Freedom Arthritis

CLIA Laboratory Citation Details

3
Total Citations
9
Total Deficiencyies
9
Unique D-Tags
CMS Certification Number 05D1099483
Address 21060 Centre Point Pkwy, Ste A, Santa Clarita, CA, 91350
City Santa Clarita
State CA
Zip Code91350
Phone(661) 254-1202

Citation History (3 surveys)

Survey - March 5, 2024

Survey Type: Standard

Survey Event ID: 9NHU11

Deficiency Tags: D3031 D5815 D3011 D5429 D6082

Summary:

Summary Statement of Deficiencies D3011 FACILITIES CFR(s): 493.1101(d) Safety procedures must be established, accessible, and observed to ensure protection from physical, chemical, biochemical, and electrical hazards, and biohazardous materials. This STANDARD is not met as evidenced by: Based on the surveyor's observation and interview with testing personnel general supervisor (GS) it was determined that the laboratory lacked an eyewash in the testing area. The laboratory failed to observe safety procedures to ensure protection from biohazardous materials. The findings included: 1. On the day of the survey March 5, 2024, at approximately 12:00 p.m. the surveyor observed that the laboratory lacked an eyewash in the area where blood samples are processed. 2. The GS affirmed the lack of an eyewash in the testing area. 3. Based on the laboratory's annual testing volume declaration signed by the laboratory director on 3/4/2024, the laboratory processed, tested, and reported approximately 4,000 samples. D3031 RETENTION REQUIREMENTS CFR(s): 493.1105(a)(3) Analytic systems records. Retain quality control and patient test records (including instrument printouts, if applicable) and records documenting all analytic systems activities specified in 493.1252 through 493.1289 for at least 2 years. This STANDARD is not met as evidenced by: Based on review of test result reports requested, lack of documentation of calibration records, and interview with the laboratory's general supervisor (GS); it was determined that the laboratory failed to retrieve calibration records for 2022 and 2023. Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 3 -- The findings included: 1. At the time of the survey on March 5, 2024, at approximately 11:00 a.m. the GS failed to retrieve documentation records requested for the ChroMate ELISA analytic plate. 2. The GS affirmed that calibration records for the years 2022 and 2023 for the ChroMate ELISA analytic plate were not retrievable at the time of the survey. 3. Based on the laboratory's testing declaration submitted at the time of the survey, the laboratory analyzed and reported approximately 4,000 tests annually for which the laboratory was unable to retrieve calibration records for the ELISA analyzer. 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 review of the laboratory's procedure manual, lack of documentation, the surveyor's observation, and interview with the general supervisor (GS); it was determined that the laboratory failed to perform and document maintenance and calibration as defined by the manufacturer and with at least the frequency specified by the manufacturer for the laboratory's pipettes. The findings included: 1. The laboratory's standard operating procedure (SOP) indicated that preventive maintenance and calibration be performed on all equipment and instruments used in the laboratory. 2. The GS confirmed on March 5, 2024, at approximately 11:00 a.m. that the laboratory failed to follow the manufacturer's instructions on preventive maintenance and calibration of pipettes used daily. 3. According to the test volume declared by the laboratory on 3/4/2024 the laboratory performs approximately 4,000 diagnostic immunology tests annually. D5815 TEST REPORT CFR(s): 493.1291(h) When the laboratory cannot report patient test results within its established time frames, the laboratory must determine, based on the urgency of the patient test(s) requested, the need to notify the appropriate individual(s) of the delayed testing. This STANDARD is not met as evidenced by: Based on review of laboratory's policies and procedures, patient test records review from 9/27/2023 to 2/20/2024, and interview with the general supervisor (GS); it was determined that the laboratory failed to have a policy for turn-around time (TAT) for all tests performed in the laboratory. 1. The laboratory failed to provide TAT of testing for four (4) out of four (4) randomly chosen patients at the time of the survey (March 5, 2024). The laboratory did not provide a TAT policy which may adversely impact patient management. 2. The laboratory GS on March 5, 2024, at approximately 12:00 p.m. affirmed that the laboratory did not have a TAT policy to notify any delay on testing to the physician. 3. The laboratory's testing declaration form, signed by the laboratory director on 3/4/2024, stated that the laboratory performs 4,000 tests annually. D6082 LABORATORY DIRECTOR RESPONSIBILITIES -- 2 of 3 -- CFR(s): 493.1445(e)(1) The laboratory director must ensure that testing systems developed and used for each of the tests performed in the laboratory provide quality laboratory services for all aspects of test performance, which includes the preanalytic, analytic, and postanalytic phases of testing. This STANDARD is not met as evidenced by: Based on the surveyor's review of the laboratory's records, policies and procedures, patients' test results records, quality assessment documentation, and interviews with the laboratory's testing personnel on March 5, 2024; it was determined that the laboratory director failed to ensure that several aspects of the preanalytic, analytic, and postanalytic phases of the laboratory testing were monitored. See D3011, D3031, D5429, and D5815. -- 3 of 3 --

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Survey - November 13, 2020

Survey Type: Standard

Survey Event ID: SN6P11

Deficiency Tags: D5437 D6014

Summary:

Summary Statement of Deficiencies D5437 CALIBRATION AND CALIBRATION VERIFICATION CFR(s): 493.1255(a) Unless otherwise specified in this subpart, for each applicable test system the laboratory must perform and document calibration procedures-- (1) Following the manufacturer's test system instructions, using calibration materials provided or specified, and with at least the frequency recommended by the manufacturer; (2) Using the criteria verified or established by the laboratory as specified in 493.1253(b) (3)-- (2)(i) Using calibration materials appropriate for the test system and, if possible, traceable to a reference method or reference material of known value; and (2)(ii) Including the number, type, and concentration of calibration materials, as well as acceptable limits for and the frequency of calibration; and (3) Whenever calibration verification fails to meet the laboratory's acceptable limits for calibration verification. This STANDARD is not met as evidenced by: Based on Surveyor review of laboratory's policy & procedure, random patient sample, calibration material and quality control (QC) testing records for the years of 2018, 2019 and 2020, and interview with the laboratory technical consultant (TC) on November 13, 2020 at 12:40 pm, the laboratory failed to perform and document calibration procedures following the manufacturer's test system instructions, using calibration materials provided, and with at least the frequency recommended by the manufacturer for all test procedures. The findings include: 1. The laboratory did not test calibration material, provided by the manufacturer, in each assay as recommended by the manufacturer. Therefore, the accuracy of the patient test results reported can not be assured. a. The laboratory used Theratest ELISA kit for ANA, RF, CCP and ACL panel testing by manual method. Each kit comes with the calibration and control materials. b. The kit manufacturer instructs that the laboratory must include the calibration and control materials in each assay. c. The laboratory did not include the calibration material in each assay. 2. The laboratory TC on November 13, 2020 at 12: 40 pm, affirmed that the laboratory did not include the calibration material in each 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 -- assay in order to save money. 3. The laboratory's testing declaration form, signed by the laboratory Director on 11/13/2020, stated that the laboratory performs 5,000 tests, annually. D6014 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(3)(iii) The laboratory director is responsible for the overall operation and administration of the laboratory, including the employment of personnel who are competent to perform test procedures, and record and report test results promptly, accurate, and proficiently and for assuring compliance with the applicable regulations. (e) The laboratory director must-- (e)(3) Ensure that-- (e)(3)(iii) Laboratory personnel are performing the test methods as required for accurate and reliable results. This STANDARD is not met as evidenced by: Based on Surveyor review of laboratory's policy & procedure, random patient, QC and calibrator testing records for the years of 2018, 2019 and 2020, and interview with the laboratory TC on November 13, 2020 at 12:40 pm, it was determined that the laboratory director failed to ensure that laboratory personnel are performing the test methods as required for accurate and reliable results. The findings include: See D5437. -- 2 of 2 --

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Survey - April 6, 2018

Survey Type: Standard

Survey Event ID: TW6U11

Deficiency Tags: D6021 D5891

Summary:

Summary Statement of Deficiencies D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1299(a) The laboratory must establish and follow written policies and procedures for an ongoing mechanism to monitor, assess and, when indicated, correct problems identified in the postanalytic systems specified in 493.1291. This STANDARD is not met as evidenced by: Based on review of the laboratory's Quality Assurance (QA) Plan manual, random patient sampling test results, and interview with the technical supervisor/testing personnel, it was determine that the laboratory failed to follow written policies and procedures for an ongoing mechanism to monitor, assess and, when indicated, correct problems identified in the postanalytic systems. The findings included: a. The laboratory's QA Plan procedure manual stated, " Goals: The Goal of the QA Plan is to improve reliability, efficient, and quality of laboratory services. The Laboratory has established a QA Review Process which: A. Identifies the reliability and effectiveness of the Laboratory's Policies and Procedures including the Quality Assurance Plan. B. Ensures accurate and reliable patient test results. C. Identifies areas for improvement to the testing process. D. Ensures competency of the Laboratory Staff." b. The laboratory uses patient log and number systems: for three (3) out of eighteen (18) random patient sampling test results reviewed covering period from 11/4/2016 to 3/2 /2018, three (3) patients did not match with the laboratory's numbering systems. c. The technical supervisor/testing personnel affirmed (4/6/2018, 1300) that the laboratory failed to identify problem and ensure that the above QA policy and procedure are followed. D6021 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(5) The laboratory director is responsible for the overall operation and administration 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 -- the laboratory, including the employment of personnel who are competent to perform test procedures, and record and report test results promptly, accurate, and proficiently and for assuring compliance with the applicable regulations. (e) The laboratory director must-- (e)(5) Ensure that quality assessment programs are established and maintained to assure the quality of laboratory services provided. This STANDARD is not met as evidenced by: Based on review of the laboratory's Quality Assurance (QA) Plan manual, random patient sampling test results, and interview with the technical supervisor/testing personnel, it was determine that the laboratory director failed to ensure that quality assessment programs are established and maintained to assure the quality of laboratory services provided. See D 5891. -- 2 of 2 --

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