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

1. ORCHID Order for “Home Hospice”

1. Will require NPI and License #

1. 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.

1. This will be received by our Home Health Department who processes the referral and finds a hospice agency who can accept the patient

1. 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