Hospice eligibility requirements.

Medicare Part A sets forth the criteria for the hospice benefit, and most other insurers also follow Medicare guidelines. In order to be eligible to elect hospice care under Medicare, your patient must be—

(a) Entitled to Part A of Medicare; and

(b) Be certified as being terminally ill in accordance with §418.22

Admission to hospice care.

Hospice can only admit a patient under the recommendation of the medical director in consultation with, or with input from, the patient’s attending physician (if any).  In reaching a decision to certify that the patient is terminally ill, the hospice medical director must consider at least the following information:

  • Diagnosis of the terminal condition of the patient.
  • Other health conditions, whether related or unrelated to the terminal condition.
  • Current clinically relevant information supporting all diagnoses.

General In-Patient (GIP) Hospice Eligibility Criteria

Patients in our hospice program may be eligible for GIP care when efforts to manage symptoms and pain cannot be managed in the patient’s current residence. A patient must be referred to an MJHS Hospice contracted facility in order to continue receiving services from MJHS Hospice. For a list of MJHS Hospice contracted facilities click here.

If you patient meets eligibility requirements and is ready to be admitted to hospice, you can refer them by filling out the Hospice Referral Form or calling  at: (212) 420-3370.