Hospice Eligibility Criteria

In order to begin hospice care, patients must meet the hospice eligibility requirements established by the U.S. Centers for Medicare & Medicaid Services. While no specific number of symptoms is required when qualifying for hospice, these guidelines can help determine if a patient’s condition is or will soon be appropriate for hospice care.

Hospice eligibility requirements:

  • Patient has been diagnosed with a life-limiting condition with a prognosis of six months or less if their disease runs its normal course.
  • Frequent hospitalizations in the past six months
  • Progressive weight loss (taking into consideration edema weight)
  • Increasing weakness, fatigue, and somnolence
  • A change in cognitive and functional abilities
  • Compromised Activities of Daily Living (ADLs) such as eating, bathing, dressing, toileting, transferring/walking, and continence
  • Deteriorating mental abilities
  • Recurrent infections
  • Skin breakdown
  • Specific decline in condition

Disease-specific hospice eligibility criteria

There are also specific hospice eligibility criteria to consider based on the patient’s primary diagnosis.

Disease-specific requirements for hospice care:

  • AIDS
  • Dementia
  • Cancer
  • Cerebral Vascular Accident (CVA) / Stroke
  • A change in cognitive and functional abilities
  • Congestive Heart Failure / Cardiopulmonary Disease
  • COPD / Cardiopulmonary Disease
  • Liver Disease
  • Neurological Conditions
    non-Alzheimer’s dementia, Parkinson’s disease, Multiple Sclerosis, ALS, and Huntington’s disease
  • Renal Disease

Please note:

Co-morbidities, the presence of two or more chronic diseases or conditions at the same time, are also a factor to consider in qualifying for hospice.

If you have any doubt about whether the requirements for hospice care have been met, please contact us at 281-313-0085 OR Email: info@saharahealthcare.com for a hospice consultation.

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