| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 531310 | (X3) Date Survey Completed 05/03/2012 |
| Name of Provider or Supplier Powell Valley Hospital | Street Address, City, State 777 Avenue H, Powell, 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) |
| C0151 | COMPLIANCE WITH FEDERAL LAWS & REGULATIONS CFR(s): 485.608(a) The CAH is in compliance with applicable Federal laws and regulations related to the health and safety of patients. This STANDARD is not met as evidenced by: Based on medical record review and staff interview, the facility failed to indicate whether additional information related to advance directives was offered and accepted or refused for 5 of 5 acute care patients (#2, #7, #8, #10, #22) documented as not having advance directives. The findings were: Review of the medical records for patients #2, #7, #8, #10 and #22 showed all indicated they did not have advance directives. Further review of each clinical record showed no evidence any patient was offered additional information about advance directives. On 5/1/12 at 10:10 AM RN #4 stated additional information would be provided and documented in the financial area of the computerized record system. On 5/3/12 at 9:55 AM RN #5 stated she had checked with financial services and there was no further information available. She further stated the process was the same for all, whether inpatients or outpatients. Review of the "Advance Directive Report" forms for patients #2, #7, #8, #10 and #22 verified there was no additional information related to advance directives. At 9:58 AM that day the medical/surgical director stated there was nothing in the current system to trigger staff to follow up on advance directives. |