Healthcare Partners

Continuum of Care

Once a patient qualifies for hospice, a primary physician’s job does not stop. Hospice care is part of the patient’s continuum of care and is meant to supplement the level of care physicians, clinical staff or nursing facilities provide. Cedar Valley Hospice staff across our 15-county service area actively monitors changes in a patient’s condition, wherever they reside, and notifies necessary parties.

Is it possible a patient you are caring for could die within the next year? OR have they experienced some of the following symptoms? If so, they may be eligible for a hospice referral.

  • Weight loss
  • Small/decreased appetite
  • Changes/increased assistance with activities of daily living (ADLs)
  • Frequent hospitalizations or ER visits
  • Increased pain

Caring for your patients living with an advance illness can be challenging, however you can offer them a better quality of life by partnering with Cedar Valley Hospice. Our team of experts can provide guidance with difficult conversations, as well as providing additional support the patient and family deserve.

How to Make a Referral

Making a referral is very simple. Please call us anytime at 800.626.2360 or complete the form below. We will follow up promptly. Thank you for trusting Cedar Valley Hospice in the care of your patients.

Some or all criteria listed may be present to qualify for hospice admission. The presence of multiple diagnoses may support admission to hospice. For more information, or and admission evaluation, call Cedar Valley Hospice

Benefits of Hospice Care

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At Cedar Valley Hospice, 96% of our patients receive hospice services in their own homes or a resident facility.

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Most patients reporting pain are brought to a comfortable level within 48 hours of initial assessment.

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Patients enrolled in hospice care live, on average, 29 days longer than patients not in hospice care.

There are multiple benefits of referring patients to Cedar Valley Hospice earlier. Our services include 24/7/365 nursing availability, personal care, family support, caregiver education, medication management, durable medical equipment, emotional and spiritual support, therapies and grief counseling. Generally, patients who enroll in hospice care report a higher quality of life and a reduction in unnecessary ER visits. We often hear from patients and families, “We wish we would have called Cedar Valley Hospice sooner!”

When to Refer to Hospice Care

A patient is eligible for hospice care when they have an advanced illness and a life expectancy of six months or less, as determined by a physician. The patient must also desire hospice as an added level of care, which focuses on comfort and pain management rather than disease-modifying therapies.

After six months, the patient will be reassessed to determine if they are still hospice eligible based on the progression of the disease.

If you would like more information OR are unsure about life expectancy, our hospice physicians are available for consult by calling 800.626.2360.

Hospice Criteria by Disease for Referring Physicians

Some or all criteria listed may be present to qualify for hospice admission. The presence of multiple diagnoses may support admission to hospice. For more information, or an admission evaluation, call Cedar Valley Hospice.
  • Rapid progression of the disease paired with critical impairment of ventilatory capacity
  • Food/fluid intake insufficient to sustain live
  • Recurrent pneumonia
  • Multiple stage 3-4 decubitus ulcers (particularly if infected)
  • Upper urinary tract infection
  • Sepsis
  • Fever that continues to occur after antibiotics
  • Evidence of end-stage disease and/or metastasis
  • No longer receiving curative treatment
  • Anorexia with weight loss
  • Requires pain/symptom management with frequent interventions
  • Significant symptoms of recurrent CHF at rest, such as: dyspnea, increased confusion, nausea & vomiting, pruritis, restlessness, decreased urine output, edema and hyperkalemia
  • Ejection fraction of 20% or less (not required for eligibility)
  • Persistent symptoms of CHF despite maximum medical treatment
  • Requires considerable assistance and frequent medical care
  • Increasing duration or frequency of arrhythmias, fainting spells or cardiac arrest
  • Food/fluid intake insufficient to sustain life
  • Dependent in activities of daily living
  • Bed or chair bound
  • Coma beyond three days duration
  • Difficulty swallowing or refusal to eat
  • Food intake insufficient to sustain life
  • Refusing G-tube placement for nutritional purposes
  • Severely compromised speech or communication
  • Incontinent of urine and stool
  • Dependent in activities of daily living
  • Co-morbid conditions associated with dementia (i.e., infections, decubitus ulcer, aspiration pneumonia)
  • Inability to ambulate without assistance
  • Documentation of specific liver disease in history and physical
  • Abnormal liver enzymes – alkaline phosphatase, SGOT and bilirubin
  • Experiencing ascites, edema, itching, progressive malnutrition, spontaneous bacterial peritonitis, hepatorenal syndrome, recurrent variceal bleeding, hepatic encephalopathy
  • Elevated prothrombin time more than five seconds over control or INR greater than 1.5 and serum albumin less than 2.5 gm/dl
  • Patients awaiting liver transplant may have Cedar Valley Hospice services
  • Dyspnea-tachypnea or tachycardia at rest (change from prior level of function)
  • Progressive cough
  • Oxygen dependent
  • Hypercapnia – PCO2 greater than or equal to 50 mmHG
  • Cor Pulmonale related to advanced pulmonary disease documented by EKG, echocardiogram or chest X-ray
  • Frequent hospitalizations or visits to ER
  • Poor or minimal response to bronchodilators
  • Discontinuing dialysis
  • Creatinine clearance < 10 cc/min and serum creatinine > 8.0 mg/dl (if diabetic serum creatinine > 6.0 mg/dl)
  • Chronic or acute illness that precipitated renal failure
  • Food/fluid intake insufficient to sustain life
  • Increasing edema
  • Patients waiting a renal transplant may have Cedar Valley Hospice services


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Physician’s Event

Held in September for providers, this event features notable healthcare speakers, education with CME credits, social hour and dinner. Physicians are invited to attend the annual Physician Education event hosted by Cedar Valley Hospice since 2009. This opportunity also offers networking, collaboration and camraderie as professionals gather to receive and exchange information for patient care at end of life. Plan to attend our event or call 319.272.2002 for more information.

Nurse Continuing Education

Cedar Valley Hospice is an approved Iowa Board of Nursing Provider, which allows nurses to receive contact hours for attending our educational events. All other disciplines receive a certificate of attendance. A variety of educational opportunities for the healthcare community are available and can be tailored to fit your needs. Call 319.272.2002 today to schedule your educational event.

Frequently Asked Questions

It is best to begin advance directive and end-of-life conversations early. This conversation can even be had during routine physical exams. Hospice and palliative care discussions are easier for patients when they are had early in a diagnosis and should be held as not one, but several conversations. The team at Cedar Valley Hospice is always available as a resource in helping with these difficult conversations.

Hospice care is provided in the patient’s home, nursing home, or hospital. Cedar Valley Hospice also offers the only Hospice Home in the area. It is a short-term, in-patient facility which provides care for patients in a home-like setting with specially trained staff. The Hospice Home is available to Cedar Valley Hospice patients as an alternative to a hospital stay.

Our hospice services are for anyone with a life threatening illness and an estimated life expectancy of six months or less.


Note: Co-morbidities are also a factor to consider in qualifying for hospice care. If you would like to discuss the possible eligibility of a patient, please contact us at any time at 800.626.2360.

Hospice care at Cedar Valley Hospice is available to anyone who qualifies for admission, regardless of ability to pay. Medicare, Medicaid and many private insurance plans cover hospice care.

Hospice care at Cedar Valley Hospice is available to anyone who qualifies for admission, regardless of ability to pay. Medicare, Medicaid, VA benefits and many private insurance plans cover hospice care. Patients who meet eligibility requirements have several options to ensure their family will receive the support hey need at this difficult time. Our clinical team is available to ensure they have the support they need and help guide patients/families in pursuing essential services.
The experts at Cedar Valley Hospice have been partnering with area professionals and providing the highest quality care since 1979. Cedar Valley Hospice is an independent, not-for-profit community hospice with the only Hospice Home in the area. We accept patients of all ages and diagnoses, and will never deny care to anyone regardless of their ability to pay. Cedar Valley Hospice also focuses on all aspects of patient-family health – physical, emotional, spiritual and social.
Yes! A patient’s physician is a crucial part of their care team at Cedar Valley Hospice. You will be asked for your recommendations regarding the course of their end-of-life care at Cedar Valley Hospice.

The staff at Cedar Valley Hospice would be glad to answer any other questions you may have regarding hospice care. Simply contact us online or call 800.626.2360 anytime for assistance.

Have a Referral?

Anyone can refer a friend or family member to Cedar Valley Hospice. Simply complete and submit the form below to get started. If you have any questions, please give us a call at 800.626.2360.

Your support is
what inspires us

Enriching lives in the Cedar Valley is at the forefront of our mission. We are experts in providing hospice and palliative care, grief support and providing additional services for those with life changing diagnoses. As a not-for-profit organization, your gifts make our mission possible!

Become a volunteer!

Our volunteers are the heart of our organization. From visiting patients to helping with events, they perform a number of different roles that are vital to helping us carry out our mission.

Healthcare Partner Resources

We offer multiple resources for physicians and healthcare clinicians dealing with serious diagnosis and end-of-life related topics as well as an easy online patient referral form. Connect with us today!