CROSSROADS HOME HEALTH & HOSPICE

CROSSROADS HOME HEALTH & HOSPICE is a For-Profit hospice center located in SAN FRANCISCO, CA that provides care to about 52 patients on average each day. The primary medical condition that brought patients to this hospice facility was Dementia (44%) and most patients receive care at Home (82%).

Hospice Report Card

How this grade is calculated:

This grade is a weighted average of up to four data sources to provide a comprehensive view of hospice quality.

Data Sources Used:

Quality of Care (HCI): 8.0/10 score (50% weight)

Start of Care (HIS): 81.7% (21% weight)

Google Reviews: 4.4/5 stars (21 reviews) (29% weight)

Not Available:

Family Caregiver Survey (CAHPS): N/A

• A minimum of two sources are required for a grade

• Google Reviews with fewer than 3 ratings have reduced weight

• Grades are capped at B+ when based only on administrative data (HCI/HIS) without human feedback (CAHPS/Google Reviews)

B-

Good Performance

Overall Score: 82.7/100

Contact Us

1109 VICENTE STREET, SUITE 101

SAN FRANCISCO, CA 94116

Get Directions

(415) 682-2111

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Overview

Facility Information

CMS Certification Number:051689

Ownership Type:For-Profit

Certification Date:June 19, 1996

Data Period:01/01/2023-12/31/2023

Patient Demographics

Patients Served Daily

Average Patients Per Day

How many patients this facility cares for each day on average

Most Common Conditions

Dementia

44.0%

Circulatory/Heart

20.0%

Other Conditions

16.0%

Other conditions: Cancer (14.0%), Stroke (6.0%)

Patient Primary Diagnoses

The primary medical conditions that brought patients to this hospice facility

Care Settings

Where Patients Receive Care

The different locations where this hospice provides care to their patients

Most Common

Home

82.0%

of care days

Assisted Living

14.0%

of care days

Skilled Nursing

3.0%

of care days

All Ratings

Family Caregiver Survey Rating:

Not Rated

The number of responses does not meet the required minimum amount for public reporting of Star Ratings for this reporting period.

Quality of Care Rating (HCI):

4.0 out of 5(HCI: 8/10)

Start of Care Score (HIS Assessment):

4.1 out of 5(HIS: 81.7)

Google Reviews:

View on Google

Family Survey Rating

Overall Star Rating Not Available

This facility did receive some family caregiver survey responses (shown in the individual components below), but the overall star rating is not available for this reporting period. The number of responses does not meet the required minimum amount for public reporting of Star Ratings for this reporting period.

Percentage of families who said the hospice team "always" communicated well with them. This includes keeping families informed about the patient's condition, treatment plans, and what to expect.

Worse

Communication

Team always communicated well

80.0%

State Avg: 81.7%

National Avg: 81.0%

Percentage of families who said they "always" got help as soon as they needed it from the hospice team. This measures responsiveness to urgent needs and concerns.

Worse

Timely Help

Team always provided timely help

63.0%

State Avg: 75.0%

National Avg: 74.0%

Percentage of families who said the hospice team "always" treated the patient with respect. This reflects dignity, courtesy, and compassionate care throughout the hospice experience.

Worse

Treated with Respect

Patient always treated with respect

84.0%

State Avg: 90.2%

National Avg: 89.0%

Percentage of families who felt the hospice team provided the "right amount" of emotional and spiritual support. This includes addressing fears, grief, and spiritual needs.

Worse

Emotional Support

Right amount of emotional/spiritual support

83.0%

State Avg: 89.7%

National Avg: 84.0%

Percentage of families who said the patient "always" got the help they needed for pain and symptoms. This measures effectiveness of comfort care and symptom management.

Worse

Pain & Symptoms

Patient always got help for pain/symptoms

59.0%

State Avg: 75.1%

National Avg: 74.0%

Percentage of families who said they "definitely" got the training they needed to care for the patient. This includes education about medications, comfort care, and what to expect.

Worse

Family Training

Definitely received needed training

74.0%

State Avg: 76.9%

National Avg: 67.0%

Percentage of families who rated the hospice 9 or 10 out of 10 (the highest ratings). This reflects overall satisfaction with the hospice experience.

Worse

Hospice Rating

Rated hospice 9 or 10 out of 10

75.0%

State Avg: 81.9%

National Avg: 79.0%

Percentage of families who said they would "definitely" recommend this hospice to others. This is a strong indicator of overall satisfaction and trust in the hospice.

Worse

Would Recommend

Would definitely recommend hospice

76.0%

State Avg: 86.2%

National Avg: 80.0%

Quality of Care Rating

What is the Hospice Care Index (HCI)?
The HCI is Medicare's official quality measure that evaluates hospices on 10 specific care indicators. It provides families with an objective way to compare hospice quality using real patient data from Medicare claims and patient records.

How are points earned?
Hospices earn exactly 1 point for each of 10 criteria they meet, such as: providing nursing visits in patients' final 3 days of life, maintaining consistent nursing schedules without gaps, avoiding unnecessary emergency hospitalizations, managing costs effectively, and ensuring adequate weekend care coverage.

Scoring methodology:
Each criterion has a national percentile threshold (typically 10th percentile). If a hospice performs better than this threshold compared to all hospices nationally, they earn 1 point for that criterion. Maximum score is 10 points.

Why this matters:
Higher HCI scores correlate with better pain management, more consistent nursing care, fewer traumatic emergency visits, better family support, and more cost-effective care delivery - all leading to improved comfort and peace of mind during end-of-life care.

Comparison vs. Scoring:
While national percentile thresholds determine points earned, the state and national averages shown provide context for how this facility compares locally and nationally.

Hospice Care Index (HCI)

4.0 out of 5 (HCI: 8.0/10)

8.0

State Average

8.2

National Average

8.8

The HCI is Medicare's comprehensive quality score that measures how well hospices provide end-of-life care. Hospices earn exactly 1 point for each of 10 specific criteria they meet (like nursing visits in patients' final 3 days, consistent care schedules, avoiding emergency hospitalizations), with each criterion having a national percentile threshold for scoring. While national thresholds determine the points earned, the averages shown below compare this facility's performance against state and national averages for reference.

This measures what percentage of care days required intensive hospice services (like continuous bedside care or inpatient care). Lower percentages are better because it means patients had their symptoms well-managed with regular home care, rather than needing costly emergency interventions.

Better

CHC/GIP Days

Percentage of days with intensive care services

0.0%

State Avg:0.3%

National Avg:0.5%

This tracks gaps between skilled nursing visits for patients receiving routine home care. Lower numbers are better because it means patients received consistent, regular nursing care without long periods between visits that could leave medical needs unaddressed.

Worse

Nursing Visits

Consistency of skilled nursing visits

65.2%

State Avg:61.2%

National Avg:53.8%

This measures patients who were discharged from hospice care within 7 days of admission while still alive. Lower rates are better because early discharges may indicate patients weren't properly assessed for hospice eligibility or didn't receive adequate support during their initial adjustment period.

Worse

Early Discharges

Avoiding premature live discharges

11.6%

State Avg:5.6%

National Avg:7.0%

This tracks patients who were discharged from hospice after 180+ days while still alive. Lower rates are better because very long stays followed by discharge may suggest the patient wasn't appropriate for hospice initially, or their condition improved but discharge was delayed.

Worse

Late Discharges

Appropriate timing of live discharges

48.4%

State Avg:46.4%

National Avg:40.1%

This measures disruptive care transitions, specifically unplanned hospitalizations that result in the patient being discharged from hospice. Lower rates are better because these transitions can be traumatic for patients and families, and may indicate inadequate symptom management at home.

Worse

Transitions Type 1

Minimizing disruptive care transitions

6.3%

State Avg:6.3%

National Avg:8.1%

This tracks another type of disruptive transition - emergency department visits or hospitalizations during hospice care. Lower rates are better because hospice should be able to manage most symptoms and crises at home or in hospice facilities, avoiding stressful hospital visits.

Better

Transitions Type 2

Minimizing unnecessary hospitalizations

1.1%

State Avg:2.0%

National Avg:2.1%

This measures the average minutes of skilled nursing care provided per routine home care day. Higher numbers are better because more nursing time typically means better symptom management, medication oversight, and family support - all crucial for quality hospice care.

Worse

Skilled Nursing

Minutes of skilled nursing per routine home care day

10 min

State Avg:27.9 min

National Avg:17.0 min

This tracks whether patients receive nursing or social work visits on weekends. Higher percentages are better because hospice patients need consistent care 7 days a week, and weekend coverage shows the facility is committed to round-the-clock support when families need it most.

Worse

Weekend Care

Percentage of skilled nursing on weekends

5.3%

State Avg:13.2%

National Avg:9.4%

This measures whether patients received nursing or social work visits in their final 2 days of life. Higher percentages are better because increased support during the dying process helps ensure comfort, dignity, and emotional support for both patient and family during this critical time.

Worse

Visits Near Death

Percentage of patients with visits in final days

79.6%

State Avg:83.4%

National Avg:89.1%

This measures the total amount Medicare spent per hospice patient at this facility. Lower spending is better because it indicates the hospice is providing efficient, cost-effective care without unnecessary expenses. However, very low spending could also mean fewer services, so this should be considered alongside other quality measures.

Worse

Cost Efficiency

Per-beneficiary spending

$29,729

State Avg:$25,150

National Avg:$17,830

Start of Care Rating

What is the Start of Care Rating?
This measures how well hospices conduct comprehensive assessments when patients first enter care. It evaluates whether key areas like pain management, breathing issues, treatment preferences, and patient values are properly addressed from day one.

How are scores calculated?
Medicare tracks the percentage of new patients who receive proper screening and assessment in 7 key areas: treatment preferences, beliefs/values, pain screening, pain assessment, breathing problems, breathing treatment, and bowel care for opioid patients.

Why this matters:
Proper start-of-care assessment ensures patients receive personalized care from day one, better pain management, respect for their values and preferences, and comprehensive symptom control - leading to better comfort and quality of life throughout their hospice journey.

Scoring:
Higher percentages mean more patients received proper assessment in each area. The composite score combines all 7 areas to show overall assessment quality.

Hospice Item Set (HIS)

4.1 out of 5 (81.7%)

81.7%

State Average

91%

National Average

92.2%

Composite score measuring quality of comprehensive assessment at admission. Higher percentages mean more patients received proper screening and assessment in key areas like pain management, treatment preferences, and symptom control from day one.

Percentage of patients who had their treatment preferences discussed and documented at admission. Higher percentages mean more patients received personalized care planning from the start.

Better

Treatment Preferences

Discussion of patient treatment preferences

100.0%

State Avg: 99.6%

National Avg: 99.5%

Percentage of patients whose spiritual and cultural beliefs were addressed if desired. Higher percentages show respect for patient values and holistic care approach.

Worse

Beliefs & Values

Addressing patient beliefs and values

90.8%

State Avg: 99.0%

National Avg: 98.5%

Percentage of patients screened for pain within 24 hours of admission. Higher percentages ensure pain issues are identified and addressed quickly.

Worse

Pain Screening

Screening for pain at admission

97.2%

State Avg: 98.9%

National Avg: 98.3%

Percentage of patients who received comprehensive pain assessment at admission. Higher percentages mean better pain management planning from day one.

Worse

Pain Assessment

Comprehensive pain assessment

91.7%

State Avg: 93.7%

National Avg: 95.7%

Percentage of patients screened for shortness of breath at admission. Higher percentages ensure breathing problems are identified early for proper treatment.

Better

Dyspnea Screening

Screening for shortness of breath

99.1%

State Avg: 98.9%

National Avg: 99.0%

Percentage of patients with breathing problems who received appropriate treatment. Higher percentages show effective symptom management.

Worse

Dyspnea Treatment

Treatment for shortness of breath

88.3%

State Avg: 98.3%

National Avg: 97.7%

Percentage of patients on opioid medications who were given bowel regimen to prevent constipation. Higher percentages show proactive side effect management.

Better

Bowel Regimen

Opioid patients given bowel regimen

100.0%

State Avg: 74.3%

National Avg: 91.1%

Options Nearby

Other hospice facilities within 25 miles of CROSSROADS HOME HEALTH & HOSPICE

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