CHF/Heart Disease

Patient must have 1 and either 2 or 3.

  1. CHF with NYHA[1] Class IV symptoms and both:
    1. Significant symptoms at rest, and;
    2. Inability to carry out minimal physical activity without angina/dyspnea.


  2. Poor response to optimal treatment with diuretics, vasodilators, and/or angiotensin converting enzyme (ACE) inhibitors or patient refuses treatment.


  3. The patient has angina pectoris at rest, resistant to standard nitrate therapy, and is either not a candidate for/or declines invasive procedures.

Supporting documentation:

  • Echo demonstrating an ejection fraction of 20% or less
  • Treatment resistant symptomatic dysrythmias
  • History of unexplained or cardiac related syncope
  • CVA secondary to cardiac embolism
  • History of cardiac arrest or resuscitation

[1] Refers to the New York Heart Association Functional Classifications

In the absence of one or more of the above findings, rapid decline or comorbidities may also support eligibility for hospice care. 

Other guides:
COPD/Pulmonary Disease
CVA /Stroke/Coma
Huntington’s Disease
Liver Disease
Neurological Diseases
      ALS (Amyotrophic Lateral Sclerosis)
      Muscular Dystrophy
      Myasthenia Gravis
      MS (Multiple Sclerosis)
Renal Failure, Chronic or Acute

Assessment Tools
Palliative Performance Scale (PPS)
New York Heart Association (NYHA) Functional Classes
Functional Assessment Staging (FAST) Scale

Frequent Co-Morbidity documentation requirements
Cachexia or Protein Calorie Malnutrition

Comments are closed.