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About: About

Referring a Patient

Home Health Referals

Referrals are processed through our Intake department 7 days a week from 10:00 AM to 5:00 PM,

excluding holidays.

Phone referrals: (818) 616-1111     -     FAX number: (818) 616-1110

Mailing Address: 7065 Hayvenhurst Ave., Ste 9, Lake Balboa, CA 91406

Please include the following necessary information when making a referral to expedite patient admission:

  • Complete patient identification for registration, confirmed address and phone numbers, birth date, gender, emergency contact name and phone numbers, and language spoken.

  • Primary insurance coverage, ID number, policy, group, and authorization contact numbers (or copy of insurance card)

  • Reason for home care, requested start of care date, diagnosis, allergies, pertinent medical history, current hospital and facility admission and discharge dates.

  • Attending Physician following the patient for Home Health (usually PCP), office contact, address, 24 hour contact phone and fax numbers and referring physician information, if not following for home care.

  • Physician Orders for disciplines requested and treatment orders


Please Note


Starting January 1, 2011, a physician certifying a Medicare patient for home health services must document that  he or she met face-to-face with the patient, either up to 90 days before the start of care

or up to 30 days after.

CMS requires the physician to list the primary diagnosis for home health care (i.e., why the patient requires nursing/therapy services in his or her home) and sign the home health face-to-face encounter (HHF2F) document, attesting that such a visit took place.

If you have further questions regarding how to make a referral, please contact the agency at (818) 616-1111, Monday through Friday, from 9:00 AM to 5:00 PM.

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Empower Home Health Care,Home Health Care Service,Van Nuys,CA