Forefront Dermatology, Sc

CLIA Laboratory Citation Details

2
Total Citations
9
Total Deficiencyies
4
Unique D-Tags
CMS Certification Number 52D2015844
Address 1245 Cheyenne Ave Ste 301, Grafton, WI, 53024
City Grafton
State WI
Zip Code53024
Phone(262) 377-2222

Citation History (2 surveys)

Survey - August 23, 2022

Survey Type: Standard

Survey Event ID: UKRB11

Deficiency Tags: D5417 D5429 D6094 D5417 D5429 D6094

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 surveyor review of laboratory records and interview with the regional clinic manager the laboratory used expired eosin stain for all Mohs procedures on May 5, 2022. Findings include: 1. Review of the "Quality Control Assessment of Mohs Tissue Staining Procedure" log showed the laboratory used Eosin stain lot 041320 with an expiration date of April 13, 2022 on May 5, 2022. 2. Interview with the regional clinic manager (staff A) on August 23, 2022 at 9:30 AM confirmed personnel used expired eosin stain for all Mohs procedures performed on May 5, 2022. D5429 MAINTENANCE AND FUNCTION CHECKS CFR(s): 493.1254(a)(1) For unmodified manufacturer's equipment, instruments, or test systems, the laboratory must perform and document maintenance as defined by the manufacturer and with at least the frequency specified by the manufacturer. This STANDARD is not met as evidenced by: Based on surveyor review of laboratory records and procedures and interview with the regional clinic manager, the laboratory staff did not document the performance of daily or monthly cryostat maintenance except on one day during 2021 and on ten of ten days of use in 2022. Findings include: 1. The "Quality Control Policies and Documentation" procedure included the statement, "Interior is cleaned each day after 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 -- use using absolute alcohol, while wearing gloves. The surface is decontaminated each day of use using TBQ or equivalent. The microtome is decontaminated every month using TBQ or equivalent." 2. The "Cryostat Maintenance & Temperature Log" included the following statement, "A checkmark in the Maintenance column indicates that maintenance (per cryostat procedure) is done daily when Mohs is performed." Review of the logs from 2021 and 2022 showed laboratory staff only documented maintenance on one day (July 1) in 2021. Laboratory staff did not document the completion of maintenance for ten of the ten days of cryostat use in 2022. The records showed no sign of monthly maintenance performance. 3. Interview with the regional clinic manager (staff A) on August 23, 2022 at 9:30 AM confirmed testing personnel did not document daily or monthly cryostat maintenance during 2021 or 2022. 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. This STANDARD is not met as evidenced by: Based on surveyor review of maintenance logs and interview with the regional clinic manager, the laboratory director did not ensure prompt review of records and did not ensure maintenance of the quality assessment program in 2021 and 2022. Findings include: 1. Review of "Cryostat Maintenance & Temperature Log" records from 2021 and 2022 showed the records included a space for the team lead or laboratory director to sign and date the record to document review. The records from 2021 were all signed and dated on December 28, 2021; the records from 2022 were not signed or dated and showed no sign of review. The reviewer did not make note of the lack of maintenance documentation in 2021. 2. Interview with the regional clinic manager (staff A) confirmed the laboratory director did not ensure the quality assurance program was maintained when the team lead or director did not review the records for 2021 promptly and did not identify the missing daily cryostat maintenance documentation in 2021 and 2022 (see D5429). -- 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 - March 30, 2021

Survey Type: Standard

Survey Event ID: TLI311

Deficiency Tags: D6094 D6046 D6094

Summary:

Summary Statement of Deficiencies D6046 TECHNICAL CONSULTANT RESPONSIBILITIES CFR(s): 493.1413(b)(8) (b) The technical consultant is responsible for-- (b)(8) Evaluating the competency of all testing personnel and assuring that the staff maintain their competency to perform test procedures and report test results promptly, accurately and proficiently. This STANDARD is not met as evidenced by: Based on surveyor review of competency assessment records and interview with the regional clinic manager, the technical consultant, who is the laboratory director, did not evaluate the competency for two of two moderate complexity testing personnel in 2020. Findings include: 1. Review of the 2020 competency assessment forms showed no evidence of evaluation of competency for two of two moderate complexity testing personnel competency by the technical consultant, who is the laboratory director. 2. Interview with the regional clinic manager on March 30, 2021 at 2:10 PM, confirmed the technical consultant, who is the laboratory director, did not document evaluation of competency for two of two moderate complexity testing personnel in 2020. 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. This STANDARD is not met as evidenced by: Based on surveyor review of laboratory records and procedures and interview with the regional clinic manager, the laboratory director did not evaluate three of three Mohs surgery slides to maintain the quality assessment program to ensure the quality 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 -- laboratory services in quarter three and four of 2020. Findings include: 1. Review of the "Frozen Section Biopsies & Mohs Micrographic Surgery Slides" procedure showed the procedure states "Three cases Mohs surgery will be send out to another Mohs surgeon to be evaluated for any inconsistencies in the quality and interpretation." Further review showed the procedure states "The Mohs surgeon will review the log after the review." 2. Review of the "Quality Control for Mohs Micrographic Surgery" log showed the peer review surgeon signed the review on October 5, 2020 for one case, and with two cases from 2020 sent for review after March 15, 2021. Further review showed the laboratory director, who is the Mohs surgeon, did not review the log. 3. Interview with the regional clinic manager on March 30, 2020 at 2:10 PM, confirmed the laboratory director did not evaluate three of three Mohs surgery slides to maintain the quality assessment program to ensure the quality of laboratory services in quarter three and four of 2020. -- 2 of 2 --

πŸ”’ Unlock Deficiency Summary

Get full access to the detailed deficiency summary for this facility

One-time payment β€’ Lifetime access