At Home With Blue Bonnet Hospice
A hospice in Wimberley, Texas 78676
12111 Ranch Rd 12 Ste 114, Wimberley, Texas 78676. (512) 537-8950.
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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.
- 7 deficiencies cited in the last three years
- Not rated family caregiver rating
- 10of 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?
7 deficiencies cited in the last three years
The middle of the 38 hospices serving ZIP code 78676 had 6.
The last inspection on record was on Mar 27, 2025: 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
7 deficiencies in 1 month of the last 36. Last cited Mar 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.
Mar 27, 2025: reaccreditation inspection by The Joint Commission7 deficiencies
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EP Program Patient Population (42 CFR 418.113(a)(3))
“Observed in Emergency Management Session. During the Emergency Management session, it was noted that the organizations Emergency Operations Plan did not identify the patient population(s) that it served and the types of services it would have the ability to provide in an emergency. This observation was reviewed with the Administrator / Director of Nursing.”
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Policies/Procedures-Volunteers and Staffing (42 CFR 418.113(b)(4))
“Observed in Emergency Management Session. During the Emergency Management session it was noted that the organizations Emergency Operations Plan did not include methods for contacting off-duty staff. This observation was reviewed with the Administrator / Director of Nursing.”
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Content of plan of care (42 CFR 418.56(c))
The inspectors’ words, 128 words
“Observed in Record Review. In 1 of 10 patient records reviewed, it was noted that the organization did not ensure that the plan of care goals included outcome measures for specific care activities. For example, during a review of the medical record for RRNHV#4, the following goal statement(s) were noted, “Instructed caregiver to ensure pt take Lasix as prescribed” and Family/caregivers will verbalize safe feeding techniques. The goal statement(s) did not include a method to measure the effectiveness of problem interventions. Example #2: During a review of the medical record for RRNHV#5, the following goal statement was noted, “Patient will be supported with maximum symptom reduction”. The goal statement did not include a method to measure the effectiveness of problem interventions. This observation was reviewed with the Administrator.”
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Content of plan of care (42 CFR 418.56(c)(1))
The inspectors’ words, 172 words
“Observed in Individual Tracer. In 1 of 10 patient records reviewed, it was noted that the organization did not ensure medication orders were clear and accurate. For example, during individual tracer activities for RRHV#2, it was noted that the patient’s medication list included the following information: Acetaminophen 325mg oral tablet - 1 tablet every 8 hours as needed for fever or pain; Morphine O/SYR 10 mg/0.5ml 1 prefilled syringe every 4 hours as needed for pain or shortness of breath; Acetaminophen 325mg / Hydrocodone bitartrate 5mg oral tablet - 1 tablet every 4 hours as needed for pain. The order nor the organization’s policy specified which medication to use first. In addition, the following information was noted: Lactulose 667mg/ml - 10g/15ml - 15ml oral solution every night at bedtime as needed for constipation, Docusate sodium 50mg / sennosides, USP 8.6mg - 1 oral capsule daily as needed for constipation. The order nor the organization’s policy specified which medication to use first. This observation was reviewed with the Administrator / Director of Nursing.”
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Quality assessment & performance improvement (42 CFR 418.58)
“Observed in Data Session. The organization leaders did not ensure that a quality assessment and performance improvement (QAPI) program was developed that involved all services provided by the organization. For example, the QAPI plan did not include indicators to evaluate the following areas: volunteer services, bereavement services, durable medical equipment, and/or supplies. This observation was reviewed with the Administrator.”
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Competency evaluation (42 CFR 418.76(c)(1))
The inspectors’ words, 125 words
“Observed in HR File Review. A review of 2 of 2 applicable human resource files, revealed the organization did not fulfill the requirement to directly observe the Hospice Aide demonstrate needed tasks with a patient/psuedo patient. For example, a review of the competence evaluation for hospice aide #1, and hospice aide #2, revealed that the following subject areas were not evaluated via direct observation during patient care activities: 1) Appropriate and safe techniques in personal hygiene and grooming that include bed, sponge, tub, or shower bath; sink, tub, or bed shampoo; nail and skin care; oral hygiene; and toileting and elimination. 2) Safe transfer techniques and ambulation. 3) Normal range of motion and positioning. This observation was reviewed with the Administrator / Director of Nursing.”
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Content (42 CFR 418.104(a)(7))
The inspectors’ words, 117 words
“Observed in Individual Tracer. In 1 of 2 applicable Individual tracers, a review of the medication list for RRHV#3, revealed that the Assisted Living Facility medication list did not include an accurate description of the medication’s the patient was currently taking. For example, the following medications were not listed: Nystatin 100,000 unit/ml topical cream - 1 ml topical cream 3 times a day as needed for peri area rash; Bisacodyl 10mg rectal suppository 10mg - 1 rectal suppository every 3 days as needed for constipation. The Assisted Living Facility medication list did not match the medication list in the hospice agency medical record for this patient. This observation was reviewed with the Administrator / Director of Nursing.”
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Mar 27, 2025 | Reaccreditation inspection by The Joint Commission | 7 deficiencies cited |
Is it certified?
- Medicare-certified hospice since Mar 16, 2012.
- 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): 14.4 nurse care minutes per routine home care day, 15.1% of skilled nursing minutes at weekends and a visit near death for 97% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 40% at home, 58% in assisted living, 2% in a nursing facility.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | This provider |
|---|---|
| Nurse care minutes per routine home care day | 14.4 min |
| Skilled nursing minutes at weekends | 15.1% |
| Visits near death | 97.0% of patients who died |
Who owns it?
- 6 owners or officers are people: Scott Ritter (owns 5% or more directly); Scott Ritter (corporate director); Alberto Santos (corporate officer); Alberto Santos (corporate director); Colleen Ritter (corporate officer); Colleen Ritter (runs it (operational or managerial control)).
- 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.”
- In CMS’s survey of family caregivers (Oct 1, 2023 to Sep 30, 2025): 95% rated it 9 or 10 out of 10, and 96% would definitely recommend it.
- CMS’s Hospice Care Index: 10 of 10 (Jan 1, 2023 to Dec 31, 2024).
- 90.91% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025); 62.2% 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 | 10 of 10 |
How does it compare nearby?
- Of the 38 hospices CMS’s data show serving patients in ZIP code 78676, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 6; this one had 7.
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 |
|---|---|
| At Home With Blue Bonnet Hospice This hospice | 7 |
| Hospice Austin | 2 |
| Hope Hospice | 5 |
| Christus Hospice - Central Texas | 0 |
| Vitas Healthcare of Texas LP | 3 |
| Methodist Healthcare Hill Country Hospice & Family Care | 1 |
| Gentiva | 7 |
| Gentiva | 10 |
| Heart of Texas Hospice | 0 |
| Gentiva | 11 |
| Alpha Omega Hospice | 10 |
| Three Oaks Hospice | 9 |
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.