Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391
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)
C0256 RESPONSIBILITIES OF MD OR DO
CFR(s): 485.631(b)

Responsibilities of MD or DO


This STANDARD is not met as evidenced by:
Based on staff interview; review of peer review activities, minutes of medical staff meetings, and policies and procedures; and interview with the medical director, the facility failed to ensure physicians conducted adequate peer review activities and provided direction and supervision for hospital staff. The findings were: Refer to C257 for details regarding this failure.