Epiphany Dermatology, Pa

CLIA Laboratory Citation Details

2
Total Citations
12
Total Deficiencyies
5
Unique D-Tags
CMS Certification Number 45D2098645
Address 4100 Hwy 377, Brownwood, TX, 76048
City Brownwood
State TX
Zip Code76048
Phone(325) 646-2929

Citation History (2 surveys)

Survey - June 19, 2023

Survey Type: Standard

Survey Event ID: RBZE11

Deficiency Tags: D0000 D0000 D5801 D5801

Summary:

Summary Statement of Deficiencies D0000 The laboratory was found to be in substantial compliance with CLIA regulations 42 CFR Part 493. Standard level deficiencies were cited. D5801 TEST REPORT CFR(s): 493.1291(a) The laboratory must have an adequate manual or electronic system(s) in place to ensure test results and other patient-specific data are accurately and reliably sent from the point of data entry (whether interfaced or entered manually) to final report destination, in a timely manner. This includes the following: (a)(1) Results reported from calculated data. (a)(2) Results and patient-specific data electronically reported to network or interfaced systems. (a)(3) Manually transcribed or electronically transmitted results and patient-specific information reported directly or upon receipt from outside referral laboratories, satellite or point-of-care testing locations. This STANDARD is not met as evidenced by: Based on review of laboratory policy, laboratory records, patient records, and confirmed in interview, the laboratory failed to ensure 2 of 7 patient KOH (potassium hydroxide) preparation results were transcribed accurately to the final test report in 2022 (random review February 2022 through December 2022). The findings include: 1. Review of the laboratory's policy titled "KOH Protocol" revealed: "RESULTS: There should be no air bubbles under the coverslip that might obscure the dermatophytes. A correctly prepared slide will allow the physician and/or mid-level provider to render a fast and correct diagnosis of a specimen. A normal, or negative, KOH test shows no evidence of fungi. Dermatophytes or yeast seen on a KOH test indicate that the person has a fungal infection. Fungi causing ringworm infections produce septate (segmented) hyphae, or long branch-like tubular structures. Yeast cells appear round and oval. Budding forms may be seen. KOH cannot identify the specific organism. If necessary, a biopsy can be procured and submitted for permanent pathologic processing, or a second scraping may be taken and submitted for culture." 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 -- 2. Review of the laboratory's "Mycology Log" and corresponding patient final reports revealed the following: 06/29/2022 MRN: MM0001240421 Mycology Log: "Positive (+)" Final report: "Examination of the slide showed: branching hyphae" 08/18/2022 MRN: MM0001002797 Mycology Log: "Positive (+)" Final report: "Examination of the slide showed: branching hyphae" The laboratory failed to accurately transcribe results of KOH preparations to the final reports. 2. During an interview on 06/19/2023 at 9:55 a.m., the Clinical Operations Manager and Quality Compliance Specialists confirmed the above findings. -- 2 of 2 --

πŸ”’ Unlock Deficiency Summary

Get full access to the detailed deficiency summary for this facility

One-time payment β€’ Lifetime access

Survey - September 28, 2021

Survey Type: Standard

Survey Event ID: 997411

Deficiency Tags: D0000 D5217 D5413 D5473 D0000 D5217 D5413 D5473

Summary:

Summary Statement of Deficiencies D0000 Laboratory representatives were present at the entrance conference. The survey process was discussed. An opportunity for questions and comments was given. The exit conference was held with the laboratory representatives. The laboratory was found to be in substantial compliance for the specialties/subspecialties for which it was surveyed. The standard level deficiencies cited were discussed. The process for submitting the corrections was explained. CMS form 2567 will be emailed from the Texas Health and Human Services Commission, Health Facility Compliance Arlington Group. Note: The CMS-2567 (Statement of Deficiencies) is an official, legal document. All information must remain unchanged except for entering the

πŸ”’ Unlock Deficiency Summary

Get full access to the detailed deficiency summary for this facility

One-time payment β€’ Lifetime access