| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 010001 | (X3) Date Survey Completed 10/05/2017 |
| Name of Provider or Supplier Southeast Health Medical Center | Street Address, City, State 1108 Ross Clark Circle, Dothan, AL | |
| For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency. | ||
| (X4) ID Prefix Tag | Summary Statement of Deficiencies
(Each deficiency should be preceded by full regulatory or LSC identifying information) |
| K0000 | This STANDARD is not met as evidenced by: . K3 Building: 0105 Hospital K6 Plan Approval: 1955/ 1960/ 1965/ 1977/ 1978/ 1989/ 1997/ 2005 K7 Survey Under: 2012 Existing K8 Hospital Corridor Smoke Detection: Complete Locking Devices: Only at the two Psych Units Generators: (3) 2000 kW Diesel, installed in 2004 Type of Structure: Seven story with a basement protected noncombustible, Type II (222). This building has a complete automatic sprinkler system. During a survey conducted on this date, this building was found to be not in compliance with 42 CFR 482.41 (b) as evidenced by the following deficiencies of NFPA 101 Life Safety Code (LSC) and codes referenced by the LSC, as observed by the LSC Surveyors while accompanied by the facility maintenance personnel. . |