Harbor:Home hospice from ED



  • 1) “Would I be surprised if this patient dies in the next 6 months?”
  • Terminal illness with prognosis of ≤ 6 months
  • Declining functional status:
  • Dependence in 3 of 6 Activities of Daily Living (ADLs)
  • Predominately chair or bedbound
  • Change in nutritional status, e.g., > 10% loss of body weight over last 4-6 months
  • Observable and documented deterioration in overall clinical condition in the past 4-6 months, as manifested by at least one of the following:
    • ≥ 3 hospitalizations or ED visits
    • Decrease in tolerance to physical activity
    • Decrease in cognitive ability
    • Other comorbid conditions
  • 2) Patient/family has chosen to focus on comfort
  • need some support at home, whether it's family, friends, neighbors. (e.g. cannot be completely dependent for ADLs).


  • ORCHID Order for “Home Hospice”
    • Will require NPI and License #
    • Please add to the order comments the physician contact #/pager, terminal diagnosis and any medical care needs patient may require for comfort
    • ie: high flow O2, therapeutic para/thora, local wound care, ostomy care, foley etc.
  • This will be received by our Home Health Department who processes the referral and finds a hospice agency who can accept the patient
  • Hospice agency will contact patient/family and sign consent for services
  • Home Health Hours: M-F 8am-5:30pm, Saturday 9am-6pm
    • They will coordinate everything after the order is placed and call the provider's Spectralink with f/u on ETA or any questions
  • Weekends/Holidays/After work hours
    • Since Home Health is not here, you will make the referral to hospice agency directly
    • Please still place “Home Hospice” order in orchid so that our Home Health Department can follow up and track the referral
    • Afterhours, the ED can directly contact the home health agency
      • Vitas 855.977.4042 or VITAS.com/Referrals - has COVID care, HFNC, thora/paracentesis if already has catheter
      • Roze Room (818) 783-1002 - has COVID care, HFNC, thora/paracentesis if already has catheter
      • Silverado (310) 634-4311 - COVID, HFNC, thora/paracentesis
      • Hope International (310) 782-7070 - thora/paracentesis, Chinese, Korean, Japanese speakers