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 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)
C0369 MAIL
CFR(s): 485.645(d)(1)

[The CAH is substantially in compliance with the following SNF requirements contained in subpart B of part 483 of this chapter:] Resident rights - mail (ยง483.10(i)): "The resident has the right to privacy in written communications, including the right to- (1) Send and promptly receive mail that is unopened; and (2) Have access to stationery, postage, and writing implements at the resident's own expense."


This STANDARD is not met as evidenced by:
Based on resident and staff interview, the hospital failed to ensure mail was delivered on Saturdays to 4 of 4 swing-bed patients. The findings were: Interview with patient #5 on 5/1/12 at 9 AM revealed s/he had not received mail on Saturday while in the hospital as a swing bed patient. Interview with the compliance officer on 5/3/12 at 3 PM revealed mail was picked up by a staff member on Saturdays so residents in the attached care center received their mail. She further said, however, the staff member who delivered the mail to the care center did not deliver to the hospital which was where the swing-bed patients/residents resided.