At Twilight Hospice & Palliative Care
A hospice in Carrollto, Texas 75007
2625 N Josey Lane Suite 301, Carrollto, Texas 75007. (956) 752-6160.
Watch and the shortlist are kept with a free account, on every device. Your watch list. CMS’s own record is on Care Compare.
The short answer
Record last released by CMS on Oct 23, 2026.
- 2 deficiencies cited in the last three years
- Not rated family caregiver rating
- 7of 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?
2 deficiencies cited in the last three years
The middle of the 100 hospices serving ZIP code 75007 had 2.
The last inspection on record was on Jul 1, 2026: a complaint 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
2 deficiencies in 1 month of the last 36. Last cited Sep 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.
Sep 25, 2025: reaccreditation inspection by the Community Health Accreditation Partner2 deficiencies
-
Medical social services (42 CFR 418.64(c))
The inspectors’ words, 213 words
“It is required that medical social services are provided by a qualified social worker per the plan of care; This standard was not met as evidenced by clinical record review and interview. In 2 of 19 (11%) clinical record review of patients that had social worker services revealed that the agency did not ensure the social worker provided care as ordered on the plan of care. CLINICAL RECORD 8: The clinical record review lacked evidence that the social worker was following the frequency ordered on the plan of care. During the benefit period from 02/09/2025 to 04/09/2025, the social worker documented patient visits twice in March (03/10/1015 and 03/18/2025). However, the care plan specified that the frequency order was once a month. CLINICAL RECORD 11: The clinical record review lacked evidence that the social worker was following the frequency ordered on the plan of care. During the benefit period from 01/23/2025 to 04/22/2025, the social worker documented patient visits twice in February (02/04/2025 and 02/05/2025). However, the care plan specified that the frequency was once a month. During an interview on 09/25/2025, the administrator (Personnel Record 7) stated that they will educate the social workers on how to enter frequency and the importance of following frequency as ordered in the plan of care.”
-
Counseling services (42 CFR 418.64(d)(1)(iv))
The inspectors’ words, 304 words
“It is required that counseling services include an organized program for providing bereavement services delivered by or under the supervision of a qualified professional with experience or education in grief or loss counseling. The bereavement services reflect the needs of the bereaved per a bereavement plan of care that includes the types of bereavement services to be offered and the frequency of service delivery. This standard was not met as evidenced by clinical record review and interview. In 3 of 3 (100%) clinical record review of bereavement records revealed the agency did not ensure that a bereavement plan of care that included services offered and the frequency of service was present. CLINICAL RECORD 15: The hospice benefit was elected on 10/10/2024 and date of death 07/06/2025. The clinical record review lacked evidence of a bereavement plan of care. The record contained documentation of bereavement activity but no bereavement plan of care specify the services offered or the frequency of those services. CLINICAL RECORD 16: The hospice benefit was elected on 06/02/2025 and date of death 06/16/2025. The clinical record review lacked evidence of a bereavement plan of care. The record contained documentation of bereavement activity but no bereavement plan of care specify the services offered or the frequency of those services. CLINICAL RECORD 17: The hospice benefit was elected on 04/22/2025 and date of death 05/01/2025. The clinical record review lacked evidence of a bereavement plan of care. The record contained documentation of bereavement activity but no bereavement plan of care specify the services offered or the frequency of those services. During an interview on 09/24/2025, the administrator (Personnel Record 7) stated that they changed to a new EMR in May 2025 and are learning the system, but they will be doing additional education to review how to add the bereavement plan of care.”
All 2 inspections in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Jul 1, 2026 | Complaint inspection by the state | No deficiencies cited |
| Sep 25, 2025 | Reaccreditation inspection by the Community Health Accreditation Partner | 2 deficiencies cited |
Is it certified?
- Medicare-certified hospice since Mar 18, 2020.
- 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): 9.7 nurse care minutes per routine home care day, 5.3% of skilled nursing minutes at weekends and a visit near death for 85.5% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 8% at home, 3% in assisted living, 87% in a nursing facility, 2% in a skilled nursing facility, 1% elsewhere.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | This provider |
|---|---|
| Nurse care minutes per routine home care day | 9.7 min |
| Skilled nursing minutes at weekends | 5.3% |
| Visits near death | 85.5% of patients who died |
Who owns it?
- At Twilight Hospice & Palliative Care LLC A Delaware LLC owns 100% directly since Mar 1, 2021.
- 9 owners or officers are people: Jeffrey Unger (corporate director, 100%); Adam Mindle (owns 5% or more through other companies, 76%); Esther Kaplan (owns 5% or more through other companies, 16%); Solomon L Gurwitz (owns 5% or more through other companies, 4%); Jeffrey Unger (owns 5% or more through other companies, 4%); Florence Kaye Dawson (managing employee (on the payroll), 0%); David Garetz (corporate officer, 0%); David Garetz (runs it (operational or managerial control), 0%); Olawale O Akinmerese (managing employee (under contract), 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 |
|---|---|---|---|
| At Twilight Hospice & Palliative Care LLC A Delaware LLC | Owns 5% or more directly | 100% | Mar 1, 2021 |
| Bryn Mawr Trust | Owns 5% or more through other companies | 76% | Mar 1, 2021 |
| Kenwood Trust | Owns 5% or more through other companies | 16% | Mar 1, 2021 |
| Oxford Square LLC | Owns 5% or more through other companies | 4% | Mar 1, 2021 |
| Wellington HC Partners LLC | Owns 5% or more through other companies | 4% | Mar 1, 2021 |
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): 67% rated it 9 or 10 out of 10, and 61% would definitely recommend it.
- CMS’s Hospice Care Index: 7 of 10 (Jan 1, 2023 to Dec 31, 2024).
- 79.79% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025); 47.4% 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 | 7 of 10 |
How does it compare nearby?
- Of the 100 hospices CMS’s data show serving patients in ZIP code 75007, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 2; this one had 2.
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 |
|---|---|
| Heart to Heart Hospice of Texas Ltd | 4 |
| Precise Personalized Care Hospice LLC | 1 |
| Star City Hospice | 0 |
| At Twilight Hospice & Palliative Care This hospice | 2 |
| At Twilight Hospice & Palliative Care of TX LLC | 1 |
| Heart to Heart Hospice of Decatur | 4 |
| Carenow Hospice LLC | 0 |
| Century Hospice LLC | 1 |
| Hope 4 All Hospice LLC | 1 |
| Vitas Healthcare of Texas LP | 15 |
| VNA | 1 |
| Home Hospice | 5 |
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).
-
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).
-
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).
-
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).
-
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).
-
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.