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
▼ 921631 Good Samaritan Hospice And Palliative Care, Inc. 725 S Glendale Ave Ste M Glendale CA 9 (San Francisco) 03/03/2023 TJC 446167275 Reaccreditation
Deficiency Tag Deficiency Description Tag Type
E0039 Ep Testing Requirements Standard
L0505 Exercise Of Rights/Respect For Proprty/Person Standard
L0566 Program Activities Standard
L0570 Program Activities Standard
L0572 Performance Improvement Projects Standard
L0573 Performance Improvement Projects Standard
L0645 Recruiting And Retaining Standard
▼ 921632 Free Spirit Hospice, Inc. 5924 E. Los Angeles Avenue, Suite R Simi Valley CA 9 (San Francisco) 06/15/2023 TJC 447284305 Reaccreditation
Deficiency Tag Deficiency Description Tag Type
E0004 Develop Ep Plan, Review And Update Annually Standard
E0006 Plan Based On All Hazards Risk Assessment Standard
E0007 Ep Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0015 Subsistence Needs For Staff And Patients Standard
E0015 Subsistence Needs For Staff And Patients Standard
E0016 Hospice Follow Up For Staff Standard
E0022 Policies/Procedures For Sheltering In Place Standard
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0030 Names And Contact Information Standard
E0032 Primary/Alternate Means For Communication Standard
E0033 Methods For Sharing Information Standard
E0036 Ep Training And Testing Standard
E0042 Integrated Ep Program Standard
L0523 Timeframe For Completion Of Assessment Standard
L0531 Content Of Comprehensive Assessment Standard
L0535 Patient Outcome Measures Standard
L0545 Content Of Plan Of Care Standard
L0564 Program Data Standard
L0565 Program Data Standard
L0573 Performance Improvement Projects Standard
L0574 Executive Responsibilities Standard
L0575 Executive Responsibilities Standard
L0581 Control Condition
L0596 Counseling Services Standard
L0645 Recruiting And Retaining Standard
L0651 Governing Body And Administrator Standard
L0679 Authentication Standard
L0702 Use And Mintenance Of Equipment And Supplies Standard
▼ 921632 Free Spirit Hospice, Inc. 5924 E. Los Angeles Avenue, Suite R Simi Valley CA 9 (San Francisco) 08/01/2023 TJC 448827735 Follow-Up
Deficiency Tag Deficiency Description Tag Type
L0535 Patient Outcome Measures Standard
L0564 Program Data Standard
L0575 Executive Responsibilities Standard
▼ 921633 Victory Hospice 14349 Victory Blvd, Suite 202 Van Nuys CA 9 (San Francisco) 12/07/2022 CHAP DEC0522_ASM_8548427_ Initial with CCN
Deficiency Tag Deficiency Description Tag Type
L0531 Content Of Comprehensive Assessment Standard
L0774 Hospice Plan Of Care Standard
▼ 921634 Angelical Hospice 14349 Victory Blvd, Suite 204 Van Nuys CA 9 (San Francisco) 08/15/2022 State Agency SOCQ11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
E0004 Develop Ep Plan, Review And Update Annually Standard
L0000 Initial Comments Memo
L0537 Idg, Care Planning, Coordination Of Services Standard
L0538 Idg, Care Planning, Coordination Of Services Standard
L0543 Plan Of Care Standard
L0579 Prevention Standard
▼ 921634 Angelical Hospice 14349 Victory Blvd, Suite 204 Van Nuys CA 9 (San Francisco) 09/15/2022 State Agency SOCQ12 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
E0004 Develop Ep Plan, Review And Update Annually Standard
L0000 Initial Comments Memo
L0537 Idg, Care Planning, Coordination Of Services Standard
L0538 Idg, Care Planning, Coordination Of Services Standard
L0543 Plan Of Care Standard
L0579 Prevention Standard
▼ 921635 Hearten Hospice Care Inc. 12235 Beach Blvd., Ste 200-E Stanton CA 9 (San Francisco) 02/10/2023 ACHC 1163784 Initial with CCN
Deficiency Tag Deficiency Description Tag Type
L0523 Timeframe For Completion Of Assessment Standard
L0524 Content Of Comprehensive Assessment Standard
L0531 Content Of Comprehensive Assessment Standard
L0547 Content Of Plan Of Care Standard
L0550 Content Of Plan Of Care Standard
L0555 Coordination Of Services Standard
L0615 Competency Evaluation Standard
L0626 Hospice Aide Assignments And Duties Standard
L0673 Content Standard
L0679 Authentication Standard
▼ 921636 San Antonio Hospice, Inc. 419 West Colorado Street Ste. B Glendale CA 9 (San Francisco) 05/18/2022 ACHC 43227 Reaccreditation
Deficiency Tag Deficiency Description Tag Type
L0523 Timeframe For Completion Of Assessment Standard
L0524 Content Of Comprehensive Assessment Standard
L0530 Content Of Comprehensive Assessment Standard
L0555 Coordination Of Services Standard
L0626 Hospice Aide Assignments And Duties Standard
▼ 921636 San Antonio Hospice, Inc 419 W. Colorado St. Suite B Glendale CA 9 (San Francisco) 04/24/2025 State Agency 65F9A-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0530 Content Of Comprehensive Assessment Standard
L0531 Content Of Comprehensive Assessment Standard
L0545 Content Of Plan Of Care Standard
L0549 Content Of Plan Of Care Standard
L0596 Counseling Services Standard
▼ 921636 San Antonio Hospice, Inc. 419 West Colorado Street Ste. B Glendale CA 9 (San Francisco) 05/14/2025 ACHC 1264944 Reaccreditation
Deficiency Tag Deficiency Description Tag Type
L0533 Update Of Comprehensive Assessment Standard
L0553 Review Of The Plan Of Care Standard
L0555 Coordination Of Services Standard
L0579 Prevention Standard
L0626 Hospice Aide Assignments And Duties Standard
L0629 Supervision Of Hospice Aides Standard
L0647 Level Of Activity Standard
L0679 Authentication Standard