Clinicians refer patients to hospice based on a specific underlying disease state that is contributing to a prognosis of six months or less. The hospice physician may collaborate with the referring or attending physician to determine which diagnosis is most contributing to the terminality of the patient, but ultimately it is the decision of the hospice team.
Non-specific conditions or symptoms cannot be listed as the primary hospice diagnosis. For example, debility and failure to thrive may contribute to the terminal decline of a patient, but the underlying condition—such as heart failure or chronic obstructive pulmonary disease (COPD)—would be the primary hospice diagnosis.