Harbor:Home hospice from ED

HOSPICE ELIGIBILITY:

• 1) “Would I be surprised if this patient dies in the next 6 months?”
• Terminal illness with prognosis of ≤ 6 months
• Declining functional status:
• Dependence in 3 of 6 Activities of Daily Living (ADLs)
• Predominately chair or bedbound
• Change in nutritional status, e.g., > 10% loss of body weight over last 4-6 months
• Observable and documented deterioration in overall clinical condition in the past 4-6 months, as manifested by at least one of the following:
  • ≥ 3 hospitalizations or ED visits
  • Decrease in tolerance to physical activity
  • Decrease in cognitive ability
  • Other comorbid conditions

• 2) Patient/family has chosen to focus on comfort
• need some support at home, whether it's family, friends, neighbors. (e.g. cannot be completely dependent for ADLs).

HOME HOSPICE REFERRAL

• ORCHID Order for “Home Hospice”
  • Will require NPI and License #
  • Please add to the order comments the physician contact #/pager, terminal diagnosis and any medical care needs patient may require for comfort
  • ie: high flow O2, therapeutic para/thora, local wound care, ostomy care, foley etc.
• This will be received by our Home Health Department who processes the referral and finds a hospice agency who can accept the patient
• Hospice agency will contact patient/family and sign consent for services
• Home Health Hours: M-F 8am-5:30pm, Saturday 9am-6pm
  • They will coordinate everything after the order is placed and call the provider's Spectralink with f/u on ETA or any questions
• Weekends/Holidays/After work hours
  • Since Home Health is not here, you will make the referral to hospice agency directly
  • Please still place “Home Hospice” order in orchid so that our Home Health Department can follow up and track the referral
  • Afterhours, the ED can directly contact the home health agency Vitas 855.977.4042 or VITAS.com/Referrals