Alfa Home Health and Hospice, LLC
A hospice in Laredo, Texas 78041
315 Calle Del Norte, Ste 203, Laredo, Texas 78041. (956) 568-2240.
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The short answer
Record last released by CMS on Oct 23, 2026.
- 9 deficiencies cited in the last three years
- Not rated family caregiver rating
- 8of 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?
9 deficiencies cited in the last three years
The middle of the 18 hospices serving ZIP code 78041 had 4.5.
The last inspection on record was on Jan 10, 2024: an initial 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
9 deficiencies in 1 month of the last 36. Last cited Jan 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.
Jan 10, 2024: initial inspection by the Accreditation Commission for Health Care9 deficiencies
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Plan Based on All Hazards Risk Assessment (42 CFR 418.113(a)(1))
“Upon observation, there was no evidence the Emergency Preparedness plan: • Is based on and includes a documented, facility-based and community-based risk assessment, utilizing an all-hazards approach • Includes strategies for addressing emergency events identified by the risk assessment, including the management of the consequences of power failures, natural disasters, and other emergencies that would affect the hospice’s ability to provide care There was not evidence of a documented community-based risk assessment, utilizing an all-hazards approach.”
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Content of comprehensive assessment (42 CFR 418.54(c)(6))
The inspectors’ words, 140 words
“Upon patient record review, 2 of 11 (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: The medication profile on 11/12 23 indicated order for oxygen 2L NC PRN daily. RN recertification note on 12/26/23 stated patient was on 3L NC for PRN use. There was not evidence of an order to change the liter flow. Corrected onsite. Patient#2: The nurse documentation indicated patient is on 2L NC “at bedside for PRN use.” Oxygen therapy was not included on the medication profile. Corrected onsite.”
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Content of plan of care (42 CFR 418.56(c)(2))
The inspectors’ words, 108 words
“Upon patient record review, 1 of 11 (Patient #2) did not have evidence the plan of care must includes all services necessary for the palliation and management of the terminal illness and related conditions, including the following: • A detailed statement of the scope and frequency of services necessary to meet the specific patient and family needs • The IDG demonstrates a proactive approach in developing each patient’s plan of care by planning ahead for anticipated patient changes and needs. Decisions should reflect the patient/family preferences rather than be solely a response to a crisis. Patient#2: The SW visit order included PRN visits without frequency for those visits.”
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Content of plan of care (42 CFR 418.56(c)(4))
The inspectors’ words, 106 words
“Upon patient record review, 2 of 11 (Patient #1,#2) 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#1: The record indicated on 11/12/23 an order for oxygen 2L NC PRN daily. RN recertification note on 12/26/23 stated patient was on 3L NC for PRN use. There was not evidence of an order to change the liter flow. Corrected onsite. Patient#2: The nurse documentation indicated patient is on 2L NC “at bedside for PRN use.” Oxygen therapy was not included on the medication profile. Corrected onsite.”
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Coordination of services (42 CFR 418.56(e)(2))
“Upon client record review, 1 of 11 (Patient #2) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient#1: The record indicated order on 12/25/23 of skilled nurse visit frequency at 1x/week. There was no evidence of a visit the week of 1/1/24.”
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Core services (42 CFR 418.64)
“Upon personnel record review, 1 of 8 (Personnel #4 ) did not have evidence that the hospice routinely provide substantially all core services directly by hospice personnel (The hospice issues a W-2 form for the employee). These services include: • Physician services (may contract for physician services) • Nursing • Medical social services • Counseling Personnel#4: Record indicated MSW was working under a contract with hospice’s partner, Alfa Home Health Agency and filing under W9 tax status. Corrected onsite.”
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Counseling services (42 CFR 418.64(d)(1))
The inspectors’ words, 119 words
“Upon patient record review, 2 of 11 (Patient #8,#9) did not have evidence the hospice offers bereavement counseling that includes: • Making bereavement services available to the family and other individuals in the bereavement plan of care up to 1 year following the death of the patient. Bereavement counseling also extends to residents of a SNF/NF or ICF/IID when appropriate and identified in the bereavement plan of care • Ensuring that bereavement services reflect the needs of the bereaved • Development of a bereavement plan of care that notes the kind of bereavement services to be offered and the frequency of service delivery Patient#8, #9: There was no evidence of a one month follow up call to the bereaved.”
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Hospice aide assignments and duties (42 CFR 418.76(g)(2))
The inspectors’ words, 125 words
“Upon patient record review 2 of 11 (Patient #1,#2) did not have evidence documentation in the patient record that a hospice aide provides services that are: • Ordered by the interdisciplinary group • Included in the plan of care • Permitted to be performed under state law by such hospice aide • Consistent with the hospice aide training Patient#1: The visit frequency on the aide plan of care was indicated at 2WK12 on 11/19/23. There was no evidence of a visit until a 12/7/23 when a new aide frequency for 1WK1, 2WK9 was ordered. Patient#2: The aide plan of care indicated to perform vital signs each visit. The record indicated that this task was not performed as evidenced by aide documenting “N/A” on visits 12/1/23-1/4/24.”
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Content (42 CFR 418.104(a)(6))
“Upon patient client record review, 1 of 11 (Patient #1) did not have evidence that each patient record contains Advance Directives. Patient#1: The record indicated patient was a DNR. There was not evidence of an out of hospital DNR in patient’s record.”
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Jan 10, 2024 | Initial inspection by the Accreditation Commission for Health Care | 9 deficiencies cited |
Is it certified?
- Medicare-certified hospice since Jan 26, 2024.
- 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): 12.4 nurse care minutes per routine home care day, 3.1% of skilled nursing minutes at weekends and a visit near death for 91.3% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 100% at home.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | This provider |
|---|---|
| Nurse care minutes per routine home care day | 12.4 min |
| Skilled nursing minutes at weekends | 3.1% |
| Visits near death | 91.3% of patients who died |
Who owns it?
- 8 owners or officers are people: Lesly Cruz (managing employee (on the payroll), 50%); Henry Estrella (owns 5% or more directly, 50%); Henry Estrella (corporate director, 50%); Oseas Gomez (owns 5% or more directly, 50%); Oseas Gomez (corporate director, 50%); Oseas Gomez (corporate officer, 33.5%); Oseas Gomez (managing employee (on the payroll), 33.5%); Andres Garcia Zuniga (managing employee (on the payroll), 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: 8 of 10 (Jan 1, 2023 to Dec 31, 2024).
- 91.8% 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 | 8 of 10 |
How does it compare nearby?
- Of the 18 hospices CMS’s data show serving patients in ZIP code 78041, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 4.5; this one had 9.
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 |
|---|---|
| Altus Hospice | 15 |
| Serenity Home Care Services | 7 |
| Laredo Gentle Hands Hospice and Palliative Care | 0 |
| La Esperanza Home Health Inc. | 4 |
| Vara Hospice | 3 |
| Laredo Superior Homecare LLC | 4 |
| Alfa Home Health and Hospice, LLC This hospice | 9 |
| Optumcare Hospice LLC | 0 |
| Hospice Specialty Inc. | 4 |
| Nurses on Wheels Home Health and Hospice | 0 |
| Greater Valley Hospice Alliance, LP | 15 |
| Only Love 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 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.