Community And Family Resources

CLIA Laboratory Citation Details

1
Total Citation
2
Total Deficiencyies
2
Unique D-Tags
CMS Certification Number 16D2128693
Address 430 Southgate Ave, Iowa City, IA, 52240
City Iowa City
State IA
Zip Code52240
Phone(319) 351-4357

Citation History (1 survey)

Survey - March 28, 2019

Survey Type: Standard

Survey Event ID: 40P911

Deficiency Tags: D6063 D6065

Summary:

Summary Statement of Deficiencies D6063 LABORATORY TESTING PERSONNEL CFR(s): 493.1421 The laboratory must have a sufficient number of individuals who meet the qualification requirements of 493.1423, to perform the functions specified in 493. 1425 for the volume and complexity of tests performed. This CONDITION is not met as evidenced by: Based on review of the Laboratory Personnel Report (Form CMS-209), laboratory personnel records and confirmed by laboratory personnel identifier #1 at approximately 1:15 pm on 03/28/2019, the laboratory failed to meet the testing personnel requirements by providing documentation qualifying testing personnel that perform moderate complexity as specified in standard D6065. D6065 TESTING PERSONNEL QUALIFICATIONS CFR(s): 493.1423(b)(1)(2)(3)(4)(i) (b) Meet one of the following requirements: (b)(1) Be a doctor of medicine or doctor of osteopathy licensed to practice medicine or osteopathy in the State in which the laboratory is located or have earned a doctoral, master's, or bachelor's degree in a chemical, physical, biological or clinical laboratory science, or medical technology from an accredited institution; or (b)(2) Have earned an associate degree in a chemical, physical or biological science or medical laboratory technology from an accredited institution; or (b)(3) Be a high school graduate or equivalent and have successfully completed an official military medical laboratory procedures course of at least 50 weeks duration and have held the military enlisted occupational specialty of Medical Laboratory Specialist (Laboratory Technician); or (b)(4)(i) Have earned a high school diploma or equivalent; and 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 -- This STANDARD is not met as evidenced by: Based on review of the Laboratory Personnel Report (Form CMS-209), laboratory personnel records and confirmed by laboratory personnel identifier #1 (refer to Laboratory Personnel Report) at approximately 1:15 pm on 03/28/19, the laboratory failed to have documentation qualifying 2 out of 3 testing personnel (identifiers #5 and #6) that perform moderate complexity testing. The findings include: 1. Laboratory personnel identifier #5 started performing urine specific gravity testing in March of 2019. At the time of the survey, the laboratory did not have educational documentation to qualify the test personnel. 2. Laboratory personnel identifier #6 started performing urine specific gravity testing in March of 2019. At the time of the survey, the diploma for identifier #6 indicated a degree from Mexico. The laboratory did not have documentation verifying the degree had been evaluated by an organization to determine its' equivalency to that of a degree in the United States. -- 2 of 2 --

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