On May 17, 2011, the NRC issued a Notice of Violation to Providence Hospital for a Severity Level III violation involving the failure to develop written procedures to provide high confidence that each administration was in accordance with the written directive as required by 10 CFR 35.41(a). Specifically, as of August 30, 2010, the licensee's brachytherapy procedure did not provide high confidence that the needles would be inserted to the right depth as the licensee did not require the use of available means such as biological or needle markers.