S&C QCOR Hospital 2567s
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Hospital 2567s
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Provider Characteristics

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Survey Type & Deficiency Tags

Use these filters if you want to limit the reports to providers on specific survey types, or to reports that were cited for specific Hospital deficiency tags and tag types. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

CCN and Facility Name

Use these filters if you know the name (or partial name) of the facility you are searching for, or the CMS Certification Number (CCN) for the facility you are searching for.

Other Survey Characteristics

Select one of the options below to filter by surveys that cite deficiencies or by surveys that are deficiency-free. By default, only surveys that cite deficiencies are displayed. Selecting "All" displays all surveys.

CMS Certification Number Facility Name Hospital Subtype Address City State CMS Region Date of CMS Survey Survey Event ID Survey Type Statement of Deficiencies Report
▼ 531301 South Big Horn County Critical Access Hospital Critical Access Hospitals 388 Us Highway 20 South Basin WY 8 (Denver) 03/15/2017 QU9R21 Standard
Deficiency Tag Deficiency Description Tag Type
K0000 Initial Comments - Not A Deficiency Citation Standard
K0211 Means Of Egress - General Standard
K0293 Exit Signage Standard
K0321 Hazardous Areas - Enclosure Standard
K0351 Sprinkler System - Installation Standard
K0355 Portable Fire Extinguishers Standard
K0363 Corridor - Doors Standard
K0741 Smoking Regulations Standard
▼ 531301 South Big Horn County Critical Access Hospital Critical Access Hospitals 388 Us Highway 20 South Basin WY 8 (Denver) 05/02/2013 XO7B11 Complaint, Standard
Deficiency Tag Deficiency Description Tag Type
C0000 Initial Comments - Not A Deficiency Citation Memo
C0195 Agreements - Credentialing & Qa Standard
C0271 Patient Care Policies Standard
C0272 Patient Care Policies Standard
C0276 Patient Care Policies Standard
C0280 Patient Care Policies Standard
C0298 Nursing Services Standard
C0302 Records Systems Standard
C0304 Records Systems Standard
C0307 Records Systems Standard
C0336 Quality Assurance Standard
C0337 Quality Assurance Standard
C0361 Residents Rights Standard
▼ 531301 South Big Horn County Critical Access Hospital Critical Access Hospitals 388 Us Highway 20 South Basin WY 8 (Denver) 04/30/2013 XO7B21 Standard
Deficiency Tag Deficiency Description Tag Type
K0000 Initial Comments - Not A Deficiency Citation Standard
K0011 Life Safety Code Standard Standard
K0018 Life Safety Code Standard Standard
K0104 Life Safety Code Standard Standard
▼ 531301 South Big Horn County Critical Access Hospital Critical Access Hospitals 388 Us Highway 20 South Basin WY 8 (Denver) 09/27/2012 XXH911 Complaint
Deficiency Tag Deficiency Description Tag Type
C0270 Provision Of Services Condition
C0279 Patient Care Policies Standard
C0341 Quality Assurance Standard
▼ 531302 Memorial Hospital Of Converse County Critical Access Hospitals 111 South 5th Street Douglas WY 8 (Denver) 06/24/2025 S6Y011 Complaint
Deficiency Tag Deficiency Description Tag Type
C0000 Initial Comments - Not A Deficiency Citation Memo
C2400 Compliance With 489.24 Standard
C2405 Emergency Room Log Standard
C2406 Medical Screening Exam Standard
▼ 531302 Memorial Hospital Of Converse County Critical Access Hospitals 111 South 5th Street Douglas WY 8 (Denver) 09/08/2022 6DC811 Complaint
Deficiency Tag Deficiency Description Tag Type
C0000 Initial Comments - Not A Deficiency Citation Memo
C1104 Records System Standard
▼ 531302 Memorial Hospital Of Converse County Critical Access Hospitals 111 South 5th Street Douglas WY 8 (Denver) 04/21/2021 RC8J11 Complaint, Special
Deficiency Tag Deficiency Description Tag Type
C0000 Initial Comments - Not A Deficiency Citation Memo
C1200 Infection Prevent & Control & Abt Stewar Prog Condition
C1208 Infection Prevent Surveil & Control Of Hais Standard
▼ 531302 Memorial Hospital Of Converse County Critical Access Hospitals 111 South 5th Street Douglas WY 8 (Denver) 03/06/2020 VGME21 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
K0000 Initial Comments - Not A Deficiency Citation Standard
K0223 Doors With Self-Closing Devices Standard
K0225 Stairways And Smokeproof Enclosures Standard
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing And Maintenance Standard
K0351 Sprinkler System - Installation Standard
K0353 Sprinkler System - Maintenance And Testing Standard
K0355 Portable Fire Extinguishers Standard
K0781 Portable Space Heaters Standard
K0912 Electrical Systems - Receptacles Standard
K0919 Electrical Equipment - Other Standard
K0920 Electrical Equipment - Power Cords And Extens Standard
K0923 Gas Equipment - Cylinder And Container Storag Standard
▼ 531302 Memorial Hospital Of Converse County Critical Access Hospitals 111 South 5th Street Douglas WY 8 (Denver) 03/05/2020 VGME11 Standard
Deficiency Tag Deficiency Description Tag Type
C0000 Initial Comments - Not A Deficiency Citation Memo
C1100 Clinical Records Condition
C0884 Equipment, Supplies, And Medication Standard
C1110 Records System Standard
C1120 Protection Of Record Information Standard
C1144 Anesthetic Risk And Evaluation Standard
▼ 531302 Memorial Hospital Of Converse County Critical Access Hospitals 111 South 5th Street Douglas WY 8 (Denver) 09/15/2016 7YH121 Standard
Deficiency Tag Deficiency Description Tag Type
K0000 Initial Comments - Not A Deficiency Citation Standard
K0017 Life Safety Code Standard Standard
K0029 Life Safety Code Standard Standard
K0029 Life Safety Code Standard Standard
K0038 Life Safety Code Standard Standard
K0047 Life Safety Code Standard Standard
K0050 Life Safety Code Standard Standard
K0052 Life Safety Code Standard Standard
K0056 Life Safety Code Standard Standard
K0062 Life Safety Code Standard Standard
K0062 Life Safety Code Standard Standard
K0064 Life Safety Code Standard Standard
K0076 Life Safety Code Standard Standard
K0134 Life Safety Code Standard Standard
K0144 Life Safety Code Standard Standard
K0145 Life Safety Code Standard Standard
K0147 Life Safety Code Standard Standard