Advocare North Brunswick Pediatrics

CLIA Laboratory Citation Details

2
Total Citations
15
Total Deficiencyies
7
Unique D-Tags
CMS Certification Number 31D0125381
Address 1950 State Route 27, North Brunswick, NJ, 08902
City North Brunswick
State NJ
Zip Code08902
Phone(732) 940-5511

Citation History (2 surveys)

Survey - May 4, 2021

Survey Type: Standard

Survey Event ID: 4XJY11

Deficiency Tags: D2015 D5209 D5209 D5211 D5211

Summary:

Summary Statement of Deficiencies D2015 TESTING OF PROFICIENCY TESTING SAMPLES CFR(s): 493.801(b)(5)(6) (5) The laboratory must document the handling, preparation, processing, examination, and each step in the testing and reporting of results for all proficiency testing samples. The laboratory must maintain a copy of all records, including a copy of the proficiency testing program report forms used by the laboratory to record proficiency testing results including the attestation statement provided by the PT program, signed by the analyst and the laboratory director, documenting that proficiency testing samples were tested in the same manner as patient specimens, for a minimum of two years from the date of the proficiency testing event. (6) PT is required for only the test system, assay, or examination used as the primary method for patient testing during the PT event. This STANDARD is not met as evidenced by: Based on surveyor review of the Proficiency Testing (PT) records and interview with the Testing Personnel (TP),the laboratory failed to maintain Attestation Statements (AT) for Throat Culture tests performed with the College of American Pathologists (CAP) for events MC5-B in 2019 and D1-C in 2020. The TP #1 listed on CMS form 209 confirmed on 5/4/21 at 1:15 pm that the laboratory did not maintain AT for PT. 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: 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 surveyor review of the Competency Assessment (CA) records and interview with the Testing Personnel (TP), the laboratory failed to perform the CA from January 2020 to the date of the survey. The findings include: 1. One out of two TP did not have a CA performed in the calendar year 2020. 2. TP #1 listed on CMS form 209 confirmed on 5/4/21 at 1:30 pm that the CA was not performed . 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 the surveyor review of the Proficiency Testing (PT) records and interview with the Testing Personnel (TP), the laboratory failed to review Throat Culture (TC) results obtained from the College of American Pathologists (CAP) in the calendar years 2019 and 2020. The findings include: 1. There was no review documented for MC5-A and MC5-C in 2019 2. There was no review documented for D1-A and D1- B in 2020 3. The TP #1 listed on CMS form 209 confirmed on 5/4/2021 at 1:15 pm that the laboratory did not review all PT results. -- 2 of 2 --

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Survey - November 1, 2018

Survey Type: Standard

Survey Event ID: GUE611

Deficiency Tags: D2015 D5413 D5805 D5891 D6018 D2015 D5413 D5805 D5891 D6018

Summary:

Summary Statement of Deficiencies D2015 TESTING OF PROFICIENCY TESTING SAMPLES CFR(s): 493.801(b)(5)(6) (5) The laboratory must document the handling, preparation, processing, examination, and each step in the testing and reporting of results for all proficiency testing samples. The laboratory must maintain a copy of all records, including a copy of the proficiency testing program report forms used by the laboratory to record proficiency testing results including the attestation statement provided by the PT program, signed by the analyst and the laboratory director, documenting that proficiency testing samples were tested in the same manner as patient specimens, for a minimum of two years from the date of the proficiency testing event. (6) PT is required for only the test system, assay, or examination used as the primary method for patient testing during the PT event. This STANDARD is not met as evidenced by: Based on surveyor review of the Proficiency Testing (PT) records and interview with the Laboratory Director (LD), the laboratory failed to maintain the Attestation Statements (AS) signed by the analyst for tests performed with the College of American Pathologists (CAP) in the calendar years 2017 and 2018. The findings include: 1. The AS was not signed by the analyst for event MCS - A 2017 and MCS - A and B 2018. 2. The LD confirmed on 11/1/18 at 11:20 am that AS were not signed by the analyst. 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 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 -- 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 Procedure Manual (PM), Temperature Log (TL) and interview with Laboratory Director (LD), the laboratory failed to monitor and document Room Temperature (RT) where Throat Culture tests were performed from 11/1/16 to the date of survey. The LD confirmed on 11/1/18 at 11:40 am that the laboratory did not document RT. 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 Final Report (FR) and interview with the Laboratory Director (LD), the laboratory failed to ensure that the Test Report Date (TRD) was indicated on the FR for Throat Cultures from 11/1/16 to the date of survey. The LD confirmed on 11/1/18 at 12:35 pm that the TRD was not on the FR. D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1299(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 postanalytic systems specified in 493.1291. This STANDARD is not met as evidenced by: Based on surveyor review of the Procedure Manual and interview with the Laboratory Director (LD), the laboratory failed to have a procedure to verify manually entered results into Electronic Medical Records (EMR) from 11/1/16 to the date of the survey. The LD confirmed on 11/1/18 at 1:15 pm that the laboratory did not have the procedure mentioned above. D6018 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(4)(iii) 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 -- 2 of 3 -- director must-- (e)(4)(iii) Ensure that all proficiency testing reports received are reviewed by the appropriate staff to evaluate the laboratory's performance and to identify any problems that require

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