S&C QCOR Hospice 2567s
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Hospice 2567s
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Time Interval

Please select the calendar year or years for which you would like data.

Note: Hospice 2567s data are available from October 2021 through March 2026.

Provider Characteristics

Use these filters if you want to limit the report to providers that have certain characteristics. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

Survey Type & Deficiency Tags

Use these filters if you want to limit the reports to providers on specific survey types, or to reports that were cited for specific Hospice deficiency tags and tag types. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

CCN

Use these filters if you want to search by a specific CMS Certification Number (CCN).

Other Survey Characteristics

Select one of the options below to filter by surveys that cite deficiencies or by surveys that are deficiency-free. By default, only surveys that cite deficiencies are displayed. Selecting "All" displays all surveys. Surveys can also be filtered by surveyor type - State Agency or Accrediting Organization - and by whether immediate jeopardy was cited.

CMS Certification Number Facility Name Address City State CMS Region Survey Date Surveyed By Survey Event ID Survey Type Statement of Deficiencies Report
▼ 751590 Saint Montserrat Hospice Care Inc 523 N. Glenoaks Blvd Burbank CA 9 (San Francisco) 04/29/2025 ACHC 1264961 Initial with CCN Follow-up
Deficiency Tag Deficiency Description Tag Type
L0673 Content Standard
L0683 Discharge Or Transfer Of Care Standard
L0684 Discharge Or Transfer Of Care Standard
L0787 Personnel Qualification Standard
L0795 Criminal Background Checks Standard
▼ 751590 Saint Montserrat Hospice Care, Inc 523 N Glenoaks Blvd Burbank CA 9 (San Francisco) 05/19/2025 State Agency 66292-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0536 Idg, Care Planning, Coordination Of Services Condition
L0540 Approach To Service Delivery Standard
L0543 Plan Of Care Standard
L0559 Quality Assessment & Performance Improvement Condition
L0561 Program Scope Standard
L0562 Program Scope Standard
L0564 Program Data Standard
L0566 Program Activities Standard
L0572 Performance Improvement Projects Standard
L0648 Organizational Environment Condition
L0651 Governing Body And Administrator Standard
L0653 Services Standard
L0662 Training Standard
L0663 Training Standard
L0670 Clinical Records Condition
L0676 Content Standard
▼ 751590 Saint Montserrat Hospice Care, Inc 523 N Glenoaks Blvd Burbank CA 9 (San Francisco) 07/10/2025 State Agency 66292-H2 Recertification
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0520 Initial & Comprehensive Assessment Of Patient Condition
L0525 Content Of Comprehensive Assessment Standard
L0536 Idg, Care Planning, Coordination Of Services Condition
L0540 Approach To Service Delivery Standard
L0543 Plan Of Care Standard
L0559 Quality Assessment & Performance Improvement Condition
L0561 Program Scope Standard
L0562 Program Scope Standard
L0564 Program Data Standard
L0566 Program Activities Standard
L0572 Performance Improvement Projects Standard
L0579 Prevention Standard
L0648 Organizational Environment Condition
L0651 Governing Body And Administrator Standard
L0653 Services Standard
L0662 Training Standard
L0663 Training Standard
L0670 Clinical Records Condition
L0672 Content Standard
L0676 Content Standard
▼ 751593 Blue Butterfly Hospice, Inc. 21049 Devonshire St. Suite 103a Chatsworth CA 9 (San Francisco) 04/13/2023 TJC 446993305 Reaccreditation
Deficiency Tag Deficiency Description Tag Type
L0547 Content Of Plan Of Care Standard
L0579 Prevention Standard
L0715 Inpatient Care Provided Under Arrangements Standard
L0784 Personnel Qualification Standard
▼ 751597 Fernando Hospice Care, Llc 14545 Victory Blvd Suite 610 Van Nuys CA 9 (San Francisco) 06/02/2022 State Agency P3R411 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
E0013 Development Of Ep Policies And Procedures Standard
L0000 Initial Comments Memo
L0516 Rights Of The Patient Standard
L0530 Content Of Comprehensive Assessment Standard
L0531 Content Of Comprehensive Assessment Standard
L0549 Content Of Plan Of Care Standard
L0570 Program Activities Standard
L0620 In-Service Training Standard
L0643 Training Standard
L0651 Governing Body And Administrator Standard
L0663 Training Standard
L0670 Clinical Records Condition
L0671 Clinical Records Standard
L0672 Content Standard
L0680 Protection Of Information Standard
L0900 Covid-19 Vaccination Of Facility Staff Standard
▼ 751597 Fernando Hospice Care, Llc 14545 Victory Blvd Suite 610 Van Nuys CA 9 (San Francisco) 07/28/2022 State Agency P3R412 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
E0013 Development Of Ep Policies And Procedures Standard
L0000 Initial Comments Memo
L0516 Rights Of The Patient Standard
L0530 Content Of Comprehensive Assessment Standard
L0531 Content Of Comprehensive Assessment Standard
L0549 Content Of Plan Of Care Standard
L0570 Program Activities Standard
L0620 In-Service Training Standard
L0643 Training Standard
L0651 Governing Body And Administrator Standard
L0663 Training Standard
L0670 Clinical Records Condition
L0671 Clinical Records Standard
L0672 Content Standard
L0680 Protection Of Information Standard
L0900 Covid-19 Vaccination Of Facility Staff Standard
▼ 751598 Kairos Hospice, Inc. 161 W Arrow Hwy Glendora CA 9 (San Francisco) 06/14/2022 State Agency UXUQ11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
E0004 Develop Ep Plan, Review And Update Annually Standard
L0000 Initial Comments Memo
L0536 Idg, Care Planning, Coordination Of Services Condition
L0538 Idg, Care Planning, Coordination Of Services Standard
L0543 Plan Of Care Standard
L0552 Review Of The Plan Of Care Standard
L0555 Coordination Of Services Standard
L0559 Quality Assessment & Performance Improvement Condition
L0572 Performance Improvement Projects Standard
L0641 Volunteers Condition
L0642 Volunteers Standard
L0664 Medical Director Condition
L0667 Initial Certification Of Terminal Illness Standard
▼ 751598 Kairos Hospice, Inc. 161 W Arrow Hwy Glendora CA 9 (San Francisco) 08/08/2022 State Agency UXUQ12 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
E0004 Develop Ep Plan, Review And Update Annually Standard
L0000 Initial Comments Memo
L0536 Idg, Care Planning, Coordination Of Services Condition
L0538 Idg, Care Planning, Coordination Of Services Standard
L0543 Plan Of Care Standard
L0552 Review Of The Plan Of Care Standard
L0555 Coordination Of Services Standard
L0559 Quality Assessment & Performance Improvement Condition
L0572 Performance Improvement Projects Standard
L0641 Volunteers Condition
L0642 Volunteers Standard
L0664 Medical Director Condition
L0667 Initial Certification Of Terminal Illness Standard
▼ 751601 Americade Palliative Health Services, Inc. 420 N. Montebello Blvd. Ste. 200 Montebello CA 9 (San Francisco) 10/06/2022 TJC 440186625 Follow-Up
Deficiency Tag Deficiency Description Tag Type
E0016 Hospice Follow Up For Staff Standard
E0019 Homebound Hha/Hospice Inform Ep Officials Standard
L0512 Rights Of The Patient Standard
L0545 Content Of Plan Of Care Standard
L0579 Prevention Standard
L0581 Control Standard
L0629 Supervision Of Hospice Aides Standard
L0651 Governing Body And Administrator Condition
L0671 Clinical Records Condition
L0682 Discharge Or Transfer Of Care Standard
L0716 Inpatient Care Provided Under Arrangements Standard
▼ 751601 Americade Palliative Health Services, Inc. 420 N. Montebello Blvd. Ste. 200 Montebello CA 9 (San Francisco) 05/25/2023 TJC 447184195 Reaccreditation
Deficiency Tag Deficiency Description Tag Type
L0547 Content Of Plan Of Care Standard
L0632 Supervision Of Hospice Aides Standard