| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 531311 | (X3) Date Survey Completed 11/15/2011 |
| Name of Provider or Supplier Crook County Hospital | Street Address, City, State 713 Oak Street, Sundance, 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) |
| K0064 | LIFE SAFETY CODE STANDARD CFR(s): NFPA 101 Portable fire extinguishers are provided in all health care occupancies in accordance with 9.7.4.1. 19.3.5.6, NFPA 10 This STANDARD is not met as evidenced by: Based on observation and staff interview, the facility failed to inspect 4 of 25 portable fire extinguishers during the previous year in accordance with NFPA 10 Section 4-4.1. The findings were: Observation of facility fire extinguishers on 11/15/11 between 11:45 AM and 2:48 PM revealed an inspection tag dated 2009 was attached to the fire extinguishers located in the lab, the maintenance room and the procedure room. In addition, an inspection tag dated 2008 was attached to the fire extinguisher in the central supply room. Interview with facility manager at the times listed above confirmed the extinguishers were improperly tagged. NFPA 101, Life Safety Code, 2000 edition. Sections 19.3.5.6 Portable fire extinguishers shall be provided in all health care occupancies in accordance with 9.7.4.1. 9.7.4.1 Where required by the provisions of another section of this Code, portable fire extinguishers shall be installed, inspected and maintained in accordance with NFPA 10. 4-4.1 Maintenance Frequency. Extinguishers shall be subjected to maintenance not more than one year apart or when specifically indicated by an inspection. |