S&C QCOR Hospice 2567s
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Hospice 2567s
Selection Criteria ▸

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
▼ 751711 St. Arsenius Hospice Care, Inc 424 N. Lake Ave Suite 204 Pasadena CA 9 (San Francisco) 05/01/2025 TJC 454462065 Reaccreditation
Deficiency Tag Deficiency Description Tag Type
L0545 Content Of Plan Of Care Standard
L0557 Coordination Of Services Standard
L0579 Prevention Standard
▼ 751713 Bear Valley Hospice, Llc 909 W. Big Bear Boulevard Big Bear City CA 9 (San Francisco) 06/16/2022 TJC 438711155 Reaccreditation
Deficiency Tag Deficiency Description Tag Type
L0521 Initial & Comprehensive Assessment Of Patient Standard
L0523 Timeframe For Completion Of Assessment Standard
L0530 Content Of Comprehensive Assessment Standard
L0555 Coordination Of Services Standard
L0579 Prevention Standard
L0581 Control Standard
L0596 Counseling Services Standard
▼ 751713 Bear Valley Hospice, Llc 909 W. Big Bear Boulevard Big Bear City CA 9 (San Francisco) 07/17/2025 TJC 455054695 Reaccreditation
Deficiency Tag Deficiency Description Tag Type
L0548 Content Of Plan Of Care Standard
L0549 Content Of Plan Of Care Standard
L0619 Competency Evaluation Standard
L0625 Hospice Aide Assignments And Duties Standard
L0663 Training Standard
L0683 Discharge Or Transfer Of Care Standard
▼ 751714 Stone Creek Healthcare Llc 75410 Gerald Ford Drive Palm Desert CA 9 (San Francisco) 08/30/2024 State Agency 63FC0-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0530 Content Of Comprehensive Assessment Standard
L0547 Content Of Plan Of Care Standard
L0553 Review Of The Plan Of Care Standard
L0596 Counseling Services Standard
▼ 751714 Stone Creek Healthcare Llc 75410 Gerald Ford Drive Palm Desert CA 9 (San Francisco) 09/30/2024 State Agency 63FC0-H2 Recertification
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0530 Content Of Comprehensive Assessment Standard
L0547 Content Of Plan Of Care Standard
L0553 Review Of The Plan Of Care Standard
L0596 Counseling Services Standard
▼ 751716 Universal Hospice, Inc 151 N San Vicente Blvd, Suite 209 Beverly Hills CA 9 (San Francisco) 05/27/2022 State Agency SI3911 Recertification
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0521 Initial & Comprehensive Assessment Of Patient Standard
L0530 Content Of Comprehensive Assessment Standard
L0536 Idg, Care Planning, Coordination Of Services Condition
L0543 Plan Of Care Standard
L0546 Content Of Plan Of Care Standard
L0549 Content Of Plan Of Care Standard
L0642 Volunteers Standard
▼ 751716 Universal Hospice, Inc 151 N San Vicente Blvd, Suite 209 Beverly Hills CA 9 (San Francisco) 07/08/2022 State Agency SI3912 Recertification
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0521 Initial & Comprehensive Assessment Of Patient Standard
L0530 Content Of Comprehensive Assessment Standard
L0536 Idg, Care Planning, Coordination Of Services Condition
L0543 Plan Of Care Standard
L0546 Content Of Plan Of Care Standard
L0549 Content Of Plan Of Care Standard
L0554 Coordination Of Services Standard
L0642 Volunteers Standard
▼ 751716 Universal Hospice, Inc 151 N San Vicente Blvd, Suite 209 Beverly Hills CA 9 (San Francisco) 09/16/2022 State Agency SI3913 Recertification
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0530 Content Of Comprehensive Assessment Standard
L0536 Idg, Care Planning, Coordination Of Services Condition
L0543 Plan Of Care Standard
L0554 Coordination Of Services Standard
▼ 751718 Western Care Hospice, Inc. 14545 Victory Blvd., Suite. 505 Van Nuys CA 9 (San Francisco) 08/31/2022 State Agency 2Y8L11 Recertification
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0524 Content Of Comprehensive Assessment Standard
L0530 Content Of Comprehensive Assessment Standard
L0531 Content Of Comprehensive Assessment Standard
L0533 Update Of Comprehensive Assessment Standard
L0543 Plan Of Care Standard
L0667 Initial Certification Of Terminal Illness Standard
▼ 751718 Western Care Hospice, Inc. 14545 Victory Blvd., Suite. 505 Van Nuys CA 9 (San Francisco) 09/26/2022 State Agency 2Y8L-H2 Recertification
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0524 Content Of Comprehensive Assessment Standard
L0530 Content Of Comprehensive Assessment Standard
L0531 Content Of Comprehensive Assessment Standard
L0533 Update Of Comprehensive Assessment Standard
L0543 Plan Of Care Standard
L0667 Initial Certification Of Terminal Illness Standard