OBJECTIVES: Palliative care services (PCS), including pain management, end-of-life planning and counseling, remain uncommon in many USA hospitals. This study assessed the prevalence of potential candidates for PCS in a publicly-funded, acute-care hospital. METHODS: A consult tool was developed to identify potential need for PCS. For two months, two critical care nurses surveyed all patients in surgical and medical intensive care, and intermediate care units. The tool included 3 items tallied to create a total score. These related to basic and concomitant disease processes, and functional status (based on the Eastern Cooperative Oncology Group or ECOG scale). Under basic disease process, each life-threatening/terminal condition was 2 points. Under concomitant disease process, each comorbid condition was 1 point. The ECOG scale was scored from 0 to 3 (3=completely disabled). Patients receiving a total score of >3 were considered potential candidates for PCS. RESULTS: A total of 258 cases were reviewed; 140 (54%) were in intensive care units (ICU), while 118 (46%) were in the intermediate unit (IMC). Of the 258 cases, 105 (41%) achieved a total score >3, suggesting PCS candidates. Of the 105, 59 (56%) were in ICUs. Median total score was 3 (range 0-10), corresponding to need for continued observation. Median functional status score was 1 (range 0-3), indicating a patient was ambulatory, capable of self-care, and awake more than 50% of waking hours. However, 42 (16%) patients had a functional score of 3, indicating they were completely disabled, unable to provide any self-care, and confined to bed. CONCLUSION: PCS may be needed in 41% of critical care admissions at a community hospital. The benefits of PCS to patients, payers, and providers have been demonstrated in multiple studies, but programs offering these services are infrequent. Further research on the impact that PCS has on patient care is needed to promote such programs.