MD Choice Hospice Care Inc.
A hospice in Temecula, California 92590
43015 Black Deer Loop, Ste 106, Temecula, California 92590. (888) 407-0616.
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The short answer
Record last released by CMS on Oct 23, 2026.
- 72 deficiencies cited in the last three years
- Not rated family caregiver rating
- Not available CMS’s Hospice Care Index
Each figure’s source sits beside it, in its section below.
What these words mean3
- 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.
- Condition-level deficiency
- 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.
What did inspectors find?
72 deficiencies cited in the last three years
The middle of the 35 hospices serving ZIP code 92590 had 7.
The last inspection on record was on Jul 13, 2026: a complaint inspection by the Accreditation Commission for Health Care.
13 deficiencies at condition level, the more serious of CMS’s two levels
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
72 deficiencies in 3 months of the last 36. Last cited Jul 2026. Most serious: Condition-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.
Jul 13, 2026: complaint inspection by the Accreditation Commission for Health Care36 deficiencies
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Patients rights (42 CFR 418.52)
“Condition of Participation: Patient’s Rights. L500”
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Core services (42 CFR 418.64)
“Upon personnel record review, the agency did not have evidence that the hospice routinely provide substantially all core services directly by hospice personnel (The hospice issues a W-2 form for the employee). These services include: • Physician services (may contract for physician services) • Nursing • Medical social services • Counseling Personnel files were not maintained onsite and not available upon request for review.”
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Furnishing of non-core services (42 CFR 418.70)
“Upon observation, there was no evidence the hospice is in compliance with accepted professional standards and principles for all non-core services which includes physical therapy, occupational therapy and speech-language pathology. Unable to verify as agency was unable to provide personnel files during survey.”
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Hospice aide and homemaker services (42 CFR 418.76)
“Condition of Participation: Hospice Aide and Homemaker Services. L607”
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Volunteers (42 CFR 418.78)
“Upon personnel record review, the agency did not have evidence the individual who supervises volunteers is qualified by meeting the hospice’s policies and procedures and/or job description criteria and is a designated hospice employee. No personnel files presented during survey.”
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Organizational environment (42 CFR 418.100)
“Condition of Participation: Organization and Administration of Services.”
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Personnel qualification (42 CFR 418.114)
“Condition of Participation: Personnel Qualifications.”
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Federal, state, local laws & regulations (42 CFR 418.116)
“Upon observation, there was no evidence the hospice has the appropriate licenses/permits required by state or local rules and regulations as agency Administrator and DPCS state agency name is “Anara Hospice” which does not match license. Administrator unable to produce any change of information submitted to state or CMS. After hours phone number answers and identifies as “Anara Hospice”.”
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EP Training Program (42 CFR 418.113(d)(1))
The inspectors’ words, 98 words
“Upon personnel record review, the agency did not have evidence Emergency Preparedness training including: • Initial training in emergency preparedness policies and procedures to all new and existing hospice employees, and individuals providing services under arrangement, consistent with their expected roles • Demonstrate staff knowledge of emergency procedures • Provide emergency preparedness training at least annually • Periodically review and rehearse its emergency preparedness plan with hospice employees (including nonemployee staff), with special emphasis placed on carrying out the procedures necessary to protect patients and others • Maintain documentation of all emergency preparedness training No personnel files available.”
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Notice of rights and responsibilities (42 CFR 418.52(a)(2))
“Upon patient record review, 5 of 5 (Patients #1,2,3,4,5) did not have evidence that the hospice informed and provided written information to the patient concerning its policies on advance directives, including a description of applicable state law. Agency Administrator and DPCS state agency is operating under the name “Anara Hospice”; however, there is no evidence in patient admission paperwork consents that patient/responsible party was informed that agency has this DBA name.”
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Notice of rights and responsibilities (42 CFR 418.52(a)(3))
“Upon patient record review, 5 of 5 (Patients #1,2,3,4,5) did not have evidence that the hospice obtained the patient’s or representative’s signature confirming that they received a copy of the Patient’s Rights and Responsibilities. Agency Administrator and DPCS state agency is operating under the name “Anara Hospice”; however, there is no evidence in patient admission paperwork consents that patient/responsible party was informed that agency has this DBA name.”
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Exercise of rights/respect for proprty/person (42 CFR 418.52(b)(3))
“Upon patient record review, 5 of 5 (Patients #1,2,3,4,5) did not have evidence that if a state court has not adjudged a patient incompetent, any legal representative designated by the patient in accordance with state law may exercise the patient’s rights to the extent allowed by state law. Agency Administrator and DPCS state agency is operating under the name “Anara Hospice”; however, there is no evidence in patient admission paperwork consents that patient/responsible party was informed that agency has this DBA name.”
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Rights of the patient (42 CFR 418.52(c)(1))
“Upon patient record review, 5 of 5 (Patients #1,2,3,4,5) did not have evidence that the patient has received effective pain management and symptom control from the hospice for conditions related to the terminal illness. Agency Administrator and DPCS state agency is operating under the name “Anara Hospice”; however, there is no evidence in patient admission paperwork consents that patient/responsible party was informed that agency has this DBA name.”
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Rights of the patient (42 CFR 418.52(c)(2))
“Upon client record review, 5 of 5 (Patients #1,2,3,4,5) did not have evidence that the plan of care included IDG’s documentation of the patient’s or families level of understanding, involvement and agreement with the plan of care. Agency Administrator and DPCS state agency is operating under the name “Anara Hospice”; however, there is no evidence in patient admission paperwork consents that patient/responsible party was informed that agency has this DBA name.”
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Rights of the patient (42 CFR 418.52(c)(4))
“Upon patient record review, 5 of 5 (Patients #1,2,3,4,5) did not have evidence that the patient chooses a health care provider, including an attending physician. Agency Administrator and DPCS state agency is operating under the name “Anara Hospice”; however, there is no evidence in patient admission paperwork consents that patient/responsible party was informed that agency has this DBA name.”
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Rights of the patient (42 CFR 418.52(c)(5))
“Upon patient record review, 5 of 5 (Patients #1,2,3,4,5) did not have evidence of the appropriate documentation for release of confidential information. Agency Administrator and DPCS state agency is operating under the name “Anara Hospice”; however, there is no evidence in patient admission paperwork consents that patient/responsible party was informed that agency has this DBA name.”
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Rights of the patient (42 CFR 418.52(c)(7))
“Upon patient record review, 5 of 5 (Patients #1,2,3,4,5) did not have evidence that the patient received information about the services covered under the hospice benefit. Agency Administrator and DPCS state agency is operating under the name “Anara Hospice”; however, there is no evidence in patient admission paperwork consents that patient/responsible party was informed that agency has this DBA name.”
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Rights of the patient (42 CFR 418.52(c)(8))
“Upon patient record review, 5 of 5 (Patients #1,2,3,4,5) did not have evidence that the patient received information about the scope of services that the hospice will provide and specific limitations on those services. Agency Administrator and DPCS state agency is operating under the name “Anara Hospice”; however, there is no evidence in patient admission paperwork consents that patient/responsible party was informed that agency has this DBA name.”
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Review of the plan of care (42 CFR 418.56(d))
“Upon client record review, 5 of 5 (Patient #1,2,3,4,5) did not have evidence that the IDG in collaboration with the attending physician reviewed, revised and documents the individualized plan as frequently as the patient’s condition requires but no less frequently then every 15 calendar days. Patients#1-5: Documentation of 15 day IDG incomplete. EMR has a check box of completion within the IDG summary. It reads: Orders/Med Profile reviewed including contraindications, side effects,interactions,duplications and lab. This box is not checked on all five records.”
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Counseling services (42 CFR 418.64(d)(1)(i))
“Upon personnel record review, the agency did not have evidence that all bereavement services are provided by a qualified counselor in accordance with applicable laws and regulations, professional practice standards, the hospice’s policies and procedures and/or job descriptions which includes experience or education in grief or loss counseling. No personnel files presented during survey.”
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Competency evaluation (42 CFR 418.76(c))
The inspectors’ words, 155 words
“Upon personnel record review, the agency did not have evidence in the personnel file that the following competency assessment was performed by the aide with a patient: (This standard applies to all Hospice Aides providing care/service who are directly employed by the hospice or through a contractual agreement.) ·Communication skills, including the ability to read, write, and verbally report clinical information to patients, caregivers, and other hospice staff. ·Reading and recording temperature, pulse, and respiration ·Safe transfer techniques and ambulation. ·Normal range of motion and positioning ·Appropriate and safe techniques in personal hygiene and grooming that include-- ·(A) Bed bath ·(B) Sponge, tub, and shower bath ·(C) Shampoo, sink, tub, and bed ·(D) Nail and skin care ·(E) Oral hygiene ·(F) Toileting and elimination The other subject areas in this section may be evaluated through written examination, oral examination or after observation of a Hospice Aide with a patient. No personnel files presented during survey.”
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Hospice aide instructor qualifications (42 CFR 418.76(e))
“Upon personnel record review, 1 of 2 (Personnel #2) did not have evidence that the RN who supervises classroom and practical training possesses a minimum of 2 years nursing experience, at least 1 year of which must be in home care. No personnel file available.”
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Governing body and administrator (42 CFR 418.100(b))
The inspectors’ words, 123 words
“Upon observation, there was no evidence the hospice is directed by a Board of Directors/governing body which assumes full legal authority and responsibility for the operation of the hospice as evidenced by the agency inability to provide evidence of all core and non-core services with personnel files, Administrator and DPCS state agency DBA name is “Anara Hospice” and state staff is operating out of a “drop site” location closer to current patients in San Diego; however, no evidence of any change request submitted to CMS/ACHC/California, unable to verify Administrator and Alternate Administrator, office space does not appear to be a functioning office due to lack of personnel and patient records and resources available for staff, and no Governing Board meeting minutes on site.”
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Hospice multiple locations (42 CFR 418.100(f)(1)(iii))
The inspectors’ words, 134 words
“Upon observation, there was no evidence that the lines of authority, professional and administrative control must be clearly delineated in the provider’s organizational structure and in practice, and must be traced to the location issued the certification number. Office location for MD Choice Hospice is not operating as a base office. Administrator admits that staff are reporting to an office in San Diego. He states,”all our patients currently on service are located in San Diego. This office is too far for staff to travel back and forth.” They had plans to move the office permanently but because of the financial impacts of no reimbursement currently that has not yet happen. No office address was provided. He reports that the San Diego space is a drop site and the current address is the parent site.”
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Training (42 CFR 418.100(g)(1))
“Upon personnel record review, the agency did not have evidence the hospice employees and contract employees have received orientation on the hospice philosophy. No personnel files available.”
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Training (42 CFR 418.100(g)(2))
“Upon personnel record review, the agency did not have evidence that the hospice employees have received orientation on their specific job requirements. No personnel files available.”
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Training (42 CFR 418.100(g)(3))
“Upon personnel record review, the agency did not have evidence that a skills competency assessment, specific to each discipline had been conducted for all personnel including volunteers initially during orientation. No personnel file available.”
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Content (42 CFR 418.104(a)(2))
“Upon patient client record review, 5 of 5 (Patients #1,2,3,4,5) did not have evidence that each patient record contains: • Signed copies of the notice of patient rights in accordance with 418.52 • Signed election statement in accordance with 418.24 Agency Administrator and DPCS state agency is operating under the name “Anara Hospice”; however, there is no evidence in patient Election of Benefits form that patient/responsible party was informed that agency has this DBA name.”
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Protection of information (42 CFR 418.104(c))
“Upon observation, there was no evidence the organization follows their policies and procedures to the the patient’s clinical record in confidential manner. Records were emailed to AO in unsecure manner as PDF file. Agency unable to present policy to validate how agency maintains clinical record in a confidential manner.”
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Personnel qualification (42 CFR 418.114(a))
“Upon personnel record review, the agency did not have evidence that personnel credentialing activities are conducted to verify qualifications of all credentialed/licensed personnel in the positions they hold at the time of hire, at renewal or in accordance with specific state practice act requirements. Personnel file not available for review.”
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Personnel qualification (42 CFR 418.114(b)(3))
“Upon personnel record review, the agency did not have evidence that all Medical Social Services are provided by a qualified Medical Social Worker in accordance with the state’s Social Work Practice Act, the hospice’s policies and procedures and/or job descriptions. No personnel files presented during survey.”
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Personnel qualification (42 CFR 418.114(b)(4))
“Upon personnel record review, the agency did not have evidence that all Speech Therapy Services are provided by a qualified licensed Speech-Language Pathologist (SLP) or Audiologist in accordance with the state’s Speech-Language Pathology Practice Act and the hospice’s policies and procedures and/or job descriptions. No personnel files presented during survey.”
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Personnel qualification (42 CFR 418.114(b)(5))
“Upon personnel record review, the agency did not have evidence all Occupational Therapy Services are provided by a qualified licensed Occupational Therapist (OT) in accordance with the state’s Occupational Therapy Practice Act and the hospice’s policies and procedures and/or job descriptions. No personnel files presented during survey.”
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Personnel qualification (42 CFR 418.114(b)(7))
“Upon personnel record review, the agency did not have evidence all Physical Therapy Services are provided by a qualified licensed Physical Therapist (PT) in accordance with the state’s Physical Therapy Practice Act and the hospice’s policies and procedures and/or job descriptions. No personnel files presented.”
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Criminal background checks (42 CFR 418.114(d)(2))
“Upon personnel record review, the agency did not have evidence of criminal background checks being obtained in accordance with state requirements. In the absence of state requirements, criminal background checks are obtained within three months of the date of employment for all states that the individual has lived or worked in the past 3 years. No personnel files available.”
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Multiple locations (42 CFR 418.116(a))
“Upon observation, there was no evidence the organizational chart matches the hospice’s information submitted to CMS and/or State licensing agencies for ownership and management personnel. Agency is doing business as Anara Hospice, Administrator and DPCS refer to agency as “Anara Hospice”. License 550005190 effective 12/11/25 is MD Choice Hospice Care Inc. without a dba. Per Administrator the paperwork has been approved but the CHOW visit has not yet been completed. Administrator was unable to produce paperwork submitted.”
Feb 2, 2024: initial follow-up inspection by the Accreditation Commission for Health Care2 deficiencies
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Counseling services (42 CFR 418.64(d)(1))
The inspectors’ words, 125 words
“Upon patient record review, 1 of 5 (Patient #4) did not have evidence the hospice offers bereavement counseling that includes: • Making bereavement services available to the family and other individuals in the bereavement plan of care up to 1 year following the death of the patient. Bereavement counseling also extends to residents of a SNF/NF or ICF/IID when appropriate and identified in the bereavement plan of care • Ensuring that bereavement services reflect the needs of the bereaved • Development of a bereavement plan of care that notes the kind of bereavement services to be offered and the frequency of service delivery Patient #4 DOD 1/25/24 There is no evidence of post death assessment, bereavement POC or any evidence of post death follow up.”
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Training (42 CFR 418.100(g)(3))
“Upon personnel record review, 1 of 7 (Personnel #6) did not have evidence that a skills competency assessment, specific to each discipline had been conducted for all personnel including volunteers initially during orientation. Personnel #6 HR file for the medical director contained blank competency sheet with personnel signature and date with no items checked off for skills items nor have preceptor initials nor signatures.”
Dec 15, 2023: initial inspection by the Accreditation Commission for Health Care34 deficiencies
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IDG, care planning, coordination of services (42 CFR 418.56)
“Condition of Participation: Interdisciplinary Group, Care Planning, and Coordination of Services. L536”
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Core services (42 CFR 418.64)
“Upon personnel record review, 1 of 14 (Personnel #2) did not have evidence that the hospice routinely provide substantially all core services directly by hospice personnel (The hospice issues a W-2 form for the employee). These services include: • Physician services (may contract for physician services) • Nursing • Medical social services • Counseling Personnel #2: The RN/Alt. Adm./Alt DPCS was hired as contract staff and performing direct patient care per Administrator however, there was no evidence of extraordinary or other non-routine circumstance.”
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Hospice aide and homemaker services (42 CFR 418.76)
“Condition of Participation: Hospice Aide and Homemaker Services. L607”
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Organizational environment (42 CFR 418.100)
“Condition of Participation: Organization and Administration of Services.”
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Medical director (42 CFR 418.102)
“Upon observation, there was no evidence the hospice designates a physician to serve as Medical Director which includes: • The Medical Director must be a doctor of medicine or osteopathy who is an employee or is under contract. • When the Medical Director is not available, a physician designated by the hospice assumes the same responsibilities and obligations as the Medical Director. There was no evidence of an alternate medical director.”
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EP Training Program (42 CFR 418.113(d)(1))
The inspectors’ words, 119 words
“Upon personnel record review, 2 of 12 (Personnel #4, #5 ) did not have evidence Emergency Preparedness training including: • Initial training in emergency preparedness policies and procedures to all new and existing hospice employees, and individuals providing services under arrangement, consistent with their expected roles • Demonstrate staff knowledge of emergency procedures • Provide emergency preparedness training at least annually • Periodically review and rehearse its emergency preparedness plan with hospice employees (including nonemployee staff), with special emphasis placed on carrying out the procedures necessary to protect patients and others • Maintain documentation of all emergency preparedness training Personnel #4,#5: There was no evidence of initial training in Emergency preparedness (orientation forms are blank) for LVN and aide.”
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Rights of the patient (42 CFR 418.52(c)(4))
“Upon patient record review, 1 of 14 (Patient #9) did not have evidence that the patient chooses a health care provider, including an attending physician. Patient #9: There was no evidence the patient chose a health care provider, including an attending physician.”
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Timeframe for completion of assessment (42 CFR 418.54(b))
“Upon patient record review 1 of 14 (Patient #4) 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 #4: SOC date 11/20/2023. Spiritual needs assessment occurred on 11/30/2023”
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Content of comprehensive assessment (42 CFR 418.54(c))
The inspectors’ words, 98 words
“Upon patient record review 3 of 14 (Patient #2, #6, #11) did not have evidence in the patient record that the comprehensive assessment identifies the physical, psychosocial, emotional, and spiritual needs related to the terminal illness that must be addressed in order to promote the hospice patient’s well-being, comfort, and dignity throughout the dying process. Patient #2: SOC date 11/22/2023. Spiritual needs assessment dated 11/23/2023 is incomplete and unsigned. No evidence of a spiritual needs assessment. Patient #6: There was no evidence of a psychosocial needs assessment. Patient #11: There was no evidence of a spiritual needs assessment.”
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Content of comprehensive assessment (42 CFR 418.54(c)(6))
The inspectors’ words, 199 words
“Upon patient record review, 3 of 14 (Patient #4, #7, #10) did not have evidence in the patient record that a review was completed of all prescription and non-prescription medications, including herbal remedies that could affect drug therapy. This review includes, but is not limited to: • Effectiveness of drug therapy • Drug side effects • Actual or potential drug interactions • Duplicate drug therapy • Drug therapy currently associated with laboratory monitoring Patient #4: Medication profile dated 11/20/2023 included MS 20mg/ml 0.25ml PO Q 4 hrs. pain moderate to severe, and Norco 5-325 One tab PO Q 4 Hrs PRN pain moderate to severe. There were no parameters of how to dispense which medication. Patient #7: Medication profile dated 10/29/2023 included MS 20mg/ml 0.25ml PO Q 4 hrs. pain moderate to severe, and dated 10/16/2023 Methadone 5mg tab One tab PO BID PRN pain moderate to severe. There were no parameters of how to dispense which medication. Patient #10: Medication list (no evidence of a formal medication profile) dated 5/12/2020 included Tramadol 50mg one POQ 4-6 hrs. PRN pain moderate and MS 20mg/ml,0.5ml SL Q 2hr PRN pain moderate to severe. There were no clear parameters for dispensing.”
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Update of comprehensive assessment (42 CFR 418.54(d))
The inspectors’ words, 106 words
“Upon patient record review, 1 of 14 (Patient #10) 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 #10: There was no evidence of updated visits since initial SN visit on admission.”
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IDG, care planning, coordination of services (42 CFR 418.56)
“Upon client record review, 1 of 14 (Patient #10) did not have evidence that the plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions as identified in the comprehensive assessment. Patient #10: There was no evidence of a plan of care initiated based on comprehensive assessment needs.”
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Content of plan of care (42 CFR 418.56(c))
The inspectors’ words, 225 words
“Upon patient record review, 6 of 14 (Patient #3, #4, #5, #7, #10, #14) did not have evidence in the patient record that the hospice has developed an individualized written plan of care for each patient. The plan of care must reflect patient/family goals and interventions based on the problems identified in the initial, comprehensive, and updated comprehensive assessments. The plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions. Patient #3: SOC SN assess identified Braden score of 12-high risk, and a stage l pressure ulcer on coccyx, no evidence of problem/goals interventions for skin integrity. Patient #4: SOC SN assess identified Braden score of 12-high risk, and a stage ll pressure ulcer on coccyx, no evidence of problem/goals interventions for skin integrity. Patient #5: SOC SN assess identified Braden score of 13-high risk, dysphagia at risk for aspiration, no evidence of problem/goals interventions for skin integrity or dysphagia/aspiration risk. Patient #7: SOC SN assess identified Braden score of 14-high risk, no evidence of problem/goals interventions for skin integrity. Patient #10: There was an order for Continuous care, however no there was no evidence of a Plan of care. Patient #14: SOC SN assess identified seizure disorder, dysphagia/aspiration risk, and fall risk of 11-high risk, no evidence of problem/goals interventions for seizure,dysphagia/aspiration or falls.”
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Content of plan of care (42 CFR 418.56(c)(4))
The inspectors’ words, 171 words
“Upon patient record review, 3 of 14 (Patient #4, #7, #10) 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 #4: Medication orders dated 11/20/2023 included MS 20mg/ml 0.25ml PO Q 4 hrs. pain moderate to severe, and Norco 5-325 One tab PO Q 4 Hrs PRN pain moderate to severe. There were no parameters of how to dispense which medication. Patient #7: Medication order dated 10/29/2023 included MS 20mg/ml 0.25ml PO Q 4 hrs. pain moderate to severe, and dated 10/16/2023 Methadone 5mg tab One tab PO BID PRN pain moderate to severe. There were no parameters of how to dispense which medication. Patient #10: Medication sheet included dated 5/12/2020 included Tramadol 50mg one POQ 4-6 hrs. PRN pain moderate and MS 20mg/ml,0.5ml SL Q 2hr PRN pain moderate to severe. There were no clear parameters for dispensing and there was no evidence of an order for any medications.”
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Review of the plan of care (42 CFR 418.56(d))
“Upon patient record review, 1 of 14 (Patient #3) did not have evidence that a revised plan of care includes information from the patient’s updated comprehensive assessment and must note the patient’s progress towards outcome/goals from the plan of care. Patient #3: SN notes dated 11/11/2023 included several new pressure ulcers, no evidence of this information getting into care plan until IDG updated the POC on 11/24/2023.”
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Coordination of services (42 CFR 418.56(e)(2))
The inspectors’ words, 122 words
“Upon client record review, 5 of 14 (Patient #1, #2, #11, #12, #13) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #1: Order dated 9/27/2023 included PT evaluation and treat. There was no evidence of a PT evaluation. Patient #2: SN order on SOC is 1x wk. For week of 12/4 and 12/11/2023 the LVN visits are incomplete and unsigned. Patient #11: SN orders from SOC 2x week, last SN note dated 9/21/2020, transfer order dated 10/3/2020. Patient #12: SN orders from SOC 1x week, last SN note dated 9/24/2020, transfer order dated 10/2/2020. Patient #13: SN orders from SOC 1x week. Last SN note dated 9/21/2020.”
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Counseling services (42 CFR 418.64(d)(1))
The inspectors’ words, 175 words
“Upon patient record review, 4 of 14 (Patient #5, #6, #9, #10) did not have evidence the hospice offers bereavement counseling that includes: • Making bereavement services available to the family and other individuals in the bereavement plan of care up to 1 year following the death of the patient. Bereavement counseling also extends to residents of a SNF/NF or ICF/IID when appropriate and identified in the bereavement plan of care • Ensuring that bereavement services reflect the needs of the bereaved • Development of a bereavement plan of care that notes the kind of bereavement services to be offered and the frequency of service delivery Patient #5: No Post bereavement POC developed, no offer of services documented. Patient #6: Expired 1/7/2023, POC in place last correspondence occurred at month 6, month 9 due 11/1/2023 had no evidence of continuation of bereavement plan and no documentation as to why it ended. Patient #9: No Post bereavement POC developed, no offer of services documented. Patient #10: No Post bereavement POC developed, no offer of services documented.”
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Competency evaluation (42 CFR 418.76(c))
The inspectors’ words, 173 words
“Upon personnel record review, 1 of 12 (Personnel # 5) did not have evidence in the personnel file that the following competency assessment was performed by the aide with a patient: (This standard applies to all Hospice Aides providing care/service who are directly employed by the hospice or through a contractual agreement.) ·Communication skills, including the ability to read, write, and verbally report clinical information to patients, caregivers, and other hospice staff. ·Reading and recording temperature, pulse, and respiration ·Safe transfer techniques and ambulation. ·Normal range of motion and positioning ·Appropriate and safe techniques in personal hygiene and grooming that include-- ·(A) Bed bath ·(B) Sponge, tub, and shower bath ·(C) Shampoo, sink, tub, and bed ·(D) Nail and skin care ·(E) Oral hygiene ·(F) Toileting and elimination The other subject areas in this section may be evaluated through written examination, oral examination or after observation of a Hospice Aide with a patient. Personnel #5: There was no evidence a competency assessment was performed by the aide with a patient or pseudo pt.”
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Hospice aide assignments and duties (42 CFR 418.76(g)(1))
The inspectors’ words, 174 words
“Upon patient record review, 3 of 14 (Patient #1, #4, #9) did not have evidence in the patient record that hospice aide assignments and duties are: • Assigned to a specific patient by a registered nurse that is a member of the interdisciplinary group • Written patient care instructions for a hospice aide must be prepared by a Registered Nurse who is responsible for the supervision of a hospice aide as specified under paragraph (h) of 418.76 • There is evidence in the patient record that the plan of care; indicate what tasks are to be done by the Aide and the frequency of these tasks. The use of “PRN” or “per patient choice”, for any task, whether personal care or non-personal care tasks, are not acceptable Patient #1: On Eliquis anticoagulant, and two medications for seizure disorder, no evidence on Aide assignment of bleeding or seizure precautions. Patient #4: On Eliquis anticoagulant, no evidence on Aide assignment of bleeding precautions. Patient #9: On Eliquis anticoagulant, no evidence on Aide assignment of bleeding precautions.”
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Hospice aide assignments and duties (42 CFR 418.76(g)(2))
The inspectors’ words, 112 words
“Upon patient record review 3 of 14 (Patient #1, #2, #4) 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 #1: Aide order dated 9/15/2023 2x week, week of 11/26/2023 there were 4 aide visits. Patient #2: Aide order at SOC 2x week. There were no visits or missed visits documented week 1. Patient #4: Aide order at SOC 2x week. There were no visits or missed visits documented week 1.”
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Supervision of hospice aides (42 CFR 418.76(h)(1))
The inspectors’ words, 117 words
“Upon patient record review 3 of 14 (Patient #1, #3, #7) 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 #1: Aide ordered 2x week, no evidence of supervisory visit, last dated 11/27/2023. Patient #3: Aide ordered 2x week, last supervisory visits dated 11/16/2023 and 12/2/2023, greater than 14 days apart. Patient #7: Aide ordered 2x week, last supervisory visits dated 10/26/2023 and 11/10/2023, greater than 14 days apart.”
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Role (42 CFR 418.78(b))
“Upon observation, there was no evidence volunteers are used in day to day administrative and/or direct patient care roles. Upon arrival to agency informed they had no volunteers, Consultant asked to be a volunteer, corrected on site.”
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Recruiting and retaining (42 CFR 418.78(c))
“Upon observation, there was no evidence the hospice documents and demonstrates viable and ongoing efforts to recruit and retain volunteers. VC new to role in August, working to build a program, no evidence through current year.”
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Cost saving (42 CFR 418.78(d))
The inspectors’ words, 94 words
“Upon observation, there was no evidence the hospice documented the cost savings achieved through the use of volunteers. Documentation must include the following: • The identification of each position that is occupied by a volunteer • The work time spent by volunteers occupying those positions • Estimates of the dollar costs that the hospice would have incurred if paid employees occupied the positions identified in paragraph (d)(1) of CFR 418.78 for the amount of time specified in paragraph (d)(2) of CFR 418.78 There was no evidence of any volunteer hours documented this calendar year.”
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Governing body and administrator (42 CFR 418.100(b))
“Upon personnel record review, 1 of 12 (Personnel # 2) did not have evidence the alternate administrator’s personnel record verifies that: • The employee has appropriate education and experience requirements • There is a signed job description for this role • The employee has been orientated to this role Employee #2, There was no evidence of a job description for the alt. admin. or orientation to the role.”
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Training (42 CFR 418.100(g)(1))
“Upon personnel record review, 2 of 12 (Personnel #4, #5 ) did not have evidence the hospice employees and contract employees have received orientation on the hospice philosophy. Personnel #4, #5: No evidence of orientation on the hospice philosophy for LVN and aide.”
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Training (42 CFR 418.100(g)(2))
“Upon personnel record review, 2 of 12 (Personnel #4, #5 ) did not have evidence that the hospice employees have received orientation on their specific job requirements. Personnel #4, #5: There was no evidence the hospice employees received orientation specific to their specific roles of LVN and aide.”
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Training (42 CFR 418.100(g)(3))
“Upon personnel record review, 3 of 12 (Personnel #3, #4, #5) did not have evidence that a skills competency assessment, specific to each discipline had been conducted for all personnel including volunteers initially during orientation. Personnel #3, #4, #5: There was no evidence that skills competency assessments were conducted during orientation for LVN, SC/BC, or aide.”
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Initial certification of terminal illness (42 CFR 418.102(b))
The inspectors’ words, 102 words
“Upon patient record review, 1 of 14 (Patient #10) did not have evidence that the medical director or physician designee provides written certification that it is anticipated that the patient’s life expectancy is 6 months or less if the illness runs its normal course. The physician must consider the following when making this determination: • The primary terminal condition • Related diagnosis • Current subjective and objective medical findings • Current medication and treatment orders • Information about the medical management of any of the patient’s conditions unrelated to the terminal illness Patient #10: There was no evidence of a written certification.”
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Content (42 CFR 418.104(a)(2))
“Upon patient client record review, 1 of 14 (Patient #9) did not have evidence that each patient record contains: • Signed copies of the notice of patient rights in accordance with 418.52 • Signed election statement in accordance with 418.24 Patient #9: EOB lacking date of election and attending physician”
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Content (42 CFR 418.104(a)(5))
“Upon patient client record review, 1 of 14 (Patient #10) did not have evidence that each patient record contains Physician certification and recertification of terminal illness.”
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Discharge or transfer of care (42 CFR 418.104(e))
“Upon client record review, 3 of 14 (Patient #11, #12, #13) did not have evidence that the hospice forwarded a summary and a copy of the patient record, if requested, to a facility when transferring the patient to that facility. Patients #11, #12, #13: All three transferred to another hospice, no evidence of a transfer summary sent to agency.”
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Discharge or transfer of care (42 CFR 418.104(e)(2))
“Upon client record review, 1 of 14 (Patient #7) did not have evidence that if a patient revokes the election of hospice care or is discharged from hospice in accordance with §418.26, the hospice must forward to the patient’s attending physician: • A copy of the hospice discharge summary • The patient’s clinical record, if requested Patient #7: There was no evidence a discharge summary was sent to the attending physician.”
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Use and mintenance of equipment and supplies (42 CFR 418.106(f)(3))
“Upon observation, there was no evidence that when the hospice provides durable medical equipment under contract, then the DMEPOS provider is accredited by a CMS approved accreditation organization. Contract provided had no evidence of accreditation, call to DME company proved none exists.”
All 3 inspections in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Jul 13, 2026 | Complaint inspection by the Accreditation Commission for Health Care | 36 deficiencies cited |
| Feb 2, 2024 | Initial follow-up inspection by the Accreditation Commission for Health Care | 2 deficiencies cited |
| Dec 15, 2023 | Initial inspection by the Accreditation Commission for Health Care | 34 deficiencies cited |
Is it certified?
- Medicare-certified hospice since Oct 17, 2020.
- Ownership: for-profit.
- Cited at 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. in the last three years: it didn’t meet a whole condition of Medicare’s rules.
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.
- 36 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?
- CMS hasn’t published nursing time from Medicare claims for this hospice.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 97% at home, 3% in a skilled nursing facility.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
Who owns it?
- Amore Hospice Inc. owns 43% directly since Dec 12, 2025; Zion CARE Group LLC owns 38% directly since Dec 12, 2025; Cleon Holdings LLC owns 19% directly since Dec 12, 2025.
- 14 owners or officers are people: Patrick Landon Burrup (owns 5% or more through other companies, 19%); Andrew Aaron Burrup (owns 5% or more through other companies, 19%); Phillip Wright (owns 5% or more through other companies, 19%); Matthew Webster (owns 5% or more through other companies, 10.3%); Randall Mead (owns 5% or more through other companies, 9.9%); Karen Barias (owns 5% or more through other companies, 9.9%); Pouya Afshar (managing employee (on the payroll)); Pouya Afshar (runs it (operational or managerial control)); Randall Mead (corporate officer); Patrick Landon Burrup (corporate officer); Andrew Aaron Burrup (corporate officer); Phillip Wright (corporate officer); Maricon Geronimo (managing employee (on the payroll)); Maricon Geronimo (runs it (operational or managerial control)).
- 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.
| Organisation | Role | Share | Since |
|---|---|---|---|
| Amore Hospice Inc. | Owns 5% or more directly | 43% | Dec 12, 2025 |
| Zion CARE Group LLC | Owns 5% or more directly | 38% | Dec 12, 2025 |
| Cleon Holdings LLC | Owns 5% or more directly | 19% | Dec 12, 2025 |
| Premier Medical Investment Group LLC | Owns 5% or more through other companies | 12.9% | Dec 12, 2025 |
What do families say?
- CMS gives no family caregiver survey rating: “The number of cases is too small to report Star Ratings.”
- CMS gives no Hospice Care Index for this hospice.
CMS, CAHPS Hospice Survey and Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
How does it compare nearby?
- Of the 35 hospices CMS’s data show serving patients in ZIP code 92590, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 7; this one had 72.
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 |
|---|---|
| Good Heart Hospice and Palliative Care | 35 |
| Silverado Hospice Coastal Valleys | 1 |
| MD Choice Hospice Care Inc. This hospice | 72 |
| Greatness Hospice, Inc. | Not given |
| Eagle Glen Hospice Care | 8 |
| Elizabeth Hospice | 15 |
| Vnacare | 6 |
| Vitas Healthcare Corporation of California | 4 |
| Hospice of the Valleys | Not given |
| Lightbridge Hospice | 11 |
| Hope Hospice & Healthcare, Inc. | 3 |
| Bella Terra Hospice | 1 |
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.