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Pulmonary Disease for Physicians

To qualify for hospice, a patient with advanced pulmonary disease must have:

Severe chronic lung disease evidenced by:

  • Disabling dyspnea at rest, poorly or unresponsive to bronchodilators, resulting in decreased functional capacity, e.g., bed to chair existence, fatigue, and cough.
  • Progression of end stage pulmonary disease as evidenced by prior increasing visits to ER or prior hospitalization for pulmonary infections and/or respiratory failure.
  • Hypoxemia at rest on room air, as evidenced by p02 ≤ 55 mmHg or oxygen saturation < or = 88% on supplemental oxygen. Or hypercapnia, as evidenced by p02 ≤ 50 mmHg.
  • Cor pulmonale and right heart failure (RHF) secondary to pulmonary disease (e.g., not secondary to left heart disease or valvulopathy.

The following are not required but support a hospice referral:

  • Unintentional progressive weight loss greater than 10% of body weight in the past six months.
  • Resting tachycardia > 100/min