For Physicians & Referrers · East Texas
Hospice referrals in Tyler and East Texas.
We measure ourselves on response time, clinical communication, and what happens at 2 a.m. on a Saturday. We understand that a referral is trust. We carry it accordingly.
NPI: 1700460789
Accreditations & certifications
Medicare-Certified
CMS Provider · NPI #1700460789
Texas-Licensed
DSHS HCSSA #020708
CHAP Accredited
Independent accreditation
01 —Eligibility
“Would I be surprised if this patient died in the next six months?”
If the answer is no, hospice is appropriate today. The federal benefit requires physician certification of a six-month prognosis if the illness follows its expected course. Below are the standard clinical indicators by primary diagnosis. If you are unsure, call us — our medical director can consult with you before the referral is submitted.
02 —Clinical Indicators by Diagnosis
Cancer
- —Metastatic or stage IV with declining performance status
- —PPS ≤ 70 with continued decline
- —Declining or refractory to disease-directed therapy
- —Recurrent infections, hospitalizations, or weight loss
End-Stage Heart Disease
- —NYHA Class IV; symptomatic at rest
- —EF ≤ 20% (when measured) and optimally treated
- —Recurrent HF admissions or refractory arrhythmias
- —Persistent symptoms despite maximum therapy
End-Stage Lung Disease
- —Disabling dyspnea at rest; poor response to bronchodilators
- —FEV₁ < 30% (when measured)
- —Cor pulmonale, hypoxemia on room air, hypercapnia
- —Frequent ED visits or admissions for pulmonary exacerbations
Dementia
- —FAST Stage 7c or beyond — non-ambulatory, non-verbal, dependent
- —One or more co-morbid event in past 12 months (aspiration pneumonia, UTI, sepsis, stage 3+ pressure ulcer)
- —≥ 10% weight loss in 6 months, or albumin < 2.5 g/dL
- —Inability to maintain intake
End-Stage Renal Disease
- —CrCl < 10 (≤ 15 in diabetics) not pursuing dialysis
- —Stopping dialysis with progression
- —Symptomatic uremia, oliguria, intractable fluid overload, hyperkalemia
End-Stage Liver Disease
- —INR > 1.5, albumin < 2.5
- —One of: ascites refractory to treatment, hepatorenal syndrome, hepatic encephalopathy, recurrent variceal bleed
- —Not a transplant candidate
Stroke / Coma
- —Karnofsky ≤ 40 with complications
- —Post-acute phase with ongoing neurological decline
- —Aspiration, inability to maintain oral intake
Per CMS LCD L33393 and standard NHPCO eligibility guidelines. Call our medical director for complex cases.
03 —Operational Facts
Same-day evaluation
Within 4 hours
From receipt of the referral to a clinician at the bedside, anywhere in our eight-county service area.
After-hours nurse line
Clinician-answered
Never a service. Never a triage queue. A registered nurse, by name, available around the clock.
GIP transfer capacity
Direct admit
Established contracts with regional facilities in East Texas. Attending physicians can request direct GIP admission.
Continuous care
90-min activation
RN bedside during acute symptom crisis, dispatched within 90 minutes of the order.
04 —Referral Process
Three steps. We handle two of them.
Call or email us with the patient's name and diagnosis.
Our intake coordinator takes the referral by phone at (903) 555-0000 or by email at care@azaleahospice.com. A verbal order from the attending physician is sufficient to begin — written documentation follows within 24 hours.
We arrange the evaluation.
A nurse and social worker visit the patient and family within four hours of referral receipt. We assess eligibility, explain the benefit, and obtain consent if the family wishes to proceed.
We complete the admission.
We coordinate with the attending physician for certification, manage all admission documentation, and arrange delivery of medications and equipment. The attending receives a summary within 24 hours of admission.
05 —Communication
You hear from us. Not from a portal.
Attending physicians receive a clinical summary after the initial evaluation, IDG notes after team meetings, and a 30-day summary during each certification period. Our medical director is reachable by name — not by queue — for complex clinical questions.
06 —Lunch & Learn
We come to you.
We offer in-office education sessions for physicians, NPs, and case managers in East Texas — eligibility criteria, documentation requirements, and the referral-to-admission process. No slides, no sales pitch.
Ready to refer? We will handle the rest.
Call our intake line or send an email. We respond within the hour during business hours, and our clinical line is staffed around the clock.