Hospice referrals should balance a physician’s experienced clinical judgement, Medicare regulations, and input from the patient and family. Physicians and admissions coordinators at our local programs are available for consultation.
If you have questions, reach out to Compassus at 833.380.9583.
Medicare Eligibility
To elect hospice under Medicare, an individual must be entitled to Medicare Part A and certified as being terminally ill by a physician and have a prognosis of six months or less if the disease runs its normal course. See the Electronic Code of Federal Regulations, Part 418-22-Hospice care.
Medicare Part A always covers hospice services, even for patients with a Medicare Advantage (Part C) plan. Medicare is testing hospice coverage under Medicare Advantage in a few test markets.
- Eligibility, Election and Duration of Benefits – Code of Federal Regulations
- Hospice Pre-election Evaluation (from CMS)
Medicare allows and reimburses for a one-time visit by a physician who is either the medical director of or employee of a hospice agency. We respect the relationship physicians have with their patients. Our goal is to work together to ensure patients and families receive the right care, at the right time.
Hospice Admission Criteria and Guidelines
- Amyotrophic Lateral Sclerosis – ALS/Lou Gehrig’s disease
- Alzheimer’s Disease and Dementia
- Cancer
- Cardiac Disease
- Liver Disease
- Pulmonary Diseases
- Renal Disease
- Stroke or Coma
Prognostication and Scoring Tools
- Functional Assessment Staging (FAST) Scale or FAST Score (PDF, 37 KB)
- New York Heart Association (NYHA) Functional Classification (PDF, 130 KB)
- Palliative Performance Scale (PPS) (PDF, 120 KB)
- Online BODE index calculator for COPD survival prediction
- FLACC Pain Scale (PDF, 560 KB)
- Flacker mortality scoring tool (PDF, 86 KB)
- Karnofsky Performance Status Scale (KPS) (PDF, 65 KB)
- Pain Assessment in Advanced Dementia Scale (PDF, 60 KB) (PAINAD)
- Model for End-Stage Liver Disease (MELD) calculator
- ESAS – Edmonton Symptom Assessment System (Revised)
Information for Patients and Their Families
- Better hospice conversations
- Hospice FAQ
- Palliative care FAQ
- Hospice and end-stage cancer
- Hospice for late-stage Alzheimer’s disease or other dementia
- Hospice care for heart failure
- Hospice and palliative care for end-stage COPD
- Hospice and palliative care for stroke
- Hospice for end-stage Parkinson’s disease
- Hospice for Huntington’s disease
- Hospice for end-stage MS
- Hospice for amyotrophic lateral sclerosis – ALS
- Hospice for advanced pulmonary fibrosis
- Managing pain
If you have questions or want to connect with a local Compassus care team, call 833.380.9583 today.
