Graceful Hospice and Palliative Care LLC
A hospice in San Antonio, Texas 78230
3201 Cherry Ridge Dr Ste B-219, San Antonio, Texas 78230. (210) 371-5552.
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The short answer
Record last released by CMS on Oct 23, 2026.
- 4 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?
4 deficiencies cited in the last three years
The middle of the 100 hospices serving ZIP code 78230 had 4.
The last inspection on record was on Aug 22, 2024: 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
4 deficiencies in 1 month of the last 36. Last cited Aug 2024. 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.
Aug 22, 2024: reaccreditation inspection by the Accreditation Commission for Health Care4 deficiencies
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Content of comprehensive assessment (42 CFR 418.54(c))
The inspectors’ words, 93 words
“Upon patient record review 4 of 14 (Patient #6,#9,#10,#11) did not have evidence in the patient record that the comprehensive assessment identifies the physical, psychosocial, emotional, and spiritual needs related to the terminal illness that must be addressed in order to promote the hospice patient’s well-being, comfort, and dignity throughout the dying process. Patient #6: There was not evidence of a spiritual assessment. Patient #9: There was not evidence of a spiritual assessment. Patient #10: There was not evidence of a spiritual assessment. Patient #11: There was not evidence of a spiritual assessment.”
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Content of comprehensive assessment (42 CFR 418.54(c)(6))
The inspectors’ words, 157 words
“Upon patient record review, 2 of 14 (Patient #1,2) did not have evidence in the patient record that a review was completed of all prescription and non-prescription medications, including herbal remedies that could affect drug therapy. This review includes, but is not limited to: • Effectiveness of drug therapy • Drug side effects • Actual or potential drug interactions • Duplicate drug therapy • Drug therapy currently associated with laboratory monitoring Patient #1: Spironolactone was on the medication profile but not in the patients home. In addition, Oxygen was on the medication profile as 2-4 L via NC continuous. The patient/caregiver states she uses it prn. (Corrected on site) Patient #2: Tylenol 8 hour tablet for pain was on the medication profile but not in the patients home. (Corrected on site). The POC dated 8/15/24 indicated in the narrative that the patient is taking acetaminophen/codeine for generalized pain. The medication profile indicated it was discontinued on 7/12/24.”
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Content of plan of care (42 CFR 418.56(c)(4))
The inspectors’ words, 129 words
“Upon patient record review, 2 of 14 (Patient #3,#5) 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 #3: The medication profile contained Morphine sulfate, Lidocaine patch, Tramadol, Acetaminophen, and Hydrocodone-acetaminophen all prn for pain. There was not evidence indicating the parameters In addition, the medication profile contained Docusate Sodium, Bisacodyl prn, and Polyethylene glycol prn for constipation. There was not evidence indicating the dosage parameters of how often each could be given. (Corrected on site) Patient #5: The medication profile contains Tylenol, Lidocaine patch, and hydrocodone-acetaminophen all prn for pain. There was not evidence indicating dosage parameters and how often each could be given. (Corrected on site)”
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Level of activity (42 CFR 418.78(e))
“Upon observation, there was no evidence the annual report documents the use of volunteers providing day to day administrative and/or direct patient care services in an amount that, at a minimum, equals 5 percent of the total patient care hours of all paid hospice employees and contract personnel. Documentation reveals volunteer usage for 2023 was not tracked.”
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Aug 22, 2024 | Reaccreditation inspection by the Accreditation Commission for Health Care | 4 deficiencies cited |
Is it certified?
- Medicare-certified hospice since Aug 19, 2021.
- 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): 18.1 nurse care minutes per routine home care day, 5.2% of skilled nursing minutes at weekends and a visit near death for 100% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 96% at home, 4% 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 | 18.1 min |
| Skilled nursing minutes at weekends | 5.2% |
| Visits near death | 100.0% of patients who died |
Who owns it?
- CMS’s ownership file has no owners listed for this hospice.
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.”
- CMS’s Hospice Care Index: 9 of 10 (Jan 1, 2023 to Dec 31, 2024).
- 96.43% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025); 26.9% 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 100 hospices CMS’s data show serving patients in ZIP code 78230, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 4; this one had 4.
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 | 25 |
| Accentcare Hospice & Palliative Care of Texas -San Antonio | 6 |
| Superior Hospice LLC | 1 |
| Holy Savior Hospice | 5 |
| Opuscare of Texas | 4 |
| Companion Hospice and Palliative Care of South Texas LLC | 24 |
| Three Oaks Hospice | 1 |
| Anchorage Hospice, Inc. | 3 |
| Cardinal Hospice of South Texas | 12 |
| Advanced Hospice of Texas | 6 |
| Yellow Rose Hospice Care, Inc. | 13 |
| Advanced Hospice of Texas | 7 |
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.