| 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) |
| C0331 | PERIODIC EVALUATION CFR(s): 485.641(a)(1) The CAH carries out or arranges for a periodic evaluation of its total program. The evaluation is done at least once a year and includes review of-- This STANDARD is not met as evidenced by: Based on staff interview and review of QAPI information, policies and procedures, and "Medical Staff Bylaws and Rules & Regulations," the facility failed to conduct a yearly evaluation of their total program that included all required elements. The findings were: a. Refer to C332 in regards to the facility's failure to perform an annual review of their total program to determine if the utilization of services was appropriate. b. Refer to C333 in regard to the facility's falure to select a representative sample of open and closed records. c. Refer to C334 in regard to the facility's failure to ensure all health care policies were reviewed annually. |