| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 531311 | (X3) Date Survey Completed 10/05/2016 |
| 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) |
| K0147 | LIFE SAFETY CODE STANDARD CFR(s): NFPA 101 Electrical wiring and equipment shall be in accordance with National Electrical Code. 9-1.2 (NFPA 99) 18.9.1, 19.9.1 This STANDARD is not met as evidenced by: . Based on observation and staff interview, the facility failed to meet electrical wiring in accordance with NFPA 70. The findings were: Observation on 10/05/2016 at 10:25 AM located in rooms 4, 5, 6, 7, and 8 revealed receptacles approximately 2 feet away from sinks that were not equipped with a ground-fault circuit-interrupter. Interview with the Facility Maintenance Manager at the time of observation acknowledged the missing ground-fault circuit-interrupters. Ref: 1999 NFPA 70, Article 210.8 |