Advanced Dermatology & Cosmetic Surgery

CLIA Laboratory Citation Details

2
Total Citations
4
Total Deficiencyies
3
Unique D-Tags
CMS Certification Number 01D2198027
Address 286 Mitylene Park Drive, Montgomery, AL, 36117
City Montgomery
State AL
Zip Code36117
Phone(334) 396-1555

Citation History (2 surveys)

Survey - May 28, 2025

Survey Type: Standard

Survey Event ID: DQLF11

Deficiency Tags: D5217 D5429

Summary:

Summary Statement of Deficiencies D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(c)(1) At least twice annually, the laboratory must verify the accuracy of any test or procedure it performs that is not included in subpart I of this part. This STANDARD is not met as evidenced by: Based on reviews of the Peer Review Proficiency Testing, the MOHS Proficiency (MP) logs, and an interview with the Regional Manager (RM), the laboratory failed to ensure a consensus assessment and diagnosis was documented when there was a discrepancy of results between the Pathologist and MOHS surgeon's diagnoses. This was noted on one of the five patients submitted for December 2023. The findings include: 1. A review of the December 2023 MP logs revealed the Pathologist, and the MOHS surgeon were not in agreement on the diagnosis for case number BM23-399. Diagnoses were reported as follows: A) Pathologist - Basal Cell Carcinoma (BCC) present in tissue section. B) MOHS surgeon - Negative BCC 2. A further review of the log revealed the same MOHS surgeon had noted at the bottom of the page "True margin clear by frozen section" after the report was received on 01-26-2024. There was no evidence of a third-party assessment for the discrepancy. 3. During the exit conference with the RM and Laboratory Manager on 05-28-2025 at 2:00 PM, the RM confirmed the above findings. D5429 MAINTENANCE AND FUNCTION CHECKS CFR(s): 493.1254(a)(1) (a)(1) Maintenance as defined by the manufacturer and with at least the frequency specified by the manufacturer. This STANDARD is not met as evidenced by: 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 -- Based on reviews of the 2023-2025 Hematoxylin and Eosin (H&E) maintenance logs, the Policy and Procedure Manual (P&P), patient test logs, and an interview with the Regional Manager (RM), the laboratory failed to follow and document the stain maintenance procedure prior to patient testing. This was noted for 1 of the 31 days in October 2024. The findings include: 1. A review of the 2024 H&E logs revealed the laboratory failed to document the required stain maintenance procedures prior to patient testing on October 22, 2024. 2. A review of the P&P manual revealed a Stain Log with the following instructions: a) filter daily, b) change weekly. 3. A review of the patient test logs revealed 11 patients were performed on October 22, 2024. 4. During the exit conference on 05-28-2025 at 2:00 PM, the RM confirmed the above findings. -- 2 of 2 --

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Survey - May 4, 2023

Survey Type: Standard

Survey Event ID: 8PJO11

Deficiency Tags: D5211 D5217

Summary:

Summary Statement of Deficiencies D5211 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(a) The laboratory must review and evaluate the results obtained on proficiency testing performed as specified in subpart H of this part. This STANDARD is not met as evidenced by: Based on a review of Proficiency Testing (PT) records, a review of the PT Policy, and an interview with the Corporate Office Manager, the laboratory failed to ensure the December 2022 PT had documentation of review upon return of the results. This affected one of one PT activity performed in 2022. The findings include: 1. A review of the December 2022 PT revealed no evidence of review upon return of the results. The surveyor noted no documentation of the findings from the "Peer Reviewing Dermatopathologist", thus the laboratory failed to document whether there were any discrepancies between the Dermatopathologist and the MOHS surgeon's findings. (Refer to D5417.) 2. A review of the policy, "MOHS Histopathology & Proficiency Testing Policy" under "Procedure" revealed, "...The histological findings of the Peer Reviewing Physician will be compared with the Mohs surgeon's diagnosis." 3. During an interview on 5/4/2023 at approximately 1:30 PM the Corporate Office Manager, the surveyor reviewed and confirmed the above findings. . D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(c)(1) At least twice annually, the laboratory must verify the accuracy of any test or procedure it performs that is not included in subpart I of this part. This STANDARD is not met as evidenced by: Based on a review of Proficiency Testing (PT) records, a review of the PT Policy, 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 -- an interview with the Corporate Office Manager, the laboratory: (I) failed to perform one of two PT activities due in 2022, and (II) failed to ensure the December 2022 PT was valid and completed as per policy. The findings include: (I) 1. A review of the policy, "MOHS Histopathology & Proficiency Testing Policy" under "Procedure" revealed, "...Proficiency testing is to be sent out and returned by June 30th and December 31st each year." "...The slides from each Mohs case will be sent ... for review by a Dermatopathologist." 2. A review of MOHS patient logs revealed patient testing began on 9/7/2021. 3. A review of the PT records revealed no slides were sent out for PT review the first half of 2022. 4. During an interview on 5/4/2023 at 1:05 PM, the Corporate Office Manager confirmed the above findings. (II) 1. A review of the policy, "MOHS Histopathology & Proficiency Testing Policy" under "Procedure" revealed, "...The slides will be reviewed by a dermatopathologist (the "Peer Reviewing Physician") for a blind review to test for accuracy of the Mohs surgeon's diagnostic criteria...". "...The histological findings of the Peer Reviewing Physician will be compared with the Mohs surgeon's diagnosis." 2. A review of the December 2022 PT entitled "Quality Assurance", revealed the following: a) Accession numbers for five MOHS cases b) The MOHS surgeon's histological findings for the slides (under "Pathologist's Review") [Refer to interview below] c) The original diagnoses (BCC [Basal Cell Cancer] or SCC [Squamous Cell Cancer] under "Results"). There were no MOHS Maps attached or other information for the December 2022 PT. 3. During an interview on 5/4/2023 at approximately 1:30 PM, the surveyor asked about the MOHS surgeon's results and the comparison with the Dermatopathologist's results. The Corporate Office Manager stated the MOHS surgeon's results were under the Pathologist's Review column on the form. The surveyor asked, "Then where are the Pathologist's findings?" The Manager stated the Pathologist did not have room to write his findings, and signed on the bottom of the form with the date 1/9/2023. The Manager further stated if there had been a discrepancy the pathologist would have signed Form 4.6-CP-L 1015A. The surveyor noted the blank form with no evidence of survey details to indicate it was forwarded with this PT event, or evidence the Dermatopathologist had seen this form. 4. As the interview continued on 5/4/2023, the surveyor reviewed the PT Policy with the Manager, noting the laboratory had included the MOHS's surgeon's results, even though the Dermatopathologist was supposed to perform a "blind review". Next, the laboratory failed to ensure the Dermatopathologist was able to document his findings, so the laboratory could perform a comparison of the results. The surveyor explained the December 2022 PT was invalid because the laboratory had failed to follow their policy. SURVEYOR ID# 32558 Licensure and Certification Surveyor -- 2 of 2 --

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