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The allocation to general vs specialist palliative home care services is decided by theHome Palliative Care Unit (HPCU). The HPCU needs validated tools analyzing and stratifying the complexity and supporting good partnership working between Generalist and Specialist PCT. Methods. In order to define factors supporting the choice of Generalist versus Specialist PCT, Experts of Palliative Care Service of Emilia Romagna Region (Italy) according to Regional Health Policies Group defined a new tool to identify palliative care patient’s and family’s needs. We created a screening tool identifying terminally ill cancer metastatic patients in need of referral to a PC Generalist or Specialist PC at home than we performed a prospective, observational, no profit, multicenter study to testing it. The questionnaire compiled by the HPCU team to describe what it detected at home was reviewed by a second team (Comparison Team 2) to assess the convergent validity and inter-observer reproducibility. Results. There were 119 patients who could be evaluated. The dimensions investigated by the instrument that were most relevant in the assignment of the specialist care level were: presence of an evolutionary-unstable clinical picture, finding of limited therapeutic options for symptom control, presence of dyspnea. The convergent validity was moderate in this first phase of the study (Cohen’s Kappa 0.49); the inter-observer reproducibility in Team 2 was excellent (Cohen’s Kappa 0.94). Conclusions. The tool proved to be an easy and quick to use tool. The results of the first step are encouraging and guide the new research protocol as part of the Emilia-Romagna Year 2020 Health Research Program aimed at retesting the modified tool in the formulation of the questions, calibrated based on the results of the study.