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 531312 (X3) Date Survey Completed 03/20/2025
Name of Provider or Supplier Cody Regional Health Street Address, City, State 707 Sheridan Avenue, Cody, 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)
C2400 COMPLIANCE WITH 489.24
CFR(s): 489.20(l)

[The provider agrees,] in the case of a hospital as defined in §489.24(b), to comply with §489.24.


This STANDARD is not met as evidenced by:
Based on medical record review, staff interview, video review, and review of facility policies and procedures, the facility failed to ensure 2 of 20 sample patients (#6, #10) received a medical screening examination. In addition, the facility failed to ensure that a patient was not transferred unless the patient requested the transfer in writing or a physician signed a certification that the medical benefits outweighed the risks for 1 of 5 patients (#2) reviewed who had an emergency medical condition and was transferred to another facility. The findings were: Refer to C-2406 for details on the facility's failure to ensure patients #6 and #10 received adequate medical screening examinations. Refer to C-2409 for details on the facility's failure to ensure patient #2 was not transferred to another facility without the patient's written request or a certification signed by the physician stating the benefits outweighed the risks.