Hospice Eligibility Guidelines
Chapters Health System provides a continuum of integrated care solutions for you and your patients, including Home Care, Palliative Medicine, Hospice Care and Grief Services.
How to Determine Hospice Eligibility
Ultimately, hospice eligibility is centered on a physician’s clinical judgment. If a physician believes the patient will likely live six months or less if the disease follows its natural course, then the patient may be considered hospice eligible.
Eligibility is based on the severity of the patient’s primary diagnosis (the diagnosis contributing most to terminality), as well as secondary/comorbid conditions and nutritional/functional status.
In some cases, the primary diagnosis alone is sufficiently advanced to make a patient hospice eligible.
This determination is made with the help of disease severity guidelines called Local Coverage Determinations (LCDs) listed on each of the medical condition pages below.
While these general guidelines are helpful to select the appropriate primary hospice diagnosis and establish hospice eligibility, please keep in mind that these criteria are not requirements for eligibility.
Chapters Health System provides a continuum of integrated care solutions that begin with a chronic diagnosis.
Any time you, your staff, or patients have questions, need support or care, call 1-866-204-8611 or Contact Us.
One patient. One integrated, continuum of care.
Providing coordinated, holistic care improves patient quality of life, while also saving money.