Hospice Admission Criteria

In order to be eligible for Hospice services, an individual must be found medically appropriate by a Hospice physician and must be certified as being terminally ill. Life expectancy is expected to be 6 months or less if the illness runs its normal course.

During the normal process, Hospice admits a patient based on a recommendation or in consultation with the patient’s PCP and medical director. To be certified as terminally ill, the hospice medical director must determine the terminal condition of the patient, what other health condition that patient has that may be related or unrelated to their terminal condition and relevant information provided that supports those diagnoses.

The Hospice medical director determines that the certification of terminal illness for hospice benefits are based on their clinical judgment and their attending physician if applicable. No other doctor can certify or recertify a terminal illness, and life expectancy is not easily predictable. The individual must also elect to receive hospice care, and the first election is 90 days, then an unlimited number of 60-day periods. There must also be a safe caregiving plan in place.

Live Alone Patient:

An individual who is independent and is accustomed to living alone. The patient wishes to remain independent for as long as possible, meets the admission criteria, and is willing to make arrangements for their care needs when they are no longer able to be alone/provide their own care.

Primary Care Person:

An individual who typically has daily contact with the patient and is actively involved in the patient’s care. The primary care person will participate in planning for the patient’s care with Hospice staff.

IDG:

An Interdisciplinary Group (includes as indicated: Nursing, Social Work, Chaplain, Dietary Counselor, Bereavement staff, Home Health Aide, Volunteer, Hospice Medical Physicians, Attending Physician, and patient/family).

Do you need Hospice Service?

Do you:

Have a progressive life-limiting illness with an estimated life expectancy of six (6) months or less if the illness follows its normal course?
Have an attending physician who is willing to confirm limited life expectancy, manage the medical needs of the patient and work with the Hospice team?
Have a family member or other person willing to assume responsibility for decision making should you lack capacity?
Have a plan of care for the provision of your care when you are no longer able to live alone and/or provide your own care?
Have a 24/7 caregiver plan in place? It is the responsibility of the patient/family to meet the standard of need for caregiving as stated in the Hospice Admission Criteria and as evaluated by qualified professionals from time to time. Medicare and New York State regulations assert that “Hospices are not expected to provide the types of services associated with primary care-givers but rather they are expected to supplement the care provided by family members and others.” Hospice reserves the right to determine the extent of need for such supplemental care.
Agree to keep the primary care person informed of the diagnosis and prognosis, as culturally appropriate, and give consent for Hospice care?
Agree that the goal of treatment under Hospice care is palliative in nature, addressing pain and symptom management and is not intended to be curative, life-prolonging or remission-inducing?
Reside within the service area of the Hospice program?

For more information about Hospice care for your situation, please contact our Admission Department at 315-634-1100.