Hospice eligibility framework
| Cancer-specific guidelines |
| A. Disease with distant metastases at presentation OR |
| B. Progression from an earlier stage of disease to metastatic disease with either |
| i. Continued clinical decline, despite ongoing therapy |
| ii. Patient declining further disease-directed therapy |
| Non-disease-specific generalized indicators of decline in clinical status: supporting prognosis ≤6 months |
| A. Progression of disease |
| i. Clinical status: eg, recurrent infections, weight loss |
| ii. Symptoms: eg, dyspnea, nausea/vomiting |
| iii. Signs: eg, weakness, change in level of consciousness |
| iv. Laboratory: eg, hypercalcemia, hypo/hypernatremia |
| B. Decline in performance status due to progression of disease (Karnofsky Performance Status or Palliative Performance Scale <70%) |
| C. Increasing emergency room visits, hospitalizations, and clinic visits related to primary terminal diagnosis |
| Cancer-specific guidelines |
| A. Disease with distant metastases at presentation OR |
| B. Progression from an earlier stage of disease to metastatic disease with either |
| i. Continued clinical decline, despite ongoing therapy |
| ii. Patient declining further disease-directed therapy |
| Non-disease-specific generalized indicators of decline in clinical status: supporting prognosis ≤6 months |
| A. Progression of disease |
| i. Clinical status: eg, recurrent infections, weight loss |
| ii. Symptoms: eg, dyspnea, nausea/vomiting |
| iii. Signs: eg, weakness, change in level of consciousness |
| iv. Laboratory: eg, hypercalcemia, hypo/hypernatremia |
| B. Decline in performance status due to progression of disease (Karnofsky Performance Status or Palliative Performance Scale <70%) |
| C. Increasing emergency room visits, hospitalizations, and clinic visits related to primary terminal diagnosis |