Cytology Pathology Services, Inc

CLIA Laboratory Citation Details

3
Total Citations
27
Total Deficiencyies
26
Unique D-Tags
CMS Certification Number 15D0353522
Address 5865 N Michigan Rd, Indianapolis, IN, 46228
City Indianapolis
State IN
Zip Code46228
Phone(317) 255-3579

Citation History (3 surveys)

Survey - February 27, 2023

Survey Type: Standard

Survey Event ID: 9N3U11

Deficiency Tags: D5217

Summary:

Summary Statement of Deficiencies D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(c)(1) At least twice annually, the laboratory must verify the accuracy of any test or procedure it performs that is not included in subpart I of this part. This STANDARD is not met as evidenced by: Based on record review and interview, the laboratory failed to verify the accuracy of their dermatopathology testing twice annually in 2021 and 2022. Findings Included: 1. Review of "Dermatology Pathology Proficiency Testing 2021" and "Dermatology Pathology Proficiency Testing 2022" both signed 2/2/2023 revealed the following: a. 10 cases for 2021 were exchanged and reviewed by a pathologist on 2/2/2023. b. 10 cases for 2022 were exchanged and reviewed by a pathologist on 2/2/2023. 2. Review of agreement dated January 24, 2023 and signed by the laboratory director SP-1 on 2/3 /2023 indicated an agreement between pathologist and laboratory director to "exchange slides for review in 2021 and 2022." 3.) During an interview on 2/27/23 at 3:39 p.m., SP-1(laboratory director) confirmed proficiency testing for dermatopathology was not performed twice annually in 2021 and 2022. 4.) The annual testing volume for Histopathology is 3,587. 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 --

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Survey - May 12, 2021

Survey Type: Special

Survey Event ID: LKLD11

Deficiency Tags: D5032 D5209 D5311 D5403 D5407 D5411 D5415 D5417 D5423 D5625 D5629 D5633 D5637 D5641 D5645 D5647 D5655 D5657 D6076 D6094 D6115 D6130 D6133 D9999

Summary:

Summary Statement of Deficiencies D5032 CYTOLOGY CFR(s): 493.1221 If the laboratory provides services in the subspecialty of Cytology, the laboratory must meet the requirements specified in 493.1230 through 493.1256, 493.1274, and 493.1281 through 493.1299. This CONDITION is not met as evidenced by: Based on review of laboratory policies and procedures, laboratory records, slide preparations, observation and interviews it was determined the laboratory failed to establish written policies and procedures to assess the competency of one of one Technical Supervisors (refer to D5209); failed to establish policies and procedures for the collection, labeling, storage and preservation, and transportation of Hologic ThinPrep Pap Tests (refer to D5311); failed to establish written policies and procedures for seven laboratory test processes (refer to D5403); failed to ensure that 81 of 92 written procedures were approved, signed and dated by the Laboratory Director (refer to D5407); failed to follow the manufacturer's instructions for processing gynecologic cytology specimens (refer to D5415); failed to ensure that reagents and solutions were used before their expiration date (refer to D5417); failed to establish performance specifications when the laboratory modified the Hologic ThinPrep Pap Test system manufacturer's instructions with an alternate method of processing gynecologic cytology specimens and when preparing gynecologic slides from Hologic ThinPrep Pap Test vials utilizing cytospin preparations (refer to D5423); failed to establish written policies and procedures to ensure that the search and review of prior negative gynecologic specimens received within the previous five years for each patient with a current malignancy was performed, and failed to document the search for prior negative gynecologic cytology cases (refer to D5625); failed to establish written policies and procedures for the evaluation and comparison of six of six laboratory statistics, and failed to document six of six required annual statistics (refer to D5629); failed to establish written policies and procedures to ensure Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 14 -- that a maximum workload limit was established and reassessed at least every six months by the Technical Supervisor for one of one Technical Supervisors (refer to D5633 and D5637); failed to establish written policies and procedures to ensure the workload limit for one of one Technical Supervisors, when examining slides in less than an 8-hour workday and with duties other than slide examination, would be prorated to determine the number of slides that may be examined (refer to D5641); failed to ensure that the laboratory maintained records for one of one Technical Supervisors of the total number of slides and the total number of hours spent evaluating slides per 24-hour period (refer to D5645); failed to establish written policies and procedures to ensure that records were available to document the workload limit for one of one Technical Supervisors (refer to D5647); failed to follow written policies and procedures to ensure that gynecologic cytology slide preparations were identified and reported as unsatisfactory (refer to D5655); and failed to establish written policies and procedures for the system of narrative descriptive nomenclature used by the laboratory to report gynecologic cytology test results (refer to D5657). D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES CFR(s): 493.1235 As specified in the personnel requirements in subpart M, the laboratory must establish and follow written policies and procedures to assess employee and, if applicable, consultant competency. This STANDARD is not met as evidenced by: Based on review of laboratory policies and procedures, lack of laboratory records and interview it was determined that the laboratory failed to establish written policies and procedures to assess the competency of one of one Technical Supervisors in 2019, 2020 and to the date of the survey in 2021. Findings include: 1. The Survey Team requested and the laboratory failed to provide written policies and procedures to describe the laboratory's process for assessing the competency of one of one Technical Supervisors. 2. The Survey Team requested and the laboratory failed to provide records of competency assessment for one of one Technical Supervisors who performed microscopic evaluations during 2019, 2020 and to the date of the survey in 2021. Technical Supervisor includes: - Technical Supervisor 3. During an interview on May 11, 2021 at 11:15 AM, these findings were confirmed with the Laboratory Director/Technical Supervisor. D5311 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL CFR(s): 493.1242(a) The laboratory must establish and follow written policies and procedures for each of the following, if applicable: (1) Patient preparation. (2) Specimen collection. (3) Specimen labeling, including patient name or unique patient identifier and, when appropriate, specimen source. (4) Specimen storage and preservation. (5) Conditions for specimen transportation. (6) Specimen processing. (7) Specimen acceptability and rejection. (8) Specimen referral. This STANDARD is not met as evidenced by: Based on review of laboratory policies and procedures and interviews it was determined that the laboratory failed to establish written policies and procedures for the collection, labeling, storage and preservation, and transportation of Hologic -- 2 of 14 -- ThinPrep Pap Tests. Findings include: 1. The Survey Team requested and the laboratory failed to provide written policies and procedures for the collection, labeling, storage and preservation, and transportation of Hologic ThinPrep Pap Tests submitted to the laboratory. 2. During an interview on May 11, 2021 at 8:15 AM, the Laboratory Manager provided to the Survey Team the Hologic ThinPrep Pap Test Quick Reference Guide and stated "this is what we use for collection instructions." 3. During an interview on May 11 at 12:30 PM, these findings were confirmed with the Laboratory Director/Technical Supervisor. D5403 PROCEDURE MANUAL CFR(s): 493.1251(b) The procedure manual must include the following when applicable to the test procedure: (1) Requirements for patient preparation; specimen collection, labeling, storage, preservation, transportation, processing, and referral; and criteria for specimen acceptability and rejection as described in 493.1242. (2) Microscopic examination, including the detection of inadequately prepared slides. (3) Step-by-step performance of the procedure, including test calculations and interpretation of results. (4) Preparation of slides, solutions, calibrators, controls, reagents, stains, and other materials used in testing. (5) Calibration and calibration verification procedures. (6) The reportable range for test results for the test system as established or verified in 493.1253. (7) Control procedures. (8)

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Survey - January 15, 2019

Survey Type: Standard

Survey Event ID: JPAN11

Deficiency Tags: D5415 D5429

Summary:

Summary Statement of Deficiencies D5415 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(c) Reagents, solutions, culture media, control materials, calibration materials, and other supplies, as appropriate, must be labeled to indicate the following: (1) Identity and when significant, titer, strength or concentration. (2) Storage requirements. (3) Preparation and expiration dates. (4) Other pertinent information required for proper use. This STANDARD is not met as evidenced by: Based on observation, interview, and record review, the laboratory failed to document preparation and expiration dates for two of two Papanicolaou stains: OG-6 and Eosin Azure (EA), in use and prepared by the laboratory. Annual cytology specimens=488. Findings include: 1. On 01/14/19 at 1:55 PM, a tour of the lab was conducted with SP- 1, and the following materials were observed in the cytology cabinet, available for use: a. An opened bottle of Papanicolaou, OG-6 stain, with no preparation or expiration dates. b. An opened bottle of Papanicolaou, Eosin Azure (EA) stain, with no preparation or expiration dates. 2. In interview on 01/14/19 at 2:03 PM, SP-2 acknowledged there were no preparation and expiration dates, on the bottles labeled "OG-6" and "EA". SP-2 indicated these bottles contained stains that were mixed in the lab. 3. Review of the lab manual with the title page "CYTOLOGY STAIN FORMULAS", no effective date, included "EA - 4 LITER" and "OG-6- 4 LITER" stains, but did not include expiration dates/shelf-life time period. 4. Medical record review indicated patients (PT) #11-#20 had cytology specimen staining with Papanicolaou, OG-6 and Papanicolaou, Eosin Azure (EA) stains, on the following days: PT#11=11/30/18 PT#12=11/26/18 PT#13=11/06/18 PT#14=10/26/18 PT#15=10 /11/18 PT#16=10/01/18 PT#17=09/20/18 PT#18=07/16/18 PT#19=05/05/18 PT#20=02/16/18 D5429 MAINTENANCE AND FUNCTION CHECKS 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 -- CFR(s): 493.1254(a)(1) For unmodified manufacturer's equipment, instruments, or test systems, the laboratory must perform and document maintenance as defined by the manufacturer and with at least the frequency specified by the manufacturer. This STANDARD is not met as evidenced by: Based on observation, interviews, and record review, the laboratory failed to document compliance with manufacturer's maintenance requirements for one of one Thermo Fishers Scientific HM 325-2 Microtome. Annual histology specimens=5,845. Findings include: 1. On 01/15/19 at 9:05 AM, during lab tour, a Thermo Fishers Scientific HM 325-2 Microtome was in operation. The only documentation of maintenance was a maintenance sticker labeled "Microm/HM-325, 10/13/14". 2. In interview on 01/15/19 at 9:13 AM, SP-4 acknowledged the Thermo Fishers Scientific HM 325-2 Microtome had not been serviced in a very long time. SP-4 indicated there was a manual from 1993, but was unable to locate it. 3. In interview on 01/15/19 at 11: 30 AM, SP-3 (laboratory director), acknowledged the Thermo Fishers Scientific HM 325-2 Microtome had not been serviced in a long time. 4. Medical record review indicated patients (PT) #1-#10 had histology specimen processing with the Thermo Fishers Scientific HM 325-2 Microtome, on the following days: PT#1=01/02/18 PT#2=03/15/18 PT#3=06/11/18 PT#4=09/27/18 PT#5=10/01/18 PT#6=10/17/18 PT#7=11/08/18 PT#8=11/28/18 PT#9=12/12/18 PT#10=12/12/18 5. Review of "Rotary Microtome #M325-2 Instruction Manual" (no revision date), confirmed in "Part 5 Maintenance and Care", a recommendation for routine maintenance to be performed by a trained service technician once a year. It is also required that the battery be changed by the service technician after five years. -- 2 of 2 --

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