| 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) |
| 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 compliance with the National Electric Code in 1 of 6 smoke compartments. The findings were: Observation on 5/1/12 at 10:30 AM revealed a desk in the medical records section had an electrical cover plate that had come away from the wall. The electrical cord was still plugged into the outlet. In addition, a light switch cover plate in the soiled utility room was chipped. Interview with maintenance staff at the time of the observations confirmed the above findings. Reference: NFPA 70, National Electrical Code, 1999 Edition. |