Hospice Eligibility

Learn more about Providers and Healthcare Professionals

The Centers for Medicare and Medicaid Services (CMS) doesn’t have a specific list of symptoms which a patient must exhibit in order to qualify for hospice, instead, there is more of a guideline on how to determine a patient’s necessity for hospice services.

These guidelines are a convenient tool and not a replacement for a physician’s professional judgment. These merely help physicians determine when their patients meet clinical guidelines for hospice eligibility.

General hospice eligibility guidelines. Patient meets 2 or more of the following:

  • Dependent in 2-3 of 6 ADLs
  • SOB or fatigue at rest/minimal exertion
  • Multiple ED visits or hospitalizations
  • 10% weight loss in 6 months
  • Recurrent falls with injury
  • Decreased tolerance in physical activity

Resources for scoring and gauging patient’s hospice eligibility:
Functional Assessment Staging Scale (FAST)
Karnofsky Performance Scale (KPS)
New York Heart Association Functional Classification (NYHA)
Palliative Performance Scale (PPS)

Check hospice eligibility guidelines by specific disease:
Alzheimer’s Disease
Amyotrophic Lateral Sclerosis (ALS)
Cerebral Vascular Accident/Stroke or Coma
Chronic Renal Failure/Chronic Kidney Disease (CKD)
Heart Disease/Chronic Heart Failure (CHF)
Huntington’s Disease
Liver Disease
Lung Disease/COPD
Multiple Sclerosis (MS)
Muscular Dystrophy
Parkinson’s Disease


My impressions of the services were comparable to some of the best agencies we dealt with. The nurses were very responsive and caring. If it hadn’t been for them, it would have been very difficult for me on my own. Their help was invaluable, the agency that was sending 24-hour care. The care that they provided was very valuable, and they did an absolutely terrific job in assisting me with his care in his final days of illness. I will definitely be giving a contribution to FIAH, and highly recommend them.”