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).

ORCHID Order for “Home Hospice”
- Will require NPI and License #
- 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.
This will be received by our Home Health Department who processes the referral and finds a hospice agency who can accept the patient
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 - has COVID care, HFNC, thora/paracentesis if already has catheter
  - Roze Room (818) 783-1002 - has COVID care, HFNC, thora/paracentesis if already has catheter
  - Silverado (310) 634-4311 - COVID, HFNC, thora/paracentesis
  - Hope International (310) 782-7070 - thora/paracentesis, Chinese, Korean, Japanese speakers

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