Ask us anything. Most families ask these first.

No. It means changing the goal of treatment from cure to comfort. Hospice patients still receive active medical care — medications, oxygen, wound care, physical and occupational therapy for safety and function — all directed at symptoms and quality of life rather than at the underlying disease.

Choosing hospice is also reversible. A patient may revoke the benefit at any time to pursue curative treatment, and may elect hospice again later. Nothing is signed away permanently.

Anyone can call us — a patient, an adult child, a spouse, a neighbor, a discharge planner. You do not need a referral in hand to ask questions. Call (818) 273-4884 and Milena Pamyan, our intake coordinator, will talk it through with you at no cost and no obligation.

A physician does have to certify eligibility before care begins. In practice, we obtain that certification for you: we contact the attending physician, confirm the clinical picture with our medical director, Dr. Iraj Zamanian, and handle the paperwork. Families rarely have to chase anything.

Usually the same day, and always within 24 hours of the referral. If someone is in crisis — uncontrolled pain, severe breathlessness, an imminent death at home — we admit in the evening, overnight, or on a weekend. Those admissions are not exceptions; they are a normal part of the week.

A nurse comes to wherever the patient is. The visit is mostly listening: what the illness has been like, what medications are in the house, what the day looks like now, and what the family is most afraid of.

The nurse then reviews medications with our physician, orders the equipment that is needed, and leaves behind a comfort kit — a small supply of medications for pain, breathlessness, nausea, and agitation, so nobody is waiting on a pharmacy at three in the morning — along with a phone number that a real person answers.

Almost never. The most common regret we hear from families is that they waited. Calling to ask questions does not enroll anyone in anything, and it does not start a clock. If we think hospice is not the right fit yet, we will tell you so and point you toward palliative care or another resource.

Two physicians — usually the attending physician and our medical director — must agree that if the illness follows its expected course, life expectancy is six months or less. Eligibility is based on functional decline and disease trajectory, not on a specific diagnosis.

We care for people with advanced cancer, heart failure, COPD and other lung disease, dementia and Alzheimer’s, Parkinson’s and ALS, kidney and liver failure, stroke, and general decline in the very old.

The six-month prognosis is a clinical estimate, not a limit. Patients are certified for an initial 90-day period, a second 90-day period, and then unlimited 60-day periods for as long as they continue to meet criteria.

Some patients stabilize on hospice and are discharged because they improve. That is a good outcome, not a mistake, and they can re-enroll if they decline again.

Nothing bad happens. At the end of each benefit period our physician re-examines the patient and re-certifies eligibility if decline is continuing. Many of our patients are with us for well over six months. Nobody is discharged for outliving a prediction.

Yes, at any time and for any reason. Revoking the hospice benefit takes a signature and takes effect immediately, and full curative Medicare coverage resumes. Patients sometimes revoke to pursue a new treatment, then re-elect hospice weeks or months later. We help either way and do not make it awkward.

Sometimes, yes. The question is whether the treatment is being used for comfort or for cure. Palliative radiation to shrink a painful tumor, a transfusion that relieves exhausting fatigue, or a feeding tube already in place can all be compatible with hospice. Dialysis is compatible when the terminal diagnosis is something other than kidney failure.

These are case-by-case conversations. Call and ask about the specific situation rather than assuming the answer is no.

A typical plan of care includes a registered nurse one to three times a week, a hospice aide two to five times a week for bathing and personal care, a social worker and chaplain as often as the family wants them, and a volunteer if you would like one. Visit frequency rises as needs rise — daily nursing is common in the last days.

The schedule is set with you at admission and revised at every team meeting, which happens at least every fifteen days.

Hospice is not a live-in service, and it is important to be honest about that. Continuous shift care is available for short periods during a symptom crisis, but routine hospice means scheduled visits plus 24-hour availability by phone and in person.

Our intake coordinator answers our line at every hour, including nights, weekends, and holidays, and a nurse comes out when a visit is what is needed. Families are never left to figure out an emergency alone.

You call (818) 273-4884 and our intake coordinator picks up — not an answering service that takes a message. You are connected to the on-call nurse, who will talk through what is happening, direct you to the medications in the comfort kit if that solves it, and drive out if it does not.

Please call us before calling 911. An emergency room visit is often the opposite of what the patient wanted, and most of what sends families to the ER at night is something we can settle at home.

We do, and they are covered. Hospital bed, wheelchair, walker, bedside commode, oxygen concentrator, suction, and hospital-grade mattresses are delivered and maintained by us. Medications related to the terminal diagnosis and its symptoms are covered and delivered, including after-hours.

Incontinence supplies, wound care supplies, gloves, and similar consumables are also included. Families should not be buying these at the drugstore.

Yes, and most families do. The attending physician of record remains involved and continues to bill Medicare Part B normally. Our medical director works alongside them, and our nurses report to both.

If a patient has no attending physician, or the physician prefers to step back, our medical director assumes that role.

Yes. We provide hospice in private homes, family homes, assisted living residences, board-and-care homes, and skilled nursing facilities. In a facility, our team layers on top of the facility staff rather than replacing them — our nurse, aide, social worker, and chaplain all still visit.

Respite care allows up to five consecutive days of inpatient care at a contracted facility so a family caregiver can sleep, travel, or recover from an illness of their own. It is covered by the benefit and can be used more than once. Ask for it before you are past exhausted.

For the overwhelming majority of families, nothing out of pocket. The Medicare Hospice Benefit under Part A covers the team, visits, equipment, supplies, and medications related to the terminal illness at 100 percent, with no deductible and no copay for care.

Medicare permits a copay of up to $5 per prescription and 5 percent of the cost of inpatient respite. Rosewood does not bill families for either.

California Medi-Cal covers hospice with essentially the same benefit structure, and patients who have both Medicare and Medi-Cal are fully covered. Most commercial plans and Medicare Advantage plans include a hospice benefit that mirrors Medicare’s; we verify the specifics before admission and tell you plainly what we find.

Room and board is the big one. If a patient lives in an assisted living residence, a board-and-care home, or a nursing facility, hospice covers the hospice care but not the rent or the facility’s daily rate. That remains a private or Medi-Cal expense.

Treatment aimed at curing the terminal illness is also outside the benefit, as is care from another provider for the terminal diagnosis that we have not arranged. Care for unrelated conditions continues to bill normally through Medicare.

Call anyway. We maintain a limited charity fund and will help determine whether someone qualifies for expedited Medi-Cal, which is often faster than families expect. No one is turned away from an eligibility conversation because of the ability to pay.

The family is the unit of care, and that is not a slogan. Our social worker helps with advance directives, benefits, placement, and family meetings. Our chaplain is available to family members whether or not the patient wants chaplaincy. Volunteers sit with the patient so a spouse can sleep or run errands.

Bereavement support continues for thirteen months after a death, and it is available to families who were with us however briefly.

Yes. Our clinicians speak English, Armenian, Spanish, and Russian, and we arrange interpretation for other languages. Being able to describe your own pain in your own language is not a convenience; it is part of the care.

As death approaches, our nurse visits daily or more often, and we prepare you for what you are likely to see — changes in breathing, a drop in appetite, sleepiness, mottled skin — so it is not frightening when it happens.

When the death occurs, you call us first. A nurse comes to the home, confirms the death, notifies the physician, contacts the funeral home of your choosing, and disposes of remaining medications. There is no need to call 911 or the coroner. You do not have to hurry, and you may sit with the person as long as you wish.

Nothing right away. We collect the equipment on a schedule that suits you, usually within a few days, and our nurse safely disposes of controlled medications at the time of death. Nobody should be dragging a hospital bed to the curb.

A few signals tend to appear together: two or more hospitalizations or emergency visits in the past six months; noticeable weight loss or difficulty eating and swallowing; more time spent in bed or in a chair than up; increasing pain, breathlessness, or falls; treatments that are causing more suffering than they relieve; and a sense that the patient is telling you, in whatever words they have, that they have had enough.

If two or three of those sound familiar, it is worth a phone call.

Rosewood serves families across Southern California, in private homes, family homes, assisted living residences, board-and-care homes, and skilled nursing facilities. If you are not sure whether your address is covered, call and ask; we can often arrange care beyond our usual lines.

Yes, on all three counts. Rosewood Hospice is licensed by the California Department of Public Health, accredited by The Joint Commission, and certified by Medicare and Medi-Cal.

Those are three different kinds of oversight and it is worth knowing the difference. The CDPH license is what legally permits us to operate in California and comes with unannounced state surveys. Joint Commission accreditation is voluntary — we chose to be held to national standards for symptom management, safety, and family support, and surveyors arrive without warning to follow real patients through our charts. Medicare and Medi-Cal certification is what makes your care covered in full, with no copay and no deductible.

We are also independently owned. We are not part of a chain or a private-equity portfolio, which is why we are able to keep caseloads smaller than the state average.

Call (818) 273-4884 or fax clinical documentation to (818) 273-9136. Referrals are triaged on receipt by our intake coordinator, who confirms eligibility with our medical director and reports back to the referring office the same day. Attending physicians are encouraged to remain the physician of record and may continue to bill Part B.

Tell us directly — call the office and ask for the Director of Nursing, Liana Aleksanyan, who will respond personally. Patients and families also have the right to contact the California Department of Public Health or the Medicare Beneficiary and Family Centered Care Quality Improvement Organization at any time. That right is spelled out in the admission packet.