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Mercyone Waterloo Home Health Care

(319) 272-50502055 Kimball Ave Ste 330, Waterloo, IA 50702
CMS Certification Number 167186 · Non-Profit · Medicare-certified since 12/15/1986
20deficiencies since 2018
0serious
3inspections
3.5CMS 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 2021-08-16

· Focused Infection Control, Other-Fed, Recertification · 13 deficiencies · CMS source report (PDF)
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 2021-08-16, tag E0021 · view on CMS
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Moderate Infection Prevention

The agency failed to ensure staff provided care in accordance with accepted infection control standards of practice observed during a home visit for 1 of 5 sampled patients (Patient #2) with home visit observations.

Source: CMS Form 2567, inspection 2021-08-16, tag G0682 · view on CMS
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Moderate Authentication

The agency failed to ensure authentication of staff documentation in each patient's clinical record included the date and time of the employee signature for 1 of 1 sampled patients receiving speech therapy services (Patient #6).

Source: CMS Form 2567, inspection 2021-08-16, tag G1024 · view on CMS
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Minor A Review Of All Current Medications

The agency failed to ensure a registered nurse (RN) completed a drug regimen review, reconciled the medications and contacted the physician, if necessary, in therapy only cases for 1 of 1 sampled patients receiving only therapy services (Patient #3).

Source: CMS Form 2567, inspection 2021-08-16, tag G0536 · view on CMS
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Minor Last 5 Days Of Every 60 Days Unless:

The agency failed to ensure accurate completion of all required components of the recertification comprehensive assessments with accompanying drug regimen review between day 56 and 60 of each 60 day certification period for 2 of 6 sampled patients requiring an update to the comprehensive assessment…

Source: CMS Form 2567, inspection 2021-08-16, tag G0546 · view on CMS
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Minor Within 48 Hours Of The Patient'S Return

The agency failed to ensure completion of the update to the comprehensive assessment within 48 hours of the agency's knowledge of return home from an inpatient facility for 2 of 2 sampled patients requiring a resumption of care assessment (Patient #6 and #7).

Source: CMS Form 2567, inspection 2021-08-16, tag G0548 · view on CMS
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Minor At Discharge

The agency failed to ensure completion of the discharge comprehensive assessments within 2 calendar days of identification of the need to discharge a patient for 1 of 3 sampled patients requiring a discharge comprehensive assessment (Patient #12).

Source: CMS Form 2567, inspection 2021-08-16, tag G0550 · view on CMS
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Minor Plan Of Care Must Include The Following

The agency failed to ensure the accurate completion of all components comprising the Plan of Care, including all supplies/equipment used by the patient and accurate medication/treatment orders for 7 of 11 sampled patients (Patients #1, #2, #3, #7, #8, #9 and #12).

Source: CMS Form 2567, inspection 2021-08-16, tag G0574 · view on CMS
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Minor All Orders Recorded In Plan Of Care

The agency failed to maintain a working Plan of Care for patients and update the working Plans of Care with any new verbal/interim physician orders for 9 of 9 sampled patients with new verbal/interim orders.

Source: CMS Form 2567, inspection 2021-08-16, tag G0576 · view on CMS
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Minor Only As Ordered By A Physician

The agency failed to obtain physician orders for medications, services and treatments and provide services following such orders for 4 of 11 sampled patients (Patients #3, #8, #10 and #12).

Source: CMS Form 2567, inspection 2021-08-16, tag G0580 · view on CMS
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Minor Promptly Alert Relevant Physician Of Changes

The agency failed to report changes in patient clinical findings or changes in patient needs to the physician for 2 of 11 sampled patients (Patients #7 and #11).

Source: CMS Form 2567, inspection 2021-08-16, tag G0590 · 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 as ordered by the physician, permitted under state law and/or as directed by the skilled professional assigning the home health aide to the patient for 2 of 4 sampled patients receiving home health aide services…

Source: CMS Form 2567, inspection 2021-08-16, tag G0800 · view on CMS
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Minor Discharge And Transfer Summaries

The agency failed to send a transfer summary to the physician and other health care professionals who would be providing care to the patient within 2 business days of a planned transfer or of becoming aware of an unplanned transfer for 1 of 2 sampled patients with a transfer where a summary should…

Source: CMS Form 2567, inspection 2021-08-16, tag G1022 · view on CMS
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Inspection 2020-07-28

· Focused Infection Control, Other-Fed · no deficiencies cited · CMS source report (PDF)

Inspection 2018-09-20

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

6. Patient #1 had a start of care date of 2/27/13. The clinical record lacked documentation of an individualized emergency plan completed as part of the Recertification comprehensive assessments, dated 3/28, 5/30 and 7/26/18. On 9/19/18 at 10:38 AM, Staff B and Staff C, Clinical Manager, received…

Source: CMS Form 2567, inspection 2018-09-20, tag E0017 · view on CMS
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Moderate Homebound Hha/Hospice Inform Ep Officials

The agency failed to ensure the development of a procedure to inform State and local officials of homebound patients in need of evacuation due to an emergency situation.

Source: CMS Form 2567, inspection 2018-09-20, tag E0019 · view on CMS
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Moderate Infection Control

The agency failed to ensure staff provided care in accordance with agency expectations and accepted infection control standards of practice for 1 of 5 patients (Patient #1) with home visit observations.

Source: CMS Form 2567, inspection 2018-09-20, tag G0684 · view on CMS
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Minor Hha Administrator Contact Information

The agency failed to provide agency patients with contact information for the agency's administrator which included the administrator's name, business address and business phone number.

Source: CMS Form 2567, inspection 2018-09-20, tag G0414 · view on CMS
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Minor A Review Of All Current Medications

The agency failed to complete a drug regimen review, including all required components, with each comprehensive assessment for 3 of 13 sampled patients (Patients # 3, #8 and #11).

Source: CMS Form 2567, inspection 2018-09-20, tag G0536 · view on CMS
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Minor Plan Of Care Must Include The Following

The agency failed to ensure the accurate completion of all components comprising the Plan of Care and/ or failed to ensure the Plan of Care contained current, accurate information for 5 of 13 sampled patients (Patients #1, #2, #8, #9 and #10).

Source: CMS Form 2567, inspection 2018-09-20, tag G0574 · view on CMS
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Minor Visit Schedule

The agency failed to provide to the patients a visit schedule, including frequency of visits, and a copy of the plan of care for 2 of 4 sampled patients with home visit observations (Patients #3 and #4).

Source: CMS Form 2567, inspection 2018-09-20, tag G0614 · view on CMS
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