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Hospice Criteria for Liver Disease

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woman talks with loved one about the hospice criteria for liver diseaseWhen it comes to hospice care, specific criteria must be met for a person to qualify. In the case of liver disease, hospice eligibility is based on a few factors. The hospice team typically looks at underlying medical conditions, the presence of end-stage liver disease, and how well treatment options are working or not working.

For hospice care criteria for liver disease to be met, the patient must have been diagnosed with late-stage liver disease and have at least three conditions: ascites, jaundice, encephalopathy, variceal bleeding, or malnutrition. They should also not be candidates for a liver transplant. The hospice team will assess the patient’s pain level and other symptoms and how they respond to treatment.

In addition to hospice criteria for liver disease, hospice teams typically look at the patient’s overall quality of life before determining whether hospice care is suitable. Factors such as the person’s mental health, ability to participate in activities they usually enjoy, and the level of support they have from family members and friends can all be considered. To learn more about the criteria for hospice for liver disease, reach out to Compassus today at 833.380.9583 to speak with a hospice expert.

Hospice Eligibility for Liver Failure

Symptoms experienced by patients with end-stage liver disease (ESLD) may be well known to a physician, but determining hospice eligibility can be difficult, especially for patients eligible for transplants.

Patients will be considered to be in the terminal stage of liver disease and typically eligible for hospice if they meet the following criteria: Factors 1 and 2 must be present. Factors from 3 will lend supporting documentation. These factors are:

1. The patient has an end-stage liver disease as evidenced by BOTH of the following:

  • Prothrombin time prolonged more than five seconds over control or international normalized ratio (INR)>1.5
  • Serum albumin


2. The patient shows at least one of the following:

  • Ascites, refractory to treatment, or patient non-compliant
  • Spontaneous bacterial peritonitis
  • Hepatorenal syndrome (elevated creatinine and BUN with oliguria (<400ml/day) and urine sodium concentration
  • Hepatic encephalopathy, refractory to treatment, or patient non-compliant
  • Recurrent variceal bleeding, despite intensive therapy

3. Documentation of the following factors will support eligibility for hospice care:

  • Progressive malnutrition
  • Muscle wasting with reduced strength and endurance
  • Continued active alcoholism (>80 gm ethanol/day)
  • Hepatocellular carcinoma
  • HBsAg (Hepatitis B) positivity
  • Hepatitis C refractory to interferon treatment

Patients awaiting liver transplants who otherwise fit the above criteria may be certified for the Medicare hospice benefit. Still, the patient must be discharged from hospice if a donor organ is procured. If a patient meets the medical criteria above, they are, by definition, eligible to receive hospice services.

Some patients may not meet the criteria but may still be eligible for hospice care due to comorbidities or rapid functional decline. We rely on the experienced clinical judgment of physicians as a foundation for hospice eligibility. Medical directors at our local Compassus locations are available for consultations.

Understanding Liver Disease Hospice Criteria

Many of us are unaware of liver disease hospice criteria and how to access these services. Fortunately, with a greater understanding of the signs and symptoms associated with liver disease, it is possible to get a better handle on hospice eligibility. Knowing when and how to start the conversation about hospice is essential for ensuring that patients receive the support and care they need during their transition.

At its core, hospice can provide comfort and emotional and spiritual support for those with a terminal illness. Recognizing the appropriate time to tap into this network of resources may be difficult, but understanding what qualifies an individual can be a stepping stone in making an informed decision.

Get Help at Compassus for End-Stage Liver Failure and Hospice Eligibility

Liver failure hospice care doesn’t have to be confusing or complicated. Compassus hospice professionals can help you understand hospice criteria for patients with end-stage liver disease to make an informed decision about hospice eligibility. We work with physicians and families to determine hospice eligibility for patients with ESLD and provide hospice care for those who meet hospice criteria.

For hospice-eligible patients, hospice care provides a comfortable and supportive environment to those facing the end stages of their illness. We provide hospice services to meet each patient’s unique needs, including medical care, symptom management, and emotional and spiritual support—all focused on comfort and quality of life. During hospice care, our professionals strive to ensure that a patient’s wishes are respected, and the family is supported.

Contact us today at 833.380.9583 for more information about hospice criteria for liver disease and hospice services for patients with ESLD.