Oasis Healthcare - Who Qualifies

CARDIAC DISEASE - Patients get short of breath, have weakness and episodes of cardiac pain

NYHA Class IV criteria: significant symptoms of recurrent CHF at rest or;
Ejection fraction of 20% or less
Has poor response to or chooses not to pursue treatment with diuretics, vasodilators, and or ACE inhibitors (documentation by physician is sufficient)
History of arrhythmia, unexplained syncope, and/or cardiac arrest
Not a candidate for or declines invasive procedures

COPD/Pulmonary Disease - Patients get short of breath with little activity, are on oxygen and get weak or tired easily

Disabling dyspnea at rest resulting in decreased functional capacity or decreasing FEV1 post bronchodilator less than 30% of predicted
Frequent treatment of respiratory infections documented or decreasing FEV1 greater than 40 ml per year on oxygen
Hypoxemia with pO2 of 55mm/Hg or less or O2 SAT of 88% or less on room air
Cor pulmonale, resting tachycardia (greater than 100/min)
Unintentional weight loss

CANCER - Patients have a cancer diagnosis and have limited number of radiation and chemotherapy treatments deemed non-curative

Dementia - Increased confusion, unable to take care of personal needs, unable to walk without assistance

Unable to ambulate, or perform activities of daily living without assistance
No meaningful verbal communication
Incontinence of bladder/bowel
Stage 7 on FAST Scale and any comorbid or secondary condition (ex. coronary heart disease and COPD)
At least one of the following in the last 12 months; UTI, aspiration pneumonia, septicemia, stage 3-4 decubitus ulcers, recurrent fever after antibiotics, inability to maintain sufficient fluid and caloric intake resulting in 10% weight loss

Adult Failure To Thrive - Patient with unexplained or non-reversible weight loss, appears very thin

Stroke/Coma - Patient with recent life threatening stroke

Meet the criteria for dementia
Karnofsky score of less than 50%
Poor nutritional status evidenced by weight loss of greater than 10% over the last 6 months or serum albumin of 2.5 gm/dl or less

General Debility - Patient has general decline in overall status, weight loss, frequent falls and increased weakness

ALS - Lou Gehrig's Disease

Impaired lung function (dyspnea at rest, VC less than 30%, supplemental 02 at rest, patient declines artificial ventilation)
Rapid progression of ALS (from independent ambulation to wheelchair or bedbound, from normal to barely intelligible or unintelligible speech, from normal to pureed diet, and from independence in ADL's to major assistance by caregiver)
Critical nutritional impairment (oral intake of nutrients and liquids insufficient to sustain life, continuing weight loss, dehydration or hypovolemia, absence of artificial feeding methods)
Both rapid progression of ALS and life-threatening complications (recurrent aspiration pneumonia with or without tube feedings, upper UTI, sepsis and recurrent fever after antibiotic)

Liver Disease - Patient with jaundice (yellowish skin tone), swelling in abdomen

INR greater than 1.5, serum albumin less than 2.5
At least one of the following:
- Refractory ascites, encephalopathy
- Recurrent variceal bleeding
- Hepatorenal syndrome (elevated BUN and Creatinine with oliguria and urine sodium concentration less than 10 mEq/l

Renal Disease - Kidney failure and not on dialysis

HIV/AIDS - Patient has frequent upper respiratory infections or frequent pneumonia and increased weakness

CD 4 less than 25 or viral load greater than 100,000
Karnofsky Scale of 50% or less
Patient has elected to forgo antiretroviral and prophylactic therapy related specifically to HIV disease