| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 531311 | (X3) Date Survey Completed 09/29/2016 |
| 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) |
| C0300 | CLINICAL RECORDS CFR(s): 485.638 Clinical Records This CONDITION is not met as evidenced by: Based on observation, staff interview, and review of medical records and policy and procedure, the facility failed to ensure the medical record system was maintained under established policy and procedures (C301), and that required information was completed for 2 of 20 patients (C305). Further, the facility failed to protect medical records against loss and unauthorized use in 1 of 2 storage areas (C308). The cumulative impact of these deficiencies was a determination that the facility failed to meet the Condition of Participation for Clinical Records. |