Summary:
Summary Statement of Deficiencies 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 a review of personnel listed on Form CMS-209, a review of the personnel files, and an interview with the Laboratory Manager, the surveyor determined the Technical Consultant failed to ensure three of five testing personnel (TP) had documentation of an annual competency evaluation in 2018-2020. The findings include: 1. A review of Form CMS-209 revealed three moderate-complexity testing personnel who had been employed in the laboratory since the previous survey. 2. A review of personnel records revealed the following missing competency evaluations: A) TP #1: No 2018 or 2020 annual competency evaluations B) TP #2: No 2018 or 2020 annual competency evaluations C) TP #5: No 2018, 2019 or 2020 annual competency evaluations 3. During an interview on 10/29/2020 at 10:20 AM, the surveyor reviewed and confirmed the above noted findings with the Laboratory Manager. SURVEYOR ID #32558 Licensure and Certification Surveyor 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 --