Hospice Referral Guidelines - Coastal Hospice & Palliative Care ...
Hospice Referral Guidelines
Table of Contents
Indicators of DeclinePage 1 Palliative Performance Scale (PPS)Page 2 Cancer DiagnosisPage 3 Dementia/Alzheimer's DiagnosisPage 4 Functional Assessment Staging Scale (FAST) Page 5 Heart Disease DiagnosisPage 6 Pulmonary Disease DiagnosisPage 7 Renal Disease DiagnosisPage 8 Chronic Renal Failure DiagnosisPage 9 Liver Disease DiagnosisPage 10 Stroke and Comas DiagnosisPage 11 Parkinson's Disease DiagnosisPage 12 Amyotrophic Lateral Sclerosis Diagnosis (ALS) Diagnosis Page 13
Referral hotlines
Monday - Friday 8 am-5 pm 410-742-7878 After hours, weekends, holidays 877-839-0497
Hospice Referral Guidelines
Indicators of Decline
Medicare uses the following indicators to measure decline. Patients who suffer from a chronic disease process and exhibit one or more of these signs and/or symptoms over time may benefit from a hospice evaluation.
n Recurrent or intractable infections n Weight loss not due to reversible causes and/or decreasing anthropomorphic measurements n Decreasing serum albumin or cholesterol n Dysphagia leading to aspiration and/or inadequate nutritional intake n Dyspnea n Pain requiring increasing doses of analgesia n Decreasing systolic BP n Edema and/or ascities n Pleural effusion n Weakness n Decline in Palliative Performance Scale (PPS) to ................
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