Calstro Hospice San Diego
A hospice in San Diego, California 92111
4849 Ronson Ct. Suite 204, San Diego, California 92111. (760) 487-5595.
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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.
- 8 deficiencies cited in the last three years
- Not rated family caregiver rating
- 10of 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?
8 deficiencies cited in the last three years
The middle of the 62 hospices serving ZIP code 92111 had 8.
The last inspection on record was on Nov 22, 2024: an initial inspection by the Accreditation Commission for Health Care.
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
8 deficiencies in 1 month of the last 36. Last cited Nov 2024. 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.
Nov 22, 2024: initial inspection by the Accreditation Commission for Health Care8 deficiencies
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Timeframe for completion of assessment (42 CFR 418.54(b))
“Upon patient record review of 19 (Patient #10) did not have evidence in the patient record that the hospice interdisciplinary group, in consultation with the individual’s attending physician (if any), completed the comprehensive assessment no later than 5 calendar days after the election of hospice care. Patient #10 - SOC 08/14/24, psychosocial assessment not complete initial visit until 08/21/24.”
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Content of comprehensive assessment (42 CFR 418.54(c)(4))
“Upon patient record review, 14 of 19 (Patient #6,7,8,9,10,11,12,13,14,15,16,17,18,19) did not have evidence in the patient record that the comprehensive assessment takes into consideration the imminence of death.”
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Update of comprehensive assessment (42 CFR 418.54(d))
The inspectors’ words, 128 words
“Upon patient record review, 2 of 19 (Patient #7, 15) did not have evidence in the patient record that the comprehensive assessment is updated including and by: • The hospice interdisciplinary group (in collaboration with the individual’s attending physician, if any) • Changes that have taken place since the initial assessment • Information on the patient’s progress toward desired outcomes • Reassessment of the patient’s response to care • The assessment update must be accomplished as frequently as the condition of the patient requires, but no less frequently than every 15 days Patient #7 - RN completed assessment on 10/22/24 then again on 11/08/24 -17 days between RN assessment visits. Patient #15 - RN completed assessment on 10/21/24 then again on 11/07/24 -17 days between RN assessment visits.”
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Content of plan of care (42 CFR 418.56(c)(4))
“Upon patient record review, 3 of 19 (Patient #6, 12, 19) did not have evidence the plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions, including medications and treatments. Patient #6 - Wound care ordered on 10/06/24 did not contain wound site. Patient #12 - Wound care ordered on 11/17/24 did not contain wound care frequency. Patient #19 - wound care ordered on 11/18/24 did not contain wound care frequency.”
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Coordination of services (42 CFR 418.56(e)(2))
“Upon client record review, 1 of 19 (Patient #10) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #10 - SN visit not on 10/14/24 SN documented “cleaned wound with wound cleanser, applied bacitracin ointment and covered with Optifoam dressing. - no order for this wound care.”
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Hospice aide assignments and duties (42 CFR 418.76(g)(2))
The inspectors’ words, 170 words
“Upon patient record review 5 of 19 (Patient #6, 10, 11, 16, 17) did not have evidence documentation in the patient record that a hospice aide provides services that are: • Ordered by the interdisciplinary group • Included in the plan of care • Permitted to be performed under state law by such hospice aide • Consistent with the hospice aide training Patient #6 - Aide visit on 09/13/24 and 09/18/24 Aide documented bed bath completed but shower was ordered on care plan. Patient #10 - Aide visit on 09/16/24 and 09/19/24 Aide documented shaved patient but task shaving was not ordered on care plan. Patient #11 - Aide visit on 10/25/24 and 10/31/24 Aide documented bed bath completed but shower was ordered on care plan. Patient #16 - Aide visit on 10/09/24, 10/11/24, 10/28/24 and 11/31/24 Aide documented bed bath completed but shower was ordered on care plan. Patient #17 - Aide visit on 09/10/24 and 09/17/24 Aide documented bed bath completed but shower was ordered on care plan.”
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Supervision of hospice aides (42 CFR 418.76(h)(1))
The inspectors’ words, 102 words
“Upon patient record review 2 of 19 (Patient #7, 15) did not have evidence documentation in the patient record that a Registered Nurse made an on-site visit to the patient’s home no less frequently than every 14 days to assess the quality of care and services provided by the hospice aide and to ensure that services ordered by the hospice interdisciplinary group meet the patient’s needs. Patient #7 - Aide supervisory visit completed on 10/22/24 then again on 11/08/24 -17 days between supervisory visits. Patient #15 - Aide supervisory visit completed on 10/21/24 then again on 11/07/24 -17 days between supervisory visits.”
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Hospice plan of care (42 CFR 418.112(d)(1))
The inspectors’ words, 135 words
“Upon client record review, 2 of 19 (Patient #9, 12) did not have evidence that the hospice plan of care identifies the care and services that are needed and specifically identify which provider (nursing facility or hospice) is responsible for performing the respective functions that have been agreed upon and included in the hospice plan of care. Patient #9 - Order written on 08/07/24 regarding wound care did not identify which provider (nursing facility or hospice) is responsible for performing the respective functions that have been agreed upon and included in the hospice plan of care. Patient #12 - Order written on 11/07/24 regarding wound care did not identify which provider (nursing facility or hospice) is responsible for performing the respective functions that have been agreed upon and included in the hospice plan of care.”
All 2 inspections in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Nov 22, 2024 | Initial inspection by the Accreditation Commission for Health Care | 8 deficiencies cited |
| Sep 6, 2024 | Complaint inspection by the state | No deficiencies cited |
Is it certified?
- Medicare-certified hospice since Aug 19, 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): 15.3 nurse care minutes per routine home care day, 8.3% of skilled nursing minutes at weekends and a visit near death for 95.1% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 11% at home, 79% in assisted living, 8% in a skilled nursing facility, 1% elsewhere.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | This provider |
|---|---|
| Nurse care minutes per routine home care day | 15.3 min |
| Skilled nursing minutes at weekends | 8.3% |
| Visits near death | 95.1% of patients who died |
Who owns it?
- 9 owners or officers are people: Juan Ramon Avena (managing employee (on the payroll), 60%); Oscar Ivan Caldera (owns 5% or more directly, 50%); Alex Castro (owns 5% or more directly, 50%); Antoinette Biggs (managing employee (on the payroll), 20%); Osagie Bello (managing employee (under contract), 20%); Robert A. Deville (managing employee (on the payroll), 15%); Tanya Ramos (managing employee (on the payroll), 5%); Amarish Pradhan (managing employee (under contract), 5%); Alex Castro (runs it (operational or managerial control), 5%).
- 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.”
- In CMS’s survey of family caregivers (Oct 1, 2023 to Sep 30, 2025): 81% rated it 9 or 10 out of 10, and 86% would definitely recommend it.
- CMS’s Hospice Care Index: 10 of 10 (Jan 1, 2023 to Dec 31, 2024).
- 91.1% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025); 16% 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 | 10 of 10 |
How does it compare nearby?
- Of the 62 hospices CMS’s data show serving patients in ZIP code 92111, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 8; this one had 8.
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 |
|---|---|
| Seaport Hospice | Not given |
| Art of Hospice Care, Inc. | 0 |
| Radiant Hospice | 8 |
| Calstro Hospice San Diego This hospice | 8 |
| Topkare Hospice Inc. | 7 |
| Kaiser Foundation Hospital San Diego Hospice | 7 |
| Vitas Healthcare Corporation of California | 3 |
| Sharp Hospicecare | 12 |
| Gentiva | 21 |
| Lightbridge Hospice | 11 |
| Avalon Hospice & Palliative Care | 6 |
| Silverado Hospice San Diego | 6 |
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.