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Chickasaw Co Public Health & Home Care Services

(641) 394-4053260 East Prospect, New Hampton, IA 50659
CMS Certification Number 167076 · Government Operated · Medicare-certified since 09/10/1975
20deficiencies since 2018
0serious
3inspections
2CMS quality stars
Data from CMS inspection reports (Form 2567), 2018-01-02 to 2026-10-15, downloaded 2026-10-21; CMS agency list file dated 2026-09-21. What the labels mean

Inspection 2025-09-17

· Recertification · 2 deficiencies · CMS source report (PDF)
Minor Health, Psychosocial, Functional, Cognition

The agency failed to complete wound assessments for 1 of 3 sampled patients with wounds (Patient #1).

Source: CMS Form 2567, inspection 2025-09-17, tag G0528 · view on CMS
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Minor Onsite Supervisory Visit Every 14 Days

The agency failed to ensure a registered nurse or other appropriate health care professional completed home health aide supervision at least every 14 days for 1 of 3 sampled patients who received hands on personal care services in conjunction with a skilled service provision (Patient #3).

Source: CMS Form 2567, inspection 2025-09-17, tag G0808 · view on CMS
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Inspection 2022-10-06

· Recertification · 7 deficiencies · CMS source report (PDF)
Moderate Hha Comprehensive Assessment In Disaster

The home health agency failed to: 1) ensure the agency's emergency plan and related policies identified the need for agency staff to review/update the patient's individualized emergency preparedness plan with the comprehensive assessment and each update to the comprehensive assessment; and, 2)…

Source: CMS Form 2567, inspection 2022-10-06, tag E0017 · view on CMS
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Moderate Hha- Procedures For Follow Up Staff/Pts.

The agency failed to complete a written emergency preparedness plan that included procedures to inform State and local officials of any on duty staff and patients they are unable to contact in the event of an interruption of services related to an emergency.

Source: CMS Form 2567, inspection 2022-10-06, tag E0021 · view on CMS
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Moderate Infection Prevention

The agency failed to ensure staff provided care in accordance with agency expectations and accepted infection control standards of practice observed during a home visit for 1 of 3 sampled patients with a home visit observation (Patient #1).

Source: CMS Form 2567, inspection 2022-10-06, tag G0682 · view on CMS
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Moderate Home Health Aide Assignments And Duties

The agency failed to ensure registered nurses provided individualized and specific written patient care instructions to agency home health aides for 1 of 2 sampled patients receiving home health aide services (Patient #5).

Source: CMS Form 2567, inspection 2022-10-06, tag G0798 · view on CMS
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Minor Within 48 Hours Of The Patient'S Return

The agency failed to ensure accurate completion of all pertinent components of the update to the comprehensive assessment within 48 hours of the agency's knowledge of return home from an inpatient facility for 1 of 1 sampled patients requiring an update to the comprehensive assessment at the time…

Source: CMS Form 2567, inspection 2022-10-06, tag G0548 · view on CMS
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Minor Plan Of Care Must Include The Following

The agency failed to ensure the Plan of Care included wound care orders for 1 of 4 sampled patients (Patient #5) with a wound.

Source: CMS Form 2567, inspection 2022-10-06, tag G0574 · view on CMS
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Minor Only As Ordered By A Physician

The agency failed to ensure staff assessed wounds and provided wound care treatments only as ordered by the physician and per the Plan of Care for 3 of 4 sampled patients (Patients #1, #5 and #7) with a wound.

Source: CMS Form 2567, inspection 2022-10-06, tag G0580 · view on CMS
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Inspection 2019-10-03

· Recertification · 11 deficiencies · CMS source report (PDF)
Moderate Local, State, Tribal Collaboration Process

The agency failed to have a written policy and procedure for cooperation and collaboration with regional emergency preparedness officials.

Source: CMS Form 2567, inspection 2019-10-03, tag E0009 · view on CMS
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Moderate Homebound Hha/Hospice Inform Ep Officials

The agency failed to ensure agency staff developed a policy and procedures to inform State and local emergency officials about homebound patients in need of evacuation due to an emergency situation.

Source: CMS Form 2567, inspection 2019-10-03, tag E0019 · view on CMS
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Moderate Hha- Procedures For Follow Up Staff/Pts.

The agency failed to ensure the development of a written policy and procedure to inform State and local officials of any on duty staff and patients they are unable to contact in the event of an interruption of services related to an emergency.

Source: CMS Form 2567, inspection 2019-10-03, tag E0021 · view on CMS
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Moderate Policies/Procedures-Volunteers And Staffing

The agency failed to have a written policy and procedure for the use of volunteers in an emergency or other emergency staffing strategies, including the process and role for integration of State and Federally designated health care professionals to address surge needs during an emergency.

Source: CMS Form 2567, inspection 2019-10-03, tag E0024 · view on CMS
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Moderate Ep Training Program

The agency failed to ensure training in emergency preparedness for all employed staff and all individuals providing services under arrangement (contract staff), consistent with their expected roles on or prior to November 15, 2017. The agency reported utilizing a total of 17 direct employed staff…

Source: CMS Form 2567, inspection 2019-10-03, tag E0037 · view on CMS
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Moderate Ep Testing Requirements

The agency failed to ensure participation in two emergency preparedness exercises in 2018. The agency reported a current census of 48 patients.

Source: CMS Form 2567, inspection 2019-10-03, tag E0039 · view on CMS
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Moderate Competency Evaluation

The agency failed to ensure the home health aides successfully completed competencies in all basic home health aide skills which require a registered nurse, or other appropriate skilled professional in consultation with a registered nurse, to evaluate the competency of the aide by direct…

Source: CMS Form 2567, inspection 2019-10-03, tag G0768 · view on CMS
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Minor A Review Of All Current Medications

The agency failed to ensure agency staff completing a drug regimen review included a review of all of the required components (ineffective drug therapy, significant side effects, significant drug interactions, duplicate drug therapy, and noncompliance with drug therapy) of a drug regimen review…

Source: CMS Form 2567, inspection 2019-10-03, tag G0536 · view on CMS
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Minor All Orders Recorded In Plan Of Care

The agency failed to update the Plan of Care with all new physician orders for 6 of 7 sampled patients (Patients #1, #3, #4, #5, #6 and #7).

Source: CMS Form 2567, inspection 2019-10-03, tag G0576 · view on CMS
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Minor Services Provided By Hh Aide

The agency failed to ensure home health aides provided care to agency patients only as ordered by the physician and/or as directed by the skilled professional assigning the home health aide to the patient for 1 of 5 sampled patients (Patient #7) receiving home health aide services.

Source: CMS Form 2567, inspection 2019-10-03, tag G0800 · view on CMS
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Minor Hh Aide Supervision Elements

The agency failed to ensure registered nurses supervising home health aides maintained documentation of a review of all required supervisory elements including following the patient plan of care, maintaining open communication with patient/caregiver, demonstrating competency of all assigned tasks…

Source: CMS Form 2567, inspection 2019-10-03, tag G0818 · view on CMS
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