Alliance Urology Specialists

CLIA Laboratory Citation Details

3
Total Citations
35
Total Deficiencyies
16
Unique D-Tags
CMS Certification Number 34D0681006
Address 509 North Elam Avenue, 2nd Floor, Greensboro, NC, 27403
City Greensboro
State NC
Zip Code27403
Phone(336) 274-1114

Citation History (3 surveys)

Survey - June 25, 2025

Survey Type: Standard

Survey Event ID: 13HS11

Deficiency Tags: D3031 D5429 D6004 D6013 D6029 D3031 D5429 D6004 D6013 D6029

Summary:

Summary Statement of Deficiencies D3031 RETENTION REQUIREMENTS CFR(s): 493.1105(a)(3) Analytic systems records. Retain quality control and patient test records (including instrument printouts, if applicable) and records documenting all analytic systems activities specified in 493.1252 through 493.1289 for at least 2 years. In addition, retain the following: This STANDARD is not met as evidenced by: Based on review of 2023, 2024, and 2025 i-STAT records and interview with the TC (technical consultant) 6/25/25, the laboratory failed to retain quality control assay sheets for the lot numbers used from 3/1/23 to 12/31/24. Findings: Review of 2023, 2024, and 2025 i-STAT records revealed the laboratory failed to retain quality control assay sheets for the lot numbers used from 3/1/23 to 12/31/24. During interview at approximately 1:45 p.m., the TC confirmed there were no assay sheets available for the i-STAT quality control material used from 3/1/23 to 12/31/24. 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: Based on review of manufacturer's instructions and review of 2023, 2024, and 2025 i- STAT records 6/25/25, the laboratory failed to perform and document thermal probe checks for the i-STAT analyzer every six months during 2023. Findings: Review of i- STAT manufacturer's instructions revealed "... A quality check is performed on the thermal probes each time the external Electronic Simulator is used. To complete this 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 -- check, the surface temperature of the external Electronic Simulator must not fluctuate. If this condition is not met, the thermal probe check is not completed. Therefore, APOC recommends that the thermal probe check be verified every six months. ... 4. Interpretation of the thermal probe check value: Acceptable: a value from -0.1 to +0.1, inclusive. ..." Review of 2023, 2024, and 2025 i-STAT records revealed the laboratory had documented thermal probe checks on 6/18/24, 12/4/24, and 6/18/25. There was no documentation of thermal probe checks in 2023. D6004 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(a)(b) 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. (a) The laboratory director, if qualified, may perform the duties of the technical consultant, clinical consultant, and testing personnel, or delegate these responsibilities to personnel meeting the qualifications of 493.1409, 493.1415, and 493.1421, respectively. (b) If the laboratory director reapportions performance of his or her responsibilities, he or she remains responsible for ensuring that all duties are properly performed. This STANDARD is not met as evidenced by: Based on review of personnel records, review of job descriptions, and interview with the TC 6/25/25, the laboratory director failed to ensure competency evaluations were performed by personnel who met the qualifications of a TC. Findings: Review of personnel records revealed TP (testing personnel) #1 had performed the 2024 competency evaluations for TP #2, TP #3, TP #4, and TP #5. Review of personnel records revealed TP #1 did not meet the qualification requirements to serve as TC in a moderate complexity laboratory. Review of the job description for TP #1 revealed the following duties "... Assures the qualifications and validation of all lab personnel in areas of responsibility, specific tests, and/or work stations. Assigns personnel duties as necessary. ... manages personnel ...". During interview at approximately 12:35 p.m., the TC stated that TP #1 serves as the "on-site supervisor/designee", but is not the TC. D6013 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(3)(ii) (e)(3)(ii) Verification procedures used are adequate to determine the accuracy, precision, and other pertinent performance characteristics of the method; and This STANDARD is not met as evidenced by: Based on review of validation records, the absence of records, review of policies and procedures, and interview with the TC 6/25/25, the laboratory director failed to ensure validation procedures used by the laboratory were adequate to verify the accuracy, precision, and reportable range for the new Dirui and i-STAT analyzers installed in 2024. Findings: 1. Review of validation records revealed the laboratory installed a new Dirui 500 urine analyzer in February 2024. The laboratory had performed a correlation with an outside laboratory, but there was no documentation that the laboratory performed any studies to verify accuracy, precision, and reportable range on the new analyzer. Review of the laboratory's policies and procedures revealed a "Dirui H-500 Urine Chemistry Validation Protocol", but there were no records -- 2 of 3 -- available to indicate that the laboratory followed the instructions to validate the new analyzer. 2. Review of validation records revealed the laboratory installed a new i- STAT analyzer in March 2024. The laboratory had performed a correlation with an outside laboratory, but there was no documentation that the laboratory performed any studies to verify accuracy, precision, and reportable range on the new analyzer. During interview at approximately 11:35 a.m., the TC confirmed that the laboratory had not verified accuracy, precision, and reportable range for the Dirui and i-STAT analyzers prior to use for patient testing. D6029 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(11) (e)(11) Ensure that prior to testing patients specimens, all personnel have the appropriate education and experience, receive the appropriate training for the type and complexity of the services offered, and have demonstrated that they can perform all testing operations reliably to provide and report accurate results; This STANDARD is not met as evidenced by: Based on review of personnel records and interview with TP #1 on 6/25/25, the laboratory director failed to ensure that prior to testing patient specimens, 1 of 5 testing personnel (TP #4) had received appropriate training and had demonstrated the ability to perform all testing operations reliably to provide accurate test results. Findings: Review of personnel records for TP #4 revealed no documentation of training for urine sediment identifications. During interview at approximately 10:15 a. m., TP #1 stated that TP #4 was trained to perform urine microscopics, but the training was not documented. -- 3 of 3 --

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Survey - February 8, 2023

Survey Type: Standard

Survey Event ID: 0FDW11

Deficiency Tags: D5211 D5447 D5775 D6054 D5211 D5447 D5775 D6054

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 review of the laboratory's policies and procedures and review of 2020, 2021, and 2022 AAB (American Association of Bioanalysts) proficiency testing records 2/8 /23, the laboratory failed to evaluate the results of all ungraded proficiency testing responses for 4 of 13 test events to ensure

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Survey - March 20, 2019

Survey Type: Standard

Survey Event ID: EH6K11

Deficiency Tags: D5793 D5801 D5805 D5821 D5775 D5793 D5801 D5805 D5821 D6004 D6014 D6063 D6065 D6004 D6014 D6063 D6065

Summary:

Summary Statement of Deficiencies D5775 COMPARISON OF TEST RESULTS CFR(s): 493.1281(a)(c) (a) If a laboratory performs the same test using different methodologies or instruments, or performs the same test at multiple testing sites, the laboratory must have a system that twice a year evaluates and defines the relationship between test results using the different methodologies, instruments, or testing sites. (c) The laboratory must document all test result comparison activities. This STANDARD is not met as evidenced by: Based on procedure, record review and general supervisor (GS) interview on 3/20/19 at 1:00 p.m., the laboratory failed to perform and maintain documentation of comparison testing of the two Dirui H500 Urine Analysis Analyzers at least twice a year. Findings: 1. The General Policies and Procedures, section of the facilities Standard Operating Procedures, has the subsection of Laboratory Quality Assessment Plan, CMP-001 Revision: 001, that reads on page 19, under '...Comparison of Test Results Laboratories with multiple instruments testing locations that perform same test (s) are required to have test result compared every six months. Results are evaluated by the General Supervisor for any variance produced by each method that are not a reflection of differences in the reference ranges...". 2. The review of the records revealed that the comparison of test results was performed on: a. 1/24/2019 b. 6/27 /2017 3. The GS confirmed during interview at 1:00 p.m. that the laboratory was not performing the every six months comparison of test results as required. D5793 ANALYTIC SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1289(b)(c) (b) The analytic systems quality assessment must include a review of the effectiveness of

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