Dermsouth Pa

CLIA Laboratory Citation Details

3
Total Citations
11
Total Deficiencyies
8
Unique D-Tags
CMS Certification Number 45D2097373
Address 10970 Shadow Creek Parkway Suite 340, Pearland, TX, 77584
City Pearland
State TX
Zip Code77584
Phone(713) 340-0030

Citation History (3 surveys)

Survey - February 18, 2025

Survey Type: Standard

Survey Event ID: V5CT11

Deficiency Tags: D0000 D5433 D0000 D5433

Summary:

Summary Statement of Deficiencies D0000 A recertified survey was completed on 02/18/2025. Noted deficiencies and plans of correction were discussed with the laboratory representative(s) at the exit conference. The facility was found to be in compliance with applicable Conditions in the CLIA program, and recertification is recommended. D5433 MAINTENANCE AND FUNCTION CHECKS CFR(s): 493.1254(b)(1) (b)(1)(i) Establish a maintenance protocol that ensures equipment, instrument, and test system performance that is necessary for accurate and reliable test results and test result reporting. (b)(1)(ii) Perform and document the maintenance activities specified in paragraph b(1)(i) of this section. This STANDARD is not met as evidenced by: Based on the review of the laboratory's policy, maintenance records from September 2024 to February 2025, patient logs, and confirmed in an interview, the laboratory failed follow its own policy to perform maintenance on 1 of 1 cryostat (SN: S15049209). The findings were: 1. Review of the laboratory's policy under D. Cryostat Care revealed "*Defrosting (completed every 6-8 weeks...)" 2. Review of the laboratory's maintenance records from September 2024 to February 2025 for Cryostat revealed the Cryostat was defrosted on 11/19/2024 and then on 02/10/2025. Defrost maintenance on 11/19/2024 Due 01/19/2024 Next defrost maintenance on 02/10/2025 Due 4/10/2025 3. Review of the laboratory's patient logs from 01/20/2024 to 02/09 /2025 revealed 16 patients had testing performed. 01/20/2025 Surg# 017 01/20/2025 Surg# 018 01/20/2025 Surg# 019 01/20/2025 Surg# 020 01/27/2025 Surg# 021 01/27 /2025 Surg# 022 01/27/2025 Surg# 023 01/27/2025 Surg# 024 02/03/2025 Surg# 025 02/03/2025 Surg# 026 02/03/2025 Surg# 027 02/03/2025 Surg# 028 02/03/2025 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 -- Surg# 029 02/03/2025 Surg# 030 02/03/2025 Surg# 031 02/03/2025 Surg# 032 4. An interview on 02/18/2025 at 10:53 am in the lab, the facility director confirmed the above findings. -- 2 of 2 --

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Survey - July 23, 2021

Survey Type: Standard

Survey Event ID: Z49F11

Deficiency Tags: D0000 D5473

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 to be in compliance with applicable Conditions of Participation in the CLIA program, and recertification is recommended. 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 random review of patient test records, a review of the laboratory's quality control records, and staff interview, it was revealed the laboratory failed to document the negative and positive reactivity of quality control slides for Toluidine Blue O (T Blue) staining on each day of patient testing between March 2020 and June 2021. Findings include: 1. A random review of patient test records between March 2020 and June 2021 revealed the following patient's specimens were tested using T Blue stain on the dates listed below: a) July 20, 2020 Patient #089 Patient #090 Patient #091 Patient #092 b) May 10, 2021 Patient #103 Patient #104 Patient #105 Patient #106 Patient #107 Patient #108 Patient #109 2. A review of the laboratory's quality control records revealed there was no documentation of the negative and positive reactivity of 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 -- quality control slides for the T Blue stain on the dates listed above. 3. An interview with the histology technician on 7/23/21 at 1:30 p.m. in the nurse's station, after review of the records, confirmed the above findings. -- 2 of 2 --

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Survey - August 20, 2018

Survey Type: Standard

Survey Event ID: G5I512

Deficiency Tags: D5400 D5423 D6086 D5413 D6076

Summary:

Summary Statement of Deficiencies No Tags No deficiency details available. 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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