Family Practice Of Grand Island

CLIA Laboratory Citation Details

2
Total Citations
11
Total Deficiencyies
6
Unique D-Tags
CMS Certification Number 28D0455757
Address 3563 Prairieview Street, Suite 300, Grand Island, NE, 68803
City Grand Island
State NE
Zip Code68803
Phone308 398-4480
Lab DirectorKAREN HASTINGS

Citation History (2 surveys)

Survey - December 31, 2025

Survey Type: Special

Survey Event ID: G8LK11

Deficiency Tags: D2016 D2130 D0000 D2016 D2130 D6000 D6000 D6016 D6016

Summary:

Summary Statement of Deficiencies D0000 A proficiency testing desk review was completed on December 31, 2025. At the time of the review, the laboratory was not in compliance with the Clinical Laboratory Improvement Amendments of 1988, 42 CFR 493.1 through 42 CFR 493.1780. The following condition deficiencies were cited: D2016 - 42 C.F.R. 493.803 Condition: Successful participation [proficiency testing] D6000 - 42 C.F.R. 493.1403 Condition: Laboratories performing moderate complexity testing; laboratory director D2016 SUCCESSFUL PARTICIPATION CFR(s): 493.803(a)(b)(c) (a) Each laboratory performing nonwaived testing must successfully participate in a proficiency testing program approved by CMS, if applicable, as described in subpart I of this part for each specialty, subspecialty, and analyte or test in which the laboratory is certified under CLIA. (b) Except as specified in paragraph (c) of this section, if a laboratory fails to participate successfully in proficiency testing for a given specialty, subspecialty, analyte or test, as defined in this section, or fails to take remedial action when an individual fails gynecologic cytology, CMS imposes sanctions, as specified in subpart R of this part. (c) If a laboratory fails to perform successfully in a CMS- approved proficiency testing program, for the initial unsuccessful performance, CMS may direct the laboratory to undertake training of its personnel or to obtain technical assistance, or both, rather than imposing alternative or principle sanctions except when one or more of the following conditions exists: (1) There is immediate jeopardy to patient health and safety. (2) The laboratory fails to provide CMS or a CMS agent with satisfactory evidence that it has taken steps to correct the problem identified by the unsuccessful proficiency testing performance. (3) The laboratory has a poor compliance history. This CONDITION is not met as evidenced by: Based on a desk review of proficiency testing (PT) records from the Certification and Survey Provider Enhanced Reporting (CASPER) 0155 report and American 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 -- Proficiency Institute (API) 2025 proficiency testing records, the laboratory did not successfully participate in a proficiency testing program approved by HHS, for each specialty, subspecialty, and analyte or test in which the laboratory is certified under CLIA. The laboratory failed to successfully participate in the analyte of Hematocrit. Refer to D2130. D2130 HEMATOLOGY CFR(s): 493.851(f) (f) Failure to achieve satisfactory performance for the same analyte in two consecutive events or two out of three consecutive testing events is unsuccessful performance. This STANDARD is not met as evidenced by: Based on proficiency testing desk review of CASPER 0155 report, API Proficiency Testing 2025 records (Events 2 & 3), and a phone interview with the laboratory manager on December 31, 2025, the laboratory failed to achieve satisfactory performance (80% or better) for the same analyte for two consecutive testing events for the analyte Hematocrit. Findings are: 1. Review of the CASPER 0155 report revealed the following results: 2025 2nd Event the laboratory received an unsatisfactory score of 20% for Hematocrit 2025 3rd Event the laboratory received an unsatisfactory score of 60% for Hematocrit 2. A review of API proficiency testing records confirmed the laboratory received the above results. 3. A phone interview with the laboratory manager on December 31, 2025 at 10:20 AM, confirmed the above results. D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR CFR(s): 493.1403 The laboratory must have a director who meets the qualification requirements of 493. 1405 of this subpart and provides overall management and direction in accordance with 493.1407 of this subpart. This CONDITION is not met as evidenced by: Based on a proficiency testing desk review of CASPER 0155 report and American Proficiency Institute 2025 records, the laboratory director failed to manage successful proficiency testing participation. Refer to D6016. D6016 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(4)(i) (e)(4)(i) The proficiency testing samples are tested as required under Subpart H of this part; This STANDARD is not met as evidenced by: Based on a proficiency testing desk review of CASPER 0155 report and American Proficiency Intitute 2025 records, the laboratory director failed to manage successful proficiency testing participation. Refer to D2130. -- 2 of 2 --

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Survey - September 18, 2018

Survey Type: Standard

Survey Event ID: N7MV11

Deficiency Tags: D5477 D5477

Summary:

Summary Statement of Deficiencies D5477 CONTROL PROCEDURES CFR(s): 493.1256(e)(4)(g) (e) For reagent, media, and supply checks, the laboratory must do the following: (e) (4) Before, or concurrent with the initial use-- (e)(4)(i) Check each batch of media for sterility if sterility is required for testing; (e)(4)(ii) Check each batch of media for its ability to support growth and, as appropriate, select or inhibit specific organisms or produce a biochemical response; and (e)(4)(iii) Document the physical characteristics of the media when compromised and report any deterioration in the media to the manufacturer. (g) The laboratory must document all control procedures performed. This STANDARD is not met as evidenced by: Based on review of media check in logs, lack of documentation of media checks and an interview with the technical consultant and the laboratory supervisor at 11:55 AM on 9/18/2018 the laboratory failed to check each batch of media for its ability to support growth and, as appropriate, select or inhibit specific organisms or produce a biochemical response. Findings are: 1. Review of media check in logs for Strep selective media used by the laboratory for confirmation testing revealed media received and put in use on the following dates in 2018 - 7/18 and 8/24. 2. No end user checks of this media for its ability to support growth and, as appropriate, select or inhibit specific organisms or produce a biochemical response could be presented at the time of survey. 3. Interview with the technical consultant and the laboratory supervisor confirmed these end user checks had not been performed and an alternative Individual Quality Control Plan (IQCP) had not been implemented for these 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 1 --

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