Hospice of the North Coast
A hospice in Carlsbad, California 92008
2525 Pio Pico Drive, Suite 301, Carlsbad, California 92008. (760) 431-4100.
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The short answer
Record last released by CMS on Oct 23, 2026. We couldn’t read Centers for Medicare & Medicaid Services’ list since Oct 27, 2026: qcor.cms.gov now refuses our reader. This record is as of then.
- 12 deficiencies cited in the last three years
- 4of 5 family caregiver rating
- 10of 10 CMS’s Hospice Care Index
Each figure’s source sits beside it, in its section below.
What these words mean3
- Star ratings
- CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
- Inspection (survey)
- A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
- Deficiency, citation, violation
- What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
What did inspectors find?
12 deficiencies cited in the last three years
The middle of the 47 hospices serving ZIP code 92008 had 8.
The last inspection on record was on May 28, 2026: a complaint inspection by the state.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
CMS, Hospice ZIP Data. Released Aug 26, 2026. Updated quarterly.
When those deficiencies happened
12 deficiencies in 1 month of the last 36. Last cited Aug 2025. Most serious: Standard-level. The last 3 years, to Oct 27, 2026.
| Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2023 | Nov | Dec | ||||||||||
| 2024 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2025 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2026 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct |
Hover or focus a month to read it.
Hearth Record drew this from the dates and levels in the source’s own records.
Each deficiency, as cited
Rule titles as CMS’s inspectors cite them, set in sentence case.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
Aug 22, 2025: reaccreditation inspection by The Joint Commission12 deficiencies
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Content of comprehensive assessment (42 CFR 418.54(c)(7))
“Observed in Record Review. In 1 of 20 active patient records reviewed, the organization failed to conduct and document a patient specific comprehensive assessment and reassessment. In record RRNHV#1 there was no initial bereavement assessment documented. This RFI was reviewed with the Executive Director, Director of Patient Care Services, and Chief Financial Officer.”
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Content of plan of care (42 CFR 418.56(c))
The inspectors’ words, 146 words
“Observed in Record Review. In 18 of 18 active home patient records reviewed, most of plan of care goals were not measurable. Here are some examples. Patient/family will have spiritual needs met; IDT will develop a plan to promote patient comfort and assist in the achievement of a comfortable peaceful death; promote IDT will provide safe and personal care and hygiene; IDT will promote skin integrity; IDT will maintain clean, safe environment; patient’s personal care needs will be met; patient will demonstrate ability to cope with limitations; patient/caregiver will verbalize relief from anxiety; patient recognizes energy limitations and understands/uses energy conservation techniques; patient/caregiver will demonstrate necessary behaviors to maintain good safety awareness and minimize the risk of falls and/injury. Additionally, completion target dates were 10 months after their creation. This RFI was reviewed with the Executive Director, Director of Patient Care Services, and Chief Financial Officer.”
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Content of plan of care (42 CFR 418.56(c)(4))
The inspectors’ words, 232 words
“Observed in Patient Home. In 1 of 6 patient home visits conducted, the plan of care did not include all services needed for the palliation and management of the terminal illness and related conditions, specific to drugs and treatment. At home visit RRHV#3 the Surveyor observed during medication reconciliation that the patient had 5 prn orders for infrequent bowel movements and constipation. These included Senna, Docusate-Senna, MiraLAX, Lactulose, and Bisacodyl suppository. There was no clear direction for the order in which each medication should be used. Despite these five orders, at the time the Surveyor made the home visit, the patient had not had a bowel movement for at least 10 days. This RFI was reviewed with the Executive Director, Director of Patient Care Services, and Chief Financial Officer. Observed in Patient Home. In 1 of 6 home visits conducted, the plan of care did not include all services needed for the palliation and management of the terminal illness and related conditions. At home visit RRHV#4 the Surveyor observed during medication reconciliation that the patient was prescribed Metoprolol Succinate ER 25 mg (generic name) daily, and Toprol-XL ER 200 mg (brand name) daily. There was no documentation in the patient record to indicate that medication duplication was identified and action taken to resolve the problem. This RFI was reviewed with the Executive Director, Director of Patient Care Services, and Chief Financial Officer.”
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Review of the plan of care (42 CFR 418.56(d ))
“Observed in Record Review. In 18 of 18 active home patient records reviewed, the hospice interdisciplinary team did not consistently update the plan of care. For example, in the meeting notes of core team members there was little or no documentation of patient decline, progress towards desired outcomes, goals and plans for the following two weeks. This RFI was reviewed with the Executive Director, Director of Patient Care Services, and Chief Financial Officer.”
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Counseling services (42 CFR 418.64(d)(3)(i))
“Observed in Record Review. In 4 of 20 active patient records reviewed, the organization failed to conduct and document a patient specific comprehensive assessment and reassessment. In record RRNHV#1 there was no initial comprehensive social work assessment documented. In record RRHV#4 there was no initial comprehensive spiritual assessment documented. And in records RRHV#2, RRHV#4, RRHV#5, RRNHV#1, the initial comprehensive spiritual assessment was done by telephone. This RFI was reviewed with the Executive Director, Director of Patient Care Services, and Chief Financial Officer.”
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In-service training (42 CFR 418.76(d))
“Observed in Competency Session. In 1 of 11 HR files reviewed, the organization could not provide documentation of 12 clock hours of education for the home health aide 2023 and 2024 for personnel record HR#6 HHA. This RFI was confirmed by the Director of Patient Care Services.”
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Training (42 CFR 418.100(g)(3))
“Observed in Competency Session. In 3 of 11 HR files reviewed, Staff competence was not assessed as required by policy. In personnel files HR#3 MD and HR#4 AMD there was no documentation of competence re-assessment having been completed. The same was found in personnel file HR#11 VOL. This RFI was confirmed by the Director of Patient Care Services.”
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Initial certification of terminal illness (42 CFR 418.102(b)(3))
The inspectors’ words, 115 words
“Observed in Record Review. In 4 of 20 active patient records reviewed, certificates of terminal illness did not include subjective and objective information to support patient life expectancy of six months or less at recertification. For example, in record RRHV#1 the PPS score did not change and there was little subjective documentation to indicate decline in the previous benefit period. In record RRHV#6 13 CTIs, ADLs were consistently 5/6 and the PPS was constant at 40%. There was intermittent documentation of aspiration pneumonia that resolved in the next CTI. The same documentation was found in RRNHV#7 and RRNHV#9. This RFI was reviewed with the Executive Director, Director of Patient Care Services, and Chief Financial Officer.”
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Content (42 CFR 418.104(a)(3))
The inspectors’ words, 93 words
“Observed in Patient Home. In 1 of 6 home visits made, the organization failed to ensure that the patient record contained an accurate medication list. At home visit RRHV#4 the list used during medication reconciliation indicated that the patient was taking Metoprolol Succinate ER 25 mg daily, Toprol-XL ER 200 mg daily, and Nortriptyline. According to the daughter the patient had stopped taking these medications 6 to 12 months prior to the date of the visit. This RFI was reviewed with the Executive Director, Director of Patient Care Services, and Chief Financial Officer.”
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Discharge or transfer of care (42 CFR 418.104(e)(2)(i))
“Observed in Record Review. In 2 of 2 discharge records reviewed, the organization failed to provide the attending physician with a summary. In record RRDC#1 the patient was discharged for extended prognosis. In record RRDC#2 the patient revoked the hospice benefit for aggressive care. This RFI was reviewed with the Executive Director, Director of Patient Care Services, and Chief Financial Officer.”
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N/a (42 CFR 418.110(d)(1)(i))
“Observed in Building Tour. The fire extinguisher on the second floor was installed at greater than 60. Observed by the Hospice Administrator. This finding was observed during survey activity, but corrected onsite prior to the surveyor’s departure. The corrective action taken needs to be included in the organization’s Evidence of Standards Compliance submission.”
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N/a (42 CFR 418.110(e))
“Observed in Document Review. Annual fire alarm testing documents did not include the required NFPA code and edition. Observed by the Hospice Administrator.”
All 5 inspections in the last three years
| Date | Visit | What the record says |
|---|---|---|
| May 28, 2026 | Complaint inspection by the state | No deficiencies cited |
| Dec 26, 2025 | Complaint inspection by the state | No deficiencies cited |
| Sep 4, 2025 | Complaint inspection by the state | No deficiencies cited |
| Aug 22, 2025 | Reaccreditation inspection by The Joint Commission | 12 deficiencies cited |
| Dec 26, 2023 | Complaint inspection by the state | No deficiencies cited |
Is it certified?
- Medicare-certified hospice since Jul 22, 1999.
- Ownership: other.
- No For hospices, home health agencies, hospitals and dialysis facilities, CMS writes deficiencies at two levels. Standard is the usual one; condition-level is the more serious, when a problem is serious enough that the provider doesn’t meet a whole condition of taking part in Medicare. Source: CMS, State Operations Manual. deficiency or CMS’s most serious finding: the place’s failure to meet a rule caused, or was likely to cause, serious injury, harm, impairment or death to someone in its care. Source: CMS; 42 CFR 489.3. on record in the last three years.
CMS, Hospice General Information. Released Aug 26, 2026. Updated quarterly.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
Has anything been proven against it?
- CMS doesn’t publish fines or other penalties for hospices, so none are shown.
- 0 deficiencies cited in the last three years came from inspections that included a complaint investigation.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
Who does the caring?
- From Medicare claims (Jan 1, 2023 to Dec 31, 2024): 11.2 nurse care minutes per routine home care day, 9.6% of skilled nursing minutes at weekends and a visit near death for 96.3% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 54% at home, 39% in assisted living, 5% in a skilled nursing facility, 2% in an inpatient hospice.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | This provider |
|---|---|
| Nurse care minutes per routine home care day | 11.2 min |
| Skilled nursing minutes at weekends | 9.6% |
| Visits near death | 96.3% of patients who died |
Who owns it?
- 18 owners or officers are people: Chuck Atkinson (corporate director, 0%); Lee H Farmer (corporate director, 0%); Andy Maffia (corporate director); Leann Rytz (corporate director, 0%); Michael Landau (corporate director, 0%); Leslie Brubaker (corporate director, 0%); Jonathan Schwartz (corporate director, 0%); Sharon L Lutz (corporate officer, 0%); Sharon L Lutz (corporate director, 0%); Lisa Frazee (corporate director); Lois Martyns (corporate director, 0%); Cathy Gibson (managing employee (on the payroll), 0%); Doran Stambaugh (corporate director); Jeffrey O Leach (corporate director, 0%); Kathleen Urbina (corporate director, 0%); Lisa L Cannon-Rodman (corporate director); Charles E Hergesheimer (managing employee (under contract), 0%); Stacy L Maxa (corporate director, 0%).
- No private-equity firm among the owners CMS lists.
- No real-estate investment trust among the owners CMS lists.
CMS, Hospice All Owners and Hospice Enrollments. Released Sep 29, 2026. Updated quarterly.
What do families say?
- Family caregivers rate it 4 of 5 in CMS’s survey (Oct 1, 2023 to Sep 30, 2025): 87% rated it 9 or 10 out of 10, and 90% would definitely recommend it.
- CMS’s Hospice Care Index: 10 of 10 (Jan 1, 2023 to Dec 31, 2024).
- 98.73% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025); 73% had visits from a nurse or social worker on at least 2 of their last 3 days (Jan 1, 2023 to Dec 31, 2024).
CMS, CAHPS Hospice Survey and Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | Rating |
|---|---|
| Family caregiver survey ratingCMS star rating from its survey of patients’ family caregivers, 1 to 5 | 4 of 5 |
| Hospice Care IndexCMS’s Hospice Care Index, 0 to 10 (higher is better): a point for each of ten measures from Medicare claims on which the hospice meets CMS’s threshold | 10 of 10 |
How does it compare nearby?
- Of the 47 hospices CMS’s data show serving patients in ZIP code 92008, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 8; this one had 12.
CMS, Hospice ZIP Data. Released Aug 26, 2026. Updated quarterly.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
| Place | Deficiencies, 3 years |
|---|---|
| Hospice of the North Coast This hospice | 12 |
| Ardent Hospice | Not given |
| Kaiser Foundation Hospital San Diego Hospice | 7 |
| Elizabeth Hospice | 15 |
| Vitas Healthcare Corporation of California | 3 |
| Sharp Hospicecare | 12 |
| Hospice By the Sea | 0 |
| Gentiva | 21 |
| Lightbridge Hospice | 11 |
| Silverado Hospice San Diego | 6 |
| Accentcare Hospice & Palliative Care of California | 6 |
| Apreva Hospice | 10 |
What the record doesn’t say
- CMS doesn’t publish fines or other penalties for hospices, so none are shown.
- Only complaints that led to a citation appear; complaints that didn’t aren’t published.
- CMS ended its Special Focus Program for hospices with serious problems on Feb 14, 2025, so no hospice is marked as one.
- Hospice quality measures have a gap from October 2025: CMS replaced its patient assessment then, and public results from the new one (HOPE) are expected around November 2027.
Sources
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Centers for Medicare & Medicaid Services, Hospice General Information (yc9t-dgbk).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice Provider Data (252m-zfp9).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, CAHPS Hospice Survey (gxki-hrr8).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, QCOR hospice inspection reports (Hospice Survey Reports - Oct 2021 through Sep 2026.xlsx).
Released Oct 23, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice All Owners (e983965e-1603-4cb8-82b5-c40090e380d1).
Released Sep 29, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice Enrollments (25704213-e833-4b8b-9dbc-58dd17149209).
Released Sep 29, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice ZIP Data (95rg-2usp).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.
This copy of the record was made on Oct 27, 2026.
From the hospice
The public record above comes first. Anything the hospice adds will appear here, below it, and say who wrote it.
Replies
None. Replies aren’t open yet. When they open, the hospice will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.
Paid listing
None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the hospice”, and paying will never change a finding, a rating or the order of results.