Hospice Information – Beaumont / Lufkin Region

“Who is Eligible for Hospice Care”

Today’s edition of Southeast Texas Hospice Guide examines Southeast Texas hospice eligibility.

SETX Seniors is dedicating a year long series of articles to assist with the need for comprehensive Southeast Texas hospice information.

Today we’re looking at “Who is eligible for Southeast Texas hospice care?”

Hospice Care has grown significantly over the last two decades. Often when a loved one receives a terminal prognosis from a physician, Hospice care is discussed.

Many Southeast Texas senior citizens are understandably uncertain whether they or a loved one is eligible for Hospice.

Southeast Texas’ own Harbor Hospice provides useful reference guidelines for helping Southeast Texans determine whether or not they are eligible for Hospice care.

Guidelines in determining patient eligibility under the Medicare/Medicaid Hospice Benefit are helpful by identifying those persons that may have a life expectancy of approximately six months or less. A patient will need to meet all of the following criteria to be eligible for hospice:

• The patient’s condition is life limiting, and the patient and/or family has been informed of this determination. A “life limiting condition” may be due to a specific diagnosis, a combination of diseases, or there may be no specific diagnosis defined.
• The patient and/or family has elected treatment goals directed toward relief of symptoms rather than cure of the underlying disease.
• The patient has one of the following:

1. Documented clinical progression of a disease, which may include:
2. Progression of the primary disease process as listed in disease-specific criteria and documented by a physician assessment, laboratory, radiology, or other studies.
3. Multiple Emergency Department visits or inpatient hospitalizations over the prior six months.
4. For Homebound patients receiving home health services, nursing assessment may be documented. For patients who do not qualify under 1, 2, or 3, a recent decline in functional status may be documented.
5. Documented recent impairment of nutritional status relating to the terminal process.
6. Unintentional, progressive weight loss of greater than 10% over the prior six months.
7. Serum Albumin less than 2.5 gm/dl may be a helpful prognostic indicator, but should not be used in isolation from other factors in factors I-III above.

If some of these are confusing, your Southeast Texas physician is a great resource for evaluating SETX hospice eligibility.

Questions about hospice care? Call Harbor Hospice for a consultation.

Coverage of hospice care depends upon a physician’s certification that a person’s life expectancy is six months or less if the illness runs its normal course.

If a patient meets the medical criteria, they are, by definition, eligible to receive hospice services. Some patients may not meet the criteria, but may still be eligible for hospice care because of other co-morbidities or rapid functional decline. It is the physician’s clinical judgment regarding the normal course of the individual’s illness determines a prognosis of six months or fewer.

If you have further questions, a Harbor Hospice representative can help you get answers, information, and a better understanding of Hospice care and the eligibility of you or a loved one for Hospice.

We hope today’s Southeast Texas Hospice Guide has been a valuable tool for you.

If you’re looking for more SETX hospice care information, stay tuned to SETX Seniors.

We’re committed to bringing our readers over 30 articles each year about hospice care in Southeast Texas.

365 days a year, SETX Seniors publishes Southeast Texas senior news from exercise and social opportunities to understanding Medicare and Medicare Advantage Plans.

• Daryl Fant, Publisher East Texas Senior Resource Guide

• (512) 567-8068

• SETXSeniors@gmail.com