Islands Family Medical Center

CLIA Laboratory Citation Details

3
Total Citations
14
Total Deficiencyies
11
Unique D-Tags
CMS Certification Number 11D1019216
Address 101 Blue Fin Circle, Suite 7, Savannah, GA, 31410
City Savannah
State GA
Zip Code31410
Phone912 897-6832
Lab DirectorMARIA JAUHAR

Citation History (3 surveys)

Survey - September 24, 2024

Survey Type: Standard

Survey Event ID: 8ROT11

Deficiency Tags: D0000 D2016 D6018 D6019

Summary:

Summary Statement of Deficiencies D0000 A recertification survey was performed on September 24, 2024. The facility was found to be NOT in compliance with the CLIA conditions and standards for specialties /subspecialties for 42 CFR. CONDITION LEVEL: D2016 - Unsuccessful Particpation 493.803 (a)(b)(c) NOTE: The CMS-2567 (Statement of Deficiencies) is an official , legal document,. All information must remain unchanged except for entering the

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Survey - November 4, 2020

Survey Type: Standard

Survey Event ID: KORI11

Deficiency Tags: D0000 D2015 D5401 D6018 D6029 D6053

Summary:

Summary Statement of Deficiencies D0000 A Clinical Laboratory Improvement Amendments (CLIA) recertification survey was completed on November 4, 2020. The laboratory was not in compliance with applicable CLIA requirements found at 42 CFR 493.1 through 42 CFR 493.1780. The following deficiencies were cited: D2015 TESTING OF PROFICIENCY TESTING SAMPLES CFR(s): 493.801(b)(5)(6) (5) The laboratory must document the handling, preparation, processing, examination, and each step in the testing and reporting of results for all proficiency testing samples. The laboratory must maintain a copy of all records, including a copy of the proficiency testing program report forms used by the laboratory to record proficiency testing results including the attestation statement provided by the PT program, signed by the analyst and the laboratory director, documenting that proficiency testing samples were tested in the same manner as patient specimens, for a minimum of two years from the date of the proficiency testing event. (6) PT is required for only the test system, assay, or examination used as the primary method for patient testing during the PT event. This STANDARD is not met as evidenced by: Based on proficiency test (PT) document review and staff interview, the laboratory failed to maintain a copy of all records for a minimum of two years as required. Findings include: 1. American Academy of Family Physicians (AAFP) PT document review revealed the lack of PT log sheets available at the time of survey for the following Hematology PT events: 2019 and 2020 -- Events A, B, and C. 2. An interview with Staff #2 (CMS 209) on 11/4/2020 in the conference room at approximately 11:45 a.m. confirmed the lack of PT event log sheets available at the time of survey for the aforementioned dates. D5401 PROCEDURE MANUAL 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 -- CFR(s): 493.1251(a) A written procedures manual for all tests, assays, and examinations performed by the laboratory must be available to, and followed by, laboratory personnel. Textbooks may supplement but not replace the laboratory's written procedures for testing or examining specimens. This STANDARD is not met as evidenced by: Based on review of the laboratory policy and procedure manual (SOP), testing personnel (TP) document review, and staff interview, the laboratory failed to follow policies and procedures as required. Findings include: 1. Review of the laboratory SOP and TP document review revealed the lack of TP initial training documentation in 2019 and six-month competency documentation in 2020 as required by the policy and procedure for TP competency performance. 2. An interview with Staff #2 (CMS 209) in the conference room on 11/4/2020 at approximately 11:00 a.m. confirmed the SOP competency policy and procedure was not followed for TP evaluation of performance in 2019 and 2020. D6018 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(4)(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)(4)(iii) Ensure that all proficiency testing reports received are reviewed by the appropriate staff to evaluate the laboratory's performance and to identify any problems that require

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Survey - September 12, 2018

Survey Type: Standard

Survey Event ID: QAQP11

Deficiency Tags: D0000 D5413 D5429 D5805

Summary:

Summary Statement of Deficiencies D0000 A Clinical Laboratory Improvement Amendments (CLIA) recertification survey was completed on September 12, 2018. The laboratory was not in compliance with applicable CLIA requirements found at 42 CFR 493.1 through 42 CFR 493.1780. The following deficiencies were cited: D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(b) The laboratory must define criteria for those conditions that are essential for proper storage of reagents and specimens, accurate and reliable test system operation, and test result reporting. The criteria must be consistent with the manufacturer's instructions, if provided. These conditions must be monitored and documented and, if applicable, include the following: (1) Water quality. (2) Temperature. (3) Humidity. (4) Protection of equipment and instruments from fluctuations and interruptions in electrical current that adversely affect patient test results and test reports. This STANDARD is not met as evidenced by: Based on review of laboratory freezer temperature charts and staff interview, the laboratory failed to take

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