Hospice Eligibility, Advance Care Planning

When to Refer a Patient to Hospice

January 10, 2020


Health care specialists are sometimes uncertain whether their patient may be eligible for hospice services. VITAS offers several solutions to help clinicians better recognize when a patient has transitioned to this phase of life.

Related: How to Have a Goals of Care Conversation With Your Patient

In general, hospice should be considered with any of the following:

  • When symptoms arise secondary to the diagnosis
  • When a patient’s disease continues to progress or when the a patient stops responding to disease-modifying treatments

Additional insights into hospice eligibility can be found on our hospice guidelines, which include general and disease-specific guidance.

In general, look for these signs over the last 4-6 months:

  • The illness, if it progresses as expected, has a prognosis of six months or less. (Ask yourself: “Would I be surprised to learn, six months from now, that this patient has died?” If your answer is no, request a hospice evaluation for this patient.)
  • Patient has a PPS rating of < 50%-60%
  • Patient is dependent in any 3 out of 6 ADLs
  • Patient has lost more than 10% body weight, or another alteration in nutritional status
  • Patient has had 3 or more hospital/ED visits
  • Decrease in physical activity
  • Decrease in cognitive ability 

An interactive Palliative Performance Scale, which represents a strong predictor of hospice eligibility, can be found on our award-winning app; download it from the Apple App Store and Google Play.

Lastly, health care professionals can enhance their understanding of hospice including eligibility through our webinars and in-person trainings.