1224 Village Creek Lane A3 Mt. Pleasant, SC 294694 843-972-0500 Home Page Medicare Guide for Hospice Care Advanced end stage senescence or debility Amyotrophic lateral sclerosis ALS Cancer Cardiovascular disease End-stage dementia Failure to thrive HIV disease Liver disease Multiple sclerosis Neuromuscular disease Oncology Parkinson’s disease Pulmonary disease

STROKE AND COMA The patient has findings of: Acute hemorrhagic or ischemic stroke evidenced by: Coma or persistent vegetative state secondary to stroke, beyond 3 days duration or Coma or severe obtundation, secondary to post anoxic stroke, accompanied by severe myoclonus, persisting beyond 3 days after the anoxic event or Dysphagia, which prevents sufficient intake of food and fluids to sustain life in a patient who does not receive artificial nutrition and hydration Chronic phase of hemorrhagic or ischemic stroke evidenced by: Post-stroke dementia, stage 7 or beyond according to the Functional Assessment Scale (see Dementia) Poor functional status with Karnofsky Performance Status 50% or less or Poor nutritional status, whether on artificial nutrition or not, with inability to maintain sufficient fluid and calorie intake with > 10% weight loss during the previous six months or serum albumin < 2.5 gm/dl or Coma (any etiology) with any three of the following on day three of coma: Abnormal brain stem response Absent verbal response Absent withdrawal response to pain Serum creatinine > 1.5 mg/dl A physician may determine that a patient has a life expectancy of six months or less even if the above findings are not present. Co-morbidities also support eligibility for hospice care.