Chronic Heart Failure (CHF)
Support for Patients with Chronic Heart Failure
Living with chronic heart failure places substantial burdens on patients, caregivers and clinicians alike – as disease advances, the challenges of symptom burden, comorbidity and care coordination intensify. At Centrica Care Navigators, we bring expertise in serious illness, palliative approaches and person-centered support to help your patients with CHF live more comfortably, more predictably and with greater dignity.
Why Refer Your Patients Living with CHF to Centrica?
Our interdisciplinary team (physicians, nurses, pharmacists, social workers, aides and chaplains) works to manage dyspnea, fatigue and other symptoms that frequently diminish quality of life in advanced heart failure.
By closely monitoring volume status, medication adherence, dietary and fluid restrictions, early symptom warning signs, and coordinating interventions, we aim to reduce the number and severity of exacerbations and hospitalizations.
We help patients and families articulate and document care preferences, such as use (or non-use) of palliative medications and DNR wishes, helping their care align with their goals.
Centrica functions as an extension of your care team, ensuring smooth transitions from hospital, clinic, outpatient and long-term care settings to prevent fragmentation of care.
Heart failure is a journey with emotional, financial and spiritual stressors. We offer caregiver training, emotional counseling, education and connection to community resources to ease that burden.
Our team is available around the clock to assist with urgent symptom changes, medication challenges or to guide triage decisions.
Hospice Eligibility for CHF Patients
Eligibility is based on documented evidence of advanced heart failure, including:
- Documented diagnosis of chronic heart failure (NYHA class III or IV, or equivalent)
- Persistent symptomatic burden (e.g., dyspnea at rest or minimal exertion, fatigue, orthopnea, nocturnal dyspnea) despite guideline-directed medical therapy
- Repeated hospitalizations or ED visits for decompensated heart failure (e.g., ≥ 2 moderate or ≥ 1 severe exacerbation in past 12 months)
- Evidence of progressive decline in functional status (e.g., needing assistance with ADLs, weight loss, cachexia, muscle wasting)
- Frequent adjustments or difficulty maintaining euvolemia (fluid balance)
- Presence of device therapy (e.g., ICD, CRT) or consideration of advanced therapies (ventricular assist devices, transplantation)
- Patient/family expressing a shift in focus toward quality of life, comfort, fewer hospitalizations
- Anticipated decline or nearing end-of-life trajectory
Early referral before crisis often allows the greatest benefit in managing symptoms, planning and optimizing quality of life.
Timely Referrals Matter
In chronic heart failure, much of the suffering arises not from singular events but from cumulative burden, frequent exacerbations and reactive rather than proactive care. Referring earlier in the disease progression allows patients to benefit more fully from symptom mitigation, advance planning and longitudinal support, rather than only during crisis episodes.
Professional Benefits of Referral
Patient-centered outcomes: Fewer preventable hospital or ED visits, better symptom control, higher satisfaction
Operational support: Your team has an expert partner in managing complex heart failure cases
Continuity and communication: Regular updates, shared documentation and a clear liaison model
Resource leverage: You access palliative/serious illness resources without needing to build full infrastructure
Enhanced perception: Patients and families often appreciate the extra layer of support
Ready to Refer?
Connect with Centrica Care Navigators to discuss your patient’s needs or to learn more about how hospice and palliative care can transform care for individuals living with chronic heart failure.
