Advanced Dermatology Of Nj Pc

CLIA Laboratory Citation Details

4
Total Citations
19
Total Deficiencyies
12
Unique D-Tags
CMS Certification Number 31D2004723
Address 700 Paramus Park, Paramus, NJ, 07652
City Paramus
State NJ
Zip Code07652
Phone(201) 493-1717

Citation History (4 surveys)

Survey - March 5, 2024

Survey Type: Standard

Survey Event ID: 3MD711

Deficiency Tags: D5403 D5415 D5417

Summary:

Summary Statement of Deficiencies D5403 PROCEDURE MANUAL CFR(s): 493.1251(b) The procedure manual must include the following when applicable to the test procedure: (1) Requirements for patient preparation; specimen collection, labeling, storage, preservation, transportation, processing, and referral; and criteria for specimen acceptability and rejection as described in 493.1242. (2) Microscopic examination, including the detection of inadequately prepared slides. (3) Step-by-step performance of the procedure, including test calculations and interpretation of results. (4) Preparation of slides, solutions, calibrators, controls, reagents, stains, and other materials used in testing. (5) Calibration and calibration verification procedures. (6) The reportable range for test results for the test system as established or verified in 493.1253. (7) Control procedures. (8)

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Survey - October 20, 2022

Survey Type: Standard

Survey Event ID: 3F8111

Deficiency Tags: D3011 D5209 D5401 D5413 D5805 D5415 D5417 D5781 D6102

Summary:

Summary Statement of Deficiencies D3011 FACILITIES CFR(s): 493.1101(d) Safety procedures must be established, accessible, and observed to ensure protection from physical, chemical, biochemical, and electrical hazards, and biohazardous materials. This STANDARD is not met as evidenced by: Based on surveyor observation of the laboratory reagents and interview with the Officwe Manager (OM), the laboratory failed to ensure protection from chemical and physical hazards at the time of survey. The findings include: 1. Observation of the flammable cabinet and undersink cabinet revealed that all flammable and inhalation risk reagents were not kept in the flammable cabinet. 2. Five containers of 100% Reagent Alcohol were stored in the laboratory undersink cabinet. 3. The OM confirmed on 10/20/22 at 1:35 pm that the laboratory did not ensure protection from chemical and physical hazards. D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES CFR(s): 493.1235 As specified in the personnel requirements in subpart M, the laboratory must establish and follow written policies and procedures to assess employee and, if applicable, consultant competency. This STANDARD is not met as evidenced by: Based on the lack of Competency Assessment (CA) records and interview with the Office Manager (OM), the laboratory failed to perform a CA on two out of two testing Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 4 -- personnel for the calendar years 2020, 2021 and 2022. The OM confirmed on 10/20 /22 at 1:30 pm that the CA was not performed as stated above. Note: This was previously cited: 1/22/20 D5401 PROCEDURE MANUAL CFR(s): 493.1251(a) A written procedures manual for all tests, assays, and examinations performed by the laboratory must be available to, and followed by, laboratory personnel. Textbooks may supplement but not replace the laboratory's written procedures for testing or examining specimens. This STANDARD is not met as evidenced by: Based on surveyor review of the Procedure Manual (PM), and interview with the Office Manager (OM), the laboratory failed to have a procedure written for the preparation of Toluidin Blue reagent from 1/22/20 to the date of the survey. The OM confirmed on 10/20/22 at 1:30 pm that the laboratory did not have the aforementioned written procedure. D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(b) The laboratory must define criteria for those conditions that are essential for proper storage of reagents and specimens, accurate and reliable test system operation, and test result reporting. The criteria must be consistent with the manufacturer's instructions, if provided. These conditions must be monitored and documented and, if applicable, include the following: (1) Water quality. (2) Temperature. (3) Humidity. (4) Protection of equipment and instruments from fluctuations and interruptions in electrical current that adversely affect patient test results and test reports. This STANDARD is not met as evidenced by: Based on surveyor review of the Temperature Log (TL) and interview with the Office Manager (OM), the laboratory failed to define an acceptable Room temperature and humidity range where Histopathology tests are performed from 1/22/19 to the date of the survey. The finding include: 1. The TL did not have an acceptable range for Temperature or Humidity. 2. The OM confirmed on 10/20/22 at 1:35 pm that an acceptable range was not defined. D5415 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(c) Reagents, solutions, culture media, control materials, calibration materials, and other supplies, as appropriate, must be labeled to indicate the following: (1) Identity and when significant, titer, strength or concentration. (2) Storage requirements. (3) Preparation and expiration dates. (4) Other pertinent information required for proper use. This STANDARD is not met as evidenced by: a) Based on surveyor observation of the laboratory Cabinet and interview with the Office Manager (OM), the laboratory failed to appropriately label Toluidine Blue -- 2 of 4 -- reagent used for Histopathology testing from 1/22/20 to the date of the survey. The finding includes: 1. There were no preparation and expiration dates on the container containing Toluidine Blue. 2. The OM confirmed on 10/20/22 at 1:35 pm that all reagents were not labeled correctly. b) Based on surveyor observation of the Staining Station and interview with the OM, the laboratory failed to label the identity of all staining jars used for Histopathology testing from 1/22/20 to the date of the survey. The OM confirmed on 10/20/22 at 1:35 pm that all staining jars were not labeled. D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(d) Reagents, solutions, culture media, control materials, calibration materials, and other supplies must not be used when they have exceeded their expiration date, have deteriorated, or are of substandard quality. This STANDARD is not met as evidenced by: Based on surveyor observation of the Flammable Cabinet and interview with the Office Manager (OM), the laboratory used expired Eosin Y Alcoholic Working Solution reagent for Histopatholgy testing on 11/15/21. The findings include: 1. Eosin Y Alcoholic Working Solution Lot # 063019 expired 10/8/21. 2. Approximately 5 patients were tested with the expired reagent. 3. The OM confirmed on 10/20/22 at 1: 30 pm that the laboratory used expired reagent. D5781

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Survey - January 22, 2020

Survey Type: Standard

Survey Event ID: FCI411

Deficiency Tags: D5209 D5401 D5781 D5787

Summary:

Summary Statement of Deficiencies D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES CFR(s): 493.1235 As specified in the personnel requirements in subpart M, the laboratory must establish and follow written policies and procedures to assess employee and, if applicable, consultant competency. This STANDARD is not met as evidenced by: Based on the lack of Competency Assessment (CA) records and interview with the Office Manager (OM), the laboratory failed to perform a CA on one out of one testing personnel for the calendar years 2019 and 2018. The OM confirmed on 1/22/20 at 10: 30 am that the CA was not performed as stated above. D5401 PROCEDURE MANUAL CFR(s): 493.1251(a) A written procedures manual for all tests, assays, and examinations performed by the laboratory must be available to, and followed by, laboratory personnel. Textbooks may supplement but not replace the laboratory's written procedures for testing or examining specimens. This STANDARD is not met as evidenced by: Based on surveyor review of the Procedure Manual (PM), observation of the Manual Staining Station (MSS) and interview with the Office Manager (OM), the laboratory failed to follow Mohs Staining Procedure from 1/31/18 to the date of the survey. The findings include: 1. The MSS in the laboratory did not correspond with the staining procedure in the PM. a) The PM stated Staining Container (SC) # 5 was for 95% Alcohol but the MSS had water. 2. Approximately 300 patients were stained. 3. The OM confirmed on 1/22/20 at 10:00 am that laboratory failed to follow the PM. 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 -- D5781

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Survey - January 31, 2018

Survey Type: Standard

Survey Event ID: VGCN11

Deficiency Tags: D5401 D5603 D5805

Summary:

Summary Statement of Deficiencies D5401 PROCEDURE MANUAL CFR(s): 493.1251(a) A written procedures manual for all tests, assays, and examinations performed by the laboratory must be available to, and followed by, laboratory personnel. Textbooks may supplement but not replace the laboratory's written procedures for testing or examining specimens. This STANDARD is not met as evidenced by: Based on surveyor review of the Procedure Manual (PM) and interview with the Office Manager (OM), the laboratory failed to have a written procedure for preparing Toluidine blue stain used for Mohs testing from 11/24/15 to the date of survey. The OM confirmed on 1/31/18 at 10:30 am that the procedure mentioned above was not in the PM. D5603 HISTOPATHOLOGY CFR(s): 493.1273(b)(f) (b) The laboratory must retain stained slides, specimen blocks, and tissue remnants as specified in 493.1105. The remnants of tissue specimens must be maintained in a manner that ensures proper preservation of the tissue specimens until the portions submitted for microscopic examination have been examined and a diagnosis made by an individual qualified under 493.1449(b), (l), or (m). (f) The laboratory must document all control procedures performed, as specified in this section. This STANDARD is not met as evidenced by: Based on review of Accession log (AL), Quality control (QC) log, patient slides, and interview with the Office Manager (OM), the laboratory failed to retain stained Mohs test slides from 1/3/18 to the date of survey. The findings include: 1. The laboratory 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 -- did not retain three slides for specimen # 18001. 2. The laboratory could not locate the QC slide for for 1/3/18. 3. The OM confirmed at 10:10: am that the laboratory failed to retain Mohs test slides. D5805 TEST REPORT CFR(s): 493.1291(c) The test report must indicate the following: (c)(1) For positive patient identification, either the patient's name and identification number, or a unique patient identifier and identification number. (c)(2) The name and address of the laboratory location where the test was performed. (c)(3) The test report date. (c)(4) The test performed. (c)(5) Specimen source, when appropriate. (c)(6) The test result and, if applicable, the units of measurement or interpretation, or both. (c)(7) Any information regarding the condition and disposition of specimens that do not meet the laboratory's criteria for acceptability. This STANDARD is not met as evidenced by: Based on surveyor review of the Test Report (TR) and interview with the Office Manager (OM), the laboratory failed to ensure that the address of the laboratory where tests are performed was on the TR from 2/6/14 to the date of survey. The OM confirmed on 1/31/18 at 10:00 am that the TR did not indicate the laboratory address. This deficiency was cited on the last survey. -- 2 of 2 --

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