Congestive Heart Failure Hospice Eligibility Criteria.

Heart failure occurs when the heart muscles can no longer pump blood effectively and fluids can build up around the heart, abdomen, lungs and other parts of the body. This condition affects about 5 million people in the United States.

Patients with end-stage congestive heart failure (CHF) and terminal heart disease often make frequent doctor’s office, ER and hospital visits for breathing difficulties and fatigue. In fact, over one million people in the United States are admitted to inpatient settings for heart failure each year. One in four Medicare heart failure patients are readmitted to the hospital within 30 days at a cost of $17.4 Billion a year.

Many of these hospital visits could be prevented with the support of hospice care, but cardiac patients and families are often unaware of the hospice qualifications for CHF. And even more are unaware the added support available for CHF patients in their home or assisted living facility.

In addition to general hospice guidelines, we consider the following symptoms in cardiac patients when determining hospice eligibility criteria for CHF.

CHF and heart disease hospice criteria: 

  • Identification of specific structural/functional impairments
  • Ejection fraction <20% (not required, but an important consideration)
  • A poor response to diuretics and vasodilators
  • Dyspnea or tightness in the chest
  • Chest pain
  • Impaired heart rhythms, contraction force of ventricular muscles and impaired blood supply to the heart
  • Changes in appetite, unintentional weight loss
  • Impaired sleep functions
  • Decline in general physical endurance
  • Relevant activity limitations and or impaired mobility

While only a physician is able to make the determination of whether a CHF patient meets the qualifications to be admitted to hospice, if you are seeing any of the above signs and symptoms in a patient with CHF or other end-stage cardiac conditions, it may be time to consider adding the support of hospice care.

CHF and heart disease symptom management. 

Crossroads Hospice & Palliative Care an additional level of support and care for our CHF and heart disease. Our team is available both to the patient and their families to answer questions, as well as provide support 24 hours a day to help manage the patient’s symptoms. This will help them in avoiding late night visits to the emergency room and unnecessary hospital admissions.

For primary care physicians. 

We are your partners in supporting your end-stage CHF patient. Whenever you or your patient needs us, we are here 24/7 to admit new patients and respond to worsening heart disease symptoms. The experts of Crossroads Hospice & Palliative Care will help to facilitate an easy transition into our care, and in managing the pain of the patient.

However, if you believe the patient is not yet ready for hospice care or they do not meet the hospice qualifications for CHF, our palliative care team works side-by-side with primary care physicians to treat common symptoms and help in addressing the questions and concerns of the family. PCP’s also receive regular reports from our team, giving you an extra set of eyes and ears and keeping you posted on any changes in the patient’s condition.

When to call hospice.

While there is no cure for late-stage CHF, the added support of hospice care can improve quality of life for patients and their families. Crossroads Hospice is here to offer support wherever the patient calls home - including assisted living facilities, and in-patient units.

If you believe the patient meets the hospice criteria for CHF, it’s important to start the conversation as soon as possible. This way, you have time to explore all of your options and get your questions answered before a crisis occurs. Crossroads Hospice & Palliative Care can meet with patients and their families at the location of your choice at any time, 24 hours a day, seven days a week, 365 days a year.

If you have questions about whether a patient meets the hospice requirements for congestive heart failure, please contact Crossroads Hospice at 1-888-564-3405 for a hospice consultation.

When is it time to call hospice? Download a free guide now.