Massena Memorial Hospital

PFI # 0804

Complaints:

Complaint Information: 2000
   
Complaint Investigations Completed 3
Complaints with Statements of Deficiencies (SOD) Issued 1
% of Complaints with SODs Issued 33%
Regional % of Complaints with SODs issued: 30.6%

Areas Cited:

SOD Date Regulatory Citation Areas Cited: Date Plan of Correction Accepted
1/18/00 405.5(b) Nursing Services – Delivery of Services 2/3/00
  405.6 Quality Assurance  
  405.43(e) Orders Not to Resuscitate – Decisionmaking  
       

Surveys:

Date of Survey Type Areas Cited: Date Plan of Correction Accepted
5/30-31/00 Validation NFPA 101 - Life Safety Code No POC Required
    482.21 - Quality Assurance  
    482.23(c) - Nursing Services – Preparation and Administration of Drugs  
    482.24(c) - Medical Record Services – Content of Record  
    482.27(c) - Laboratory Services – Potentially infectious Blood and Blood Products – Quarantine of Blood and Blood Products  
    482.41(c) - Physical Environment – Facilities  
    482.42(a) - Infection Control – Organization and Policies  
    482.51(b) - Surgical Services – Delivery of Service  
       

Incident Investigations:

SOD Date Regulatory Citation Areas Cited: Date Plan of Correction Accepted