2018 HME Business Handbook: Home Access

How To Identify And Work With Home Access Partners

As the complexity of home access goes up, a partnership might make sense. How should you approach?

For retail-minded HME businesses, offering home access gives them the ability to reach out to both existing and new patient groups to provide a much-needed service that is free of Medicare interference.

Moreover, those services can be very lucrative the more complex they become. For instance, a threshold ramp is a great retail add-on, but installing ramps or vertical platform lifts can drive enough revenue to practically stand on its own feet as a business.

Best of all, home access is attractive because it offers providers a migration path for building their business. HME businesses can start off by offering simple items related to their expertise, and then build from there. For instance, a provider serving senior patients could start by offering bath safety products, and then move into other areas of the home, such as the kitchen or stairs to provide additional solutions. Eventually, they can work their way up to entire remodels.

But at providers increase the level of complexity the amount of training and expertise or licensing involved also goes up. Full bath remodels, ceiling lifts, powered cabinetry and indoor elevators require a much higher level of factory training and certification to offer and install.

At a certain point, a provider will likely need to find construction and other professionals it needs to partner up with in order to provide those more complex home access services. What should they look for?


When looking for construction experts to help with your major home access upgrade project, start by using the VGM Live at Home (LAH) and National Association of Home Builders (NAHB) networks to find credentialed professionals. You want contractors that know the local building codes and have the necessary insurance coverage, but you also need to ensure they understand home access.

LAH’s Certified Environmental Access Consultant (CEAC) credential ensures its holders can work up from one level to the next while ensuring they cover the minimum standards for safety, competence and capability. Moreover, other home access businesses that might want to work with them will be able to get a clear picture as to the extent of the provider’s home access skill and knowledge.

At its basic end (Level 1) the CEAC credential means the provider can offer threshold and suitcase ramps, basic assistive transfer devices, bath safety, and multiple aids to daily living products. At its highest level (Level 5) designates that professional as a licensed contractor or remodeler. Projects at this level are considered quite involved and a team approach is recommended. Level 5 providers comply with any applicable building codes and license requirements along with involving the licensed trades, such as plumbers and electricians. Typical projects would be complete bathroom modifications or renovations, such as roll-in showers, walk-in tubs, widening doors, kitchen modifications, additions and elevators.

The NAHB National Association of Homebuilders (NAHB; nahb.org) provides home access training and certification via its Certified Aging-in-Place Specialist (CAPS) designation. The CAPS program gives contractors an overview of the equipment and fixtures that can make life safer and easier for seniors living at home, and also offerings technical insights on how to properly install these items. More in-depth knowledge on more complex solutions is available through an NAHB course called Universal Design that shows how to install devices such as elevators, and movable sinks and cabinets.


For the most part, home access is not a funded item, which means that the transaction will be largely retail, and as the equipment gets more complex it gets more expensive. Moreover, major home remodeling projects can involve even more money. In fact, the construction costs associated with remodeling and reconstruction projects can cost as much as 12 percent higher for an accessible home as a standard home.

This becomes especially important when you start to consider the means available to mobility patients. Many patients that need serious home access overhauls do not necessarily have the income to pay for such major projects, because often their condition can impact their earning power. According to some studies, as many as one-third of disabled patients live at or below the poverty line and might not qualify for home loans. In this case, there are special loan programs and other forms of funding that can help them attain the home access services they need.

So how do patients pay for these costs? Providers should have some answers. First off, there are special grants and other options outside of true financing solutions. For instance, the Department of Veterans Affairs (VA) offers its Home Improvement and Structural Alterations and Special Home Adaptations grants for disabled veterans. Many state Medicaid programs offer home and community-based waivers that can help fund accessibility modifications. Also, local grant programs can sometimes help. Often area charitable organizations will provide financial help to those who qualify. Local or area Muscular Dystrophy Associations often keep lists of these sorts of organizations and can help providers better understand the grants available.

For patients that don’t need financial assistance, providers should build relationships with lending professionals that have a solid understanding of special local, state and national lending programs from commercial and government sources that are geared toward helping patients finance their home access modifications and construction. These partners will not only help their patients and help generate the funding necessary to drive a home access project, but they can also become key referral partners that will use their marketing resources and their reputation to help drive business back to the provider.


  • Home access can be extremely lucrative as the products and installations grow more complex.
  • As those projects require more knowledge, providers might need to start partnering up with contractors and other non-HME professionals.
  • For contractors, besides having the necessary licensure, insurance and building code knowledge, make sure they have access-specific credentials, such as CEAC and CAPS.
  • Your home access funding partners should also include funding sources, ranging from grants to lenders that specialize in loan programs that can facilitate home access.


You can find out more about the Certified Environmental Access Consultant (CEAC) credential through the VGM Live at Home (vgmliveathome.com), and learn more about the Certified Aging in Place Specialist (CAPS) designation from the National Association of Home Builders (nahb.org).

This article originally appeared in the June 2018 issue of HME Business.

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