Valley Regional Hospice Inc.
A hospice in Fresno, California 93710
6311 N Fresno Street, Suite 103, Fresno, California 93710. (559) 431-3333.
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The short answer
Record last released by CMS on Oct 23, 2026.
- 4 deficiencies cited in the last three years
- Not rated family caregiver rating
- 8of 10 CMS’s Hospice Care Index
Each figure’s source sits beside it, in its section below.
What these words mean2
- 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?
4 deficiencies cited in the last three years
The middle of the 29 hospices serving ZIP code 93710 had 5.
The last inspection on record was on Jun 12, 2025: a reaccreditation inspection by The Joint Commission.
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
4 deficiencies in 1 month of the last 36. Last cited Jun 2025. Most serious: Standard-level. The last 3 years, to Nov 5, 2026.
| Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2023 | 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 | Nov |
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.
Jun 12, 2025: reaccreditation inspection by The Joint Commission4 deficiencies
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Plan of care (42 CFR 418.56(b))
The inspectors’ words, 147 words
“Observed in Record Review. In 2 of 10 active patient records reviewed, It was noted that the organization failed to ensure that both the patient and the primary caregiver received appropriate education and training from the hospice, in alignment with their responsibilities as outlined in the plan of care. For example, during home visit of RRHV#1, an interview with the patient’s family revealed that based on the son’s understanding, he was irrigating the Foley catheter with 15 mL of acetic acid once daily, instead of the prescribed 30 mL twice daily. Additionally, upon review of record RRNHV#3, the patient was noted to be receiving oral morphine. However, there was no documented evidence of education provided regarding morphine as a high-risk medication during the initial assessment or in the first several visits, as required by agency policy. This finding was discussed with and confirmed by the DPCS Designee.”
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Content of plan of care (42 CFR 418.56(c)(4))
The inspectors’ words, 164 words
“Observed in Record Review. In 3 of 10 active patient records reviewed, It was noted that the organization failed to ensure that the written hospice plan of care includes all services needed for the palliation and management of the terminal illness and related conditions, including the treatment necessary to meet the patient’s and family’s needs. For example, in record RRHV#1, there was an order to irrigate the urinary catheter with 30 mL of acetic acid as needed; however, the order lacked specific indications and frequency for the irrigation. In record RRNHV#1, the order directed irrigation of a suprapubic catheter with 20 mL of acetic acid as needed did not have an indications or clinical justifications for the PRN instructions. In record RRNHV#2, the order included routine and PRN irrigation of a Foley catheter with 30 mL of acetic acid, yet did not specify the reasons for PRN use. These findings were discussed with and confirmed by the Director of Patient Care Services (DPCS) designee.”
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Coordination of services (42 CFR 418.56(e)(2))
The inspectors’ words, 189 words
“Observed in Record Review. In 4 of 10 active patient records reviewed, It was noted that the organization failed to ensure that care and services were delivered in accordance with the established hospice plan of care. For example, in review of record RRHV#1, the spiritual counseling was ordered to visit the patient once or twice per month; however, no visits were documented for the month of April 2025. Also noted, the medical social worker (MSW) was ordered to visit the patient twice per month for three months, yet only one visit was completed in both April and May. In record of RRNHV#1, five (5) PRN nursing visits were conducted, despite the plan of care indicating a maximum of three PRN visits. In record of RRNHV#4, the skilled nurse was ordered to visit the patient twice weekly, but only one visit was documented. In record of RRNHV#5, the skilled nurse was ordered to make three visits per week for two months; however, only two visits were completed during the week of the recertification period. These findings were discussed with and confirmed by the Director of Patient Care Services (DPCS) designee.”
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Hospice aide assignments and duties (42 CFR 418.76(g)(1))
The inspectors’ words, 97 words
“Observed in Record Review. In 1 of 10 active patient records reviewed, It was noted that the organization failed to ensure that written patient care instructions for the home health aide were prepared by the registered nurse assigned as the immediate nursing supervisor of the hospice aide. For example, during the record review of RRNHV No. 3, it was noted that the patient was taking Eliquis, an anticoagulant. However, the aide care plan did not include instructions to monitor for and report signs and symptoms of bleeding. This finding was discussed and validated by the DPCS designee.”
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Jun 12, 2025 | Reaccreditation inspection by The Joint Commission | 4 deficiencies cited |
Is it certified?
- Medicare-certified hospice since Jan 20, 2019.
- Ownership: for-profit.
- 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): 24.7 nurse care minutes per routine home care day, 4.3% of skilled nursing minutes at weekends and a visit near death for 87% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 68% at home, 20% in assisted living, 12% in a skilled nursing facility.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | This provider |
|---|---|
| Nurse care minutes per routine home care day | 24.7 min |
| Skilled nursing minutes at weekends | 4.3% |
| Visits near death | 87.0% of patients who died |
Who owns it?
- 5 owners or officers are people: Mari Zakaryan (owns 5% or more directly, 100%); Mari Zakaryan (corporate officer, 100%); Mari Zakaryan (corporate director, 100%); Mari Zakaryan (managing employee (on the payroll), 100%); Armen H Bedrosian (managing employee (under contract), 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?
- CMS gives no family caregiver survey rating: “The number of cases is too small to report Star Ratings.”
- CMS’s Hospice Care Index: 8 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); 40% 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 | Not rated |
| 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 | 8 of 10 |
How does it compare nearby?
- Of the 29 hospices CMS’s data show serving patients in ZIP code 93710, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 5; this one had 4.
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 |
|---|---|
| Saint Agnes Home Health & Hospice | 6 |
| Bright Horizon Hospice Services | 19 |
| Oyuna Hospice, Inc. | 2 |
| Hospice of the Valley | 13 |
| Valley Regional Hospice Inc. This hospice | 4 |
| Healthcare California Hospice | 21 |
| 1st Choice Hospice | 4 |
| Angel’s Best Hospice Care Inc. | 6 |
| Hinds Hospice - Fresno | 3 |
| Bristol Hospice Fresno | 4 |
| Aseracare Hospice | 6 |
| St Mary’s Hospice Services, Inc. | 19 |
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 Nov 5, 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 Nov 5, 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 Nov 5, 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 Nov 5, 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 Nov 5, 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 Nov 5, 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 Nov 5, 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.