Cypress Ob Gyn

CLIA Laboratory Citation Details

3
Total Citations
24
Total Deficiencyies
10
Unique D-Tags
CMS Certification Number 45D1050724
Address 10680 Jones Rd Ste 600, Houston, TX, 77065
City Houston
State TX
Zip Code77065
Phone281 477-0417
Lab DirectorOANH BUI

Citation History (3 surveys)

Survey - April 30, 2024

Survey Type: Standard

Survey Event ID: E9DK11

Deficiency Tags: D0000 D3031 D6053 D0000 D3031 D6053

Summary:

Summary Statement of Deficiencies D0000 The laboratory was surveyed and found to be in compliance with the Conditions of the CLIA regulations found at 42 CFR 493.1 through 493.1780, and recertification is recommended. D3031 RETENTION REQUIREMENTS CFR(s): 493.1105(a)(3) Analytic systems records. Retain quality control and patient test records (including instrument printouts, if applicable) and records documenting all analytic systems activities specified in 493.1252 through 493.1289 for at least 2 years. This STANDARD is not met as evidenced by: Based on a review of the laboratory's American Proficiency Institute (API) proficiency testing records from 2023, and staff interview, the laboratory failed to retain the Cepheid Xpress analyzer printouts for three of three proficiency testing events in 2023. Findings include: 1. A review of the laboratory's API testing records revealed the laboratory participated in the following 3 testing events in 2023: - 2023 Microbiology- 1st Event - 2023 Microbiology- 2nd Event - 2023 Microbiology- 3rd Event 2. Further review of the API testing records revealed the laboratory failed to retain the analyzer printouts for the Cepheid Xpress analyzer for all 3 testing events in 2023. 3. In an interview on 4/30/24 at 2:05 p.m. in the office, the laboratory supervisor revealed the laboratory disposed of the analyzer printouts once they entered the results into API's website. This confirmed the above findings. D6053 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 semiannually during the first year the individual tests patient specimens. 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 a review of the laboratory's submitted CMS 209 form, the laboratory's personnel records, and staff interview, the laboratory failed to have documentation of the technical consultant performing a competency assessment, at least twice during the first year of testing, for one of two testing personnel performing moderate complexity testing. Findings include: 1. A review of the laboratory's submitted CMS 209 form revealed the laboratory identified 2 testing personnel performing moderate complexity testing on the Cepheid Xpress and BD Affirm analyzers. 2. A review of the laboratory's personnel records revealed the following testing personnel, their hire date, and date(s) a competency assessment was performed: a) Testing person #2 Hire date: August 2022 Competency assessment performed: August 2022 Based on the hire date, testing person #2 should have had at least 2 competency assessments performed prior to August 2023. 3. In an interview on 4/30/24 at 1:50 p.m. in the office, the laboratory supervisor, after review of the records, confirmed the above findings. -- 2 of 2 --

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Survey - September 12, 2022

Survey Type: Standard

Survey Event ID: UDIO11

Deficiency Tags: D0000 D5209 D5445 D5791 D6004 D6020 D6021 D0000 D5209 D5445 D5791 D6004 D6020 D6021

Summary:

Summary Statement of Deficiencies D0000 Noted deficiencies and plans of correction were discussed with the laboratory representative(s) at the exit conference. The facility representative(s) were given an opportunity to provide evidence of compliance with the noted deficiencies, and no such evidence was provided prior to survey exit. The facility was found in compliance with applicable Conditions of Participation in the CLIA program, and certification is recommended. Note: The CMS-2567 (Statement of Deficiencies) is an official, legal document. All information must remain unchanged except for entering the

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Survey - September 12, 2022

Survey Type: Special

Survey Event ID: P7TH11

Deficiency Tags: D0000 D3000 D0000 D3000

Summary:

Summary Statement of Deficiencies D0000 Noted deficiencies and plans of correction were discussed with the laboratory representative(s) at the exit conference. The facility representative(s) were given an opportunity to provide evidence of compliance with the noted deficiencies, and no such evidence was provided prior to survey exit. The facility was found in compliance with applicable Conditions of Participation in the CLIA program, and certification is recommended. Note: The CMS-2567 (Statement of Deficiencies) is an official, legal document. All information must remain unchanged except for entering the

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