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Hospice Eligibility Criteria

  • Nov 2, 2025
  • 2 min read

Updated: Apr 20

Making a difference in the Lives of our patients and their families everyday!!!


If you or someone you know has symptoms of a life-limiting illness, give us a call for a free evaluation at 770.940.0700.


The following clinical signs often support hospice eligibility in combination with another primary diagnosis.

hospice eligibility criteria

ALZHEIMER'S DISEASE

  • Limited vocabulary or meaningful conversation

  • Unable to sit / stand without assistance

  • Needs assistance with bathing or dressing without assistance

  • Weight loss, infections, falls or ER visits

  • Comorbid / Secondary conditions


HEART DISEASE

  • Swelling leg and / or feet

  • Shortness of breath on exertion

  • Symptoms present even at rest

  • Ejection fraction 20% or less

  • Fatigue

  • Recent cardiac hospitalization, not transplant candidate


LIVER DISEASE

  • Swollen abdomen

  • Weight loss abnormal clotting

  • Fluid has to be drained from abdomen by physician


LUNG DISEASE

  • Shortness of breath at rest

  • Progressive weight loss

  • Must sit up straight to breathe

  • Chronic CO2 retention

  • Emergency room visits, hospitalizations, for infections, respiratory failure or distress


STROKE OR COMA

  • Unable to sit / stand without assistance

  • Unable to maintain weight

  • Needs assistance with bathing or dressing without assistance

  • Weight loss, infections, falls, ER visits

  • Comorbid / secondary conditions


NEUROLOGIC DISEASE: Chronic degenerative conditions such as ALS, Parkinson’s, Muscular Dystrophy, Myasthenia Gravis or Multiple Sclerosis)

  • Critically impaired breathing capacity

  • Rapid disease progression with progression from:

    • Independent ambulation to wheelchair or bed-bound status

    • Normal to barely intelligible or unintelligible speech

    • Normal to pureed diet

    • Independence in most ADLs to needing major assistance in all ADLs

    • Critical nutritional impairment demonstrated by all of the following in the preceding 12 months:

      • Oral intake of nutrients/fluids insufficient to sustain life

      • Continuing weight loss

      • Dehydration or hypovolemia

    • Absence of artificial feeding methods OR Life-threatening complications in the past 12 months

      • Recurrent aspiration pneumonia,

      • pyelonephritis,

      • sepsis,

      • recurrent fever,

      • stage 3 or 4 pressure ulcers


RENAL DISEASE

  • Patient not seeking dyalisis

  • Patient not a candidate for renal transplant

  • Swelling

  • Weakness / occasional confusion


CANCER

  • Not seeking treatment

  • Not taking chemo, radiation or oral chemo


HIV / AIDS

  • Weight loss

  • Not responding to treatment

  • Infections

  • No HIV treatment

  • Presence of other medical treatments

  • CD4 count <25 or persistent viral load > 100,000


AMYOTROPHIC LATERIAL SCLEROSIS (ALS)

  • Overall decline

  • Weight loss

  • Fatigue


***Other Terminal Illness

  • If the family member does not meet any of the above guidelines, the family member may still be eligible if there's a prognosis of less than 6 months

    • ie. Sepsis, Severe limb-threatening ischemia due to PVD


Timely and appropriate identification of hospice-eligible 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.


Always there for You! Your Team, For Your Comfort, to Your Home!!


At Avycare, we are committed to making this journey as peaceful and meaningful as possible, regardless of it's length. Avycare is your Partner in End-of-Life Care.

Call Avycare at 770.940.0700 For a FREE ASSESSMENT!



 
 
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