Hospice Eligibility Criteria for Heart Failure

Heart failure hospice criteria

People living with advanced heart disease are eligible for hospice care if they meet one or more of the following criteria:

• You have CHF symptoms in spite of using medications to relieve fluid retention (diuretics) and improve circulation (vasodilators).
• You have a medical history of cardiac arrest.
• You have angina (sharp chest pain) at rest despite medical efforts to relieve it.
• Your angina at rest and patient is not a candidate for surgery, or refuses surgery.
  New York Heart Association Class IV disease: Physicians use this system to place patients in one of four categories based on how much they are limited during physical activity. Patients in Class IV are unable to carry on any physical activity without discomfort and show CHF symptoms at rest.
• You have an Ejection Fraction (EF) of less than 20%: Ask your doctor about your score on this test to measure how well your heart is pumping out blood. The EF for a normal heart ranges between 50 and 70.
• You have an abnormally fast heart rhythm (known as symptomatic SVT or ventricular arrhythmia) that does not respond to treatment.
• You experience unexplained fainting (also known as syncope).
• You have a blockage that formed in the heart and lodged in the brain (called a cardiogenic brain embolism).
• You wish to remain out of the hospital if the illness gets worse.
• You have more than one serious medical condition that may shorten survival (e.g. CHF with COPD).
• You need more help with basic tasks of daily living.

Does congestive heart failure qualify for hospice?

Yes. Congestive heart failure may qualify for hospice when the condition has progressed to an advanced stage, symptoms continue despite treatment, and the patient has a life expectancy of six months or less if the disease follows its expected course.