Aspirus Kronenwetter Clinic

CLIA Laboratory Citation Details

4
Total Citations
10
Total Deficiencyies
8
Unique D-Tags
CMS Certification Number 52D0395521
Address 1881 Cty Hwy Xx, Mosinee, WI, 54455
City Mosinee
State WI
Zip Code54455
Phone715 355-4040
Lab DirectorTHEODORE WAGNER

Citation History (4 surveys)

Survey - June 3, 2026

Survey Type: Special

Survey Event ID: F89Q11

Deficiency Tags: D0000 D2130 D6016 D2016 D6000

Summary:

Summary Statement of Deficiencies D0000 The following deficiencies are a result of a desk review of proficiency testing (PT) scores obtained from the national database and verified with the proficiency testing company. The facility was found to be out of compliance with the conditions of the Clinical Laboratory Improvement Amendments (CLIA) program. The following CONDITION LEVEL DEFICIENCIES were found to be out of compliance: D2016 - 42 C.F.R. 493.803 Condition: Successful Participation [proficiency testing] D6000 - 42 C.F.R. 493.1403 Condition: Laboratories Performing Moderate Complexity Testing; Laboratory Director D2016 SUCCESSFUL PARTICIPATION CFR(s): 493.803(a)(b)(c) (a) Each laboratory performing nonwaived testing must successfully participate in a proficiency testing program approved by CMS, if applicable, as described in subpart I of this part for each specialty, subspecialty, and analyte or test in which the laboratory is certified under CLIA. (b) Except as specified in paragraph (c) of this section, if a laboratory fails to participate successfully in proficiency testing for a given specialty, subspecialty, analyte or test, as defined in this section, or fails to take remedial action when an individual fails gynecologic cytology, CMS imposes sanctions, as specified in subpart R of this part. (c) If a laboratory fails to perform successfully in a CMS- approved proficiency testing program, for the initial unsuccessful performance, CMS may direct the laboratory to undertake training of its personnel or to obtain technical assistance, or both, rather than imposing alternative or principle sanctions except when one or more of the following conditions exists: (1) There is immediate jeopardy to patient health and safety. (2) The laboratory fails to provide CMS or a CMS agent with satisfactory evidence that it has taken steps to correct the problem identified by the unsuccessful proficiency testing performance. (3) The laboratory has a poor compliance history. This CONDITION 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 3 -- Based on a desk review of proficiency testing (PT) records from the Certification and Survey Provider Enhanced Reporting (CASPER) 0155 report and American Proficiency Institute (API) PT reports, and interview with the Laboratory Director, the laboratory failed to successfully participate in a PT program approved by Centers for Medicare and Medicaid Services (CMS), for each analyte or test in which the laboratory is certified under Clinical Laboratory Improvement Amendments (CLIA). The laboratory failed to successfully participate in the speciality of hematology for the white blood cell (WBC) differential test. Refer to D2130. D2130 HEMATOLOGY CFR(s): 493.851(f) (f) Failure to achieve satisfactory performance for the same analyte in two consecutive events or two out of three consecutive testing events is unsuccessful performance. This STANDARD is not met as evidenced by: Based on a PT desk review of CASPER 0155 report and API PT 2025 Event 2 and 2026 Event 1 records, and interview with the Laboratory Director, the laboratory failed to achieve satisfactory performance (80% or better) for the WBC differential test in the speciality of hematology in two out of three consecutive testing events resulting in unsuccessful performance. Findings include: 1. Review of the CASPER 0155 report revealed the following results: Hematology 2025-Event 2: the laboratory received an unsatisfactory score of 20% for WBC differential. Hematology 2026- Event 1: the laboratory received an unsatisfactory score of 0% for WBC differential. 2. Review of the API Hematology/Coagulation Performance Summary report for 2025 - 2nd Event and 2026 -1st Event confirmed the laboratory received the above results. 3. A phone interview with the Laboratory Director on June 3, 2026, at 2:10 PM confirmed the laboratory's unsuccessful PT performance in the WBC differential test and confirmed understanding that this is a mandatory PT deficiency. D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR CFR(s): 493.1403 The laboratory must have a director who meets the qualification requirements of 493. 1405 of this subpart and provides overall management and direction in accordance with 493.1407 of this subpart. This CONDITION is not met as evidenced by: Based on surveyor review of records from the Certification and Survey Provider Enhanced Reporting (CASPER) reports and American Proficiency Institute (API) proficiency testing (PT) reports, and interview with the Laboratory Director, the Laboratory Director failed to provide overall management and direction of the laboratory services. The Laboratory Director failed to ensure the laboratory tested and reported PT samples as required. Refer to D6016. D6016 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(4)(i) (e)(4)(i) The proficiency testing samples are tested as required under Subpart H of this part; -- 2 of 3 -- This STANDARD is not met as evidenced by: Based on a PT desk review of CASPER 0155 report and API 2025 and 2026 records, the Laboratory Director failed to ensure PT samples were tested as required. The Laboratory Director failed to ensure successful participation for the WBC differential test in a Centers for Medicare and Medicaid (CMS) approved PT program. Refer to D2130. -- 3 of 3 --

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Survey - March 4, 2026

Survey Type: Standard

Survey Event ID: QHYI11

Deficiency Tags: D5209

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 surveyor review of laboratory records and interview with the laboratory director, the laboratory did not document site-specific competency for three of three testing personnel that occasionally perform testing at this laboratory. Findings include: 1. Review of laboratory personnel records showed no competence evaluations of the three testing personnel (Staff A, B, and C) who occasionally perform testing at this laboratory. 2. Interview with the laboratory director on March 4, 2026, at 9:00 AM confirmed the laboratory had not documented full competence assessments for the three occasional testing personnel at this location. Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 1 --

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Survey - March 6, 2024

Survey Type: Standard

Survey Event ID: X3DB11

Deficiency Tags: D5441 D5441

Summary:

Summary Statement of Deficiencies D5441 CONTROL PROCEDURES CFR(s): 493.1256(a)(b)(c)(g) (a) For each test system, the laboratory is responsible for having control procedures that monitor the accuracy and precision of the complete analytic process. (b) The laboratory must establish the number, type, and frequency of testing control materials using, if applicable, the performance specifications verified or established by the laboratory as specified in 493.1253(b)(3). (c) The control procedures must-- (c)(1) Detect immediate errors that occur due to test system failure, adverse environmental conditions, and operator performance. (c)(2) Monitor over time the accuracy and precision of test performance that may be influenced by changes in test system performance and environmental conditions, and variance in operator performance. (g) The laboratory must document all control procedures performed. This STANDARD is not met as evidenced by: Based on surveyor review of Individualized Quality Control Plans (IQCP) and interview with the Laboratory Director, three of four current IQCPs did not specify the number and or type of external quality control required. Findings include: 1. Review of four current IQCP procedures showed references to the laboratory's required external quality controls for three IQCP were as follows: KOH (Potassium Hydroxide) IQCP: "The target level for one of the external quality control is near the medical decision cutoff point. (Positive KOH)." "This lab will perform external QC on this assay monthly; with each new lot; for each new shipment; for each newly trained testing staff." Troponin IQCP: "Level 1 control has a defined mean around 0.5 which is near the 0.3 medical decision cutoff level." "We verify the integrity of cartridges included in every shipment, upon receipt, by analyzing two levels of external controls. We also run two levels of external controls monthly." INR (International Normalized Ratio) IQCP: "The target level for one of the external quality control is near the medical decision cutoff point. Level 2 routinely runs at an INR of 2.8 - 3.2 which is the top of the normal therapeutic range." "We will run QC 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 -- monthly and with each new lot to ensure accuracy. QC results must be within the Roche established QC range before testing can proceed." The fourth IQCP identified the number and type of controls required. 2. Interview with the laboratory director on March 6, 2024, at 1:00 PM confirmed the KOH, Troponin, and INR IQCP procedures did not specify the number and or type of external controls required. -- 2 of 2 --

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Survey - March 22, 2022

Survey Type: Standard

Survey Event ID: Z8HH11

Deficiency Tags: D5439 D5439

Summary:

Summary Statement of Deficiencies D5439 CALIBRATION AND CALIBRATION VERIFICATION CFR(s): 493.1255(b) Unless otherwise specified in this subpart, for each applicable test system the laboratory must do the following: Perform and document calibration verification procedure - (b)(1) Following the manufacturer's calibration verification instructions; (b)(2) Using the criteria verified or established by the laboratory under 493.1253(b)(3) -- (b)(2)(i) Including the number, type, and concentration of the materials, as well as acceptable limits for calibration verification; and (b)(2)(ii) Including at least a minimal (or zero) value, a mid-point value, and a maximum value near the upper limit of the range to verify the laboratory's reportable range of test results for the test system; and (b)(3) At least once every 6 months and whenever any of the following occur: (b)(3)(i) A complete change of reagents for a procedure is introduced, unless the laboratory can demonstrate that changing reagent lot numbers does not affect the range used to report patient test results, and control values are not adversely affected by reagent lot number changes. (b)(3)(ii) There is major preventive maintenance or replacement of critical parts that may influence test performance. (b)(3)(iii) Control materials reflect an unusual trend or shift, or are outside of the laboratory's acceptable limits, and other means of assessing and correcting unacceptable control values fail to identify and correct the problem. (b)(3)(iv) The laboratory's established schedule for verifying the reportable range for patient test results requires more frequent calibration verification. This STANDARD is not met as evidenced by: Based on surveyor review of calibration verification records and interview with the laboratory director, the laboratory did not perform calibration verification every six months on the Roche Cobas Integra 400 plus chemistry analyzer in 2021 and 2022. Finding include: 1. Review of calibration verification records showed calibration verification performed on the Roche Cobas Integra 400 plus chemistry analyzer on: August 6, 2020 and March 1, 2021. Calibration verification was due February 6, 2021. 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 -- July 26, 2021, and February 15, 2022. Calibration verification was due January 26, 2022. 2. Interview with the laboratory director on March 22, 2022 at 1:30 PM confirmed the laboratory did not perform calibration verification every six months on the Roche Cobas Integra 400 plus chemistry analyzer in 2021 and 2022. -- 2 of 2 --

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