Referrals answered day, night, and weekend Direct line 435-635-1001
For physicians, hospitals, facilities & case managers

Send a referral. We will call you back.

Leave your name and the best number to reach you — that is all this form needs. A member of our team calls back, usually within the hour during business hours, and we take the clinical details by phone or secure fax.

Same-day response Admissions 7 days a week We can meet a hospital discharge 10/10 Medicare Hospice Care Index

Provider referral

Four fields. Roughly sixty seconds.

This form sends provider contact information only. It does not collect or store patient health information, and it is not a secure channel for clinical data — we will take those details by phone or secure fax. For anything urgent, call 435-635-1001.

Prefer to just call?

Direct line, answered by our team — not an answering service.

435-635-1001

Fax or secure email

Clinical documentation — face-to-face notes, history and physical, medication lists. Ask for our fax number when we call back, or call the direct line and we will give it to you immediately.

Why send it to us

Your patient gets visits, not a phone tree

Every hospice bills Medicare the same daily rate. What separates agencies is how often somebody actually walks into the house — which is exactly what the Hospice Care Index measures.

10 out of 10 on the Care Index

Ten Medicare quality indicators, all met — nurse visits at the end of life, skilled visits on weekends, live-discharge and hand-off rates. It is the highest score the index gives. Look us up on Care Compare and compare us to anyone.

Locally owned, team of ten

Staffing decisions are made here in Southern Utah, by people who will be in the home. No regional call center, no rotating cast.

Nights and weekends covered

After-hours calls reach our own nurse, and a nurse will come out. Fewer 2am emergency room trips bouncing back to you.

We train our own CNAs

Certified nursing assistants trained in-house, so personal care meets one standard — ours — and families see familiar faces.

Your patient keeps you

The attending physician stays in the loop and stays in charge. We coordinate, document, and report back — we don’t take over.

13 months of bereavement

Family support continues well past the death, which means fewer unsupported family members landing back in your office.

Provider questions

Referral logistics

Who can refer?

Anyone. Physicians, nurse practitioners, hospitalists, case managers, discharge planners, facility directors of nursing, social workers, chaplains — and families themselves. A physician order is required to admit, but not to start the conversation, and we will obtain the order and certification with the attending physician.

What documentation do you need?

Typically a face-to-face or recent progress note supporting prognosis, a history and physical, current medication list, and demographics and insurance information. Send it by secure fax or bring it to the phone call — we will tell you exactly what is missing rather than sending your team on a scavenger hunt.

Can you admit on a weekend or holiday?

Yes. Admissions happen seven days a week, including evenings. If a discharge is scheduled for a Friday afternoon, call us Thursday and we will have the equipment and medications lined up so the patient goes home once, not twice.

Do you serve patients in facilities?

Yes — assisted living, memory care, and skilled nursing facilities throughout Washington and Iron County, alongside private homes. We coordinate with facility staff and document to their requirements.

What if the patient is not hospice-eligible yet?

We will tell you plainly, explain why, and point the family toward what does fit — home health, palliative care, or community resources. We would rather give you an accurate answer than an admission.

Why does this form not ask for patient information?

A public web form is not an appropriate channel for protected health information under HIPAA (the Health Insurance Portability and Accountability Act). We collect provider contact details here and take everything clinical by phone or secure fax. It is a deliberate choice, and it protects your patient and your organization as well as ours.

Need an answer right now?

Call the direct line. A member of our team picks up — any hour, any day.