Healthcare Providers
Collaborative Approach to End-of-Life Care
As the first hospice in Wisconsin, you can rely on Unity to provide the highest quality end-of-life care to your patients and families.
Our collaborative approach to care enables attending physicians to oversee symptom management while Unity’s care team, consisting of Registered Nurses, Licensed Practical Nurses, Social Workers, Certified Nursing Assistants, Grief Counselors, Chaplains and volunteers, assess and assist with ongoing medical, emotional and spiritual needs. Together we can maximize patient comfort and family support while minimizing hospital visits.
The Referral and Admission Process
When your patient has a prognosis of 6 months or less …
- Document why your patient is ready for hospice. (Documentation matters as hospices are audited routinely. Call the hospice medical director if you have questions.)
- Examples of information that supports a six-month prognosis from the perspective of CMS:
- Cancer – Imaging abnormalities, particularly metastatic cancer
- Cardiac – NYHA Class IV and Echo abnormalities, particularly EF<20% and/or severe diastolic dysfunction.
- Pulmonary – PFTs with FEV1 <30%, Pulse oximetry on RA <88%, Resting tachycardia
- Labs – Decreasing albumin / severe anemia / Cr >8.0
- Recurrent hospitalizations, especially for infection disease reasons
- Weight loss greater than 10% body weight in 6 months
- Pressure sores stage 3 or 4 despite good wound care
- Worsening function – ADLs / falls / mobility / dysphagia
- The patient’s medical information is gathered by the hospice.
- The hospice medical director verifies hospice eligibility.
- The hospice medical director determines hospice diagnosis(es).
- The patient is informed they are eligible for hospice services.
- The patient chooses an “attending” provider who gives medical care until death (typically the provider making that hospice referral).
- The attending and hospice medical director sign a “Certification of Terminal Illness (COTI).”
- The hospice team completes the admission process and begins providing care.