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Hospice Eligibility Criteria

Making a difference in the Lives of our patients and their families everyday!!!


If you or someone you know has symptoms of a life-limiting illness, give us a call for a free evaluation at 855-655-0500.


The following clinical signs often support hospice eligibility in combination with another primary diagnosis.

hospice eligibility criteria

ALZHEIMER'S DISEASE

  • Limited vocabulary or meaningful conversation

  • Unable to sit / stand without assistance

  • Needs assistance with bathing or dressing without assistance

  • Weight loss, infections, falls or ER visits

  • Comorbid / Secondary conditions

HEART DISEASE

  • Swelling leg and / or feet

  • Shortness of breath on exertion

  • Symptoms present even at rest

  • Ejection fraction 20% or less

  • Fatigue

  • Recent cardiac hospitalization, not transplant candidate

LIVER DISEASE

  • Swollen abdomen

  • Weight loss abnormal clotting

  • Fluid has to be drained from abdomen by physician

LUNG DISEASE

  • Shortness of breath at rest

  • Progressive weight loss

  • Must sit up straight to breathe

  • Chronic CO2 retention

  • Emergency room visits, hospitalizations, for infections, respiratory failure or distress

STROKE OR COMA

  • Unable to sit / stand without assistance

  • Unable to maintain weight

  • Needs assistance with bathing or dressing without assistance

  • Weight loss, infections, falls, ER visits

  • Comorbid / secondary conditions

NEUROLOGIC DISEASE: Chronic degenerative conditions such as ALS, Parkinson’s, Muscular Dystrophy, Myasthenia Gravis or Multiple Sclerosis)

  • Critically impaired breathing capacity

  • Rapid disease progression with progression from:

    • Independent ambulation to wheelchair or bed-bound status

    • Normal to barely intelligible or unintelligible speech

    • Normal to pureed diet

    • Independence in most ADLs to needing major assistance in all ADLs

    • Critical nutritional impairment demonstrated by all of the following in the preceding 12 months:

      • Oral intake of nutrients/fluids insufficient to sustain life

      • Continuing weight loss

      • Dehydration or hypovolemia

    • Absence of artificial feeding methods OR Life-threatening complications in the past 12 months

      • Recurrent aspiration pneumonia,

      • pyelonephritis,

      • sepsis,

      • recurrent fever,

      • stage 3 or 4 pressure ulcers

RENAL DISEASE

  • Patient not seeking dyalisis

  • Patient not a candidate for renal transplant

  • Swelling

  • Weakness / occasional confusion

CANCER

  • Not seeking treatment

  • Not taking chemo, radiation or oral chemo

HIV / AIDS

  • Weight loss

  • Not responding to treatment

  • Infections

  • No HIV treatment

  • Presence of other medical treatments

  • CD4 count <25 or persistent viral load > 100,000

AMYOTROPHIC LATERIAL SCLEROSIS (ALS)

  • Overall decline

  • Weight loss

  • Fatigue

***Other Terminal Illness

  • If the family member does not meet any of the above guidelines, the family member may still be eligible if there's a prognosis of less than 6 months

    • ie. Sepsis, Severe limb-threatening ischemia due to PVD

Timely and appropriate identification of hospice-eligible patients increases the likelihood that they and their families will benefit from compassionate, end-of-life care. By law, healthcare professionals must certify that patients meet guidelines to be eligible for a referral to a hospice provider.


Call Goldencare Hospice and Palliative Care at 855-655-0500 for a FREE ASSESSMENT.

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