Durable Medical Equipment: What It Is, Why It Matters, and How Case Managers Make It Happen
One of the most important parts of a safe discharge plan isn’t medication or follow-up appointments—it’s durable medical equipment (DME). Whether it’s a walker, hospital bed, or bedside commode, DME helps patients stay functional and safe once they leave the hospital or ED. And more often than not, it’s the case manager making sure that equipment is identified, justified, approved, and delivered on time.
What Is Durable Medical Equipment?
DME refers to medical items that:
Are reusable
Are used for a medical reason
Are appropriate for home use
Are needed due to illness, injury, or disability
Common examples include:
Walkers, rollators, and canes
Manual or power wheelchairs
Bedside commodes and shower chairs
Hospital beds and over-bed tables
Oxygen equipment
CPAP/BiPAP machines
Suction devices and nebulizers
In the acute care or emergency department setting, mobility aids and toileting support are some of the most frequently needed.
When DME Delays Discharge
Sometimes the only thing holding up a discharge is a missing piece of equipment. Maybe the patient is recovering from a fall and needs a walker, or they’re weak and can't safely get to the bathroom. Without the right equipment, discharging them becomes risky—or simply not possible.
Justifying DME: Cue the Therapy Team
A physical therapy (PT) or occupational therapy (OT) evaluation is often the gold standard when it comes to DME justification—especially for mobility aids or when higher-level equipment like a hospital bed is needed. Therapists assess the patient’s functional status and mobility, and their evaluation provides documentation that supports medical necessity for insurance coverage.
When discharge is coming fast, early involvement of PT/OT is key. Their recommendations help ensure that the equipment is appropriate, justified, and likely to be approved.
Insurance Coverage: What to Expect
Most insurance plans, including Medicare, will cover medically necessary DME when properly justified. Coverage typically requires:
A documented need due to illness or injury
PT/OT or clinical evaluation
Evidence that the equipment is for in-home use and not convenience
Some equipment requires prior authorization or has frequency limits, so knowing what your patient’s plan covers is important.
Coordinating Delivery: Bedside or Home?
Once equipment is approved or ordered, delivery logistics matter. As case managers, we often coordinate:
Bedside delivery for patients discharging from inpatient units, rehab, or SNF
Direct-to-home delivery for ED discharges or short-stay patients, especially when avoiding admission
For emergency discharges, delivery to the patient’s home may be the only option if DME reps can’t respond quickly enough for bedside delivery. It’s helpful to work with vendors who offer same-day delivery and have a reliable communication process for troubleshooting.
Some hospitals have preferred vendors, while others allow families to choose. Keeping a short list of responsive suppliers on hand makes all the difference when time is short.
When Insurance Doesn’t Cover It: Private Pay Options
Sometimes insurance won’t cover the item—or can’t cover it fast enough. In those cases, private pay is the backup. It’s not ideal, but a $40 bedside commode from a local pharmacy may prevent an overnight stay that costs thousands.
When guiding patients through private pay:
Share local DME suppliers, pharmacies, or even online options like Amazon
Clarify that they may still pursue reimbursement or coverage later through their primary care provider
Be honest about urgency versus cost: safety usually comes first
Final Thoughts
Durable medical equipment might seem like a small piece of the discharge plan, but it has a major impact on patient safety and hospital flow. Whether you’re preventing an admission from the ED or helping a frail patient return home after surgery, having the right equipment in place is essential.
Case managers don’t just place DME orders—we coordinate, communicate, and advocate to make sure the right tools are there when and where they’re needed most.
