Information for Health Professionals

To make a referral to Lakeland Hospice & Home Care simply call (218) 998-1400

Fast Facts:

Diagnosis: any one, of any age, with any life-limiting illness following its normal course, would typically give the patient six months or less to live.

On Call: Nurses are on call throughout our service area 24 hours a day / 7 days a week.

Payer Source: hospice care is a benefit of MediCare, MedicAid, most private insurances, Veteran's benefits, and more. No one is ever turned away for inability to pay for hospice services provided in their home.

Service Area: Lakeland Hospice serves 13 counties in West Central Minnesota - Otter Tail, Grant, Douglas, Todd, Wadena, Becker, Clay, Wilkin, Traverse, Big Stone, Swift, Stevens and Pope; and Richland county in North Dakota and Roberts county in South Dakota.

Diagnosis Specific Guidelines for Hospice Services

ALS

Critical Impairment of breathing capacity
Rapid progression of ALS with nutrition impairment
Rapid progression with complications such as repeated infections

Alzheimer's / Dementia

Progression of the dementia process over an extended period of time
Requires assist for ambulation, dressing & bathing
Urinary & bowel incontinence
Speaks 6 words or less - no consistent, meaningful conversation
Weight loss - 10% loss in past 6 months or albumin level < 2.5gm/dl
Recurrent infections such as pneumonia, UTI, pressure ulcers
Increased ER visits or hospitalizations
Frequent falls

Cancer

Advanced, recurrent or metastatic cancer
No curative treatment is being sought
We will consider palliative radiation or chemo (evaluated on individual basis)

COPD / Lung Disease

COPD, emphysema and end stage pulmonary disease, may also include disease such as pulmonary fibrosis & pulmonary hypertension
Disabling dyspnea at rest - often even talking causes dyspnea
Unresponsive / poor response to bronchodilators
Decreased functional capacity as evidenced by bed to chair existence, fatigue, cough
Increased ER visits or hospitalizations
Right Heart Failure (RHF) 2nd to the pulmonary disease
Unintentional progressive weight loss of greater than 10% of body weight over past 6 months.
Resting tachycardia > 100/min
Continued smoking is also a significant factor

End Stage Diabetes

Frequent skin or wound infections
Heart or lung disease comorbidities that are worsening

Heart Disease

Optimally treated for heart disease or is not a candidate for surgery or refuses surgery that is recommended.
Patients with CHF or angina should meet critera for New York Heart Association Class IV
CHF can be documented with ejection fraction of 20% if available. Patients with Diastolic CHF do not need to meet critera
Comorbidities including COPD, renal disease, liver disease, dementia, diabetes, Parkinson's for example
Patients can by NYHA Class III if significant comorbidities

Liver Disease

Ascites not responsive to treatment
Serum albumin <2.5gm/ml
Hepatic encephalopathy not responsive to treatment
Hepatorenal syndrome
Additional factors: progressive malnutrition & muscle washting, active alcoholism, hep B positive, hep C not responsive to interferon

Renal Failure

Patient is not on dialysis
Serum creatinine> 8 mb/dl (6 mg/dl for diabetics) or creatinine clearance < 10cc/min (15 cc/min for diabetics)
Existing comorbidities; COPD, heart disease, advanced liver diease or any malignancies
Patients receiving dialysis can receive hospice care if they have a different terminal diagnosis such as heart disase, cancer, or COPD

Unspecified Debility

Failure to thrive patient
Progressive decline with weight loss & decrease in functional status
May have multiple comorbidities
Dependence for assistance for most cares
Recurrent infections
Increase ER visits or hospitalizations