88 Neurologic Disease

• ALS
• Parkinsons
• Muscular Dystrophy
• Myasthenia Gravis
• Multiple Sclerosis
• Neuromuscular Disease

Meet at least one of the following criteria:

1. Critically impaired breathing capacity – all of following:
   1. Dyspnea at rest
   2. Vital capacity < 30%
   3. Requires oxygen at rest
   4. Declines mechanical ventilation
2. Rapid disease progression:
   1. Independent ambulation to wheelchair or bed-bound status
   2. Normal to barely intelligible or unintelligible speech
   3. Normal to pureed diet
   4. Independence in most ADLs to needing major assistance in all ADLs

AND

Critical nutritional impairment – all of the following in the last 12 months:

2. 1. Oral intake of nutrients and fluids insufficient to sustain life
   2. Continuing weight loss
   3. Dehydration or hypovolemia
   4. Absence of artificial feeding methods
3. Rapid disease progression:
   1. Independent ambulation to wheelchair or bed-bound status
   2. Normal to barely intelligible or unintelligible speech
   3. Normal to pureed diet
   4. Independence in most ADLs to needing major assistance in all ADLs

AND

Life threatening complications – one or more of the following in the last 12 months:

1. 1. Recurrent aspiration pneumonia
   2. Pyelonephritis
   3. Sepsis or recurrent fever
   4. Stage 3 or 4 decubitus ulcer(s)