Hospice Eligibility

As the attending physician, you will be certifying, that based on your clinical judgment, the patient has a prognosis of six months of less, should the illness run its expected course. You, the patient and the Hospice Hawaii medical director along with the interdisciplinary team will develop a plan of care.

All Levels of Care – The Right Choice for Your Patients

Our Hospice Hawaii medical director can assume patient care or work with you to provide your patients and families with an extra layer of support, including:

  • 24-hour on-call nurse and doctor
  • Regular RN and SW home visits
  • Emotional and spiritual support
  • Assistance with errands, meal preparation
  • Bathing services
  • Respite services when caregiver needs a break
  • Assistance with benefit applications (Medicaid, VA)
  • Medical supplies and equipment
  • Medications related to hospice diagnosis
  • Nursing home benefit for qualified patients
  • Continued therapies for non-hospice-related conditions
  • Diapers and incontinence supplies
  • Massage therapy, art therapy, pet therapy, aromatherapy, music therapy, and healing touch
  • Japanese-speaking team
  • Only dedicated pediatric hospice program in the state
  • At-home notary
  • Volunteer companionship

Guidelines for Determining Hospice Eligibility

ALS:

Critically impaired breathing: Dyspnea at rest. Requires O2 at rest. Declines artificial ventilation OR Critical nutrition impairment: At least 5% weight loss.

Cancer:

Tissue dx or reason why tissue dx not available. Mets with continued decline despite therapy or pt declines therapy.

Dementia:

Incontinent. Unable to bathe or dress by self. Unable to have consistently meaningful communication AND one of the following in the past 12 months: Aspiration pneumonia. Pyelonephritis. Septicemia. Decubitus Stage 3 or 4. Fever even with antibiotics. 10% wt loss or*albumin1.5 and albumin <2.5gm/dl AND ONE of the following: Ascites, SBP, hepatorenal syndrome, hepatic encephalopathy or recurrent variceal bleeding.

Heart Disease:

Already optimally treated; not a surgical candidate. Unable to carry on any physical activity. Chest pain or dyspnea at rest.

HIV:

Karnovsky Performance scale <50% (requires considerable assistance). CD4+100K copies/ml AND ONE of the following: CNS lymphoma. Wasting syndrome. MAC. PML. Renal failure. Opportunistic infection unresponsive to therapy.

Liver Disease:

INR>1.5 and albumin <2.5gm/dl AND ONE of the following: Ascites, SBP, hepatorenal syndrome, hepatic encephalopathy or recurrent variceal bleeding.

Pulmonary Disease:

Disabling dyspnea at rest. Increasing ER/hospitalizations or physician visits AND O2 sat <88%, pO2<55% or pCO2>50%.

Renal Disease:

Not seeking dialysis or renal transplant. Cr>8.0mg/dl (>6.0mg/dl if DM) GFR <10(<15 if DM).

Stroke and Coma:

Acute Coma OR Chronic: ONE of the following: 10% wt loss. Dysphagia preventing adequate nutrition. Aspiration. Albumin<2.5.

Other Diagnoses:

Other diagnoses may qualify, please call us for consultation.

Refer your patients via phone or fax.

Phone: (808) 791-8000Fax: (808) 791-8056