All About Nursing · Hospice & Palliative Care

Hospice General Criteria

Clinical progression of disease:

  • Multiple hospitalizations, emergency department visits, or increased use of other health care services
  • Serial physician assessments, laboratory or x-ray studies consistent with progressive illness
  • Changes in minimal data set (MDS) for patients in long-term care facilities
  •  Progressive deterioration of the patient while receiving home health care

Declining functional status as defined by:

  • For patients with malignant diseases: 
    • Palliative Performance Status (PPS) or the Karnofsky Performance Status (KPS) < or = 50 or Eastern Cooperative Oncology Group (ECOG) > or =3
    • PPS < or = 60 or ECOG > or =2 with symptoms
    • Decline in PPS of at least 20 units in 2-3 months
  • For patients with nonmalignant diseases:
    • Dependence in at least 3/6 activities of daily living
    • PPS or KPS < or = 50

 Declining nutritional status as defined by:

  • Unintentional weight loss > or = 10% of normal body weight and /or BMI <22

Intangible factors

  • Patient’s personal goals, approach to his or her disease, treatment
  • Burden of investigation and treatment versus potential gain for the patient

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