| 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) |
| K0211 | LIFE SAFETY CODE STANDARD CFR(s): NFPA 101 Where Alcohol Based Hand Rub (ABHR) dispensers are installed in a corridor: o The corridor is at least 6 feet wide o The maximum individual fluid dispenser capacity shall be 1.2 liters (2 liters in suites of rooms) o The dispensers have a minimum spacing of 4 ft from each other o Not more than 10 gallons are used in a single smoke compartment outside a storage cabinet. o Dispensers are not installed over or adjacent to an ignition source. o If the floor is carpeted, the building is fully sprinklered. 19.3.2.7, CFR 403.744, 418.100, 460.72, 482.41, 483.70, 483.623, 485.623 This STANDARD is not met as evidenced by: Based on observation and staff interview, the facility failed to ensure an alcohol based hand rub (ABHR) dispenser was not installed over an ignition source in 1 of 4 smoke compartments. The findings were: Observation on 11/15/11 at 9:48 AM revealed one ABHR dispenser was attached to the wall directly over a light switch in the outpatient entrance. Interview with the maintenance manager at the time of the observation confirmed the dispenser was located over a possible ignition source. Reference: NFPA 101, Life Safety Code, 2000 edition, Section 19.3.2.7. CFR 403.744. |