Cpa - Mission Trails

CLIA Laboratory Citation Details

2
Total Citations
11
Total Deficiencyies
6
Unique D-Tags
CMS Certification Number 45D2007460
Address 3333 Research Plaza, San Antonio, TX, 78235
City San Antonio
State TX
Zip Code78235
Phone(210) 297-3000

Citation History (2 surveys)

Survey - February 6, 2024

Survey Type: Standard

Survey Event ID: F06I11

Deficiency Tags: D6127 D6128 D5473 D6127 D6128

Summary:

Summary Statement of Deficiencies D5473 CONTROL PROCEDURES CFR(s): 493.1256(e)(2)(g) (e) For reagent, media, and supply checks, the laboratory must do the following: (e) (2) Each day of use (unless otherwise specified in this subpart), test staining materials for intended reactivity to ensure predictable staining characteristics. Control materials for both positive and negative reactivity must be included, as appropriate. (g) The laboratory must document all control procedures performed. This STANDARD is not met as evidenced by: Based on review of the laboratory's daily histology stain quality records from May 2022 and April 2023, and staff interview, the laboratory failed to have documentation of assessing stain quality on 2 of 2 days. The findings include: 1. A random sampling of histology stain quality records from May 2022 and April 2023 identified 2 of 2 days where the laboratory failed to have documentation of acceptable stain quality. The days were: May 16, 2022 April 13, 2023 2. The laboratory was asked to provide documentation of acceptable histology stain quality on the identified days. No documentation was provided. 3. The Clinical Service Manager confirmed the findings after her review of the records on 02/06/2023 at 1424 hours in the office. D6127 TECHNICAL SUPERVISOR RESPONSIBILITIES CFR(s): 493.1451(b)(9) The technical supervisor is responsible for evaluating and documenting the performance of individuals responsible for high complexity testing at least semiannually during the first year the individual tests patient specimens. This STANDARD is not met as evidenced by: Based on review of the laboratory's personnel records, and staff interview, the 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 -- laboratory failed to have documentation of competency assessments being performed twice within the first year of employment for 2 of 2 personnel requiring them. The findings include: 1. A review of the laboratory's personnel records identified 2 testing personnel who required semiannual competency assessments within the first year of testing during the record review period. They were (as listed on Form CMS 209): Testing personnel number 3 Testing personnel number 4 2. Further review of the personnel records revealed: Testing personnel number 3 Hired: 04/2022 One competency assessment performed: 2023 Testing personnel number 4 Hired: 07/2021 One competency assessment performed: 2021 3. The laboratory was asked to provide documentation of 2 competency assessments being performed within the first year of employment for each of the 2 identified personnel. No documentation was provided. 4. The Clinical Service Manager confirmed the findings during an interview conducted 02/06/2024 at 1424 hours in the office. D6128 TECHNICAL SUPERVISOR RESPONSIBILITIES CFR(s): 493.1451(b)(9) The technical supervisor is responsible for evaluating and documenting the performance of individuals responsible for high complexity testing at least annually after the first year, unless test methodology or instrumentation changes, in which case, prior to reporting patient test results, the individual's performance must be reevaluated to include the use of the new test methodology or instrumentation. This STANDARD is not met as evidenced by: Based on review of the laboratory's personnel records and staff interview, the laboratory failed to have documentation of annual competency assessments for 3 of 3 testing personnel requiring them in 2022. The findings include: 1. A review of the laboratory's personnel records identified 3 testing personnel who required annual competency assessments in 2022. They were (as listed on Form CMS 209): Testing personnel number 2 Testing personnel number 5 Testing personnel number 6 2. Competency assessments were not available for 3 of the 3 identified personnel. 3. The laboratory was asked to provide documentation of annual competency assessments being performed in 2022 for each of the 3 identified personnel. No documentation was provided. 4. The Clinical Service Manager confirmed the findings during an interview conducted 02/06/2024 at 1424 hours in the office. -- 2 of 2 --

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Survey - November 7, 2018

Survey Type: Special

Survey Event ID: G0I211

Deficiency Tags: D5401 D5411 D9999 D5401 D5411 D9999

Summary:

Summary Statement of Deficiencies D5401 PROCEDURE MANUAL CFR(s): 493.1251(a) A written procedures manual for all tests, assays, and examinations performed by the laboratory must be available to, and followed by, laboratory personnel. Textbooks may supplement but not replace the laboratory's written procedures for testing or examining specimens. This STANDARD is not met as evidenced by: Based on the review of the procedure manual and review of Becton Dickinson (BD) training records it was determined that the laboratory failed to follow one of fifteen written procedures in the procedure manual. Findings include: 1. The laboratory failed to follow the written procedure titled "Proficiency Testing and Training Records" (signed and dated by the Laboratory Director/Technical Supervisor on 6/1/18). The procedure stated, "Training records for Thinprep and Surepath pap smears are maintained in the Procedure Manual for all testing personnel at this location". a. The Survey Team requested and the laboratory failed to provide BD SurePath Pap Test training records for Technical Supervisor #1. D5411 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(a) Test systems must be selected by the laboratory. The testing must be performed following the manufacturer's instructions and in a manner that provides test results within the laboratory's stated performance specifications for each test system as determined under 493.1253. This STANDARD is not met as evidenced by: Based on the review of the BD SUREPATH IMPLEMENTATION GUIDE 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 -- certification records for the BD SurePath Pap Test it was determined that the laboratory failed to ensure that one of five Technical Supervisors had received the appropriate training to evaluate gynecologic specimens using the BD SurePath Pap Test, according to the manufacturer's instructions. Cross Refer to D5401 Findings include: 1. The BD SUREPATH IMPLEMENTATION GUIDE states that the "BD Surepath Morphology Training" must be completed for cytotechnologists and pathologists who evaluate BD SurePath prepared slides. 2. The Survey Team requested and the laboratory failed to provide morphology training records for one of five Technical Supervisors who performed diagnostic interpretations on BD SurePath Pap Tests. (See D5401) D9999 By agreement between ASCT Services, Inc. and CMS, information provided for CMS's completion of CMS Form 670 are ASCT Services, Inc. averages only. This information is confidential and proprietary to ASCT Services, Inc., is exempt under the Freedom of Information Act (5 U.S.C. 552 et seq.), and shall be used for federal government purposes only. -- 2 of 2 --

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