General Hospice Eligibility Guidelines

Timely and appropriate identification of hospice-appropriate 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.    

For a patient to be eligible for hospice, the following serve as general guidelines:

  • The illness is terminal (a prognosis of ≤ 6 months) and the patient and/or family has elected palliative care. 
  • The patient has a declining functional status as determined by either: 
    • Palliative Performance Scale (PPS) rating of ≤ 50%-60% 
    • Dependence in 3 of 6 Activities of Daily Living (ADLs) 
  • The patient has alteration in nutritional status, e.g., > 10% loss of body weight over last 4-6 months 
  • The patient has an observable and documented deterioration in overall clinical condition in the past 4-6 months, as manifested by at least one of the following: 
    • ≥ 3 hospitalizations or ED visits 
    • Decrease in tolerance to physical activity
    • Decrease in cognitive ability
  • Other comorbid conditions 

Clinical Hospice Guidelines by Diagnosis >

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