Auburn Crest Hospice
A hospice in Coeur d’Alene, Idaho 83814
1221 Ironwood Dr Suite 102, Coeur d’Alene, Idaho 83814. (208) 665-8111.
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The short answer
Record last released by CMS on Oct 23, 2026.
- 6 deficiencies cited in the last three years
- 5of 5 family caregiver rating
- 10of 10 CMS’s Hospice Care Index
Each figure’s source sits beside it, in its section below.
What these words mean3
- Star ratings
- CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
- 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 7 hospices serving ZIP code 83814 had 6.
The last inspection on record was on Jun 26, 2026: a reaccreditation inspection by The Joint Commission.
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 Jun 2026. 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.
Jun 26, 2026: reaccreditation inspection by The Joint Commission6 deficiencies
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EP Training Program (42 CFR 418.113(d)(1)(iii))
“Observed in HR File Review. In 1 of 10 HR files reviewed, it was noted that the ongoing emergency management training was not completed every 2 years. For example the Medical Directors HR file did not contain emergency management training every 2 years. This was confirmed and discussed with the Office Manager present.”
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Plan of care (42 CFR 418.56(b ))
The inspectors’ words, 241 words
“Observed in Record Review. In 14 of 14 patient records reviewed, it was noted that the written plan of care was not individualized. For example, in RRNHV#1 two areas on the POC had interventions documented and no goal documented. Also goals such as: Family/CG will have mechanisms to cope appropriately. are not individualized. In RRHV#1 the POC had bereavement interventions documented, but no goal was documented where a goal would be written. Also goals such as: Patient/caregiver demonstrates ability to cope with limitations are not individualized. In RRHV#2 the POC had a wound care intervention documented, but no goal documented where a goal would be written and 2 intervention for agitation, but no goal documented. Also goals such as: Patient achieves feelings of spiritual comfort are not individualized to the patient. In RRHV#3 goals such as: Isolation/loneliness will be decreased per Chaplain visits.; Family/CG will have mechanisms to cope appropriately and Anxiety/agitation controlled through course of care are not individualized to the patient. In RRHV#4 the POC had 2 areas with documented interventions, but no goal. Goals such as: IDT will develop a plan to promote patient comfort and assist in the achievement of a comfortable peaceful death are not individualized. In RRNHV#4 the POC had Infection control interventions, but no goal and the skin integrity goal time frame was in the past. Other records contained similar problems with the POC. This was confirmed and discussed with the General Manager present.”
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Content of plan of care (42 CFR 418.56(c)(2))
The inspectors’ words, 154 words
“Observed in Record Review. In 11 of 14 patient records reviewed, it was noted that the organization had not obtained visit frequency orders. For example, in record RRHV#1 the volunteer had documented 4 visits with the patient and there were no visit orders on the IDG or supplemental orders. In records RRHV#3, RRNHV#7 and RRHV#2 the nursing orders for the patient visits were 1 time a week with 20 as needed visits. The 20 as needed visits were not based on patient’s identified individualized needs. In records RRHV#1 and RRNHV#4, #5,#6, #9,#10 the nursing orders for the patient visits were 1 time a week with 10 as needed visits. In record RRNHV#8 the nursing orders for the patient visits were 1 time a week with 15 as needed visits. The 10 and 15 as needed visits were not based on patient’s identified individualized needs. This was confirmed and discussed with the General Manager present.”
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Control (42 CFR 418.60(b)(2)(ii))
“Observed in Data Session. During the Data session it was noted that the organization was unable to show improved compliance toward established hand hygiene goal of 90%. For example, the General Manager, and Compliance department staff stated that they observed hand hygiene and placed the documentation in staff human resource files. It was not aggregated and reported with the Infection Control/QAPI program for 2026 or 2025. This was confirmed and discussed with the General Manager and Compliance Manager present.”
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Level of activity (42 CFR 418.78(e))
“Observed in Tracer Activities. During review of Volunteer documents and discussion with the Volunteer Coordinator it was noted that the Volunteers did not provide at least 5% of the total patient care hours of all paid hospice employees and contract staff. For example in the year 2025 1% and in 2026 January to May 1% of the total patient care hours was provided by volunteers. This was confirmed and discussed with the Volunteer Coordinator and MSW present.”
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Training (42 CFR 418.100(g)(3))
The inspectors’ words, 102 words
“Observed in HR File Review. In 2 of 10 HR files reviewed, it was noted that staff competence was not assessed once every 3 years. For example in the Spiritual Counselor/Bereavement Coordinator file the Spiritual Counselor competency was completed at 4 years, also this document was not signed by the staff member or a manager. There were no competencies documented for the Bereavement Coordinator position after the initial competency 8 years ago. For example, in the Volunteer Coordinator file there were no competencies documented after the initial competency over 8 years ago. This was confirmed and discussed with the Office Manager present.”
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Jun 26, 2026 | Reaccreditation inspection by The Joint Commission | 6 deficiencies cited |
Is it certified?
- Medicare-certified hospice since Dec 5, 2008.
- 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): 10.7 nurse care minutes per routine home care day, 4.9% of skilled nursing minutes at weekends and a visit near death for 91% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 24% at home, 74% 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 | 10.7 min |
| Skilled nursing minutes at weekends | 4.9% |
| Visits near death | 91.0% of patients who died |
Who owns it?
- Synergy Healthcare Holdings LLC owns 100% directly since Apr 21, 2008.
- 9 owners or officers are people: Jason R Fletcher (managing employee (under contract), 100%); Jason R Fletcher (owns 5% or more through other companies, 32.15%); Elizabeth Fletcher (owns 5% or more through other companies, 22%); Keith C Fletcher (owns 5% or more through other companies, 16.32%); Florence E Fletcher (owns 5% or more through other companies, 15.3%); Kameron Ann Lemon (owns 5% or more through other companies, 14.23%); Michael Haycraft (runs it (operational or managerial control)); Heidi Gliddens (runs it (operational or managerial control)); Michael Lee Oglesbay (corporate director).
- 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 |
|---|---|---|---|
| Synergy Healthcare Holdings LLC | Owns 5% or more directly | 100% | Apr 21, 2008 |
| Fletcher Investments, LP | Owns 5% or more through other companies | 51% | Oct 27, 2007 |
| Elson Capital Group, LLC | Owns 5% or more through other companies | 44% | Sep 1, 2014 |
| Cbkm Investments | Owns 5% or more through other companies | 5% | Nov 1, 2014 |
What do families say?
- Family caregivers rate it 5 of 5 in CMS’s survey (Oct 1, 2023 to Sep 30, 2025): 87% rated it 9 or 10 out of 10, and 93% would definitely recommend it.
- CMS’s Hospice Care Index: 10 of 10 (Jan 1, 2023 to Dec 31, 2024).
- 98.93% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025); 68.7% 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 | 5 of 5 |
| Hospice Care IndexCMS’s Hospice Care Index, 0 to 10 (higher is better): a point for each of ten measures from Medicare claims on which the hospice meets CMS’s threshold | 10 of 10 |
How does it compare nearby?
- Of the 7 hospices CMS’s data show serving patients in ZIP code 83814, 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 |
|---|---|
| Crest Home Health and Hospice, LLC | 4 |
| Auburn Crest Hospice This hospice | 6 |
| Gentiva Hospice | 9 |
| Advanced Home Care and Hospice of Coeur D’alene | 8 |
| Hospice of North Idaho | 2 |
| Eden Hospice at the Inland Northwest LLC | 18 |
| Elite Hospice | 0 |
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.