| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 531311 | (X3) Date Survey Completed 11/17/2011 |
| 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) |
| C0154 | LICENSURE, CERTIF. OR REGIST. OF PERSONNEL CFR(s): 485.608(d) Staff of the CAH are licensed, certified, or registered in accordance with applicable Federal, State, and local laws and regulations. This STANDARD is not met as evidenced by: Based on review of personnel files and staff interview, the facility failed to ensure current licensure by the State of Wyoming for prescribing controlled substances for 1 of 5 physicians (physician #1). The findings were: Review of personnel records on 11/16/11 at 2:48 PM revealed the Wyoming Controlled Substance Registration for physician #1 had expired on 6/30/11. Interview with the CNO on 11/17/11 at 8:48 AM revealed she spoke with the physician who confirmed the license had expired; therefore, the physician was not currently licensed to prescribe controlled substances in the State of Wyoming. |