Adjustable Care Life Inc.
A hospice in Fullerton, California 92835
1440 N. Harbor Blvd, Suite 600b, Fullerton, California 92835. (714) 684-4115.
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The short answer
Record last released by CMS on Oct 23, 2026.
- 7 deficiencies cited in the last three years
- Not rated family caregiver rating
- 9of 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?
7 deficiencies cited in the last three years
The middle of the 76 hospices serving ZIP code 92835 had 7.
The last inspection on record was on Apr 19, 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
7 deficiencies in 1 month of the last 36. Last cited Apr 2024. 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.
Apr 19, 2024: initial inspection by the Accreditation Commission for Health Care7 deficiencies
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Content of comprehensive assessment (42 CFR 418.54(c)(6))
The inspectors’ words, 108 words
“Upon patient record review, 1 of 14 (Patient #3) 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 3: The plan of care includes an order for oxygen 2 liters per minute via nasal cannula as needed for shortness of breath. There is no evidence of an entry for oxygen on the medication profile.”
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Content of comprehensive assessment (42 CFR 418.54(c)(7))
The inspectors’ words, 124 words
“Upon patient record review, 2 of 14 (Patient #4,#5) did not have evidence in the patient record that the comprehensive assessment includes a bereavement component which includes the needs of the patient’s family and other individuals focusing on the social, spiritual, and cultural factors that may impact their ability to cope with the patient’s death. Information gathered from the initial bereavement assessment is incorporated into the plan of care and is considered in the bereavement plan of care. Patient 4:The patient was admitted to hospice on 1/16/24. There is no evidence that a bereavement risk assessment was completed prior to 2/18/24. Patient 5:The patient was admitted to hospice on 1/5/24. There is no evidence that a bereavement risk assessment was completed prior to 2/16/24.”
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Content of plan of care (42 CFR 418.56(c))
The inspectors’ words, 193 words
“Upon patient record review, 3 of 14 (Patient #3,#4,#7) 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:The medical record contains an order for oxygen 2 liters per minute via nasal cannula PRN for shortness of breath. There is no evidence of problems, goals and interventions for the use and safety of oxygen on the plan of care. Patient 4:The medical record contains nursing documentation on admission that the patient is at risk for seizures. There is no evidence of problems, goals and interventions related to the risk for seizures on the plan of care. Patient 7:The medical record contains nursing documentation on admission that the patient required an indwelling foley catheter. There is no evidence of problem, goals and interventions related to the management of a foley catheter on the plan of care.”
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Content of plan of care (42 CFR 418.56(c)(4))
“Upon patient record review, 1 of 14 (Patient #7) 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 7:The medical record includes an order entered on 9/22/23 of Nystatin Powder thin layer to rash. There is no evidence in the order of the location for administration of the Nystatin powder.”
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Content of plan of care (42 CFR 418.56(c)(5))
“Upon patient record review, 1 of 14 (Patient #1) 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 equipment and supply needs. Patient 1: The medical record includes SN documentation that the patient equipment needs includes a walker and shower chair. There is no evidence that a walker and shower chair are included on the plan of care.”
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Coordination of services (42 CFR 418.56(e)(2))
“Upon client record review, 1 of 14 (Patient #4) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient 4:The medical record includes SN documentation of foley catheter insertion on 4/7/24. There is no evidence that the plan of care included an order for foley catheter placement.”
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Hospice aide assignments and duties (42 CFR 418.76(g)(1))
The inspectors’ words, 153 words
“Upon patient record review, 1 of 14 (Patient #4) 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 4:The aide plan of care includes the task of dressing patient in PJ/Gown. There is no evidence of a frequency associated with the provision of the care.”
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Apr 19, 2024 | Initial inspection by the Accreditation Commission for Health Care | 7 deficiencies cited |
Is it certified?
- Medicare-certified hospice since Apr 29, 2021.
- 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): 11.7 nurse care minutes per routine home care day, 4.9% of skilled nursing minutes at weekends and a visit near death for 100% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 88% at home, 12% in assisted living.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | This provider |
|---|---|
| Nurse care minutes per routine home care day | 11.7 min |
| Skilled nursing minutes at weekends | 4.9% |
| Visits near death | 100.0% of patients who died |
Who owns it?
- 9 owners or officers are people: Lila Girish Patel (owns 5% or more directly, 50%); Lila Girish Patel (corporate officer, 50%); Lila Girish Patel (corporate director, 50%); Harshal Ashok Vaza (owns 5% or more directly, 50%); Harshal Ashok Vaza (corporate officer, 50%); Harshal Ashok Vaza (corporate director, 50%); Harshal Ashok Vaza (managing employee (on the payroll), 50%); Pin Hung Hsieh (managing employee (under contract), 0%); Ronak Vaza (managing employee (on the payroll), 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: 9 of 10 (Jan 1, 2023 to Dec 31, 2024).
- 88.64% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025); 33.3% 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 | 9 of 10 |
How does it compare nearby?
- Of the 76 hospices CMS’s data show serving patients in ZIP code 92835, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 7; this one had 7.
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 Orange County, Inc. | 23 |
| Rnplus Hospice Care, Inc. | 1 |
| Adjustable Care Life Inc. This hospice | 7 |
| Valhalla Hospice LLC | Not given |
| Providence at Home With Compassus Hospice Care La County | 5 |
| Memorialcare Hospice and Palliative Services | 9 |
| Vitas Healthcare Corporation of California | 3 |
| Accentcare Hospice & Palliative Care of California | 3 |
| Providence at Home With Compassus Hospice Care Orange County | 5 |
| Bristol Hospice-Orange County | 8 |
| Silverado Hospice Inc. | 16 |
| Carechoices Hospice and Palliative Services, LLC | 18 |
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.