Referrals

An African American nurse walking with a resident in the hallway

Submit a Referral

Tranquil Care collaborates closely with our patient’s physicians and other healthcare providers, serving patients with life-limiting illnesses in Los Angeles County.

Hospice care is for patients when the focus of treatment shifts from curative measures to comfort care, and the patient may have a life expectancy of six months or less.

  • Routine home care – provided in your home, independent or assisted living facility, or skilled nursing facility. Interdisciplinary care, supplies, durable medical equipment, and medications related to the patient’s hospice diagnosis are provided.
  • Inpatient care – provided in a facility
  • Respite care – provided for up to five days in approved health-care facilities when caregivers cannot temporarily care for the patient at home.
  • Continuous care – continuous bedside nursing care provided during a medical crisis to allow a patient to remain at home.
  • Bereavement support – provided for families for up to 13 months following a loved one’s death.

Eligibility:

Your patient is eligible for hospice care if:

  • The patient may have a life expectancy of six months or less, or
  • The disease runs its expected course.

Many diseases are hard to prognosticate; for this reason, Medicare does not penalize the referring physician even if a patient lives longer. Hospice care can be extended beyond six months as long as the patient continues to have a prognosis of six months or less if the disease follows its normal course from the time of the most recent reassessment. Tranquil Care physicians are experts in determining prognosis and navigating Medicare guidelines.

Both the patient and the family benefit most from hospice care when they can access the full range of services. This is done best when the Tranquil Care hospice team has months or weeks, rather than days, to address their needs.

When is it time to refer?

Your patient may be eligible for hospice care if he or she exhibits one or more of the following:

  • The focus of treatment shifts from curative measures to comfort care
  • The patient, in your best judgment, has a prognosis of six months or less if the disease has run its normal course
  • There is a loss of function/physical decline
  • There is a history of frequent hospitalizations or emergency room visits
  • Your patient needs help in most activities of daily living
  • There are multiple co-morbidities
  • Your patient has lost weight without trying
  • Your patient’s pain and symptoms require close monitoring
  • When the patient and family need additional physical, emotional, or religious support

Management of the following diseases:

  • AIDS
  • ALS (Lou Gehrig’s disease)
  • Alzheimer’s
  • Cardiovascular disease
  • Cancer
  • Cerebrovascular disease
  • COPD (chronic obstructive pulmonary disease)
  • Alzheimer’s Dementia
  • Lewy Body Dementia
  • Liver disease
  • Multiple sclerosis
  • Muscular dystrophy
  • Neurological disorders
  • Parkinson’s disease
  • Pulmonary fibrosis (emphysema)
  • Other diseases as determined by the physician

Our goal is to provide your patients with the best care possible.

Tranquil Care Hospice cares for any patient who qualifies for our services. Please contact us at 310-264-8413.

Hospice care is for patients when the focus of treatment shifts from curative measures to comfort care, and the patient may have a life expectancy of six months or less.

Facility Address
Email
MM slash DD slash YYYY
PATIENT INFORMATION
Name
MM slash DD slash YYYY
Gender
Address
**For Physician Use Only**
PHYSICIAN ORDER FOR HOSPICE SERVICES
Diagnosis: I certify that this patient has a terminal diagnosis with a prognosis of 6 months or less if the disease runs its normal course.
Areas of Volunteer Interest (select all that apply)
Insurance Information
Acknowledgement(Required)
Telephone: (310) 264-8413
Fax: (310) 829-6032

THANK YOU FOR YOUR REFERRAL!