When “Cheap” DME Becomes a Clinical Risk

At first glance, a low DME per diem looks like a smart financial decision. The price is clear, the contract is signed, and the equipment shows up. At least, in theory.

But clinical teams know the reality.

In most hospice settings, the real cost of DME isn’t just about the rate. It’s about what happens when that system breaks. And more often than not, it’s the clinical team that feels it first.

It Starts With Delays

Hospice care doesn’t run on a 9 to 5 schedule. But many DME vendors do. That disconnect creates real consequences.

The Friday night admit where the bed doesn’t show.

The oxygen delivery that’s “on the way” for four hours.

The support call that rolls to voicemail after 5 PM.

Each breakdown may seem minor in isolation, but for your team, it often means:

• Nurses making workaround decisions instead of delivering care
• Staff calling multiple vendors just to track one item
• Patients and families left confused, waiting, or worse — in pain

These aren't just operational annoyances. They’re clinical risks.

And It Shows Up in the Metrics That Matter

What many hospice leaders overlook is how DME performance ties directly into clinical outcomes and oversight.

• CAHPS Scores: Nearly 50% of survey questions are influenced by equipment availability, patient comfort, and staff responsiveness. All areas impacted by DME reliability.
• Referrals: One bad family experience can affect the trust built with referral partners, especially when discharge delays or poor transitions are equipment-related.
• Compliance Risk: When beds or equipment don’t arrive on time, staff are forced to improvise. That can lead to charting inconsistencies or care plans that don’t align with expectations.

In short, the “cheapest” model isn’t cheap when it costs you compliance, reputation, or clinical trust.

The Risk Isn’t Obvious Until It Is

Most low-cost DME models look fine at first. The vendor is responsive, deliveries show up, and the per diem feels sustainable.

But hospice care changes.

• Patient acuity increases
• Admission volume fluctuates
• After-hours needs grow
•  

When vendors can’t flex with those changes or when their support structure relies too heavily on your internal staff to follow up, the cracks become clinical.

Missed care windows. Delayed symptom management. Burnout among nurses who are stuck on the phone with DME reps instead of with patients.

The tipping point usually comes quietly, after months of minor disruptions become normalized.

What Clinical Leaders Should Watch For

If your DME partner isn’t built specifically for hospice, here’s what to look out for:

• High volume of non-formulary exceptions
• Nurses chasing updates outside business hours
• Families reporting confusion about what’s been delivered
• Increased pressure on admission or triage nurses to track equipment status
• Lack of escalation path when something goes wrong
•  

Each of these is a signal. Not of clinical failure, but of a fragile support model.

What a Better Model Looks Like

At Qualis, we work with clinical leaders who’ve dealt with this firsthand. The shift they make is simple: They stop evaluating DME as a cost and start evaluating it as a system.

That means working with a partner who:

• Stays accountable after delivery, not just at order
• Owns vendor follow-up and escalation
• Operates 24/7 to meet clinical need, not office hours
• Surfaces visibility into delays before they affect care
• Protects nurses from playing “equipment middleman”

Because when your DME support structure works, your team can focus on what actually matters. Delivering comfort, quality, and peace of mind.

Final Thought

Cheap DME is easy to defend on paper. But in real hospice care, what seems like a savings often becomes a silent clinical burden.

If your nurses are doing more work to make DME “work,” it’s time to ask:

What is that really costing you, and who’s paying for it?