Dermatology Associates, Pc

CLIA Laboratory Citation Details

2
Total Citations
5
Total Deficiencyies
5
Unique D-Tags
CMS Certification Number 44D0310678
Address 2885 Boones Creek Road, Johnson City, TN, 37615
City Johnson City
State TN
Zip Code37615
Phone(423) 928-9014

Citation History (2 surveys)

Survey - April 22, 2024

Survey Type: Standard

Survey Event ID: FVV611

Deficiency Tags: D5417 D5473

Summary:

Summary Statement of Deficiencies D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(d) Reagents, solutions, culture media, control materials, calibration materials, and other supplies must not be used when they have exceeded their expiration date, have deteriorated, or are of substandard quality. This STANDARD is not met as evidenced by: Based on observation of the laboratory and staff interview, the laboratory failed to ensure expired tissue marking dye was not used in micrographically oriented histographic surgery (Mohs) histopathology tissue processing for patient testing from 11.01.2023 through the survey date 04.22.2024. The findings include: 1. Observation of the Mohs laboratory in patient room number 1 on 04.22.2024 at 9:25 a.m. revealed one bottle of StatLab green tissue marking dye (lot number 132307) in use with an expiration date of 10.31.2023. 2. Interview on 04.22.2024 at 9:25 a.m. with the lead processing histotechnician confirmed the above survey findings. 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 a review of the laboratory's Hematoxylin and Eosin (H&E) stain control slide log, laboratory policy, and staff interview, the laboratory failed to define 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 -- predicted characteristics of the H&E stain in 2023, though the survey date of 04.22.2024. The findings include: 1. A review of the laboratory's H&E stain control slide logs revealed the laboratory failed to document the predicted characteristics of the H&E stain quality for 2023 through the survey date of 04.22.2024. 2. A review of the laboratory's policy, "H&E Stain Approval Log," revealed the policy did not define the predictable characteristics of H&E stain quality. 3. An interview on 04.22.2024 at 11:45 a.m. with the lead processing histotechnician confirmed the above survey findings. -- 2 of 2 --

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Survey - December 17, 2019

Survey Type: Standard

Survey Event ID: GRTS11

Deficiency Tags: D5413 D6094 D6046

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 review of MOH'S Cryostat Temperature log for 2019 for 2 of 2 cryostats, with documented required temperature range, and interview with Director of Nursing, it was determined the cryostats' temperatures were documented out of range with no

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