America's Top Assisted Living Resources LLC 480-795-7776
  • Home
    • About
    • Contact Us
    • Blog
    • Articles
  • Living Options
    • In Home Care
    • Transition & Relocating >
      • Assessment Information
      • FAQ's
    • Assisted Living Home
    • Assisted Living Communities
    • Skilled Nursing Facility
    • Memory Care
  • Resource Directory
    • Assisted Livings
    • Independent Living
    • Resources
  • Paying For Care
    • ALTCS / Medicaid
    • V.A. Benefits
    • Medicare Insurance
    • Elder Law
    • Estate Planning
    • Retirement Planning
  • End of Life
    • Hospice >
      • Palliative
      • Earlier Admission Benefits
    • Funeral Services >
      • Preplan Your Funeral
      • Obituaries
Picture

Terminal Prognosis

Hospice Eligibility Quick Reference Guide
If someone has partial qualifications they can be assessed for Palliative Care
Alzheimer’s/Dementia (1 and 2 be present: 3 shows additional support)
1.Must show ALL of the following:
  • Unable to ambulate (walk) without assistance
  • Unable to dress without assistance
  • Unable to bathe without assistance
  • Urinary and fecal incontinence, intermittent or constant
  1. Must be stage 7A or beyond on FAST scale (scale is progressive cannot skip stages):
    • 7A – Ability to speak is limited to 1 to 5 words a day
    • 7B – All intelligible (understandable by listener) vocabulary is lost
    • 7C – Ambulatory ability is lost (non-ambulatory)
    • 7D – Cannot sit up without assistance (e.g., patient will fall over if there are no lateral rests (arms) on the chair)
    • 7E – Loss of ability to smile
    • 7F – Loss of ability to hold up head independently
  2. The following secondary conditions to the functional impairment: aspiration pneumonia, pyelonephritis or other upper urinary tract infection, septicemia, decubitus ulcers, multiple, stage 3-4, fever, recurrent after antibiotics, inability to maintain sufficient fluid and calorie intake with 10% or >loss of total body weight during the previous 6 months or serum albumin <2.5 gm/dL
Heart Disease (1 and 2)
  1. Significant symptoms of recurrent congestive heart failure at rest, classified as NYHA Class IV and/or ejection fraction <20%
  2. Optimal treatment with diuretics and vasodilators or angina pectoris at rest is resistant to standard nitrate therapy, and is not a candidate or declines invasive procedures
  3. Secondary conditions such as delirium, pneumonia, stasis ulcers and pressure ulcers
Picture
Renal Disease (1 and 2 must be present: any from 3 supportive)
  1. The patient is not seeking dialysis or renal transplant (or)
  2. Is discontinuing dialysis.
  3. Nausea/vomiting, pruritis, restlessness, oliguria, edema, abnormal labs such as hyperkalemia, creatinine clearance <10cc/min (15 for diabetics), serum creatinine >6gm/dL (8 for diabetics), documented weight loss of 10% or > of total body weight or decrease in MUAC, serum albumin <2.5 gm/dL
Stroke and Coma (Chronic phase patients) (1 and 2)
  1. Poor functional status, Karnofsky score < / =40
  2. Poor nutritional status evidence by weight loss over previous 3 months, serum albumin <2.5 gm/dL
  3. Secondary conditions could include dysphagia, pneumonia, and pressure ulcers
Liver Disease (1 and 2 must be present: 3 adds support)
1. The patient should show both:
  • Prothrombin time prolonged more than 5 seconds over control, or International Normalized Ratio (INR)> 1.5
  • Serum albumin <2.5 gm/dL
2. End stage liver disease is present and the patient shows at least one of the following:
  • Ascites, refractory to treatment or patient non-compliant
  • Spontaneous bacterial peritonitis
  • Hepatorenal syndrome (elevated creatinine and BUN with oliguria (<400ml/day) and urine sodium
  • Hepatic encephalopathy, refractory to treatment, or patient non-compliant
  • Recurrent Variceal bleeding, despite intensive therapy
3. Documentation of the following factors will support eligibility for hospice care:
  • Progressive malnutrition; Muscle wasting with reduced strength and endurance; Continued active alcoholism (> 80 gm ethanol/day); Hepatocellular carcinoma; HBsAg (Hepatitis B) positivity; Hepatitis C refractory to interferon treatment
Patients awaiting liver transplant who otherwise fit the above criteria may be certified to the Medicare hospice benefit, but if a donor organ is procured, the patient must be discharged from hospice.
Pulmonary Disease (1 and 2 should be present: 3 or 4 show additional support)
  1. Disabling dyspnea at rest resulting in decreased functional capacity, little or no response to bronchodilators (may be documented by FEV1 post bronchodilators < 30%)
  2. Progression documented by increasing ER visits, Physician and/or respiratory failure, use of antibiotics
  3. Hypoxemia at rest of room air O2 sat <88%, pO2 </=55mm Hg
  4. Hypercapnia with PCO2 > / =50%
Cancer (1 and 2 must be present: 3 shows additional support)
  1. Disease with metastases at presentation or
  2. Progression from an earlier stage of disease to metastatic disease with either
  • A continued decline in spite of therapy or
  • Patient declines further disease directed therapy
   3.  Supporting signs/symptoms (pain requiring increasing doses of major analgesics, documented weight loss or decrease          in MUAC)
For Help or Information Please Call 480-795-7776
​Email: [email protected]
​Fax: 480-795-7717
Picture

Americas Top Assisted Living Resources LLC  is a locally owned and operated agency in the State of Arizona providing quality assistance to families throughout the State of Arizona. Selecting a long-term care facility can be an overwhelming experience. To help you and your family through this transition we have compiled information to help you make the right decision & determine what level of care you or your loved one requires. Our only objective is to assist your family find direction,
​well being, and ultimately peace of mind.

We offer comprehensive resources to guide families through all of the senior housing options and elder
care needs. At Americas Top Assisted Living Resources LLC, We staff knowledgeable consultants helping
​seniors and their families make informed, educated decisions regarding all options available.
​
If you would like information pertaining to another USA based State, please "Click Here"

Home I Living Options I Directory I Paying For Care I End of Life
Terms of Use I Privacy Policy
Copyright © 2021 Americas Top Assisted Living Resources, LLC. All Rights Reserved
An Arizona Based Company
  • Home
    • About
    • Contact Us
    • Blog
    • Articles
  • Living Options
    • In Home Care
    • Transition & Relocating >
      • Assessment Information
      • FAQ's
    • Assisted Living Home
    • Assisted Living Communities
    • Skilled Nursing Facility
    • Memory Care
  • Resource Directory
    • Assisted Livings
    • Independent Living
    • Resources
  • Paying For Care
    • ALTCS / Medicaid
    • V.A. Benefits
    • Medicare Insurance
    • Elder Law
    • Estate Planning
    • Retirement Planning
  • End of Life
    • Hospice >
      • Palliative
      • Earlier Admission Benefits
    • Funeral Services >
      • Preplan Your Funeral
      • Obituaries