General Admission Guidelines
Patient has an advanced chronic illness or a terminal illness.
Patient/family has been informed the condition is life-limiting and has elected palliative care.
Patient has one or more of the following disease-specific indicators:

End-Stage Heart Disease
· Recurrent CHF
· Frequent hospitalizations
· Stage IV cardiac status
· LVEF£20%

Neuromuscular Degenerative Diseases (ALS, MS, MD, Parkinson’s)
· Progression of illness
· Nutrition impairment
· Life-threatening complications

Dementia
· Unable to perform ADLs independently
· Presence of medical complications
· Unintentional weight loss

Cancer or Malignancy
· Confirmed diagnosis
· Not undergoing aggressive, curative treatment
· Evidence of end-stage disease or metastasis

End-Stage Liver Disease
· Ascites
· Hepatorenal syndrome
· Hepatic encephalopathy
· Recurrent variceal bleeding

End-Stage Pulmonary Disease
· Frequent hospitalizations
· Recurrent infections
· Hypoxemia at rest

Stroke and Coma
Acute phase:
· Comatose state>3 days
· Abnormal brain stem response
· Absence of verbal response
Chronic phase:
· Post-stroke dementia
· Unintentional, progressive weight loss
· Presence of medical complications

Failure to Thrive
· Weight loss
· Multi-system failure
· Body Mass Index (BMI) below 22 kg/m2

HIV/AIDS
· CD4 count of <25
· Viral load>100,000
· Viral load>100,000 with other related complications

End-Stage Renal
· Serum creatinine>8mg/dl (>6mg/dl for diabetics)
· Oliguria (<400cc/day)
· Intractable hyperkalemia (K>7)

For a consultation or a referral, call:
781-749-2900