From the Guidelines
Inpatient hospice care is appropriate for patients with a terminal illness and a prognosis of six months or less, who have symptoms that cannot be managed at home, such as severe pain, acute respiratory distress, or uncontrolled nausea/vomiting, as certified by their physician and hospice medical director 1. To qualify for inpatient hospice care, patients must meet specific criteria, including:
- A terminal illness with a prognosis of six months or less if the disease follows its normal course
- Symptoms that cannot be managed at home, such as:
- Severe pain requiring IV medication adjustments
- Acute respiratory distress
- Uncontrolled nausea/vomiting
- Wounds requiring complex care
- Severe agitation/delirium
- Need for intensive nursing interventions
- Actively dying with symptoms requiring continuous monitoring
- Family caregivers experiencing a crisis that prevents adequate home care The patient's physician and hospice medical director must certify that the patient meets these criteria, documenting declining functional status, significant weight loss, and disease-specific decline 1. Inpatient hospice stays are typically short-term, until symptoms stabilize, after which patients often transition back to home hospice care, ensuring patients receive intensive symptom management during crisis periods while maintaining comfort and dignity at the end of life.
From the Research
Criteria for Inpatient Hospice Care
The criteria for inpatient hospice care include:
- A prognosis of 6 months or less, as determined by a physician 2, 3, 4, 5
- The need for pain and symptom management that cannot be managed in another setting 4
- The goal of avoiding hospitalization and maximizing time at home for patients who are dying 2
- The need for comprehensive comfort care, including medical care, pain management, and emotional and spiritual support tailored to patient needs and wishes 5
Eligibility Rules
Eligibility rules for hospice care require:
- A physician to determine that the prognosis for the patient involves an estimated life expectancy of 6 months or less if the illness runs its expected course 3, 5
- Certification of a prognosis of six months or less for a beneficiary to access hospice support 3
- Two physicians to predict that a patient is more likely to die in the next six months than survive, based on clinical status, at the time of admission to hospice 3
Goals of Care
The goals of care for inpatient hospice patients include: