Dermatologic Surgicenter

CLIA Laboratory Citation Details

2
Total Citations
5
Total Deficiencyies
3
Unique D-Tags
CMS Certification Number 39D0998457
Address 1200 Locust Street, Philadelphia, PA, 19107
City Philadelphia
State PA
Zip Code19107
Phone(215) 546-3666

Citation History (2 surveys)

Survey - June 16, 2022

Survey Type: Standard

Survey Event ID: 6E1N11

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 review of the laboratory procedure manual, peer review records and interview with the MOHS Tech, the laboratory failed to ensure that 2 of 2 Testing Personnel (TP) performed the verification of accuracy of MOHS micrographic surgery slides examined from 01/01/2020 through the date of survey. Findings Include: 1. On the day of survey, 06/16/2022 at 10:17 am, the MOHS Tech could not provide a procedure for the verification of accuracy performed on the MOHS micrographic surgery slides examined from 01/01/2020 to 06/16/2022. 2. 122 MOHS micrographic surgery slides were examined from 01/01/2021 through 12/31/2021. 3. Interview with the MOHS Tech on 06/16/2022 at 10:41 am, revealed that 1 of 2 TP meets biannually with a committee to perform peer review analyses of slides. 4. The laboratory could not provide documentation of twice annual verification of accuracy for MOHS micrographic surgery slides examined from 01/01/2020 through the date of survey for the following TP: -1 of 2 TP (CMS 209 personnel #1) completed peer review once in 2020 and 2021. -1 of 2 TP (CMS 209 personnel #2) completed peer review once in 2020. No docmentation was provided for peer review in 2021. 5. The MOHS Tech confirmed the findings above on 06/16/2022 around 10:45 am. 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 - January 12, 2018

Survey Type: Standard

Survey Event ID: K7OF11

Deficiency Tags: D5413 D6094 D5413 D6094

Summary:

Summary Statement of Deficiencies D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(b) The laboratory must define criteria for those conditions that are essential for proper storage of reagents and specimens, accurate and reliable test system operation, and test result reporting. The criteria must be consistent with the manufacturer's instructions, if provided. These conditions must be monitored and documented and, if applicable, include the following: (1) Water quality. (2) Temperature. (3) Humidity. (4) Protection of equipment and instruments from fluctuations and interruptions in electrical current that adversely affect patient test results and test reports. This STANDARD is not met as evidenced by: Based on, a tour of the laboratory, the review of laboratory records and interview with the Laboratory Technician, the laboratory failed to properly store flammable Alcohol in a flammable cabinet, from 2016 to the date of survey. Findings: 1) On the date of survey (01/12/2018 at 10:15 am), during the laboratory tour 5 of 5 bottles of StatLab 100% Reagent Alcohol (lot# 062340 exp: 12/19) were found stored in a non- flammable cabinet. 2) According to the Laboratory's Safety Data Sheet "Section 7. Handling and Storage: The Alcohols inside storage should be in a NFPA approved flammable liquid storage room or cabinet." 3) On 01/12/2018 at 10:15 am an interview with the Laboratory Technician confirmed the findings above. D6094 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1445(e)(5) The laboratory director must ensure that the quality assessment programs are established and maintained to assure the quality of laboratory services provided and to identify failures in quality as they occur. 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, the review of laboratory policy and procedure manual and interview with the Laboratory Technician, the Laboratory Director failed to ensure that the quality assessment program is maintained and documented to assure the quality of laboratory services provided from 2016 to date of survey. Findings: 1) On the day of survey 01 /12/2018 at 10:30 am the surveyor reviewed the Quality Assurance Program policy and discovered that the laboratory's quality assessment of the pre-analytic, analytic and post analytic phases were not documented from 06/01/2016 to the date of survey. 2) According to the Quality Assurance Program policy, signed by the Laboratory Director, Section titled: Annual Evaluation of Quality Improvement Program: "The Quality Improvement Committee will annually evaluate the effectiveness of the Quality Improvement plan and revise it accordingly." 3) On 01/12/2018 at 10:30 am and interview with the Laboratory Technician confirmed the findings above. -- 2 of 2 --

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