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A hospice aide kneeling down to be eye level with her patient in a wheelchair as they share a smile together.

Hospice Admission Guidelines

Parkinson's Disease

LCD Guidelines

Parkinson's Disease

(1 of the following criteria must be met)

1. Severely impaired breathing capacity w/ all of the findings: Dyspnea at rest vital capacity less than 30%, the requirement of supplemental oxygen at rest, the patient declines artificial ventilation


2. Rapid disease progression & either A or B below:
Progression from independent ambulation to wheelchair or bedbound status
Progression from normal to barely intelligible or unintelligible speech
Progression from normal to pureed diet
Progression from independence in most or all activities of daily living (ADLs) to needing major assistance by caretaker in all ADLs


A. Severe nutritional impairment demonstrated by all of the following in the preceding 12 months: oral intake of nutrients & fluids insufficient to sustain life continuing weight loss dehydration or hypovolemia absence of artificial feeding


B. Life-threatening complications demonstrated by 1 or more of the following in the preceding 12 months: Recurrent aspiration pneumonia (w/ or without tube feedings), Upper urinary tract infection (e.g. Pyelonephritis), Sepsis, Recurrent fever after antibiotic therapy, Stage 3 or 4 decubitus ulcer(s)

Rapid decline or Comorbidities may support eligibility in the absence of the above criteria

Doctor and Patient _edited_edited.jpg

Comparative Data

Fast Score - On admission Fast 7a now 7c
PPS/ADL - On admission PPS 50%, now PPS 40%
Intake - Was eating 100% of meals now only eats 50% of meals, Patient is pocketing food, Diet change from regular to pureed, Patient was eating independently but now needing cues to eat
Weight Change - Lost 10lbs since admission
Alert/ Oriented - On admission patient was sleeping 10 hours a day, now sleeping 15+ hours a day, patient has become combative w/ care, needs medication intervention for behaviors
Skin Issues - Should be documented on every visit, redness noted to coccyx, previously had no skin issues
Activity - Patient can no longer move themself in wheelchair, could move independently in wheelchair on admission, patient is leaning in wheelchair and now requires lateral support
Infections - New and/or recurrent infection(s)
Fever - Recurrent fever


Kidney Failure

Syncopal Episodes


Weight Gain

Available 24/7

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