Pulmonary Disease

The patient has:

• Disabling dyspnea at rest or with minimal exertion and little or no response to bronchodilators, resulting in decreased functional capacity, fatigue and cough and
• Progression of end stage pulmonary disease, as evidenced by prior increasing visits to the emergency department or prior hospitalizations for pulmonary infections and/or respiratory failure and
• Room air findings of hypoxemia, as evidenced by pO2 < 55 mmHg and oxygen saturation < 88% or hypercapnia, as evidenced by pCO2 > 50 mmHg
• Cor pulmonale and right heart failure (RHF) secondary to pulmonary disease (e.g., not secondary to left heart disease or valvulopathy)
• Unintentional progressive weight loss greater than 10% of body weight over the preceding six months
• Resting tachycardia > 100/mm

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.