Bridging the gap in advanced heart failure care

By Joseph Shega, MD, Chief Medical Officer - VITAS Healthcare

Only one in 10 patients with advanced heart failure is referred to hospice¹, despite evidence that hospice involvement is associated with fewer emergency department visits and hospitalizations and improved quality of life.

At VITAS Healthcare, we want to bridge the gap to ensure patients and families receive the support they need at the end of life.

Our comprehensive cardiac program is certified nationwide by the American Heart Association (AHA), tailored to meet the needs of patients with advanced heart disease, including heart failure and other serious cardiac conditions. The AHA Palliative/Hospice Heart Failure certification recognizes that our clinical practices meet the AHA’s rigorous, evidence-based standards.

5 ways our AHA-certified program enhances quality of life

Below are five ways our AHA‑certified program improves care and comfort for patients with advanced heart disease.

1. Open formulary for cardiac medications

Our open formulary ensures uninterrupted, guideline-directed therapy by access to diuretics, ACE inhibitors, ARBs, beta blockers, nitrates, vasodilators, SGLT2 inhibitors, IV inotropes and other evidence-based cardiac medications.

2. Implantable device support

Patients nearing the end of life often still rely on cardiac devices, such as ICDs, CRTs and LVADs. Our expertise in supporting these devices, aligned with AHA post-implant care standards, enhances hospital quality metrics and improves the patient and family experience.

3. Symptom management

Advanced heart failure brings frequent exacerbations and a heavy symptom load. We continue AHA-recommended therapies and interventions to ease common symptoms like breathlessness, edema, fatigue and pain. Nurses with cardiac expertise are trained to assess and monitor cardiac symptoms, manage medication and intervene early when symptoms intensify.

4. Interdisciplinary support

Our interdisciplinary team delivers individualized care plans with integrated emotional, psychosocial and SDOH-informed support. We coordinate with the patient’s cardiologist for seamless communication on treatment goals, medication changes and device management decisions.

5. 24/7/365 availability for admissions and clinical support

We are available around the clock to give patients, families and healthcare professionals peace of mind and mitigate 911 calls, emergency room visits and rehospitalizations. Our availability also supports hospitals with rapid transitions and immediate care for patients nearing the end of life.

When to refer

Consider a referral to VITAS when patients with advanced heart failure (NYHA Class III or IV):

• Have worsening symptoms despite optimal medical therapy (e.g., ACE inhibitors, beta blockers, diuretics, SGLT2 inhibitors)
• Experience dyspnea, fatigue or chest pain at rest or with minimal exertion
• Have frequent ED visits or hospitalizations

¹Gotsman, I., et al. “Heart failure and preserved left ventricular function: Long‑term clinical outcome.” PLoS One, 2012; CMS Hospice Monitoring Report FY 2025.