Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391

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)
K0232 Aisle, Corridor, or Ramp Width
CFR(s): NFPA 101

Aisle, Corridor or Ramp Width 2012 EXISTING The width of aisles or corridors (clear or unobstructed) serving as exit access shall be at least 4 feet and maintained to provide the convenient removal of nonambulatory patients on stretchers, except as modified by 19.2.3.4, exceptions 1-5. 19.2.3.4, 19.2.3.5


This STANDARD is not met as evidenced by:
. Based on observation and interview, the building failed to maintain the corridors per the requirements of: 2012 NFPA 101, 19.2.3.4 (5) (a) and (c) Findings include: On 10/02/2017, during a tour of the building from 10:30 am to 5:45 pm, the facility failed to maintain the Fourth Floor corridors: 1. In the 8'-0" corridors unsecured furniture was observed in the following locations: a. In the connector wing at room 470 b. At elevator B1 2. The furniture at elevator B1 was observed to be on both sides of the 8'-0" corridor. A member of the maintenance staff was present when this deficiency was identified. .