Hospice Eligibility
Understanding common signs that it may be time to ask whether hospice care is appropriate.
Changes that may signal increasing care needs
Hospice eligibility is based on the individual clinical picture and applicable criteria. A referral can begin with a conversation—even when you are unsure whether the patient qualifies.
- Progressive decline in strength, mobility, or ability to perform daily activities.
- Increasing sleep, fatigue, weakness, or time spent in bed or a chair.
- Poor appetite, weight loss, swallowing difficulty, or reduced intake.
- Frequent hospitalizations, emergency visits, or repeated infections.
- Worsening shortness of breath, pain, agitation, or other difficult symptoms.
- Progression of serious neurologic, cardiac, pulmonary, renal, cancer, or other life-limiting disease.
- The patient or family is increasingly prioritizing comfort and avoiding burdensome interventions.
How hospice eligibility is determined
Eligibility is determined through clinical evaluation and physician certification under applicable hospice requirements. For the Medicare hospice benefit, a central criterion is a prognosis of six months or less if the illness runs its normal course.
The presence of one sign alone does not determine eligibility. Diagnosis, disease trajectory, comorbidities, functional status, nutrition, symptoms, and other clinical findings may all be considered.
You do not need to have every answer before calling.
If you are noticing decline or wondering whether hospice may help, Amenity Health Care can review the situation and explain what information is needed for an evaluation.
Patients & families
Call to discuss goals, concerns, recent changes, and what hospice care could look like.
Physicians & clinicians
Refer when the patient has progressive life-limiting illness or increasing symptom and support needs.
Facilities & care partners
Coordinate referrals and records so hospice can evaluate eligibility and begin planning promptly when appropriate.
Discuss a possible hospice referral
Call 630-366-6424 or review our referral page for the information that is helpful when starting an evaluation.