Sequoia Hospice Inc.
A hospice in Clovis, California 93612
55 Shaw Ave Suite 112, Clovis, California 93612. (559) 321-8054.
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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.
- 25 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 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?
25 deficiencies cited in the last three years
The middle of the 31 hospices serving ZIP code 93612 had 6.
The last inspection on record was on Aug 28, 2024: a follow-up inspection by The Joint Commission.
3 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
25 deficiencies in 2 months of the last 36. Last cited Aug 2024. 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.
Aug 28, 2024: follow-up inspection by The Joint Commission1 deficiency
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Level of activity (42 CFR 418.78(e))
“Observed in Tracer Activities. During discussion with the DPCS/owner and review of documentation it was noted that the organization volunteer hours had not met the 5% of total patient care hours. The organization’s volunteer hours were 1.7%. This was discussed with the DPCS/owner and office manager present.”
Aug 1, 2024: follow-up inspection by The Joint Commission7 deficiencies
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Governing body and administrator (42 CFR 418.100(b))
“Observed in Tracer Activities. The governing body for the organization did not act on and comply with recommendations made by The Joint Commission at the triennial survey two months ago as repeat condition level findings were found at §418.58 and §418.78. This RFI was reviewed and discussed with the Administrator/Director of Patient Care Services.”
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Methods for Sharing Information (42 CFR 418.113(c)(4))
“Observed in Tracer Activities. The organization did not ensure that the communications plan included a method for sharing and/or releasing information under their care to patient’s family representatives; disaster relief organizations and relevant authorities; and other health care providers. This RFI was reviewed and discussed with the Administrator/Director of Patient Care Services.”
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Program activities (42 CFR 418.58(c)(1)(iii))
“Observed in Tracer Activities. The organization had not initiated a performance improvement project since the triennial survey two months ago. This RFI was reviewed and discussed with the Administrator/Director of Patient Care Services.”
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Performance improvement projects (42 CFR 418.58(d)(1))
“Observed in Tracer Activities. The organization was not able to provide documentation that a performance improvement project based on identified opportunities had been initiated since the triennial survey. This RFI was reviewed and discussed with the Administrator/Director of Patient Care Services.”
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Recruiting and retaining (42 CFR 418.78(c))
“Observed in Tracer Activities. The organization did not document efforts to recruit and retain volunteers since the triennial survey two months ago. This RFI was reviewed with and validated by the Administrator/Director of Patient Care Services.”
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Cost saving (42 CFR 418.78(d))
“Observed in Tracer Activities. The organization had not documented since the triennial survey two months ago the position occupied, the work time spent, or the cost savings provided by their one volunteer year to date. This RFI was reviewed with and validated by the Administrator/Director of Patient Care Services.”
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Level of activity (42 CFR 418.78(e))
“Observed in Tracer Activities. The organization did not document the level of volunteer activity towards the minimum requirement of 5% of total patient care hours since the triennial survey two months ago. This RFI was reviewed with and validated by the Administrator/Director of Patient Care Services.”
Jun 20, 2024: reaccreditation inspection by The Joint Commission17 deficiencies
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Quality assessment & performance improvement (42 CFR 418.58)
“Observed in Data Session. The QAPI program was not reflective of the complexity of the organization and did not involve all services provided by the organization, including those provided under contract or arrangement. During review of the QAPI plan and discussion with the DPCS, it was noted that the organization does not collect data for bereavement or volunteer services. Additionally, there is no formal data collection about services provided under contract. This was discussed with the DPCS.”
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Governing body and administrator (42 CFR 418.100(b))
“Observed in Tracer Activities. There was no evidence that the governing body and leadership had established requirements to support patient care treatment and services as evidenced by CLD level observations at 418.58. 418.78, 418.113 and 418.100 as discussed with the DPCS.”
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EP Program Patient Population (42 CFR 418.113(a)(3))
“Observed in Environment of Care Session. The organization’s emergency operations plan did not identify the patient population(s) that it will serve and the types of services it would have the ability to provide in an emergency or disaster event. This was discussed with the DPCS.”
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Methods for Sharing Information (42 CFR 418.113(c)(4))
“Observed in Emergency Management Session. The organization’s communications plan did not include a method for sharing and/or releasing location information and medical documentation for patients under the organization’s care to the following individuals or entities, in accordance with law and regulation: Patient’s family, representative, or others involved in the care of the patient; Disaster relief organizations and relevant authorities; Other health care providers. This was discussed with the DPCS.”
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Information on Occupancy/Needs (42 CFR 418.113(c)(7))
“Observed in Emergency Management Session. The communications plan did not describe how the organization will communicate with and report information about its needs and ability to provide assistance to relevant authorities. This was discussed with the DPCS.”
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EP Training Program (42 CFR 418.113(d)(1)(iii))
“Observed in HR File Review. In 1 of 6 HR files reviewed, the organization had not provided training to all staff on the emergency operations plan at least every two years. This training was missing in the file for the medical director since hire four years prior to the survey as confirmed with the Office Manager.”
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Exercise of rights/respect for proprty/person (42 CFR 418.52(b)(1)(i))
“Observed in Record Review. In 1 of 1 patient records reviewed, in which the patient was discharged due to extended prognosis, the organization had not involved the patient in making decisions about their care, treatment, or services. In the chart for RRD/C#11, the NOMNC form was provided on the day of discharge, rather than at least two days in advance. This was discussed with the DPCS.”
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Timeframe for completion of assessment (42 CFR 418.54(b))
The inspectors’ words, 120 words
“Observed in Record Review. In 4 of 13 patient records reviewed, the hospice’s interdisciplinary group, in consultation with the patient’s attending physician, if any, had not completed the comprehensive assessment no later than five calendar days after the election of hospice care. In the chart for RRHV#1, neither the Spiritual assessment nor the Psychosocial assessments were completed within the five calendar days. In the chart for RRHV#2, it was nine days after the election of hospice care that the psychosocial assessment was completed. In the chart for RRNHV#9, the psychosocial assessment was not completed until thirteen days post-election. In the chart for RRD/C#10, the spiritual care assessment was not attempted until 10 days post-election. This was discussed with the DPCS.”
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Update of comprehensive assessment (42 CFR 418.54(d))
The inspectors’ words, 115 words
“Observed in Record Review. In 2 of 13 patient records reviewed, the hospice’s interdisciplinary group had not updated the comprehensive assessment in collaboration with the patient’s attending physician, if any, as frequently as the patient’s condition requires, but no less than every 15 days. In the chart for RRHV#1, there were multiple instances since admission that the RN documented that supervisory visits had been completed at least every 15 days, however no patient assessment occurred at those visits. During one benefit period, 6 weeks lapsed between RN visits. In the chart for RRHV#2, there were twenty-four days between RN assessment visits at the beginning of the current benefit period. This was discussed with the DPCS.”
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Content of plan of care (42 CFR 418.56(c)(4))
The inspectors’ words, 280 words
“Observed in Record Review. In 5 of 13 patient records reviewed, the plan of care did not include all services needed for the palliation and management of the terminal illness and related conditions, including the following: Medications and treatment necessary to meet the patient’s needs. In the chart for RRNHV#3, the admission nurse applied a dressing to the patient’s rash for protection. The LVN made a subsequent visit to provide wound care and re-apply the dressing which had fallen off. There was no order for wound care/dressings on the hospice plan of care. In the chart for RRHV#1, the medication orders were not clear. For example, Acetaminophen and Acetaminophen-hydrocodone were both ordered prn pain with no further instruction about when to give which medication. Docusate, Senna and Milk of Magnesia were all ordered prn for constipation with no further instruction. In the chart for RRNHV#6, Oxycodone, Tylenol and Morphine were all ordered prn for pain with no further direction on when to administer which medication. The Foley catheter order was missing the size of the catheter and balloon. The patient had sacral DTI on admission. There were no orders for wound care on the hospice POC. The RN noted that a foam protective dressing would be provided by hospice. In the chart for RRNHV#4, an LVN made a prn visit for a new skin tear and that skin/wound care was provided during the visit. The plan of care did not include orders for wound care. In the chart for RRD/C#10, the RN noted in a visit note that the patient was using Naprosyn for pain. This was not on the hospice plan of care. This was discussed with the DPCS.
”
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Program data (42 CFR 418.58(b)(3))
“Observed in Data Session. The organization’s governing body had not approved the frequency and detail of the data collection. The QAPI plan did not specify the frequency of data collection on any measure. This was discussed with the DPCS.”
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Program activities (42 CFR 418.58(c)(1)(iii))
“Observed in Data Session. The hospice had not selected performance improvement activities that affect palliative outcomes, patient safety, and the quality of care and that are based on the prevalence and severity of problems in its high-volume, high-risk, and problem-prone areas. The organization had no current PI projects, only quality assurance data collection projects at the time of survey as confirmed with the DPCS.”
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Performance improvement projects (42 CFR 418.58(d)(1))
“Observed in Data Session. During discussion with the DPCS, it was found that the organization is currently collecting data on processes they feel are important, however have no current, active performance improvement projects based on an identified opportunity for improvement.”
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Control (42 CFR 418.60(b)(2)(ii))
The inspectors’ words, 153 words
“Observed in Data Session. The organization’s written infection prevention and control goals did not include the following: Addressing its prioritized risks. This was confirmed with the DPCS. Observed in Data Session. The organization’s written infection prevention and control goals did not include the following: Improving compliance with hand hygiene guidelines. This was confirmed with the DPCS. Observed in Data Session. The organization’s written infection prevention and control goals did not include the following: Limiting the spread of infections associated with the use of medical equipment, devices, and supplies. This was confirmed with the DPCS. Observed in Data Session. The organization’s written infection prevention and control goals did not include the following: Limiting unprotected exposure to pathogens. This was confirmed with the DPCS. Observed in Data Session. The organization’s written infection prevention and control goals did not include the following: Limiting the spread of infections associated with procedures. This was confirmed with the DPCS.”
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Recruiting and retaining (42 CFR 418.78(c))
“Observed in Tracer Activities. The hospice had not documented its efforts to recruit and retain volunteers as discussed with the DPCS.”
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Cost saving (42 CFR 418.78(d))
“Observed in Tracer Activities. The hospice had not documented the cost savings achieved through the use of volunteers. The documentation did not include the following: the positions occupied by volunteers; the work time spent by volunteers occupying those positions; estimated dollar costs that the hospice would have incurred if paid employees occupied those positions for the same amount of time that volunteers spent working in those positions. This was discussed with the DPCS.”
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Level of activity (42 CFR 418.78(e))
“Observed in Tracer Activities. The hospice had not documented the level of volunteer activity could not demonstrate that a minimum of 5% of total patient care hours was met as confirmed with the DPCS.”
All 3 inspections in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Aug 28, 2024 | Follow-up inspection by The Joint Commission | 1 deficiency cited |
| Aug 1, 2024 | Follow-up inspection by The Joint Commission | 7 deficiencies cited |
| Jun 20, 2024 | Reaccreditation inspection by The Joint Commission | 17 deficiencies cited |
Is it certified?
- Medicare-certified hospice since Aug 20, 2021.
- 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.
- 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): 9.7 nurse care minutes per routine home care day, 5.1% 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): 60% at home, 40% in assisted living.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | This provider |
|---|---|
| Nurse care minutes per routine home care day | 9.7 min |
| Skilled nursing minutes at weekends | 5.1% |
| Visits near death | 100.0% of patients who died |
Who owns it?
- 8 owners or officers are people: Kristin Elaine Amorino (owns 5% or more directly, 50%); Gary Dean Becker (owns 5% or more directly, 50%); Kristin Elaine Amorino (corporate officer); Kristin Elaine Amorino (corporate director); Kristin Elaine Amorino (managing employee (on the payroll)); Gary Dean Becker (corporate officer); Gary Dean Becker (managing employee (on the payroll)); Gary Dean Becker (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.
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).
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 31 hospices CMS’s data show serving patients in ZIP code 93612, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 6; this one had 25.
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 |
|---|---|
| Sequoia Hospice Inc. This hospice | 25 |
| One Good Hospice Inc. | 6 |
| Saint Agnes Home Health & Hospice | 6 |
| Hinds Hospice - Fresno | 3 |
| Bristol Hospice Fresno | 4 |
| Aseracare Hospice | 6 |
| Bright Horizon Hospice Services | 19 |
| St Mary’s Hospice Services, Inc. | 19 |
| Ardent Hospice of Fresno | 23 |
| Oyuna Hospice, Inc. | 2 |
| Hospice of the Valley | 13 |
| Physicians Preferred Hospice Inc. | 25 |
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.