Advanced Dermatology Pc

CLIA Laboratory Citation Details

2
Total Citations
12
Total Deficiencyies
5
Unique D-Tags
CMS Certification Number 33D2043167
Address 449 North State Road Ste 203, Briarcliff Manor, NY, 10510
City Briarcliff Manor
State NY
Zip Code10510
Phone(914) 488-8188

Citation History (2 surveys)

Survey - April 14, 2023

Survey Type: Standard

Survey Event ID: 5O8V11

Deficiency Tags: D5413 D5417 D6053 D6054 D5413 D5417 D6053 D6054

Summary:

Summary Statement of Deficiencies 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 the review of the Mohs laboratory procedure manual, the temperature log sheets for 2022, the ambient temperature and humidity range requirements, 2022 Mohs accession log, and an interview with the office manager, the laboratory failed to monitor the room temperature and humidity for the testing area where Mohs patient sample processing occurs. FINDINGS: 1. The laboratory's procedure requires ambient temperature range between 68 - 78.6 F and humidity range between 0 - 60%. 2. The laboratory performed Mohs procedures on the following dates and failed to record the room temperature and humidity for the following: a. April 14, 2022, eight Mohs procedures were performed and patient results were reported. b. May 12, 2022, six Mohs procedures were performed and patient results were reported. c. July 7, 2022, seven Mohs procedures were performed and patient results were reported. 3. Office manager confirmed on April 14, 2023, at approximately 10:30 A.M. that the room temperature and humidity were not documented for the above dates. D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(d) Reagents, solutions, culture media, control materials, calibration materials, and other 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 -- 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 upon the Toluidine Blue bottle label indications and confirmation in an interview with the office manager, the laboratory failed to ensure that stain utilized for Mohs slide processing did not exceed the indicated expiration dates. FINDINGS: The surveyor confirmed on April 14, 2023, at 11:00 A.M. through direct observation that expired Toluidine Blue stain was utilized for Mohs slide processing: 1. Toluidine Blue 0.1% lot # 113324 expired 2/27/2023. 2. Approximately ten patient samples were processed on March 16, 2023, utilizing the expired Toluidine Blue stain and patient results were subsequently reported. D6053 TECHNICAL CONSULTANT RESPONSIBILITIES CFR(s): 493.1413(b)(9) The technical consultant is responsible for evaluating and documenting the performance of individuals responsible for moderate complexity testing at least semiannually during the first year the individual tests patient specimens. This STANDARD is not met as evidenced by: Based on review of the Competency Evaluation policy, testing personnel file records, and confirmed in an interview with office manager, the laboratory director failed to follow the established competency evaluation procedure and perform the six-month competency evaluation due June 2021 for the Mohs technician hired January 21, 2021. D6054 TECHNICAL CONSULTANT RESPONSIBILITIES CFR(s): 493.1413(b)(9) The technical consultant is responsible for evaluating and documenting the performance of individuals responsible for moderate complexity testing at least annually, after the first year. This STANDARD is not met as evidenced by: Based on review of the Competency Evaluation policy, testing personnel file records, and confirmed in an interview with office manager, the laboratory director failed to follow the established competency procedure and perform the Mohs technician annual competency evaluation due January 2022. -- 2 of 2 --

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Survey - August 14, 2018

Survey Type: Standard

Survey Event ID: ST7O11

Deficiency Tags: D5413 D6094 D6094 D5413

Summary:

Summary Statement of Deficiencies 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 a lack of humidity records and an interview with the practice manager, the laboratory failed to follow the manufacturer's instructions to monitor and document the room humidity where testing is performed. Findings Include: It was confirmed by the Moh's technician, on August 14, 2018, approximately 1:00 pm that the Moh's technician failed to follow the manufacturer's written criteria to monitor and document the humidity of the room where Moh's testing is performed from August 9, 2016 through the date of this survey. D6094 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1445(e)(5) The laboratory director must ensure that the quality assessment programs are established and maintained to assure the quality of laboratory services provided and to identify failures in quality as they occur. This STANDARD is not met as evidenced by: Based on a review of procedures and an interview with the practice manager, the 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 -- laboratory director failed to ensure that the laboratory's QA program was maintained as part of the laboratory's overall quality systems program. Refer to D5413 -- 2 of 2 --

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