Gladstone A Payton Do

CLIA Laboratory Citation Details

3
Total Citations
7
Total Deficiencyies
5
Unique D-Tags
CMS Certification Number 23D0363649
Address 247 N Gratiot Ave, Mount Clemens, MI
City Mount Clemens
State MI
Phone(586) 468-8088

Citation History (3 surveys)

Survey - September 11, 2023

Survey Type: Special

Survey Event ID: Z0PI11

Deficiency Tags: D2016 D2096 D2096

Summary:

Summary Statement of Deficiencies 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 record review of the CMS database and the American Association of Bioanalysis and Medical Laboratory Evaluation proficiency testing reports, it was determined the laboratory failed to successfully participate in a CMS-approved proficiency testing program for the chemistry specialty analyte uric acid. Findings include: The laboratory failed to attain a score of at least 80% of acceptable responses for the chemistry analyte uric acid, which is unsatisfactory performance. Refer to D2096. D2096 ROUTINE CHEMISTRY 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 -- CFR(s): 493.841(f) Failure to achieve satisfactory performance for the same analyte or test in two consecutive testing events or two out of three consecutive testing events is unsuccessful performance. This STANDARD is not met as evidenced by: . Based on review of the CMS database and the American Association of Bioanalysis and Medical Laboratory Evaluation proficiency testing reports, the laboratory failed to attain a score of at least 80% of acceptable responses for the chemistry analyte uric acid, which is unsatisfactory performance for 2 (2022 3rd event and 2023 2nd event) of 3 consecutive testing events. Findings include: A review of the CMS database and the American Association of Bioanalysis and Medical Laboratory Evaluation proficiency testing reports revealed the following proficiency testing results for uric acid: PT Event Uric Acid Score 3rd event 2022 40% 2nd event 2023 20% -- 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 10, 2022

Survey Type: Standard

Survey Event ID: 3AH011

Deficiency Tags: D5807 D5807

Summary:

Summary Statement of Deficiencies D5807 TEST REPORT CFR(s): 493.1291(d) Pertinent "reference intervals" or "normal" values, as determined by the laboratory performing the tests, must be available to the authorized person who ordered the tests and, if applicable, the individual responsible for using the test results. This STANDARD is not met as evidenced by: . Based on record review and interview with Technical Consultant #1 (TC1), the laboratory failed to include the reference intervals for testosterone testing for its female patients for 2 (March 2020 to March 2022) of 2 years reviewed. Findings include: 1. A review of patient test records revealed the reference intervals on test reports for testosterone were 190-890 pg/mL for both male and female patients. 2. An interview on 3/10/22 at 10:45 am with TC1 revealed the reference interval of 190-890 pg/mL is for male patients and that same reference interval is used on all patient test reports regardless of sex. 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 --

πŸ”’ Unlock Deficiency Summary

Get full access to the detailed deficiency summary for this facility

One-time payment β€’ Lifetime access

Survey - January 9, 2018

Survey Type: Standard

Survey Event ID: 5FBC12

Deficiency Tags: D5209 D5417

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 --

πŸ”’ Unlock Deficiency Summary

Get full access to the detailed deficiency summary for this facility

One-time payment β€’ Lifetime access