| 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) |
| C0225 | MAINTENANCE CFR(s): 485.623(b)(4) [The CAH has housekeeping and preventive maintenance programs to ensure that- the premises are clean and orderly; This STANDARD is not met as evidenced by: Based on observation and staff interview, the facility failed to provide a clean and safe environment in 1 of 1 laundry rooms and in 1 of 1 patient bathing rooms. The findings were: Observation on 11/15/11 at 1:48 PM revealed the following concerns: a. The small area (approximately 3 feet by 3 feet) behind the clothes dryer in the laundry room was accessed by the main corridor door to allow servicing of the dryer. However, the area was littered with an inch build-up of lint. An operational 220 volt electrical outlet located on the wall serviced the dryer. b. The wall in the patients' bathing room shower area had two "L" shaped metal brackets that jutted 3 inchs out into the room. They were attached to the wall approximately 5 feet off the floor directly over a patient shower bench and presented a safety hazard to patients. c. Interview with the facility operations manager at the time of the observations confirmed the above findings. |