| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 530025 | (X3) Date Survey Completed 11/07/2011 |
| Name of Provider or Supplier Ivinson Memorial Hospital | Street Address, City, State 255 N 30th, Laramie, WY | |
| 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) |
| K0147 | LIFE SAFETY CODE STANDARD CFR(s): NFPA 101 Electrical wiring and equipment is in accordance with NFPA 70, National Electrical Code. 9.1.2 This STANDARD is not met as evidenced by: Based on observation and staff interview, the facility failed to ensure damaged electrical equipment was replaced, failed to provide receptacle face plates, failed to maintain adequate work space in front of electrical panels, failed to ensure temporary wiring did not replace permanent fixed wiring, and failed to ensure electrical receptacles in wet locations had ground fault circuit interruption (GFCI) protection on 3 of 3 floors. The findings were: 1. Observation of the first floor biohazard room on 11/3/11 at 11:56 AM showed an electrical receptacle port was damaged. At the time of observation the facility supervisor could not explain why the receptacle had not been noticed and replaced during the semi-annual inspection. 2. Observation of the second floor telecommunication room on 11/3/11 at 3:03 PM showed the face plate was missing from an electrical receptacle. At the time of observation the facility supervisor could not explain why the receptacle had not been noticed and replaced during the semi-annual inspection. 3. Observation of the electrical system on 11/4/11 between 8:30 AM and 12 PM showed items were stored in front of the electrical panels in the deionized water room, the MRI equipment room, and the pharmacy. At 8:40 AM the facility supervisor reported he was aware of the spacing requirement and also that staff had been instructed several times to not store items in front of electrical panels. 4. Observation of operating room #1 on 11/4/11 at 1:02 PM showed the anesthesia drug cart was plugged into an uninterrupted power supply (UPS) device which was plugged into a surge protector. At the time of observation the director of surgery services reported she was unaware equipment towers in the surgery field could not be plugged into surge protectors and must be plugged directly into a fixed permanent receptacle. 5. Observation of the obstetrics housekeeping closet on 11/7/11 at 10:37 AM showed the two electrical outlets were installed closer than 6 feet from a sink and did not have GFCI protection. At the time of observation the facility supervisor reported he was aware of the requirement and could not explain why the receptacle had not been identified and replaced during the semi-annual inspections. Reference: NFPA 101, 2000 Edition, 19.5.1, 9.1.2; NFPA 70, 1999 Edition; 90-7 Examination of Equipment for Safety. ...It is the intent of this Code that factory-installed internal wiring or the construction of equipment need not be inspected at the time of installation of the equipment, except to detect alterations of damage ... 110-26. Spaces About Electrical Equipment. Sufficient access and working space shall be provided and maintained about all electrical equipment to permit ready and safe operation and maintenance of such equipment ... (a) Working Space. Working space for equipment operating at 600 volts, nominal, or less to ground and likely to require examination, adjustment, servicing, or maintenance while energized shall comply with the dimensions of (1), (2), and (3) or as required or permitted elsewhere in this Code. (1) Depth of Working Space. The depth of the working space in the direction of access to live parts shall not be less than indicated in table 110-26(a) ... Table 110-26(a) Nominal Voltage Minimum Clear Distance (ft) To Ground _______________________________________ 0/150 3 ft. (b) Clear Space. Working space required by this section shall not be used for storage ... 110-27. Guarding of Live Parts. (b) Prevent physical damage. In locations where electric equipment would be exposed to physical damage, enclosure of guards shall be so arranged and of such strength so to prevent such damage. 370-28. Pull and Junction Boxes. (3) (c) cover. All pull boxes, junction boxes and conduit bodies shall be provided with covers compatible with the box or conduit body construction and suitable for the conditions of use.... 384 Switchboards and Panel boards C Panel boards 517-20. Wet Locations. (a) All receptacles and fixed equipment within the area of the wet location shall have ground-fault circuit-interrupter protection for personnel if interruption or power under fault conditions can be tolerated, or be served by an isolated power system if such interruption cannot be tolerated. NFPA 101, 2000 Edition, 19.3.2.3; NFPA 99, 1999 Edition; 7-5.1.2.5 Line Voltage Equipment-Anesthetizing Locations. Flexible cord for portable lamps or portable electrical appliances operating at more than 12 V between conductors, intended for use in anesthetizing locations, shall be continuous and without switches from the appliance to the attachment plug and of a type designated for extra-hard usage in accordance with Article 501-11 of NFPA 70 ... |