Methodist Healthcare Hill Country Hospice & Family Care
A hospice in Fredericksburg, Texas 78624
808 Reuben St, Brune Bldg 2nd Flr, Fredericksburg, Texas 78624. (830) 997-1335.
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The short answer
Record last released by CMS on Oct 23, 2026.
- 1 deficiency 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?
1 deficiency cited in the last three years
The middle of the 19 hospices serving ZIP code 78624 had 5.5.
The last inspection on record was on Dec 15, 2023: a recertification inspection by the state.
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
1 deficiency in 1 month of the last 36. Last cited Dec 2023. 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.
Dec 15, 2023: recertification inspection by the state1 deficiency
-
Update of comprehensive assessment (42 CFR 418.54(d))
The inspectors’ words, 583 words
“Based on record review and interview the agency failed to update the comprehensive assessment with changes agreed upon by the interdisciplinary team for 3 of 19 patients for which records were reviewed (Patient #12, #18 and #19) in that hospice aide (HHA) services for Patient #12 and volunteer services for Patients #18 and #19 were not added to plan of care. Failure to ensure that patients plan of care was updated per the hospice interdisciplinary group (IDG) orders had the potential to affect these 3 patients due to a need to change the care plan and could prevent the provision and supervision of necessary services. Findings include: Review of the clinical record for Patient #12 revealed a start of care date of 08/22/2023. Review of the POC for the certification period 07/08/2020 – 08/28/2020 revealed orders: SN 2wk X 13wk (2 times per week) +15 prn, SW 1mo X 3mo + 8 prn and Chaplain 2mo X 3mo + 10 prn. Review of the record revealed HHA services were provided 3 times per week from 08/28/2023 – 10/20/2023. Review of the POC revealed the POC was not updated to reflect HHA services were added. An Interview was conducted on 12/12/2023 at 12:00 p.m. with the Administrator. The clinical record for Patient #12 was reviewed. Surveyor requested documentation that the patients POC had been updated per the IDG meeting notes. The Administrator acknowledged the POC had not been updated to reflect the addition of HHA services. Surveyor asked what may have caused the failure. Administrator stated there had been several staffing changes since the change in ownership of the agency. Review of the clinical record for Patient #18 revealed a start of care date of 06/27/2023. Review of the POC for the certification period 09/25/2023-11/25/2023 revealed orders: SN 2wk X 13wk + 15 prn, HHA 3wk X 13wk, Chaplain 1mo X 3mo + 10 prn and SW 1mo X 2mo + 8 prn. Review of the clinical revealed volunteer services were provided on 10/09/2023, 10/16/2023, 10/26/2023 and 11/14/2023. Review of the POC revealed the agency failed to update the patients POC to reflect the addition of volunteer services. Review of the clinical record for Patient #19 revealed a start of care date of 09/02/2023. Review of the POC for the certification period 09/02/2023 – 10/28/2023 revealed orders: SN 2wk X 13wk + 15 prn, HHA 3wk X 13wk, 2wk X 1wk, Chaplain 2m X 3m + 10 prn and SW 1m X 3m + 8 prn. Review of the clinical record revealed volunteer services were provided on 10/07/2023 and 10/25/2023. Review of the POC revealed the agency failed to update the patients POC to reflect the addition of volunteer services. Surveyor conducted an interview on 12/14/2023 at 11:40 a.m. with the Volunteer Coordinator. Surveyor reviewed the clinical records for Patient #18 and #19 with the Volunteer Coordinator. Volunteer Coordinator confirmed volunteer services were provided. Surveyor asked if volunteer services were added to the patients POC. Volunteer Coordinator stated, “;No. I should have done that. I didnt think about it. Ive only been the Volunteer Coordinator for 3 months.” Review of the agencys policy and procedure manual revealed a policy entitled “;Plan of Care Process, PC.30, Rvd:102022”, which read in part “;The POC includes, but is not limited to: Designation of discipline(s) responsible for providing specific services. A revised POC will include information from the patients updated comprehensive assessment and will note the patients progress toward outcomes and goals specified in the plan of care.””
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Dec 15, 2023 | Recertification inspection by the state | 1 deficiency cited |
Is it certified?
- Medicare-certified hospice since Jul 27, 1994.
- Ownership: non-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): 16.7 nurse care minutes per routine home care day, 10.6% of skilled nursing minutes at weekends and a visit near death for 98.4% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 46% at home, 21% in assisted living, 32% in a nursing facility, 1% in a hospital.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | This provider |
|---|---|
| Nurse care minutes per routine home care day | 16.7 min |
| Skilled nursing minutes at weekends | 10.6% |
| Visits near death | 98.4% of patients who died |
Who owns it?
- Hcm HH Holdings LLC owns 100% directly since Apr 1, 2023; Hill Country Home Health & Hospice, LLC owns 100% directly since Apr 1, 2023.
- 6 owners or officers are people: Justin Davis (corporate officer, 0%); Kara Wimberly (managing employee (on the payroll), 0%); Clint Kotal (corporate officer); Randa Kirchner (runs it (operational or managerial control)); Yvonne Haug (managing employee (under contract)); Brad Williams Parrish (corporate officer, 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.
| Organisation | Role | Share | Since |
|---|---|---|---|
| Hcm HH Holdings LLC | Owns 5% or more directly | 100% | Apr 1, 2023 |
| Hill Country Home Health & Hospice, LLC | Owns 5% or more directly | 100% | Apr 1, 2023 |
| HCA Inc. | Owns 5% or more through other companies | Apr 1, 2023 | |
| Methodist Healthcare Ministries of South Texas, Inc. | Owns 5% or more through other companies | Apr 1, 2023 | |
| HCA Healthcare Inc. | Owns 5% or more through other companies | Apr 1, 2023 | |
| Women’s Hospital Indianapolis, L.P. | Owns 5% or more through other companies | Apr 1, 2023 | |
| W & C Hospital, Inc. | Owns 5% or more through other companies | Apr 1, 2023 | |
| San Antonio Regional Hospital, Inc. | Owns 5% or more through other companies | Apr 1, 2023 | |
| Methodist Healthcare System of San Antonio Ltd LLP | Owns 5% or more through other companies | Apr 1, 2023 | |
| Healthtrust Inc. - the Hospital Company | Owns 5% or more through other companies | Apr 1, 2023 | |
| Mgh Medical Inc. | Owns 5% or more through other companies | Apr 1, 2023 | |
| Indianapolis Hospital Partner, LLC | Owns 5% or more through other companies | Apr 1, 2023 | |
| Frisco Holding II | Owns 5% or more through other companies | Apr 1, 2023 | |
| Hercules Holding II | Owns 5% or more through other companies | Apr 1, 2023 | |
| Columbia-HCA Healthcare Corporation of Central Texas | Owns 5% or more through other companies | Apr 1, 2023 | |
| Hti Hospital Holdings Inc. | Owns 5% or more through other companies | Apr 1, 2023 |
What do families say?
- Family caregivers rate it 5 of 5 in CMS’s survey (Oct 1, 2023 to Sep 30, 2025): 92% rated it 9 or 10 out of 10, and 94% would definitely recommend it.
- CMS’s Hospice Care Index: 10 of 10 (Jan 1, 2023 to Dec 31, 2024).
- 100% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025); 89.6% 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 19 hospices CMS’s data show serving patients in ZIP code 78624, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 5.5; this one had 1.
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 |
|---|---|
| Methodist Healthcare Hill Country Hospice & Family Care This hospice | 1 |
| Ave Maria Hospice | Not given |
| Votive Hospice LLC | 40 |
| Hope Hospice | 5 |
| Vitas Healthcare of Texas LP | 3 |
| Gentiva | 10 |
| Solaris Hospice Inc. | 5 |
| Reliant at Home | 8 |
| Heart to Heart Hospice of San Antonio, LLC | 6 |
| Peterson Hospice | 2 |
| New Century Hospice of San Antonio | 15 |
| Embrace Hospice | 14 |
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
-
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).
-
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.