Legacy Hospice
A hospice in Fredericktown, Missouri 63645
733 West Main St, Ste C, Fredericktown, Missouri 63645. (573) 783-7625.
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The short answer
Record last released by CMS on Oct 23, 2026.
- 6 deficiencies cited in the last three years
- 4of 5 family caregiver rating
- 8of 10 CMS’s Hospice Care Index
Each figure’s source sits beside it, in its section below.
What these words mean3
- Star ratings
- CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
- 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?
6 deficiencies cited in the last three years
The middle of the 9 hospices serving ZIP code 63645 had 9.
The last inspection on record was on Feb 29, 2024: an initial inspection by the Accreditation Commission for Health Care.
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
6 deficiencies in 1 month of the last 36. Last cited Feb 2024. 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.
Feb 29, 2024: initial inspection by the Accreditation Commission for Health Care6 deficiencies
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Content of comprehensive assessment (42 CFR 418.54(c)(6))
The inspectors’ words, 156 words
“Upon patient record review, 2 of 19 (Patient #1,4) did not have evidence in the patient record that a review was completed of all prescription and non-prescription medications, including herbal remedies that could affect drug therapy. This review includes, but is not limited to: • Effectiveness of drug therapy • Drug side effects • Actual or potential drug interactions • Duplicate drug therapy • Drug therapy currently associated with laboratory monitoring Patient 1: Duplicate therapy: Aluminum-mag Hydroxide-simethicone 400mg-400mg-40mg/5ml PRN every 4 hours for reflux. Calcium carbonate 50mg chewable tab PRN every 4 hours for reflux. No evidence that instructions were given on which medications to give first when treating reflux. Patient 4: Duplicate drug therapy: Bisacodyl 5mg tabs 2 tabs a daily PRN for constipation. Bisacodyl 10mg sup one per day PRN for constipation. Senna Plus 8.6mg/50mg 2 tabs daily for constipation. No evidence that instructions were given on which medication to give first for constipation.”
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Content of comprehensive assessment (42 CFR 418.54(c)(7))
The inspectors’ words, 100 words
“Upon patient record review, 1 of 8 (Patient #8) did not have evidence in the patient record that the comprehensive assessment includes a bereavement component which includes the needs of the patient’s family and other individuals focusing on the social, spiritual, and cultural factors that may impact their ability to cope with the patient’s death. Information gathered from the initial bereavement assessment is incorporated into the plan of care and is considered in the bereavement plan of care. Patient 8: No evidence that the initial bereavement risk assessment was completed with 5 after admit. Completed on 03/22/2023, admitted on 03/16/2023.”
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Content of plan of care (42 CFR 418.56(c)(2))
The inspectors’ words, 123 words
“Upon patient record review, 1 of 19 (Patient #8) did not have evidence the plan of care must includes all services necessary for the palliation and management of the terminal illness and related conditions, including the following: • A detailed statement of the scope and frequency of services necessary to meet the specific patient and family needs • The IDG demonstrates a proactive approach in developing each patient’s plan of care by planning ahead for anticipated patient changes and needs. Decisions should reflect the patient/family preferences rather than be solely a response to a crisis. Patient 8: Social Worker and Spiritual counselor only have PRN orders on current plan of care. No evidence of routine visits on plan of care. Corrected during survey.”
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Content of plan of care (42 CFR 418.56(c)(5))
“Upon patient record review, 1 of 19 (Patient #6) did not have evidence the plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions, including equipment and supply needs. Patient 6: Patient has pressure wound to right heel activated on 12/26/2023. No evidence of an order to add wound care supplies to current plan of care. POC updated during survey.”
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Hospice aide assignments and duties (42 CFR 418.76(g)(2))
The inspectors’ words, 188 words
“Upon patient record review 2 of 19 (Patient #6,12) did not have evidence documentation in the patient record that a hospice aide provides services that are: • Ordered by the interdisciplinary group • Included in the plan of care • Permitted to be performed under state law by such hospice aide • Consistent with the hospice aide training Patient 6: POC has aide frequency listed at twice weekly. No evidence that 2 visits occurred for the week of 12/24/2023, only one documented visit for that week. No evidence of an order to decrease weekly visits for that week or that the visit was missed at the request of the patient/caregiver. Missed visit note entered stated that the visit was missed due to staff illness. Patient 12: POC has aide frequency listed at twice weekly. No evidence that 2 visits occurred for the week of 02/04, only one documented on 02/08/2024. No evidence of an order to decrease weekly visits for that week or that the visit was missed at the request of the patient/caregiver. Missed visit note entered stated that the visit was missed due to staff illness.”
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Hospice plan of care (42 CFR 418.112(d))
“Upon client record review, 1 of 19 (Patient #2) did not have evidence that a written hospice plan of care is established and maintained in consultation with SNF/NF or ICF/IID representatives. All hospice care provided is in accordance with this hospice plan of care. Patient 2: Initial plan of care has orders for one Chaplain visit for evaluation. No evidence that evaluation visit occurred. Patient accepted spiritual care on initial RN assessment.”
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Feb 29, 2024 | Initial inspection by the Accreditation Commission for Health Care | 6 deficiencies cited |
Is it certified?
- Medicare-certified hospice since May 31, 2000.
- Ownership: for-profit.
- 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?
- From Medicare claims (Jan 1, 2023 to Dec 31, 2024): 14.8 nurse care minutes per routine home care day, 6.4% of skilled nursing minutes at weekends and a visit near death for 96.9% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 34% at home, 17% in assisted living, 41% in a nursing facility, 7% in a skilled nursing facility.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | This provider |
|---|---|
| Nurse care minutes per routine home care day | 14.8 min |
| Skilled nursing minutes at weekends | 6.4% |
| Visits near death | 96.9% of patients who died |
Who owns it?
- Legacy Operating Company LLC owns 100% directly since Feb 17, 2023.
- 9 owners or officers are people: James G Corbin (managing employee (on the payroll)); James G Corbin (runs it (operational or managerial control)); Edward Burke (managing employee (under contract)); Carol Ziegler (corporate officer); Carol Ziegler (managing employee (on the payroll)); Carol Ziegler (runs it (operational or managerial control)); Cara Costephens (managing employee (on the payroll)); Andrew P Lofaso (managing employee (on the payroll)); Andrew P Lofaso (runs it (operational or managerial control)).
- A private-equity firm is 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 |
|---|---|---|---|
| Bcdi Legacy Holdings, LP | Owns 5% or more through other companies | 100% | Nov 10, 2025 |
| LH Holding Company LLC | Owns 5% or more through other companies | 100% | Feb 17, 2023 |
| Bcdi Legacy Midco, LLC | Owns 5% or more through other companies | 100% | Nov 10, 2025 |
| Bcdi Legacy Topco, LLC | Owns 5% or more through other companies | 100% | Nov 10, 2025 |
| Legacy Operating Company LLC | Owns 5% or more directly | 100% | Feb 17, 2023 |
| Bcdi Legacy Investor, LP | Owns 5% or more through other companies | 96.71% | Nov 10, 2025 |
| BAIN Capital Double Impact Fund III, L.P. | Owns 5% or more through other companies | 76.82% | Nov 10, 2025 |
| Bcip Double Impact II, LP | Owns 5% or more through other companies | 6.27% | Nov 10, 2025 |
What do families say?
- Family caregivers rate it 4 of 5 in CMS’s survey (Oct 1, 2023 to Sep 30, 2025): 87% rated it 9 or 10 out of 10, and 87% would definitely recommend it.
- CMS’s Hospice Care Index: 8 of 10 (Jan 1, 2023 to Dec 31, 2024).
- 100% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025); 75% had visits from a nurse or social worker on at least 2 of their last 3 days (Jan 1, 2023 to Dec 31, 2024).
CMS, CAHPS Hospice Survey and Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | Rating |
|---|---|
| Family caregiver survey ratingCMS star rating from its survey of patients’ family caregivers, 1 to 5 | 4 of 5 |
| Hospice Care IndexCMS’s Hospice Care Index, 0 to 10 (higher is better): a point for each of ten measures from Medicare claims on which the hospice meets CMS’s threshold | 8 of 10 |
How does it compare nearby?
- Of the 9 hospices CMS’s data show serving patients in ZIP code 63645, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 9; this one had 6.
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 |
|---|---|
| Legacy Hospice This hospice | 6 |
| Bjc Hospice | 0 |
| Gentiva | 9 |
| Serenity Hospicecare | 20 |
| Legacy Hospice, LLC | 3 |
| Preferred Hospice of Missouri | 9 |
| Alternative Hospice, LLC | 11 |
| Heart & Soul Hospice | 4 |
| Crown Hospice, Inc. | 10 |
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.