Appl Orchard Hospice of Kansas Inc.
A hospice in Shawnee, Kansas 66227
7730 Hedge Lane Terr, Shawnee, Kansas 66227. (913) 320-1688.
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The short answer
Record last released by CMS on Oct 23, 2026.
- 10 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?
10 deficiencies cited in the last three years
The middle of the 25 hospices serving ZIP code 66227 had 6.
The last inspection on record was on May 22, 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
10 deficiencies in 1 month of the last 36. Last cited May 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.
May 22, 2026: reaccreditation inspection by The Joint Commission10 deficiencies
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Timeframe for completion of assessment (42 CFR 418.54(b))
The inspectors’ words, 120 words
“Observed in Record Review. In 2 of 15 patient records reviewed, the organization had not conducted and documented a patient-specific comprehensive assessment in accordance with their policy no. 2-030 Comprehensive Assessment which states that a comprehensive assessment will be performed by the hospice IDG no later than 5 calendar days after the election of hospice care. In review of the medical record for RRNHV#6 the surveyor noted that the psychosocial assessment had been completed on the 6th day following the election of the hospice benefit. Also, in review of the medical record for RRNHV#8 the spiritual care assessment had been completed on the 6th day following the election of the hospice benefit. This was validated with the Director of Nursing.”
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Content of comprehensive assessment (42 CFR 418.54(c)(5))
The inspectors’ words, 129 words
“Observed in Patient Home. In 1 of 4 home visits conducted, the organization had not reassessed the hospice patient in accordance with their policy no. 2-031.1 On Going Comprehensive Assessments which states, the nurse will assess the patient on each visit for: Pain, Secondary symptoms related to the terminal illness (nausea, resp distress, response to medications), vital signs, breath sounds, skin integrity, bowel sounds, elimination, mental status, appetite/diet, functional status, safety/home environment, patient/family support. For RRHV #4 the RN did not do a complete skin integrity assessment even though there is documentation in the clinical record of excoriation on patient’s right buttock. The patient was not turned for assessment of skin condition on the back of her legs, back and buttocks. This was validated with the Director of Nursing.”
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Content of comprehensive assessment (42 CFR 418.54(c)(6)(i))
The inspectors’ words, 100 words
“Observed in Patient Home. In 1 of 4 home visits conducted, the hospice nurse failed to conduct a medication assessment in accordance with the organizations policy no. 3-002.1 Medication Profile Policy which states, during subsequent hospice visits the medication profile will be used to evaluate the use of the drugs in the home setting. For RRHV #4 the RN had completed the home visit without assessing or reconciling the medications. This was validated with the Director of Nursing who had stated the expectation is that medications in the home will be reconciled using the medication bottles/containers and the medication list.”
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Content of plan of care (42 CFR 418.56(c)(1))
The inspectors’ words, 159 words
“Observed in Record Review. In 2 of 15 patient records reviewed, the organization failed to revise the plan of care and goals for care, treatment, or services based on the patient’s needs. In review of the medical record for RRNHV#1 the RN documented that the patient had severe left anterior rib pain when moving following a fall and increased the frequency of the patient’s Tramadol to four times a day however there was no evidence that the care plan had been revised to include a plan for pain management. Also, in review of the medical record for RRNHV#4 there was documentation and orders for a skin tear /left leg and a skin tear/right foot with physician orders to clean with wound cleanser, pat dry and apply xerofoam dressing however the plan of care had not been revised to include the skin integrity problem. This was validated with the Director of Nursing. This was validated with the Director of Nursing.”
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Content of plan of care (42 CFR 418.56(c)(3))
The inspectors’ words, 208 words
“Observed in Record Review. In 11 of 15 patient records reviewed, the plan of care did not include measurable outcomes anticipated from implementing and coordinating the plan of care. In review of the medical record for RRHV#1, RRHV#4 and RRNHV#3 the surveyor noted there was a problem for Pain with a goal; patient will be pain free or verbalize an acceptable pain level with current pain management regimen and did not include the patient’s goal for acceptable pain management such as 4 out 10. Also, for RRHV#3 there was a problem of Heart Failure with the goal: patient’s symptoms will be consistent with stage of disease process and problems managed as well as disease process will allow and did not include goals for specific symptoms such as shortness of breath, edema or weight gain. Additionally, for RRNHV#2 there was a documented problem of heart failure and the goal: optimal cardiac status within disease limitations, as evidenced by ability to resume and maintain adapted lifestyle without distress or complications, however the goal failures to specify what optimal cardiac status is for the patient and what lifestyle activities the patient would like to resume. This also occurred in review of RRNHV#5, RRNHV#6, RRNHV#7This was validated with the Director of Nursing.”
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Prevention (42 CFR 418.60(a))
“Observed in Patient Home. In 1 of 4 home visits conducted, staff failed to follow standard precautions and organizational policy for infection control practices. The surveyor noted that during the bed bath for RRHV #3 the hospice aide was observed to cleanse the patient’s perineum and then continued the bath without a glove change and hand hygiene. This was validated with the Director of Nursing.”
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Hospice aide assignments and duties (42 CFR 418.76(g)(2)(ii))
“Observed in Patient Home. In 1 of 1 home visits conducted, with hospice aides, staff did not follow the plan of care. The Aide plan of care for RRHV #3 included shave each visit and oral care each visit however the hospice aide completed the visit and did not offer or provide that care to the patient. This was validated with the Director of Nursing.”
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Level of activity (42 CFR 418.78(e))
“Observed in Document Review. the organization had not achieved volunteer savings in an amount that equals 5% of the total patient care hours of all paid hospice employees and contract staff. The hospice demonstrated volunteer utilization and cost savings of 5.5% for 2024 and 2.575% for 2025. This was validated with the Volunteer Coordinator.”
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Training (42 CFR 418.100(g)(3))
“Observed in HR File Review. In 1 of 8 HR files reviewed, the organization had not assessed staff competence in accordance with their policy which requires annual competency assessments. In review of the personnel file for the Hospice Medical Director, HR#1 there was no evidence that competency had been assessed in 2024 or 2025. This was validated with the Assistant Administrator.”
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Criminal background checks (42 CFR 418.114(d)(1))
“Observed in Document Review. In 1 of 3 contracts reviewed, the written agreement did not include a stipulation that the outside agency will complete criminal background checks on contracted employees. In review of the Durable Medical Equipment contract there was no language that included the requirement for criminal background checks. This was validated with the Director of Nursing.”
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| May 22, 2026 | Reaccreditation inspection by The Joint Commission | 10 deficiencies cited |
Is it certified?
- Medicare-certified hospice since Mar 13, 2020.
- 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): 11.3 nurse care minutes per routine home care day, 9% of skilled nursing minutes at weekends and a visit near death for 97.3% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 64% at home, 5% in assisted living, 25% in a nursing facility, 6% 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 | 11.3 min |
| Skilled nursing minutes at weekends | 9% |
| Visits near death | 97.3% of patients who died |
Who owns it?
- Home Health and Hospice Holding Company LLC owns 100% directly since Jun 1, 2025.
- 13 owners or officers are people: Jason Grundstrom (corporate director, 16.66%); Jessica L Kalender-Rich (corporate director, 16.66%); Bradley A Appl (corporate director, 16.66%); Clay T Appl (corporate director, 16.66%); Gunnar J Appl (owns 5% or more through other companies, 14%); Cory Matthew Appl (owns 5% or more through other companies, 14%); Bradley A Appl (owns 5% or more through other companies, 14%); Allison A Stewart (owns 5% or more through other companies, 14%); Clay T Appl (owns 5% or more through other companies, 14%); Bradley A Appl (corporate officer); Allison A Stewart (corporate director); Eileen M Orel (managing employee (on the payroll)); Gloria Soendker (managing employee (on the payroll)).
- 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 |
|---|---|---|---|
| Home Health and Hospice Holding Company LLC | Owns 5% or more directly | 100% | Jun 1, 2025 |
| Appl Holdco, Inc. | Owns 5% or more through other companies | 70% | Jun 1, 2025 |
| Cambridge Ventures, LLC | Owns 5% or more through other companies | 30% | Jun 1, 2025 |
| University of Kansas Hospital Authority | Owns 5% or more through other companies | 29.7% | Jun 1, 2025 |
What do families say?
- CMS gives no family caregiver survey rating: “The number of cases is too small to report Star Ratings.”
- In CMS’s survey of family caregivers (Oct 1, 2023 to Sep 30, 2025): 83% rated it 9 or 10 out of 10, and 78% would definitely recommend it.
- CMS’s Hospice Care Index: 9 of 10 (Jan 1, 2023 to Dec 31, 2024).
- 96.2% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025); 49.3% 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 25 hospices CMS’s data show serving patients in ZIP code 66227, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 6; this one had 10.
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 |
|---|---|
| Appl Orchard Hospice of Kansas Inc. This hospice | 10 |
| Prairie Wind Hospice LLC | 9 |
| Monarch Hospice & Palliative Care | 2 |
| Hospice the University of Kansas Health System | 23 |
| Saint Lukes Hospice of Leavenworth, LLC | 7 |
| Elara Caring | 10 |
| Kansas Palliative & Hospice Care | 7 |
| Ascend Hospice | 3 |
| Gentiva | 16 |
| Amedisys Hospice | 4 |
| Kansas City Hospice and Palliative Care | 0 |
| HCA Midwest Hospice & Family Care | 12 |
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.