Marshfield Medical Center - Dickinson Hospice
A hospice in Iron Mountain, Michigan 49801
722 River Ave, Iron Mountain, Michigan 49801. (906) 776-1925.
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The short answer
Record last released by CMS on Oct 23, 2026.
- 12 deficiencies cited in the last three years
- Not rated family caregiver rating
- Not available CMS’s Hospice Care Index
Each figure’s source sits beside it, in its section below.
What these words mean2
- Inspection (survey)
- A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
- Deficiency, citation, violation
- What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
What did inspectors find?
12 deficiencies cited in the last three years
The middle of the 6 hospices serving ZIP code 49801 had 9.
The last inspection on record was on Mar 7, 2025: a reaccreditation inspection by The Joint Commission.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
CMS, Hospice ZIP Data. Released Aug 26, 2026. Updated quarterly.
When those deficiencies happened
12 deficiencies in 2 months of the last 36. Last cited Mar 2025. Most serious: Standard-level. The last 3 years, to Oct 27, 2026.
| Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2023 | Nov | Dec | ||||||||||
| 2024 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2025 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2026 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct |
Hover or focus a month to read it.
Hearth Record drew this from the dates and levels in the source’s own records.
Each deficiency, as cited
Rule titles as CMS’s inspectors cite them, set in sentence case.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
Mar 7, 2025: reaccreditation inspection by The Joint Commission6 deficiencies
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Plan of care (42 CFR 418.56(b))
“Observed in Patient Home. In 1 of 3 home visits conducted, The organization failed to provide patient education and training based on each patient’s needs and abilities per Medication Policy No 3-002-1, as evidenced by HOSRRHV#3 there was no written list/education on morphine sulfate which is a high risk medication, this was validated by Administrator”
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Content of plan of care (42 CFR 418.56(c))
The inspectors’ words, 266 words
“Observed in Individual Tracer. In 10 of 10 patient records reviewed, The HCO failed to create measurable outcomes and goals as evidenced by all goals in charts reviewed were to be achieved by the end of the certification period, yet all were not appropriate for that length of time. Example in HOS RRHV#1 goal was : patient at risk for UTI/r/t disease progression, problem UTI/urinary elimination and patient has had no UTI since soc of care in 2024. HOSRRHV#2 patient/CG will engage in conversation about funeral arrangements within 2 weeks since SOC in 2024. HOSRRHV#3 pain will be controlled at a tolerable level of 0-4 since SOC in 2024 and within 1 cert period since SOC. HOSRRNHV#1 Patients SOB on the Edmonton scale was 6/10 and goal was patient at risk for respiratory distress r/t COPD and increase in secretions. HOSRRNHV#2 patient is alert and orientated at SOC and goal is patient at risk for confusion related to the se disease process, and progression. HOSRRNHV#3 patient rates SOB 5 on Edmonton scale: goals, goal is that patient with End stage COPD, symptoms to be managed within episode. HOSRRNHV#4: : Pain management within home setting to a tolerable level. within cert period and pain rated pain a 5 @ SOC HOSRRNHV#5: Patient with stg 4 lung cancer, respiratory symptoms to be managed within episode. HOSRRNHV#6: Patients pain will be controlled within home during episode. and patient rated her pain a 7/10. HOSRRNHV#7 the patient rated his pain an 8/10 and goal was : patients pain will be well managed throughout the episode This was validated by Administrator”
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Content of plan of care (42 CFR 418.56(c)(4))
“Observed in Record Review. In 2 of 10 patient records reviewed, The organization failed to review orders and prescriptions for appropriateness and accuracy before providing care, treatment, or services as evidenced that in both cases there was no clarification to use as evidenced in HOSRRHV#2 the order for oxygen was incomplete: it states 2-5 litres continuous. In HOSRRHV#3 morphine sulphate ordered 0.5mls- 2mls q 2 hourly PRN for pain rating of 5-10/10, this was validated by the Administrator”
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Prevention (42 CFR 418.60(a))
“Observed in Patient Home. In 1 of 3 home visits conducted, The HCO implements activities for the prevention of infection, including the use of standard precautions as evidenced by in HOSHV#2 the RN failed to perform hand hygiene consistent with Hand Hygiene Policy No 9-009., the RN petted the patients dog on the bed, then worked on her computer and placed cleaned equipment back in the medical bag without cleaning her hands first, this was validate by the Administrator”
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Professional management responsibility (42 CFR 418.100(e))
“Observed in Competency Session. The HCO had an incomplete contract evidenced by the Medical Director’s contract was not dated, this was observed and validated by the Administrator”
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Clinical records (42 CFR 418.104)
“Observed in Record Review. In 2 of 12 patient records reviewed, The HCO did not maintain a current accurate record as evidenced in HSPRRHV#! ; one IDG note contained information from another patient, included summary of the other patients IDG notes and corrected on site In HOSRRDC#2, the revocation order date was inaccurate as it was documented the day before the revocation which aligns with the patients hospital admission, this was observed and validated by Administrator”
Apr 11, 2024: initial inspection by The Joint Commission6 deficiencies
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Content of plan of care (42 CFR 418.56(c))
The inspectors’ words, 91 words
“Observed in Record Review. In 7 of 10 patient records reviewed, the organization did not plan the patient’s care by ensuring the written plan of care was based on the patient’s goals and the timeframes required to meet those goals. In RRHV#1, RRHV#2, RRHV#3, RRNHV#1, RRNHV#2, RRNHV#3, and RRNHV#6 the patient’s plan of care did not include short term goals, including for pain and other symptom management. All timeframes for goals to be achieved were documented to be within the hospice certification period. This was reviewed and verified with the Administrator.”
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Content of plan of care (42 CFR 418.56(c)(4))
The inspectors’ words, 114 words
“Observed in Record Review. In 3 of 10 patient records reviewed, the plan of care did not include all services needed for the palliation and management of the terminal illness and related conditions, including medications and treatment necessary to meet the patient’s needs. In RRHV#3 and RRNHV#3, the patient’s plan of care included Morphine Sulfate (Concentrate) Oral Solution and Hydrocodone-Acetaminophen Oral Tablet 5-325 MG ordered as needed for pain with no clear indications for use (which prn analgesic to take when). In RRNHV#4, the patient’s plan of care orders included Morphine Sulfate Oral Solution prn and Norco prn for pain with no clear indications for use. This was reviewed and verified with the Administrator.”
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Prevention (42 CFR 418.60(a))
“Observed in Patient Home. In 2 of 3 home visits conducted, the organization did not implement infection prevention and control activities when cleaning and performing disinfection of medical supplies and devices to reduce the risk of infections. In RRHV#1 and RRHV#2, the registered nurse cleaned the care equipment before placing the items back into the field bag, but did not disinfect the cell phone and electronic tablet device after use according to the organizational policy. This was reviewed and verified with the Administrator.”
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Supervision of hospice aides (42 CFR 418.76(h)(1)(i))
“Observed in Record Review. In 2 of 10 patient records reviewed, the registered nurse did not supervise the hospice aide during an on-site home visit at least every 14 days to assess the quality of care/services provided by the aide and ensure the services ordered met the patient’s needs. In RRHV#3 and RRNHV#1, the registered nurse did not perform/document hospice aide supervision consistently every 14 days, with 20 days or more between supervisory visits noted. This was reviewed and verified with the Administrator.”
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Initial certification of terminal illness (42 CFR 418.102(b))
The inspectors’ words, 117 words
“Observed in Record Review. In 10 of 10 patient records reviewed, the medical director, physician member of the interdisciplinary team, or physician designee did not review the clinical information for each hospice patient and provide written certification that the patient’s life expectancy was six months or less if the illness ran its normal course. In RRHV#1, RRHV#2, RRHV#3, RRNHV#1, RRNHV#2, RRNHV#3, RRNHV#4, RRNHV#5, RRNHV#6, and RRNHV#7, it was noted the hospice medical director did review the clinical information of each patient and sign the Certificate of Terminal Illness (CTI), but did not document a written narrative that included the required elements/factors needed for determination of the patient’s life expectancy. This was reviewed and verified with the Administrator.”
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Use and mintenance of equipment and supplies (42 CFR 418.106(f)(2))
“Observed in Patient Home. In 2 of 3 home visits conducted, the organization did not provide education and training based on each patient’s needs and abilities, including procedures to follow if care, treatment, or services were disrupted by a natural disaster or emergency. In RRHV#1 and RRHV#2, the patient’s individual home evacuation/emergency plan and related education was not provided to the patient/family. This was reviewed and verified with the Administrator”
All 2 inspections in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Mar 7, 2025 | Reaccreditation inspection by The Joint Commission | 6 deficiencies cited |
| Apr 11, 2024 | Initial inspection by The Joint Commission | 6 deficiencies cited |
Is it certified?
- Medicare-certified hospice since May 9, 2024.
- CMS doesn’t list its type of ownership.
- No For hospices, home health agencies, hospitals and dialysis facilities, CMS writes deficiencies at two levels. Standard is the usual one; condition-level is the more serious, when a problem is serious enough that the provider doesn’t meet a whole condition of taking part in Medicare. Source: CMS, State Operations Manual. deficiency or CMS’s most serious finding: the place’s failure to meet a rule caused, or was likely to cause, serious injury, harm, impairment or death to someone in its care. Source: CMS; 42 CFR 489.3. on record in the last three years.
CMS, Hospice General Information. Released Aug 26, 2026. Updated quarterly.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
Has anything been proven against it?
- CMS doesn’t publish fines or other penalties for hospices, so none are shown.
- 0 deficiencies cited in the last three years came from inspections that included a complaint investigation.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
Who does the caring?
- CMS hasn’t published nursing time from Medicare claims for this hospice.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
Who owns it?
- Mchs Hospitals Inc. owns 100% directly since Feb 3, 2022.
- Mchs Hospitals Inc. runs it.
- 21 owners or officers are people: Tina Zarcone (managing employee (on the payroll), 100%); Tina Zarcone (runs it (operational or managerial control), 100%); Kristi R Olson (managing employee (on the payroll), 100%); Brian D Hoerneman (corporate officer); Brian D Hoerneman (corporate director); Tony Lee Morrison (managing employee (on the payroll), 0%); John F Baltus (corporate officer); John F Baltus (corporate director); Jolyn Joy Munson (managing employee (on the payroll)); Dennis H Smith (corporate director); Jeffrey Douglas Poppen (corporate officer, 0%); Jeffrey Douglas Poppen (managing employee (on the payroll), 0%); Edward G Fernandez (corporate officer); Edward G Fernandez (corporate director); Samantha L Klebe (corporate director); Samantha L Klebe (managing employee (on the payroll)); Linda Laverne Procci (corporate director); Beth Schroeder (managing employee (on the payroll), 0%); Everett W Newcomb (corporate director); Douglas Mathison (corporate director); Nicholas Wayne Olson (managing employee (on the payroll)).
- No private-equity firm among the owners CMS lists.
- No real-estate investment trust among the owners CMS lists.
CMS, Hospice All Owners and Hospice Enrollments. Released Sep 29, 2026. Updated quarterly.
| Organisation | Role | Share | Since |
|---|---|---|---|
| Sanford | Owns 5% or more through other companies | 100% | Jan 1, 2025 |
| Mchs Hospitals Inc. | Owns 5% or more directly | 100% | Feb 3, 2022 |
| Mchs Hospitals Inc. | Runs it (operational or managerial control) | 100% | Feb 3, 2022 |
| Marshfield Clinic Health System Inc. | Owns 5% or more through other companies | 100% | Feb 3, 2022 |
What do families say?
- CMS gives no family caregiver survey rating: “The number of cases is too small to report Star Ratings.”
- CMS gives no Hospice Care Index for this hospice.
CMS, CAHPS Hospice Survey and Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
How does it compare nearby?
- Of the 6 hospices CMS’s data show serving patients in ZIP code 49801, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 9; this one had 12.
CMS, Hospice ZIP Data. Released Aug 26, 2026. Updated quarterly.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
| Place | Deficiencies, 3 years |
|---|---|
| Marshfield Medical Center - Dickinson Hospice This hospice | 12 |
| Lake Superior Life Care & Hospice | 10 |
| Upper Peninsula Home Health & Hospice | 11 |
| North Woods Home Nursing & Hospice | 8 |
| OSF Bay De Noc Hospice | 1 |
| Up Health System Home Care & Hospice | 4 |
What the record doesn’t say
- CMS doesn’t publish fines or other penalties for hospices, so none are shown.
- Only complaints that led to a citation appear; complaints that didn’t aren’t published.
- CMS ended its Special Focus Program for hospices with serious problems on Feb 14, 2025, so no hospice is marked as one.
- Hospice quality measures have a gap from October 2025: CMS replaced its patient assessment then, and public results from the new one (HOPE) are expected around November 2027.
Sources
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Centers for Medicare & Medicaid Services, Hospice General Information (yc9t-dgbk).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice Provider Data (252m-zfp9).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, CAHPS Hospice Survey (gxki-hrr8).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, QCOR hospice inspection reports (Hospice Survey Reports - Oct 2021 through Sep 2026.xlsx).
Released Oct 23, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice All Owners (e983965e-1603-4cb8-82b5-c40090e380d1).
Released Sep 29, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice Enrollments (25704213-e833-4b8b-9dbc-58dd17149209).
Released Sep 29, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice ZIP Data (95rg-2usp).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.
This copy of the record was made on Oct 27, 2026.
From the hospice
The public record above comes first. Anything the hospice adds will appear here, below it, and say who wrote it.
Replies
None. Replies aren’t open yet. When they open, the hospice will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.
Paid listing
None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the hospice”, and paying will never change a finding, a rating or the order of results.