| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 530033 | (X3) Date Survey Completed 03/21/2018 |
| Name of Provider or Supplier Mountain View Regional Hospital | Street Address, City, State 6550 East 2nd Street, Casper, 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) |
| A2400 | COMPLIANCE WITH 489.24 CFR(s): 489.20(l) [The provider agrees,] in the case of a hospital as defined in §489.24(b), to comply with §489.24. This STANDARD is not met as evidenced by: Based on medical record review, receiving hospital record review, staff interview, and policy review, the facility failed to ensure the receiving hospital accepted transfer for 1 of 1 sample patients (#2) who had an emergency medical condition and then experienced cardiac arrest. Refer to A2409 for details concerning facility failure to inform the accepting physician of the cardiac arrest and confirm the receiving facility agreed to accept the patient, whose condition had significantly changed and was no longer stable. |