Admission Eligibility

All hospice and palliative care providers are not the same. Hospice Alliance has been an active member of the communities we serve for over 35 years. We are truly community based and community focused.

Hospice Alliance is a non-profit provider. We offer services that corporate-owned providers can’t or won’t. Every patient receives award-winning care, regardless of ability to pay.

Hospice Eligibility:

The first step in evaluating whether a patient with a life-limiting illness is appropriate for hospice care is determining that the patient prefers hospice and palliative care over curative treatment. In addition, a patient will likely have one or more of the following indicators present:

  • Loss of function/physical decline
  • Increase in hospitalizations
  • Dependence in most activities of daily living
  • Multiple co-morbidities
  • Increase in ER visits
  • Unexplained weight loss

The patient’s personal physician or a hospice physician must certify that the patient’s prognosis is six months or less if the disease runs its normal course. Hospice care can be extended beyond six months as long as the patient continues to meet eligibility criteria.

Disease specific eligibility indicators:

(Patient may not need to meet all disease specific criteria if the patient has worsening clinical status)

Alzheimer’s Disease

1) Stage VII or beyond according to the Functional Assessment Staging Scale (FAST) with ALL of the following:

  • Ambulatory ability is lost
  • Ability to speak limited to approximately 5-6 intelligible words or fewer in the course of an average day or in the course of an intensive interview.
  • Speech ability is limited to the use of a single intelligible word in an average day or in the course of an intensive interview (the person may repeat the word over and over)
  • Cannot sit up without assistance
  • Loss of the ability to smile
  • Loss of ability to hold head up independently

 

AND

 

2) Has had at least one of the following conditions within the past 12 months:

  • Aspiration Pneumonia
  • Pyelonephritis or other upper urinary tract infection
  • Septicemia
  • Decubitus ulcers, Multiple and/or Stage 3-4
  • Fever, recurrent after antibiotics
  • Inability to maintain sufficient fluid and caloric intake demonstrated by either of the -following:

-10% weight loss during the previous 6 months

– Serum albumin <2.5 gm/dl

Amyotrophic Lateral Sclerosis
  • Unable to walk, needs assistance with ADLs
  • Barely intelligible speech
  • Difficulty swallowing
  • Weight loss
  • Significant dyspnea
  • Co-morbidities: pneumonia, URI
Cancer
  • Metastasis to multiple sites    
  • Weight loss
  • Patient/family chooses palliative care
CVA and Coma
  • Decreased level of consciousness, coma, or persistent vegetative state
  • Dysphagia
  • Paralysis
  • Post-stroke dementia
  • Decreased nutritional status (despite artificial nutrition)
  • Co-morbidities
Heart Disease – CHF
  • NYHA Class III or IV
  • Discomfort with physical activity
  • Symptomatic despite maximal medical management
  • Arrhythmias resistant to treatment
  • History of cardiac arrest
  • Cardiogenic embolic
HIV/AIDS
  • Wasting syndrome
  • CNS lymphoma/Kaposi’s sarcoma
  • AIDS dementia
  • Decision to forego antiretrovirals
  • Co-morbidities/severe infection
Liver Disease
  • Not a transplant candidate
  • Ascites despite maximum diuretics
  • Peritonitis
  • Hepatorenal syndrome
  • Encephalopathy with somnolence, coma
  • Recurrent variceal bleeding
Pulmonary Disease – COPD
  • Dyspnea at rest
  • Poor response to bronchodilators
  • Recurrent pulmonary infections
  • Cor pulmonale/right heart failure
  • Weight loss
  • Resting tachycardia
  • Hypercapnia/hypoxemia
Renal Disease
  • Plan for discontinuing dialysis
    • Rapidly declining despite dialysis
    • no renal transplant
  • Displays signs of uremia (confusion, nausea, pruritus, restlessness, pericarditis)
  • Intractable fluid overload
  • Oliguria
  • Hyperkalemia
Dementia and/or General Decline
(*Per CMS can only be used as secondary diagnosis/not primary.)

More Resources

Information on Caring Connections can assist people in making decisions about end of life care and services before they are absolutely needed. It is offered as a program of the National Hospice and Palliative Care Organization, which also provides quality resource materials and information.
The National Hospice Foundation and the Hospice Foundation offers valuable supporting resources as well.

Contact us for more information or to schedule a consultation: 1-800-830-8344