive

Within your community, health system, business corporation, or on social media host an equipment drive. Once you have collected some equipment from the community, you can really begin to build the program. Ask the OTs in your department to purchase or collect a piece of low cost equipment in honor of OT Month.

Some other suggestions are to post flyers in the community with a number to call and drop off location date/time. If there is one in your area, OT school student organizations can join and assist, setting similar goals for their student body. You could also speak with your state organization and ask for assistance from OT association members and have an easy drawing for most items collected.

In the digital age, it is entirely feasible to host this drive by yourself. Using social media, you are able to ask for equipment donations and to search equipment that has been posted for sale but not sold, sharing your mission for the equipment loan program and asking the original poster to consider a donation. There is likely equipment near you, not being reused or recycled and probably wasting space. Get your hands on it and start your program!

5. Create Your Documents

Some individuals who are donating items may be interested in a charitable donation receipt. Donation receipts must be provided from a 501(c) 3 classified organization. You may need to create a 501(c) 3 for your DME loan program, or partner with an organization that has this capability. The exemplar loan program has partnered with the parent Health System Foundation to write and mail these receipts after the name, address and cost of items donated has been collected.

Being able to provide formal receipts for tax purposes will encourage equipment donation and will be necessary as the program grows and larger items or multiple items are donated equal to thousands of dollars. Additional documents you will need to create include equipment check out forms, listing item numbers that have been checked out and anticipated return dates, and liability waivers for equipment loaned. It should be noted that all documentation including patient information must be kept in a locked filing cabinet.

6. Train Your Workers

This process is impacted by who you have in this role, and who you have chosen to develop a partnership with. Are the volunteers like minded and can fit equipment for patients, such as OT students? Or are they members of a church group who would not know that when someone calls to request a “portable potty” for loan, they actually mean bedside commode?

Take the time to train your workers on the process, and build confidence when they begin taking calls, loaning items, or cleaning and fitting the equipment on your behalf. Consider developing a step by step instruction manual for such processes as how to loan equipment, how to clean a returned item, or how to fit someone for a wheelchair.

A template is located below for you by following the link provided. There may be some pieces of the DME loan program you would like to continue taking lead on and other processes that would be easier for you to delegate to community partners. Divide and conquer!

7. Get a Google Account (Drive, Voice, Sheets)

Bottom line, this is a free service. There are other platforms as well that provide similar services. The use of Google Drive will allow you to create documents that all community partners and coworkers have access to, such as the documents above and the inventory. The inventory is a Google sheet that updates in real time for anyone who has access to the account.

Each piece of DME that is acquired through the loan program is inventoried and given an item number, description, check out date and return date within the Google Drive account. All monitoring and circulation of the equipment is done within this document. As long as those with access understand the process of check out and return, the loan process will go smoothly.

Access to Google Voice allows you to not have to staff open hours, eliminating the need to pay full time employers. Create a Google Voice number for your DME loan program and assign a custom voicemail that shares briefly how your equipment runs and all those in search of equipment or ready to return equipment will leave their details. Google Voice allows you to forward messages to another phone number, to an email, via text, etc. so you can choose the option that works best for your loan program’s efficiency. You can also designate an email for the DME loan program, if you so desire.

8. Decide on a Cleaning Process per CDC Standards

Occupational therapists are no strangers to infection control! Of course, to ensure the safety of all persons who will utilize the equipment, it must be cleaned per CDC standards. There are a number of ways this can be accomplished and guidelines can be reviewed online through the CDC website here.

How equipment will be cleaned may impact the long term space allocated for your loan program, as you may need to consider the flow of your equipment so dirty and clean don’t come into contact. You will need a separate space for clean and dirty equipment. This could be a room with closed doors in the same building, or you could have your dirty equipment returned and cleaned in one location (community partner) and picked up and transported to clean storage space to be loaned.

In the exemplar equipment loan program there are multiple spaces for clean equipment and one closed door room for dirty. Cleaning supplies and gloves are kept in the room with dirty equipment. Proper cleaning supplies may be a sanitizing wipe, a spray with microfiber rag, or potentially a HubScrub unit where equipment is placed inside, sanitized and then removed. Cost may impact the cleaning process you choose to use.

9. Organize your Space and Equipment

Organized storage of your equipment can be key to the loan programs growth. Creating a space where clients or their family members can walk through clean equipment, hold it, sit on it, trial it prior to taking it home for use creates satisfaction and builds trust. It may also prevent mistakes, such as sending someone home with a standard toilet riser when they actually need a toilet riser with handles.

Once your space is organized, you can take pictures for marketing or brochures and invite your community partners to view the program you have built. You may take this opportunity to look for smaller community grants or donations to buy supplies that improve the flow of the program, such as wall mounts for walkers or shelving units to place equipment off the floor. Your space may also need a small toolbox, laminator, tape measure, artwork, signage for the door, etc. A positive experience is often created when a visitor likes the look and feel of the service they are utilizing.

10. Collect Data

All the boxes you have already checked above allow you to get to the point where your DME loan program is up and running. The documents created, platforms utilized, community partners trained, etc. have paved the way for you to be collecting data without even trying. Your equipment can be easily tracked in Google Sheets and the check out forms will tell you how many clients have benefited from DME loan savings.

Yearly or quarterly, we suggest looking at the data and creating a document to show all the ways your DME loan program has been successful and how much it has grown with just one year of support and collaboration. Use this to support funding (grants), continued allocation of space, encourage new equipment donations, identify the equipment with highest need, and motivate and encourage more support from your coworkers or place of business. Getting your DME loan program off the ground takes time, and the continued success of your loan program takes effort and tracking!

______________

We hope by now you are interested in getting your own durable medical equipment loan program off the ground! If you are committed to making this change for your community and your clients, you can also check out UniteOT’s Etsy shop for fully customizable documents to further help you get started.

 

References

The American Occupational Therapy Association, Inc. (AOTA). 2019. AOTA Unveils Vision 2025. Retrieved from https://www.aota.org/AboutAOTA/vision-2025.aspx