Baptist Health Medical Center Arkadelphia

CLIA Laboratory Citation Details

3
Total Citations
11
Total Deficiencyies
10
Unique D-Tags
CMS Certification Number 04D0466006
Address 3050 Twin Rivers Dr, Arkadelphia, AR, 71923
City Arkadelphia
State AR
Zip Code71923
Phone(870) 245-2622

Citation History (3 surveys)

Survey - January 11, 2024

Survey Type: Standard

Survey Event ID: DIPA11

Deficiency Tags: D5553

Summary:

Summary Statement of Deficiencies D5553 IMMUNOHEMATOLOGY CFR(s): 493.1271(b)(f) (b) Immunohematological testing and distribution of blood and blood products. Blood and blood product testing and distribution must comply with 21 CFR 606.100(b)(12); 606.160(b)(3)(ii) and (b)(3)(v); 610.40; 640.5(a), (b), (c), and (e); and 640.11(b). (f) Documentation. The laboratory must document all control procedures performed, as specified in this section. This STANDARD is not met as evidenced by: Through review of the laboratory records, lack of documentation and interview it was determined that the laboratory failed to complete compatibility testing for four of six instances of the emergency release of blood as required by CFR 606.160 (b) (3) (v). Findings follow: A) Review of Blood Bank records for emergency release of blood products for 2022 and 2023 revealed that thirty-one units were released on emergency release basis for the two-year period. The surveyor selected xix of the events at random for review. B) Review of CFR 606.160 (b)(3)(v) revealed that the laboratory must keep records of "Emergency release of blood, including signature of requesting physician obtained before or after release" and "compatability test records". C) Review of the Blood Bank record of six randomly selected occasions of the emergency release of blood products revealed that on 7/29/22 unit # WO 910 247899 was released on an emergency basis to patient 00420506 with no follow-up cross- match result being recorded, on 4/22/23 unit # WO 910 194102 was released on an emergency release basis to patient ( # 1 on a separate patient identification list) with no follow-up cross-match result being recorded, on 8/14/23 unit # WO 910 270165 was released on an emergency release basis to patient (# 2 on a separate patient identification list) with no follow-up cross-match result being recorded. and on 10/25 /23 unit # WO 910 283569 was released on an emergency release basis to patient 02195250 with no follow-up cross-match result being recorded . D) Upon request, the laboratory was unable to provide documentation of cross-matches being completed for 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 -- the cases identified above or to provide documentation of the reasons that cross- matches were unable to be completed. E) In an interviw on 1/10/24 at 01:35 p.m., laboratory staff member (# 4 on CMS 209 form) confirmed that the units identified above were released and administered to patients without follow-up cross-matches being performed or reasons for the lack of cross-matches documented. -- 2 of 2 --

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Survey - February 16, 2022

Survey Type: Standard

Survey Event ID: BOQ011

Deficiency Tags: D5791 D6032

Summary:

Summary Statement of Deficiencies D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1289(a)(c) (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 analytic systems specified in 493.1251 through 493.1283. (c) The laboratory must document all analytic systems assessment activities. This STANDARD is not met as evidenced by: Through a review of 2020 and 2021 temperature records for refrigerators, freezers, and rooms in the laboratory, and through interviews with laboratory staff, it was determined the laboratory quality assurance failed to identify temperatures documented on days that do not exist. Survey findings follow: A. A review of the Temperature Recording Chart labeled "Sendout Frig" for 2021 revealed temperatures documented on 6/31/2021, 9/31/2021, and 11/31/2021. The three dates, of 368 dates listed on the form, do not occur on a calendar. B. Through a review of the Temperature Recording Chart labeled "Sendout Frig" for 2021 it was determined the technical consultant (employee #19 as listed on the form CMS-209), as part of her quality assurance review, had signed the months with temperatures documented on nonexistent dates. There was no documentation that improper temperatures or dates had been identified in the quality assurance records. C. During an interview, at 10:55 on 2/16/2022, with laboratory employees #11 and #19 (as listed on the form CMS- 209), it was confirmed the laboratory documented temperatures on days that do not exist on the calendar and that it wasn't identified in quality assurance reviews. D6032 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(14) The laboratory director is responsible for the overall operation and administration of the laboratory, including the employment of personnel who are competent to perform 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 -- test procedures, and record and report test results promptly, accurate, and proficiently and for assuring compliance with the applicable regulations. (e) The laboratory director must-- (e)(14) Specify, in writing, the responsibilities and duties of each consultant and each person, engaged in the performance of the preanalytic, analytic, and postanalytic phases of testing, that identifies which examinations and procedures each individual is authorized to perform, whether supervision is required for specimen processing, test performance or results reporting, and whether consultant or director review is required prior to reporting patient test results. This STANDARD is not met as evidenced by: Through review of the CMS 209 form, review of personnel records, lack of documentation and interview it was determined that the laboratory director failed to provide written authorization to perform Arterial Blood Gas (ABG) analyses with or without supervision for one of three testing personnel surveyed. Findings follow: A) Review of the CMS 209 form revealed that the testing person , identified as number 17 on the CMS 209 form, was listed as a testing personnel for moderately complex testing procedures. B) Review of personnel records revealed that no written authorization to perform moderately complex procedures was provided for the testing person, identified as number 17 on the CMS 209 form. C) Upon request, the laboratory was unable to provide written authorization signed by the laboratory director authorizing the testing person, identified as number 17 on the CMS 209 form, to perform moderately complex ABG analysis either with or without supervision. D) In an interview on 2/15/22 at 03:15 PM, the laboratory staff member, identified as number 12 on the CMS form, confirmed that the testing person, identified as number 17 on the CMS 209 form, performed ABG analysis without supervision and there was no written authorization from the laboratory director authorizing that testing person to perform ABG analysis. -- 2 of 2 --

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Survey - December 20, 2019

Survey Type: Standard

Survey Event ID: 9F7K11

Deficiency Tags: D5293 D5407 D5413 D5785 D5317 D5411 D5417 D6032

Summary:

Summary Statement of Deficiencies D5293 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1239(b)(c) (b) The general laboratory systems quality assessment must include a review of the effectiveness of

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