Neuromuscular Disease:

Parkinson’s, ALS, MS Patient must exhibit the following:

• W/C or bed bound
• Dyspnea @ rest; uses supplemental O2
• Speech is barely intelligible or unintelligible
• Karnofsky $core of 5 or less
• Dysphagia; with or without peg tube

Supporting Signs/Symptoms Include:

• Recurrent aspiration pneumonia
• Nutritional decline/deficit
• Urinary tract infection
• Decubitus ulcers, stage 3-4
• Fever recurrent after antibiotic treatment