Hospice of Grace and Palliative Care Inc.
A hospice in Arcadia, California 91006
351 E Foothill Blvd Suite 250, Arcadia, California 91006. (818) 553-6646.
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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.
- 6 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?
6 deficiencies cited in the last three years
The middle of the 117 hospices serving ZIP code 91006 had 6.
The last inspection on record was on Sep 4, 2025: a reaccreditation 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
6 deficiencies in 1 month of the last 36. Last cited Sep 2025. 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.
Sep 4, 2025: reaccreditation inspection by the Accreditation Commission for Health Care6 deficiencies
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Content of comprehensive assessment (42 CFR 418.54(c)(6))
“Upon patient record review, 3 of 14 (Patient #1,2,9) 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#1, 2, 9 - Miralax had no diluent listed on the medication profile. - corrected onsite”
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Content of plan of care (42 CFR 418.56(c))
The inspectors’ words, 261 words
“Upon patient record review, 5 of 14 (Patient #3,4,5,8,10) 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 - Pt is a full code with no problems, goals or interventions. - corrected onsite Patient #4 - The nursing comprehensive dated 08/25/25 noted patient health history included seizures. There was no problems, goals or interventions. - corrected onsite Patient #5 - The nursing comprehensive dated 08/13/25, noted patient to be at high risk of aspiration. The patient was noted to have an order for a pureed diet and an order to thicken all liquids. There was no evidence of problems, goals, or interventions. - corrected onsite Patient #8 - The nursing comprehensive on 08/20/25, noted that patient suffered from dysphagia and was utilizing a thickening product for all fluids. There was no problems, goals or interventions related to dysphagia on the patient’s plan of care. In addition, the patient was taking Eliquis and did not have bleeding precaution on the plan of care. - corrected onsite Patient #10 - The nursing comprehensive dated 08/25/25, noted the patient required a mechanical soft diet with thickened liquids. There was no evidence of problems, goals or interventions related to the risk of aspiration. - corrected onsite”
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Content of plan of care (42 CFR 418.56(c)(4))
“Upon patient record review, 3 of 14 (Patient #1,2,9) 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 #1, 2, 9 - Miralax had no diluent on the POC orders. - corrected onsite”
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Review of the plan of care (42 CFR 418.56(d))
“Upon patient record review, 1 of 14 (Patient #1) 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. Patient #1 - The IDG note for the date of 08/18/25, is missing the signature of the RN and the MD. The IDG note from 08/29/25 is also missing the signatures of the RN and the MSW.”
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Coordination of services (42 CFR 418.56(e)(3))
The inspectors’ words, 159 words
“Upon patient record review 1 of 14 (Patient #2) did not have evidence that the IDG ensures that the care and services provided are based on all assessments of the patient and family needs. Patient #2 - The social worker comprehensive assessment noted at the visit, there was much conflict noted between family members present about the care of their mother. The social worker also noted that the patient’s spouse stated she had an order of protection against her brother who had showed up at the patient’s home. The note also stated that the wife called the police to report this violation of that order during the comprehensive assessment. The assessment also stated that as the Social Worker was walking out of the patient’s home, the police department showed up. There was no evidence of follow up by this Social Worker to this incident on this day or the following days. The next Social Worker visit was on 08/28/25.”
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Hospice aide assignments and duties (42 CFR 418.76(g)(2))
The inspectors’ words, 133 words
“Upon patient record review 1 of 14 (Patient #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 #4 - The initial plan of care had evidence of an order outlining the patient was to receive aide visits two times per week. The aide plan of care dated 08/05/25, also contained a frequency order for aide visits as two times per week. The week of August 17th, there was only one aide visit completed on 08/22/25. There was no evidence of any missed or refused visit documentation for the other required visit.”
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Sep 4, 2025 | Reaccreditation inspection by the Accreditation Commission for Health Care | 6 deficiencies cited |
Is it certified?
- Medicare-certified hospice since Sep 21, 2022.
- CMS doesn’t list its type of ownership.
- 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): 8.4 nurse care minutes per routine home care day, 6.5% of skilled nursing minutes at weekends and a visit near death for 85.2% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 76% at home, 21% in assisted living, 2% in a skilled nursing facility.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | This provider |
|---|---|
| Nurse care minutes per routine home care day | 8.4 min |
| Skilled nursing minutes at weekends | 6.5% |
| Visits near death | 85.2% of patients who died |
Who owns it?
- 10 owners or officers are people: Martin Kestenian (owns 5% or more directly, 50%); Martin Kestenian (corporate officer, 50%); Martin Kestenian (corporate director, 50%); Martin Kestenian (managing employee (on the payroll), 50%); Catherine Khatoun Kestenian (owns 5% or more directly, 50%); Catherine Khatoun Kestenian (corporate officer, 50%); Catherine Khatoun Kestenian (corporate director, 50%); Catherine Khatoun Kestenian (managing employee (on the payroll), 50%); Garo Harmandayan (corporate director, 50%); Garo Harmandayan (managing employee (on the payroll), 50%).
- 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).
- 73.56% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025).
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 117 hospices CMS’s data show serving patients in ZIP code 91006, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 6; this one had 6.
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 |
|---|---|
| Assurance Hospice, Inc. | Not given |
| Immanuel Hospice, Inc. | Not given |
| Angel Care Hospice of Arcadia, Inc. | 18 |
| Transitions Hospice, Inc. | Not given |
| Pacific Sun Hospice | 12 |
| Galenus Hospice Care Inc. | 0 |
| Ava Hospice Corp | 2 |
| No Pain Hospice Care, Inc. | 0 |
| Caring Help Hospice Agency, Inc. | Not given |
| Hospice of Grace and Palliative Care Inc. This hospice | 6 |
| Dependable Hospice Services Inc. | Not given |
| One for All Hospice Inc. | Not given |
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.