Harmony Hospice Care
A hospice in San Antonio, Texas 78230
4402 Vance Jackson Rd, Ste 222, San Antonio, Texas 78230. (210) 807-7484.
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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
- 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?
2 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 Dec 31, 2025: a reaccreditation inspection by the Community Health Accreditation Partner.
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 Dec 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.
Dec 31, 2025: reaccreditation inspection by the Community Health Accreditation Partner2 deficiencies
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Timeframe for completion of assessment (42 CFR 418.54(b))
The inspectors’ words, 192 words
“It is required that the hospice Interdisciplinary Group, in consultation with the individual’s attending physician (if any), completes an initial comprehensive assessment no later than five (5) calendar days after the election of hospice care, in accordance with CMS §418.24–the elements of the hospice care election statement. This standard was not met as evidenced by clinical record review and interview. In 1 of 14 (7%) clinical record reviewed revealed that the agency did not ensure an initial comprehensive assessment was completed no later than five calendar days after the election of hospice care. CLINICAL RECORD 11: The patient’s election of hospice care was dated 04/16/2025. A review of the clinical record for benefit period dated 04/16/2025-06/02/2025 identified that the initial nursing comprehensive assessment was dated 04/16/2025. The MSW initial psychosocial assessment was dated 04/22/2025, 6 days after the election of hospice care. During an interview with the Administrator/Director of Nurses (Personnel Record 5) on 12/31/2025 she stated she did not know why the comprehensive was not done by day five, but that additional education would be provided to the clinical staff on the importance of completing the comprehensive assessment by day five.”
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Supervision of hospice aides (42 CFR 418.76(h)(1)(i))
The inspectors’ words, 293 words
“It is required that hospice aides are supervised by a registered nurse who makes an on-site visit to the patient’s home no less frequently than every 14 days to assess the quality of care and services provided by the hospice aide and ensure that services ordered by the hospice Interdisciplinary Group (IDG) meet the patient’s need. The hospice aide does not need to be present. This standard was not met as evidenced by clinical record review and interview. In 2 of 9 (22%) clinical records reviewed of patient’s who elected hospice aide services revealed that the agency did not ensure a registered nurse makes an on-site visit to supervise the hospice aide no less frequently than every 14 days. CLINICAL RECORD 1: The patient elected hospice care 06/03/2025. A review of the plan of care dated 06/03/2025-08/31/2025 included an order for the hospice aide one time a week (1xw). The hospice aide provided visits as ordered. The registered nurse (RN) documented aide supervisory visits on 06/17/2025, 07/02/2025 (15 days) and then on 07/18/2025 (16 days). There was no documented evidence that the RN supervised the hospice aide no less frequently than every 14 days. CLINICAL RECORD 5: The patient elected hospice care 05/17/2024. The plan of care dated 05/17/2025 -08/14/2025 included an order for the hospice aide. The RN supervisory visits were dated 06/04/2024, 06/19/2024 (15 days) and 07/10/2024 (21 days). There was no documented evidence that the RN supervised the hospice aide no less frequently than every 14 days. During an interview with the Administrator/Director of Nurses (Personnel Record 5) on 12/31/2025, she stated that an audit is done frequently for supervisory visit, but they will continue to monitor and educate on importance of completing supervisory visits at least every 14 days.”
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Dec 31, 2025 | Reaccreditation inspection by the Community Health Accreditation Partner | 2 deficiencies cited |
Is it certified?
- Medicare-certified hospice since Mar 7, 2023.
- CMS doesn’t list its type of ownership.
- 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): 9.3 nurse care minutes per routine home care day, 7.6% 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): 99% at home.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | This provider |
|---|---|
| Nurse care minutes per routine home care day | 9.3 min |
| Skilled nursing minutes at weekends | 7.6% |
| Visits near death | 100.0% of patients who died |
Who owns it?
- 19 owners or officers are people: Ronnie Muniz (owns 5% or more directly, 100%); Sylvia L Muniz (corporate officer, 50%); Sylvia L Muniz (corporate director, 50%); Sylvia L Muniz (managing employee (on the payroll), 50%); Ronnie Muniz (corporate officer, 50%); Ronnie Muniz (corporate director, 50%); Ronnie Muniz (managing employee (on the payroll), 50%); Justo L Cisneros (managing employee (under contract), 0%); Justo L Cisneros (runs it (operational or managerial control), 0%); James J Galizia (managing employee (under contract), 0%); James J Galizia (runs it (operational or managerial control), 0%); Richard Roland Lares (managing employee (on the payroll), 0%); Richard Roland Lares (runs it (operational or managerial control), 0%); Ronnie Nathen Muniz (corporate officer, 0%); Ronnie Nathen Muniz (corporate director, 0%); Ronnie Nathen Muniz (managing employee (on the payroll), 0%); Ronnie Nathen Muniz (runs it (operational or managerial control), 0%); Ashley Quintana (managing employee (on the payroll), 0%); Ashley Quintana (runs it (operational or managerial control), 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.
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).
- 95.74% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025).
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 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 |
|---|---|
| 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.