Hospice Criteria

Guardian Angel Hospice uses admission criteria guidelines established by Medicare to identify and evaluate patients’ eligibility for Hospice. It is important to remember that these are “guidelines” and individual patient conditions (such as significant comorbidities or rapid decline) may also qualify the patient for Hospice services. We offer evaluations by a physician or nurse to assist you. We do admissions 365 days a year.

Bookmark this page or download our “When is Hospice an option” handout to always have the CORE and disease-specific indicators at your fingertips.

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CORE Indicators

  • Physical decline
  • Weight loss
  • Serum Albumin <2.5 gm/dl
  • Not responding to nutritional support
  • Frequent ER visits or hospitalizations related to primary dx or multiple co-morbidities

(These are just guidelines and a patient may not exhibit all indicators.)

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Amyotrophic Lateral Sclerosis (ALS)

  • Needs assistance with ADL’s
  • Barely intelligible speech
  • Difficulty swallowing
  • Significant dyspnea
  • Declines feeding tube
  • Declines ventilator support

(These are just guidelines and a patient may not exhibit all indicators.)

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Cancer

  • Widespread invasion or metastases
  • Progression despite medical intervention

(These are just guidelines and a patient may not exhibit all indicators.)

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Congestive Heart Failure

  • Optimally treated with diuretics & vasodilators
  • NYHA Class IV
  • Ejection Fraction =<20%
  • History of cardiac arrest
  • Treatment-resistant arrhythmias

(These are just guidelines and a patient may not exhibit all indicators.)

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COPD

  • Dyspnea at rest
  • Recurrent pulmonary infections and/or exacerbations
  • Unintentional weight loss
  • Resting tachycardia >100/min
  • FEV1 <30% predicted
  • O2 sat = or < 88% in room air

(These are just guidelines and a patient may not exhibit all indicators.)

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Alzheimer's Disease

FAST Score of 7:

  • Limited ability to speak (1-5 words/day)
  • Non-ambulatory (cannot walk w/o personal assistance)
  • Dysphagia
  • Not responding to nutritional support
  • Weight loss

 

Co-morbidities:

  • Aspiration
  • Pneumonia
  • Urosepsis
  • Decubiti

(These are just guidelines and a patient may not exhibit all indicators.)

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HIV/AIDS

  • CD4 level is at or <25 cells/ml
  • Persistent viral load >100,000 copies/ml
  • Not responsive to antiretrovirals
  • Nonadherence to antiretrovirals

(These are just guidelines and a patient may not exhibit all indicators.)

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Liver Disease

  • Prothrombin time INR >1.5
  • Serum albumin <2.5gm/dl
  • Ascites despite maximum therapy
  • Peritonitis
  • Hepatorenal syndrome
  • Hepatic encephalopathy refractory to treatment
  • Recurrent variceal bleeding

(These are just guidelines and a patient may not exhibit all indicators.)

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Renal Disease

  • Creatinine clearance <10cc/min
  • Serum creatinine >8.0mg/dl
  • Declines dialysis

(These are just guidelines and a patient may not exhibit all indicators.)

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Stroke and Coma

  • Poorly responsive or comatose
  • Dysphagia with very limited intake

(These are just guidelines and a patient may not exhibit all indicators.)

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