Hospice eligibility
Could hospice be appropriate?
Hospice may be available when a serious illness is progressing and doctors believe life expectancy may be six months or less.
An evaluation does not commit you to hospice.
Eligibility at a glance
- 01
Six-month prognosis
Physicians certify that life expectancy may be six months or less if the illness follows its normal course.
- 02
Comfort-focused care
Care focuses on comfort rather than curing the terminal illness.
- 03
Patient choice
The patient or representative chooses hospice after the care approach is explained.
Six months is not a deadline. Hospice can continue when the patient remains eligible and is recertified.
Signs it may be time to ask about hospice
Daily activities
More help with walking, bathing, dressing, eating, toileting, or transferring.
Nutrition and strength
Weight loss, reduced intake, swallowing difficulty, weakness, or more time in bed.
Symptoms and complications
More pain, breathlessness, infections, confusion, or hospital visits.
Overall progression
Less recovery, more time in bed, or treatment providing limited benefit.
No single sign determines eligibility.
Eligibility by diagnosis
A diagnosis alone does not determine eligibility. Doctors consider the patient’s overall decline and prognosis.
How a hospice eligibility review works
- 01
Share what has changed
Call or submit a referral with the primary diagnosis and recent changes in health or daily function.
- 02
Clinical review
A hospice nurse reviews symptoms, recent decline, medical history, and available records.
- 03
Physician certification
The physicians review the clinical picture and certify whether the patient meets hospice requirements.
Hospice eligibility questions
Not sure whether it’s time to request an evaluation?
Tell us what has changed. Caritas can explain the next step without requiring you to have every answer.