General guidelines: The eligibility criteria referenced above are based on guidelines from the Centers for Medicare and Medicaid Services (CMS). Although these guidelines are limited to a select list of diagnoses for hospice benefit coverage, this list should not be considered all-inclusive. Some patients may not meet all the criteria in the guidelines but may still be eligible for hospice care. Additionally, any disease process in its terminal stage is suitable for hospice care. Hospice-eligible individuals may exhibit some or all of the following:  

• Deteriorating mental abilities 
• Inability to perform daily tasks 
• Frequent hospitalizations or trips to the ER 
• Rapid decline in health over the past six months 
• Inability of the family and medical teams to care for the patient 
• Physical symptoms – reduced desire to eat, significant weight loss, and body changes 
• Signs of increasing illness – uncontrollable pain, shortness of breath, nausea, or vomiting, and frequent or recurring infections 

For determination of hospice care eligibility, we encourage you to contact your local OhioHealth Hospice program for further clarification or to request an assessment.