A Tidewater Womens Health Clinic

CLIA Laboratory Citation Details

3
Total Citations
14
Total Deficiencyies
10
Unique D-Tags
CMS Certification Number 49D0977679
Address 891 Norfolk Square, Norfolk, VA, 23502
City Norfolk
State VA
Zip Code23502
Phone(757) 461-0011

Citation History (3 surveys)

Survey - June 8, 2022

Survey Type: Standard

Survey Event ID: CSH111

Deficiency Tags: D0000 D2159 D5217 D6017 D6018

Summary:

Summary Statement of Deficiencies D0000 An announced CLIA recertification survey was conducted at A Tidewater Women's Health Clinic on June 8, 2022 by the Virginia Department of Health's Office of Licensure and Certification. The laboratory was surveyed under 42 CFR part 493 CLIA Requirements. Specific deficiencies cited are as follows: D2159 ABO GROUP AND D(RHO) TYPING CFR(s): 493.859(d) Failure to return proficiency testing results to the proficiency testing program within the time frame specified by the program is unsatisfactory performance and results in a score of 0 for the testing event. This STANDARD is not met as evidenced by: Based on an review of proficiency testing (PT) records, lack of documentation, and an interview, the laboratory failed to submit immunohematology ABO and RHo (D) Typing PT results for two (2) of seven (7) events reviewed receiving unsatisfactory scores (review timeframe February 2020 to 6/8/22). Findings include: 1. Review of the laboratory's American Proficiency Institute (API) ABO and RHo (D) Typing PT Modules (2020 Events 1-3, 2021 Events 1-3, 2022 Event 1) revealed unsatisfactory scores for the following events: API 2020 Event 1: ABO/Rh Group = 0 % and D (Rho) Typing = 0%; API report noted "failed to participate; results not reported to API for five of five challenge samples resulting in score of zero"; API 2021 Event 1: ABO/Rh Group = 0% and D (Rho) Typing = 0%, API report noted "failed to participate; results not reported to API for five of five challenge samples resulting in score of zero". 2. The inspector inquired regarding

πŸ”’ Unlock Deficiency Summary

Get full access to the detailed deficiency summary for this facility

One-time payment β€’ Lifetime access

Survey - February 5, 2020

Survey Type: Standard

Survey Event ID: 5J5W11

Deficiency Tags: D6000 D6021 D6046 D0000

Summary:

Summary Statement of Deficiencies D0000 An announced CLIA recertification survey was conducted at A Tidewater Women's Health Clinic on February 5, 2020 by the Virginia Department of Health's Office of Licensure and Certification. The laboratory was surveyed under 42 CFR part 493 CLIA Requirements. Specific deficiencies cited are as follows: D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR CFR(s): 493.1403 The laboratory must have a director who meets the qualification requirements of 493. 1405 of this subpart and provides overall management and direction in accordance with 493.1407 of this subpart. This CONDITION is not met as evidenced by: Based on a review of policies and procedures, personnel records, patient test logs, quality assurance (QA) records, Centers for Medicare and Medicaid Services Laboratory Personnel Report form, lack of documentation, and interviews on the date of the survey 2/5/20, the laboratory director (LD) failed to: 1. ensure that the laboratory's QA policies were maintained during the twenty (20) months reviewed (See D6021 *REPEAT DEFICIENCY); 2. document annual competency assessments for immunohematology blood grouping (Rh) testing for two (2) of 2 testing personnel (TP) in calendar years 2018 and 2019 (See D6046 * REPEAT DEFICIENCY). D6021 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(5) The laboratory director is responsible for the overall operation and administration of the laboratory, including the employment of personnel who are competent to perform test procedures, and record and report test results promptly, accurate, and proficiently and for assuring compliance with the applicable regulations. (e) The laboratory director must-- (e)(5) Ensure that quality assessment programs are established and Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 2 -- maintained to assure the quality of laboratory services provided. This STANDARD is not met as evidenced by: **REPEAT DEFICIENCY** Based on a review of policies and procedures, personnel records, patient test logs, quality assurance (QA) records, and an interview, the laboratory director (LD) failed to ensure that the QA policies were maintained during the twenty (20) months reviewed. Findings include: 1. Review of the laboratory's policy and procedure manual revealed a written and approved QA policy that included a quarterly check list and monitors for compliance to be performed by the LD. The QA plan and check list included a Personnel Section that stated "All personnel who perform testing have documented training for the tests and have read the protocol and procedures for the tests. Personnel evaluations are performed annually." 2. Review of the testing personnel records revealed no annual competency assessments for two (2) of 2 testing personnel in calendar years 2018 and 2019. (See D6046.) 3. Review of the laboratory's available quarterly QA documentation from June 2018 through the date of the survey on 2/5/20 revealed no documentation of

πŸ”’ Unlock Deficiency Summary

Get full access to the detailed deficiency summary for this facility

One-time payment β€’ Lifetime access

Survey - June 6, 2018

Survey Type: Standard

Survey Event ID: UEJO11

Deficiency Tags: D5791 D6046 D0000 D5407 D6021

Summary:

Summary Statement of Deficiencies D0000 An announced CLIA recertification survey was conducted at A Tidewater Women's Health Clinic on June 6, 2018 by the Virginia Department of Health's Office of Licensure and Certification. The laboratory was surveyed under 42 CFR part 493 CLIA Requirements. Specific deficiencies cited are as follows: D5407 PROCEDURE MANUAL CFR(s): 493.1251(d) Procedures and changes in procedures must be approved, signed, and dated by the current laboratory director before use. This STANDARD is not met as evidenced by: Based on review of policies and procedures, a facility tour, patient test logs, and an interview, the laboratory director (LD) failed to document approval and review of the laboratory's modifications of the written procedure for patient Rh blood typing. Findings include: 1. Review of the laboratory's policy and procedure manual revealed a procedure for Rh Blood Slide Test Typing that was approved by the LD on 6/2/14. The procedure stated in step number nine (9) and ten (10) "If no agglutination occurs initially, incubate the test for five minutes at 18-24 degrees Celsius. After incubation, immediately observe for agglutination. If the slide is smooth after that time, no agglutination, the result is negative and the patient is Rh negative. Record all results into the daily log and patient's chart". 2. During a tour of the facility, the inspector made an inquiry of where and what timing device is used when the testing personnel perform the incubation step for negative results of the Rho Blood Slide Test Typing. The primary testing personnel stated, "We do not perform the five minute incubation step. I was not trained to do that step." 3. Review of the laboratory's patient log documentation from July 2016 to the date of the survey on 6/6/18, a total of twenty- four (24) months, revealed no evidence of the laboratory performing the additional incubation step per the written protocol for negative results. The inspector requested to review documentation of the incubation step. No documentation was available for Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 3 -- review. 4. In an interview with the primary testing personnel at approximately 4:30 PM on 6/6/18, it was confirmed that the laboratory failed to follow the established policy for Rh Blood Slide Test Typing and that the LD failed to document approval and review of the laboratory's modifications of the written procedure for patient Rh blood typing during the twenty-four (24) months reviewed. D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1289(a)(c) (a) The laboratory must establish and follow written policies and procedures for an ongoing mechanism to monitor, assess, and when indicated, correct problems identified in the analytic systems specified in 493.1251 through 493.1283. (c) The laboratory must document all analytic systems assessment activities. This STANDARD is not met as evidenced by: Based on a review of policies and procedures, patient test logs, quality assurance (QA) records, and an interview, the laboratory failed to ensure that the quality assurance (QA) policies were maintained during the twenty-four (24) months reviewed. Findings include: 1. Review of the laboratory's policy and procedure manual revealed a written and approved QA policy that included a quarterly check list and monitors for compliance to be performed by the LD. The QA plan and check list included a Personnel Policies section that stated: "All personnel who perform tests have documented training for the tests and understand the protocol and procedures for the tests". The QA plan included a Compliance Monitor section that stated "Explanation of any "no" responses to the QA plan or

πŸ”’ Unlock Deficiency Summary

Get full access to the detailed deficiency summary for this facility

One-time payment β€’ Lifetime access