Hello Mark

   We techs here in Halifax do the home assessment and we then have the potential home patient call at least two contractors for quotes which are then assessed by myself and the home unit manager. On our initial visit we make sure treatment and storage space is adequate, test water supply for sufficient flow and pressure and draw a water sample and submit to lab.

Sometimes things get missed that you would not think about.
Example:  Recent new home patient assessment went very well with regard to water, electrical and space. It was to be set up in a large room in the basement and I arranged a courier to deliver the dialysis machine only to find out that the door to the room was too narrow to let the dialysis machine pass through. Turns out the home had been renovated and this particular doorway was built too narrow(it actually did not meet the provincial building code).  All we needed was about 1 more inch so with the home owners approval we removed the door frame. Whatever it takes!!LOL
  
Mark, this example illustrates your concern about inexperienced techs doing assessments. I am 20 years experienced in a home dialysis program and this narrow door got by me but will not again. Live and learn as they say.
 
I like Ron's way of having a single contractor under contract but I have had problems here in N.S. with some contractors who do not want to travel very far.  But I have several "goto" contractors who do good work and have experience in the application. We provide the contractors with the proper specs and pictures of other installations.