Cardiac Heart Failure patients (CHF) have been front and center for the attention of both home health and hospice agencies.  CHF patients are almost always the first choice of home health agencies for telehealth monitoring.  And "Across the board, physicians reported that they were unlikely to refer a patient with end-stage heart failure for hospice care.  Their reluctance was due in part to uncertainty about timing and patient acceptance of the (hospice) recommendation."  This is an interesting article reporting on a study conducted by St. Louis University which provides insight into  physicians' beliefs and biases.