The patient has severe chronic lung disease
as documented by 1, 2 and 3
1.
- Disabling dyspnea at
rest
- Poor response to bronchodilators
- Decreased functional
capacity (e.g. bed to chair existence, fatigue and cough).
- An FEVI < 30%
is objective evidence for disabling dyspnea but is not required
2.
Progression of disease as evidenced by a recent history of increasing
office, home or emergency visits and/or hospitalizations for pulmonary
infections and /or respiratory failure.
3.
Documentation within
the past 3 months of a or b or both:
- Hypoxemia at
rest (pO2 = 55mgHg by ABG) or oxygen saturation equals to
88%
- Hypercapnia evidenced
by pCO2 > 50mmHg
Supportive
Condition:
Cor pulmonale and right heart failure secondary to pulmonary
disease, unintentional progressive weight loss >10% over
the preceding six months, resting tachycardia > 100bpm
In the absence of one or more of the above findings,
rapid decline or comorbidities may also support eligibility for hospice
care.
