Bespoke Hospice Care, LLC.
A hospice in North Richland Hills, Texas 76180
9001 Airport Freeway Suite 580, North Richland Hills, Texas 76180. (817) 507-6751.
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The short answer
Record last released by CMS on Oct 23, 2026.
- 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 73 hospices serving ZIP code 76180 had 3.
The last inspection on record was on Feb 19, 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
7 deficiencies in 1 month of the last 36. Last cited Feb 2026. Most serious: Standard-level. The last 3 years, to Nov 5, 2026.
| Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2023 | 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 | Nov |
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.
Feb 19, 2026: reaccreditation inspection by the Accreditation Commission for Health Care7 deficiencies
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Content of comprehensive assessment (42 CFR 418.54(c)(6))
The inspectors’ words, 97 words
“Upon patient record review, 1 of 14 (Patient #8) 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 • Actual or potential drug interactions Patient #8: The medication profile listed Eucerin cream was applied topically but, there was no evidence of where (route) the cream was to be applied. Additionally, MiraLAX 17gm was listed on the medication profile, but there were no instructions for a diluent.”
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Content of comprehensive assessment (42 CFR 418.54(c)(7))
The inspectors’ words, 109 words
“Upon patient record review, 1 of 14 (Patient #3) did not have evidence in the patient record that the comprehensive assessment includes a bereavement component which includes the needs of the patient’s family and other individuals focusing on the social, spiritual, and cultural factors that may impact their ability to cope with the patient’s death. Information gathered from the initial bereavement assessment is incorporated into the plan of care and is considered in the bereavement plan of care. Patient #3: The RN assessment dated 01/23/24 and MSW assessment dated 01/24/24 documented the bereavement assessment was, “completed by chaplain” however, there was no evidence the chaplain completed the bereavement assessment.”
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Content of plan of care (42 CFR 418.56(c))
The inspectors’ words, 190 words
“Upon patient record review, 2 of 14 (Patient #9,#13) 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 #9: The patient’s initial and all following care plans listed interventions and goals for COPD, but there was no evidence that COPD was documented as a primary or comorbid diagnosis nor was COPD corroborated by the MD CTI or the initial RN assessment. Additionally, the patient’s hospice diagnosis was Heart Failure, but there was no evidence of a cardiac care plan. Patient #13: The MD CTI and the patient’s diagnosis list indicated the patient’s hospice diagnosis was CVA with visual disturbances and extensive dysphagia, with comorbid diagnoses of idiopathic epilepsy with tonic-clonic seizures. However, there was no evidence that Neurological goals or interventions or seizure precautions were part of the patient’s plan of care.”
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Coordination of services (42 CFR 418.56(e)(2))
The inspectors’ words, 91 words
“Upon client record review, 1 of 14 (Patient #11) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #11: The SCC visited the patient on 08/08/25 for a routine visit; 08/12/25 for a PRN visit; 08/15/25 routine visit, and 08/22/25 PRN visit. However, the plans of care for the same time periods indicated the frequency was 1 month 3 with 3 PRN visits. Additionally, the SCC documented at each visit, “the plan continues at 1 x month.””
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Hospice aide assignments and duties (42 CFR 418.76(g)(1))
The inspectors’ words, 98 words
“Upon patient record review, 1 of 14 (Patient #6) did not have evidence in the patient record that hospice aide assignments and duties are: • There is evidence in the patient record that the plan of care; indicate what tasks are to be done by the Aide and the frequency of these tasks. The use of “PRN” or “per patient choice”, for any task, whether personal care or non-personal care tasks, are not acceptable Patient #6:The aide care plan dated 02/09/26 documented the tasks of 1) assist with transfers and 2) change patient linens were assigned “as needed.””
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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. The Annual report for 2025 documented volunteers provide 4.16% of total patient care hours of all paid hospice employees.”
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Content (42 CFR 418.104(a)(2))
“Upon patient client record review, 1 of 14 (Patient #13) 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 #13: The Election of Benefit signed 07/01/25 did not identify the attending physician as evidenced by the acceptance or declination of an attending physician was left blank.”
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Feb 19, 2026 | Reaccreditation inspection by the Accreditation Commission for Health Care | 7 deficiencies cited |
Is it certified?
- Medicare-certified hospice since Apr 17, 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): 10.6 nurse care minutes per routine home care day, 6.7% of skilled nursing minutes at weekends and a visit near death for 94.2% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 10% at home, 90% in assisted living.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | This provider |
|---|---|
| Nurse care minutes per routine home care day | 10.6 min |
| Skilled nursing minutes at weekends | 6.7% |
| Visits near death | 94.2% of patients who died |
Who owns it?
- Bespoke Holdings LLC owns 100% directly since Jun 1, 2022.
- 8 owners or officers are people: Jim Andrew (limited partner, 49.25%); Tyler Mckibben (limited partner, 49.25%); Kandice Alcorn (owns 5% or more through other companies, 15%); Gregory Roderick (owns 5% or more through other companies, 5%); John Tipton (owns 5% or more through other companies, 5%); Mandi Brickey (managing employee (on the payroll), 0.5%); Jim Andrew (corporate officer, 0%); Tyler Mckibben (corporate officer, 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 |
|---|---|---|---|
| Bespoke Holdings LLC | Owns 5% or more directly | 100% | Jun 1, 2022 |
| Plaid Investments LP | Limited partner | 60% | Jun 1, 2022 |
| Roderick Family, LLC | Owns 5% or more through other companies | 15% | Jun 1, 2022 |
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: 10 of 10 (Jan 1, 2023 to Dec 31, 2024).
- 75% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025); 51.1% 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 73 hospices CMS’s data show serving patients in ZIP code 76180, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 3; 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 |
|---|---|
| Freedom Hospice | 0 |
| Bespoke Hospice Care, LLC. This hospice | 7 |
| Bestcare Home Health Inc. | Not given |
| Community Healthcare of Texas | 2 |
| Vitas Healthcare of Texas LP | 15 |
| VNA | 1 |
| Vitas Healthcare of Texas, L.P. | 3 |
| Custom Care Hospice | 4 |
| Universal Health Services | 0 |
| Cardinal Hospice | 2 |
| Solaris Hospice Inc. | 5 |
| Amedisys Hospice | 8 |
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 Nov 5, 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 Nov 5, 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 Nov 5, 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 Nov 5, 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 Nov 5, 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 Nov 5, 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 Nov 5, 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.