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Liberty Home Care V, LLC

(910) 815-3122336 N. South Street, Mount Airy, NC 27030
CMS Certification Number 347172 · Proprietary · Medicare-certified since 09/18/1987
11deficiencies since 2018
0serious
3inspections
3CMS 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 2025-09-09

· Recertification · 2 deficiencies · CMS source report (PDF)
Moderate Infection Prevention

The RN failed to follow correct bag technique for 1 of 1 patient who received wound care during a home visit [3]. The findings included: The policy, Bag Technique, home care [revised 5/19/25], was provided by the agency director on 9/9/25 at 8 am.

Source: CMS Form 2567, inspection 2025-09-09, tag G0682 · view on CMS
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Minor Plan Of Care Must Include The Following

The Plan of Care [POC] failed to include all current/correct medications the patient was taking for 2 of 3 home visits [#3 and 4]; and the POC failed to include all wound care orders for 1 of 1 patient receiving wound care during a home visit [#3]. The findings included: The policy, Care Planning…

Source: CMS Form 2567, inspection 2025-09-09, tag G0574 · view on CMS
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Inspection 2022-09-14

· Recertification · 7 deficiencies · CMS source report (PDF)
Moderate Conformance With Physician Orders

Staff interviews the agency failed to follow the physician’s order related to Heparin [blood thinner] flushes for 1 of 1 patient with a PICC line [peripherally inserted central catheter] [#11]; and failed to follow the physician’s order related to new wound care orders for 1 of 5 patients with a…

Source: CMS Form 2567, inspection 2022-09-14, tag G0578 · view on CMS
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Moderate Home Health Aide Assignments And Duties

Staff interviews the agency failed to include vital sign parameters on the aide care plan for 1 of 3 patients who received aide services [#6]. The findings included: The policy, Home Health Aide Care Plan and Documentation [4/2021], was provided by RN # 1 on 9/14/22 at 2:30 pm.

Source: CMS Form 2567, inspection 2022-09-14, tag G0798 · view on CMS
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Minor Plan Of Care Must Include The Following

Staff interviews the agency failed to include correct medication doses/strength on the Plan of Care for 2 of 14 patients [#3 and 6]; failed to include all pertinent diagnoses for 1 of 14 patients [#6]; and failed to include the bulb size for a urinary catheter for 1 of 2 patients with a catheter…

Source: CMS Form 2567, inspection 2022-09-14, tag G0574 · view on CMS
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Minor Communication With All Physicians

Staff interviews the agency failed to communicate with the physician when vital signs were outside the given parameters for 1 of 14 patients [#2]. The findings included: The policy, Coordination and Communication Activities [12/2021], was provided by RN # 1 on 9/14/22 at 9:00 am.

Source: CMS Form 2567, inspection 2022-09-14, tag G0602 · view on CMS
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Minor Communication With Physicians

Staff interviews the agency failed to notify the physician of an overdose of medications for 1 of 1 patient who overdosed on prescription medication [#8]. The findings included: The policy, Coordination and Communication Activities [12/2021], was provided by RN # 1 on 9/14/22 at 9:00 am.

Source: CMS Form 2567, inspection 2022-09-14, tag G0718 · view on CMS
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Minor Required Items In Clinical Record

The clinical record failed to include the bulb size for an indwelling catheter for 1 of 2 patients with an indwelling catheter [#9]; and failed to include PICC [peripherally inserted central catheter] line assessments for 1 of 1 patient with a PICC line [#11];and failed to include orders related to…

Source: CMS Form 2567, inspection 2022-09-14, tag G1012 · view on CMS
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Minor Discharge And Transfer Summaries

Staff interviews the clinical record failed to include a discharge summary for 1 of 4 discharged patients [#1]. The findings included: The policy, Discharge and Transfer of Patients [9/2021] was provided by the agency administrator on 9/14/22 at approximately 11 am.

Source: CMS Form 2567, inspection 2022-09-14, tag G1022 · view on CMS
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Inspection 2019-09-25

· Recertification · 2 deficiencies · CMS source report (PDF)
Moderate Infection Prevention

Direct observation and interviews with the agency staff the agency failed to maintain separation between a clean and soiled area for dressing supplies for 1 of 1 patient with wound care orders during home visits [#1]. The findings included: Patient # 1 had a Start of Care [SOC] date of 2/28/19 and…

Source: CMS Form 2567, inspection 2019-09-25, tag G0682 · view on CMS
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Minor All Orders Recorded In Plan Of Care

The agency failed to include orders to increase the flow rate of oxygen for 1 of 3 patients with oxygen (#5).

Source: CMS Form 2567, inspection 2019-09-25, tag G0576 · view on CMS
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