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Carroll County Memorial Hospital

No longer in CMS list This agency is not in CMS's current list of Medicare-certified home health agencies (file dated 2026-09-21), but it has federal inspection records. It may have closed, changed ownership, or changed its certification number. Address shown is from its inspection records.
1502 N Jefferson Street, Carrollton, MO 64633
CMS Certification Number 267206
11deficiencies since 2018
0serious
3inspections
n/aCMS 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 2021-11-03

· Recertification · 6 deficiencies · CMS source report (PDF)
Moderate Plan Of Care

The agency failed to ensure that the patients received the home health services that were written on the individualized POC (plan of care) when the patients did not receive visits according to the visit frequency ordered on the POC in, but not limited to, one (Record/Patient #2) of five full record…

Source: CMS Form 2567, inspection 2021-11-03, tag G0572 · view on CMS
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Minor Payment From Federally Funded Programs

The agency failed to update the written notice of patient rights to be advised, orally and in writing, of the extent to which payment for services may be expected from Medicare, Medicaid, or any other Federally-funded or Federal aid program known to the HHA (home health agency).

Source: CMS Form 2567, inspection 2021-11-03, tag G0440 · view on CMS
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Minor State Toll Free Hh Telephone Hotline

The agency failed to ensure staff provided the written notice of the updated state toll free home health telephone hotline hours of operation (7:00 AM to 8:00 PM, seven days a week) in the admission booklet.

Source: CMS Form 2567, inspection 2021-11-03, tag G0444 · view on CMS
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Minor A Review Of All Current Medications

The agency failed to complete medication reconciliations and ensure staff reviewed all of the medications the patients were currently using in order to identify any potential adverse effects, drug interactions and noncompliance with drug therapy in one (Record/Patient #4) of three home visit…

Source: CMS Form 2567, inspection 2021-11-03, tag G0536 · view on CMS
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Minor Visit Schedule

The agency failed to ensure staff provided a written visit schedule to patients that included what discipline was visiting, when the discipline would visit, and the frequency of visits in two (Record/Patient #4, and #5) of three home visits.

Source: CMS Form 2567, inspection 2021-11-03, tag G0614 · view on CMS
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Minor Discharge And Transfer Summaries

The agency failed to provide evidence that a completed comprehensive discharge summary was sent to the primary care physician after discharge from the agency's services within five business days of the patient's discharge in one (RECORD/PATIENT#3) of two discharge records reviewed.

Source: CMS Form 2567, inspection 2021-11-03, tag G1022 · view on CMS
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Inspection 2018-11-28

· Recertification · 5 deficiencies · CMS source report (PDF)
Moderate Program Data

The agency failed to provide evidence that the frequency and detail of the quality data collection was approved by the agency's governing body.

Source: CMS Form 2567, inspection 2018-11-28, tag G0644 · view on CMS
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Moderate Home Health Aide Assignments And Duties

The agency failed to ensure the registered nurse (RN) developed and maintained a complete and accurate aide care plan/assignment in two (Record/Patient #3, #4) of two applicable records of patients receiving aide services.

Source: CMS Form 2567, inspection 2018-11-28, tag G0798 · view on CMS
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Minor Plan Of Care Must Include The Following

The agency failed to ensure the individualized plan of care (POC) contained accurate and complete information in but not limited to two (Record/Patient #3, #5) of five records reviewed.

Source: CMS Form 2567, inspection 2018-11-28, tag G0574 · view on CMS
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Minor Verbal Orders

The agency failed to ensure all verbal orders were timed in two (Record/Patient #3, #4) of five records reviewed.

Source: CMS Form 2567, inspection 2018-11-28, tag G0584 · view on CMS
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Minor Participate In Hha-Sponsored In-Service

Employee file review and interview the agency failed to ensure staff completed agency in-service training/education in three applicable cases (E-1, E-2, E-3).

Source: CMS Form 2567, inspection 2018-11-28, tag G0722 · view on CMS
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Inspection 2018-01-08

· Complaint · no deficiencies cited · CMS source report (PDF)