Alamo Hospice of Conroe
A hospice in Conroe, Texas 77302
11133 Interstate 45 South, Suite 240, Conroe, Texas 77302. (936) 788-5900.
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The short answer
Record last released by CMS on Oct 23, 2026.
- 13 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?
13 deficiencies cited in the last three years
The middle of the 55 hospices serving ZIP code 77302 had 6.
The last inspection on record was on May 8, 2026: 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
13 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 8, 2026: reaccreditation inspection by the Accreditation Commission for Health Care13 deficiencies
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Content of comprehensive assessment (42 CFR 418.54(c)(6))
“Upon patient record review, 3 of 14 (Patients #7,#9,#10) did not have evidence in the patient record that a review was completed of all prescription and non-prescription medications. Patient 7,10: The medication profile contained oxygen with instructions allowing titration without a max dose identified. Patient 9: The medication profile contained two differing oxygen orders identifying as PRN 4/8/26 and continuous 5/3/36, both instructions allowing titration without a max dose identified.”
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Approach to service delivery (42 CFR 418.56(a)(1))
“Upon patient record review, 1 of 14 (Patient #2) did not have evidence that a Registered Nurse is designated to ensure continuous assessment of the patient and family’s needs and to coordinate activities with other members of the interdisciplinary group (IDG). The IDG must work together and is responsible for supervision of the care and service for each patient and family. Patient 2: There was no evidence of weekly wound assessments and measurements as required per agency policy, between 4/7/26 and 4/23/26.”
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Content of plan of care (42 CFR 418.56(c))
The inspectors’ words, 147 words
“Upon patient record review, 2 of 14 (Patients #6,#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 6: The medical record contained nursing documentation upon admission identifying patient issues with dyspnea requiring oxygen. There was no evidence of problems, goals, and interventions related to respiratory dysfunction and oxygen use included in the plan of care. Patient 10: The medical record contained nursing documentation upon admission identifying patient issues with dysphagia. There was no evidence of problems, goals, and interventions related to dysphagia included in the plan of care.”
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Content of plan of care (42 CFR 418.56(c)(4))
The inspectors’ words, 105 words
“Upon patient record review, 3 of 14 (Patients #7,#9,#10) 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 7: The medical record contained an order for oxygen with instructions allowing titration without a max dose identified. Patient 9: The medical record contained two differing oxygen orders identifying as PRN 4/8/26 and continuous 5/3/36, both orders containing instructions allowing titration without a max dose identified. Patient 10: The medical record also contained an order for oxygen with instructions allowing titration without a max dose identified.”
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Content of plan of care (42 CFR 418.56(c)(5))
The inspectors’ words, 145 words
“Upon patient record review, 3 of 14 (Patients #5,#6,#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 equipment and supply needs. Patient 5: The medical record contained nursing documentation upon recertification assessment 4/1/26 identifying patient use of foam boots for wound prevention. There was no evidence of an order for the boots included in the plan of care. Patient 6: The medical record contained nursing documentation upon admission identifying patient use of a Hoyer lift and bedrails. There was no evidence of orders for the DME included in the plan of care. Patient 9: The medical record contained nursing documentation upon admission identifying patient use of a shower chair and overbed table. There was no evidence of orders for the DME included in the plan of care.”
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Program activities (42 CFR 418.58(c)(2))
“Upon observation, there was no evidence the hospice investigates all adverse events, incidents, accidents, variances or unusual occurrences that involve patient care and develops a plan of correction to prevent the same or similar event from occurring again. Patient 9: The medical record contained nursing documentation identifying a patient fall 3/21/26. There was no evidence of an investigation of the incident and a plan of correction for prevention of similar incidents.”
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Prevention (42 CFR 418.60(a))
“Upon observation during 2 of 3 home visits, there was no evidence the hospice follows acceptable standards of practice to prevent the transmission of infections and communicable diseases, including standard precautions. Patient 6: During home visit with the RN, the RN did not disinfect vital sign equipment prior to returning to bag as required per agency policy. Patient 7: During home visit with the MSW, the MSW did not cleanse hard surface or use a barrier before placing her bag down on a chair as required per agency policy.”
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Content (42 CFR 418.104(a)(2))
“Upon patient client record review, 1 of 14 (Patient #9) did not have evidence that each patient record contains: • Signed copies of the notice of patient rights in accordance with 418.52 • Signed election statement in accordance with 418.24 Patient 9: The election form identified the patient elected to receive the Notification of Hospice Non-Covered Items. There was no evidence the agency provided the addendum upon request.”
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Authentication (42 CFR 418.104(b))
The inspectors’ words, 122 words
“Upon patient client record review, 2 of 14 (Patients #1,#8) did not have evidence that all entries are legible, clear, complete, and appropriately authenticated and dated in accordance with the organizations policies and procedures and currently accepted standards of practice. Electronic signatures are acceptable as long the hospice is following appropriate safeguards to prevent unauthorized access to the patient records. Patient 1: The medical record contained an order for oxygen supplies 5/3/26 that was entered in error. Nursing documentation 4/3/26 identified the patient requested oxygen to be picked up from home due to no need at this time. Patient 8: The medical record contained an order for an oxygen concentrator in error. Agency verified the patient does not have oxygen in home.”
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Ordering of drugs (42 CFR 418.106(b)(2))
The inspectors’ words, 102 words
“Upon patient record review, 1 of 14 (Patient #10) did not have evidence that if a drug order is verbal or given via an electronic transmission, it is given to a Registered Nurse, Nurse Practitioner, pharmacist, physician or other licensed individuals as designated by state regulations. The person receiving the order records and signs it immediately and has the prescribing person sign it in accordance with state and federal regulations. Patient 10: The medical record contained nursing documentation 4/1/26 identifying a verbal order was received for Cipro. There was no evidence of a physician order documented and signed in the medical record.”
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Inpatient care provided under arrangements (42 CFR 418.108(c)(2))
“Upon inpatient contract review, 1 of 6 (WNR) did not have evidence that the inpatient provider has established patient care policies consistent with those of the hospice and agrees to abide by the palliative care protocols and plan of care established by the hospice for its patients.”
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Inpatient care provided under arrangements (42 CFR 418.108(c)(3))
“Upon inpatient contract review, 1 of 6 (WNR) did not have evidence that the hospice patient’s inpatient clinical record includes a record of all inpatient services furnished and events regarding care that occurred at the facility; that a copy of the discharge summary be provided to the hospice at the time of discharge; and that a copy of the inpatient clinical record is available to the hospice at the time of discharge.”
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Inpatient care provided under arrangements (42 CFR 418.108(c)(5))
“Upon inpatient contract review, 1 of 6 (WNR) did not have evidence that the hospice retains responsibility for ensuring that the training of personnel who will be providing the patient’s care in the inpatient facility has been provided and that a description of the training and the names of those giving the training are documented.”
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| May 8, 2026 | Reaccreditation inspection by the Accreditation Commission for Health Care | 13 deficiencies cited |
Is it certified?
- Medicare-certified hospice since Apr 10, 2009.
- Ownership: other.
- 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): 12.1 nurse care minutes per routine home care day, 12.5% of skilled nursing minutes at weekends and a visit near death for 86.5% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 62% at home, 23% in assisted living, 2% in a nursing facility, 13% 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 | 12.1 min |
| Skilled nursing minutes at weekends | 12.5% |
| Visits near death | 86.5% of patients who died |
Who owns it?
- Hospice Partners of America LLC owns 100% directly since May 11, 2016.
- 9 owners or officers are people: Brian T Monahan (corporate officer); Angella Brucksch (managing employee (on the payroll)); Wanda Simons (managing employee (on the payroll)); Kimberly D Petitt (managing employee (under contract)); William Bradley Bickham (corporate officer); Rodney Dirk Allison (corporate officer); Heather B Dixon (corporate officer); Heather B Dixon (managing employee (on the payroll)); Brian W Poff (corporate officer).
- 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 |
|---|---|---|---|
| NEW Capital Partners II- Hs, Inc. | Owns 5% or more through other companies | 100% | Oct 1, 2019 |
| Addus Homecare Corporation | Owns 5% or more through other companies | 100% | Oct 1, 2019 |
| Addus Healthcare Inc. | Owns 5% or more through other companies | 100% | Oct 1, 2019 |
| Hospice Partners of America LLC | Owns 5% or more directly | 100% | May 11, 2016 |
| Black Rock Institutional Trust Company NA | Owns 5% or more through other companies | 16% | Oct 1, 2019 |
| Capital One NA | Holds 5% or more of the mortgage | 11.6% | Oct 1, 2019 |
| Bank of America, N.A. | Holds 5% or more of the mortgage | 9.2% | Jan 1, 2024 |
| Wells Fargo Bank, N.A. | Holds 5% or more of the mortgage | 9.2% | Jan 1, 2024 |
| Fifth Third Bank, National Association | Holds 5% or more of the mortgage | 9.2% | Oct 1, 2019 |
| Pnc Bank | Holds 5% or more of the mortgage | 9.2% | Mar 1, 2023 |
| Bmo Bank, N.A. | Holds 5% or more of the mortgage | 9.2% | Jan 1, 2025 |
| Vanguard Group Inc. | Owns 5% or more through other companies | 6.8% | Oct 1, 2019 |
| Citizens Bank NA | Holds 5% or more of the mortgage | 5.4% | Oct 1, 2019 |
| The Huntington National Bank | Holds 5% or more of the mortgage | 5.4% | Jan 1, 2024 |
| Synovous Bank, National Association | Holds 5% or more of the mortgage | 5.4% | Jan 1, 2025 |
| Regions Bank | Holds 5% or more of the mortgage | 5.4% | Jan 1, 2025 |
| Royal Bank of Canada | Holds 5% or more of the mortgage | 5.4% | Jan 1, 2025 |
| Us Bank, N.A. | Holds 5% or more of the mortgage | 5.4% | Jan 1, 2025 |
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).
- 100% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025); 53.3% 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 55 hospices CMS’s data show serving patients in ZIP code 77302, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 6; this one had 13.
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 |
|---|---|
| Alamo Hospice of Conroe This hospice | 13 |
| Oasis Hospice | Not given |
| Amedisys Hospice | 9 |
| Heart to Heart Hospice of Houston | 1 |
| Elara Caring | Not given |
| St Joseph Hospice of Conroe Texas | 12 |
| Harbor Hospice 28, L.P. | 8 |
| Choice Hospice | 4 |
| Home Care Select Hospice | Not given |
| Choice Hospice | 7 |
| Hospice 365 LLC | 5 |
| Vitas Healthcare of Texas L P | 4 |
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.