About Hospice Eligibility Hospice Services Hospice FAQs Locations/Contact Information

Hospice care is available for all age groups .... and is not only for cancer patients!

Medicare, TennCare and most private insurance companies cover hospice care.  Hospice provides drugs for pain control and symptom management.  Supplies and durable medical equipment for comfort are also provided.  A physician, patient, family member of friend may initiate a referral by calling the hospice office.  We encourage referral of patients to hospice as early as possible.  Early admission provides time for the hospice team to establish a bond of trust and communication with the patient and family to be able to serve them better.

Hospice PatientWho is Eligible?

Anyone who:

  • Has a life-limiting medical condition (cancer or non-cancer diagnosis)
  • Chooses comfort care rather than curative care
  • Requests hospice care
  • Has had a recent decline in functional status and has a Karnofsky Performance Status less than or equal to 50% (the Karnofsky index helps classify patients as to their functional impairment)
    And/or
  • Dependence in 3 of 6 Activities of Daily Living (bathing, dressing, grooming, etc.)
    And/or 
  • Recent impaired nutritional status (unintentional, progressive weight loss of 10% over the past six months)

General items to look for:  
  • Multiple hospital stays
  • New diagnosis following hospitalization
  • Repeat and/or multiple infections
  • Weakness and fatigue
  • Shortness of breath
  • Difficulty swallowing
  • Mental status changes
  • Uncontrolled symptoms

Adult Failure to Thrive

  • Palliative Performance Scale less than or equal to 40% (helps predict survival time lines) 
  • Body mass index of less than 22
  • Patient refuses enteral or parenteral nutrition support or has not responded to such nutritional support, despite adequate caloric intake

Dementia/Alzheimer's

  • FAST Stage 7 (the Functional Assessment Staging scale describes the progression of dementia)
  • Co-morbid and/or secondary (structural/ functional) impairments; conditions such as infections or pressure ulcers

 

HIV

  • CD4+ count less than 25 cells/mcL
  • Viral load greater than 100,000 copies/ml
  • Co-morbid or secondary conditions
  • Palliative Performance Scale score of less than or equal to 50%

Liver Disease

  • Buildup of fluid in abdominal area
  • Mental status change
  • Prothrombin time (how long it takes blood to clot) prolonged more than 5 seconds over control or INR greater than 1.5
  • Serum albumin less than 2.5 gm/d (a serum albumin test helps determine if a patient has liver or kidney disease or if the body is not absorbing enough protein)

Pulmonary Disease

  • Shortness of breath when at rest or lying down
  • Shortness of breath during normal activities
  • Dependence on continuous oxygen
  • Frequent infections and/or hospitalizations

Stroke or Coma

  • Palliative Performance Scale less than or equal to 40%
  • Poor nutritional status
  • Serum albumin less than 2.5 gm/dl

 

 

 

 

 

Heart Disease

  • New York Heart Association Stage 4 (this scale helps assess the stages of heart failure)
  • Patient is optimally treated
  • Inability to carry out even minimal physical activity without dyspnea or angina
  • Angina pectoris at rest, resistant to standard nitrate therapy and is either not a candidate for or has declined invasive procedures

Neurologic Disease
(ALS, Parkinson's, muscular dystrophy, multiple sclerosis)

  • Structural/functional impairments
  • Secondary conditions, such as dysphagia, pneumonia and pressure ulcers
  • Co-morbid conditions

Renal Disease

  • Candidate for dialysis, but refuses treatment
  • Creatinine clearance less than 10 cc/min or less than 15 for diabetics (testing creatinine levels helps provide information on kidney function)
  • Serum creatinine greater than 8.0 mg/dl or greater than 6.0 mg/dl for diabetics
  • Co-morbid conditions 

 

 





 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

On receiving a referral from your doctor, our nurse will visit you or your family at home to discuss Hospice services, assess your immediate needs and recommend a plan of care. If we cannot meet your needs, we will not be able to admit you to the program or provide services for you.

Serving the people of Northeast Tennessee and Southwest Virginia

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