Johnson Regional Medical Center

CLIA Laboratory Citation Details

4
Total Citations
19
Total Deficiencyies
16
Unique D-Tags
CMS Certification Number 04D0469039
Address 1100 East Poplar, Clarksville, AR, 72830
City Clarksville
State AR
Zip Code72830
Phone(479) 754-5454

Citation History (4 surveys)

Survey - December 11, 2024

Survey Type: Standard

Survey Event ID: ZKQY11

Deficiency Tags: D5293

Summary:

Summary Statement of Deficiencies D5293 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1239(b)(c) (b) The general laboratory systems quality assessment must include a review of the effectiveness of

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Survey - March 16, 2023

Survey Type: Standard

Survey Event ID: CQVK11

Deficiency Tags: D5417 D5413 D5555 D5805 D5793

Summary:

Summary Statement of Deficiencies 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: Through observations made during a tour of the laboratory, review of manufacturer's package inserts, review of the laboratory's temperature and humidity records and interviews with staff, it was determined the laboratory criteria for storage of quality control materials was not consistent with the manufacturer's instructions and the acceptable range for humidity levels in the laboratory were outside the manufacturer's requirement for operating humidity levels for the laboratory's routine chemistry analyzers. Survey findings include: 1) Storage temperature requirement for chemistry controls: A) During a tour of the laboratory at 9:45 a.m. on 3/15/23 the surveyor observed BioRad Cardiac Controls (lots 67641, 67642, and 67643) and BioRad Multiqual Controls (lot 45911, 45912, and 45913) stored in the laboratory freezer . The manufacturers storage instructions on the packages states that the controls are to be stored at -70 to -20 degrees Celsius in a non-defrosting freezer. B) In an interview, at 9:45 am on 3/15/23, the laboratory personnel (#2 on the CMS 209 form) ,when asked if the freezer was automatic self-defrosting (frost free), replied "yes sir" and confirmed that the manufacturer's instructions require storage of Biorad quality control materials in a non-defrosting freezer. 2) Room humidity requirement for chemistry analyzers. A) During a tour of the laboratory on 3/14/23 at 10:45 am, two Beckman Coulter AU 480 chemistry anayzers were observed in the main laboratory. Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 4 -- B) In an interview on 2/14/23 at 10:45 am the laboratory staff member (# 2 on the CMS 209 form) stated that the Beckman Coulter AU 480 analyzers were the only analyzers in use for routine chemistry testing and the instruments were used interchangeably. C) Review of the manufacturer's user manual for the Beckman Coulter AU 480 analyzers revealed an operating humidity requirement of 40% to 85% non-condensing humidity. D) Review of the laboratory's room humidity documentation for 2022 revealed a defined acceptable range of 20% to 80% and humidity levels were less than 40% for 29 of 31 days in January 2022, 28 of 28 days in February 2022 and 30 of 31 days in March 2022. E) In an interview on 3/16/23 at 08:45 am the laboratory staff member (# 2 on the CMS 209 form) confimed that the minimum humidity requirement for the Beckman Coulter AU 480 analyzers was 40%, that the acceptable range defined on the laboratory's humidity records did not meet the manufacturer's requirement and that humidity records in January, February and March 2022 were below the manufacturer's requirement. 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: Through observation and interview with laboratory staff it was determined that the laboratory had supplies available for use after their expiration date. Findings follow: A) During an inital tour of the laboratory on 3/14/.23 at 10:45 am, two phlebotomy rooms were observed in the laboratory; one to the right side and one to the left side of the laboratory entrance. B) During a tour of the laboratory on 3/16/23 at 10:30 am six of seventeen Vacuette Na Citrate blood collection tubes (lot 8220233N expiration date 2023-02-01) were observed in bins in the right-side phlebotomy room and five of eighteen Vacuette Na Citrate blood collection tubes (lot 8220233N expiration date 2023-02-01) were observed in bins in the left-side phlebotomy room and eleven of twenty-three Vacuette Na Citrate blood collection tubes (lot 8220233N expiration date 2023-02-01) were observed in a phlebotomy tray in the left-side phlebotomy room. C) In an interview on 3/16/23 at 10:45 am the laboratory staff member (number 2 on the CMS 209 form) confirmed that the items, identified above, had exceeded their expiration dates and were available for use. D5555 IMMUNOHEMATOLOGY CFR(s): 493.1271(c)(f) (c) Blood and blood products storage. Blood and Blood products must be stored under appropriate conditions that include an adequate temperature alarm system that is regularly inspected. (c)(1) An audible alarm system must monitor proper blood and blood product storage temperature over a 24-hour period. (c)(2) Inspections of the alarm system must be documented. (f) Documentation. The laboratory must document all control procedures performed, as specified in this section. This STANDARD is not met as evidenced by: Through observation, lack of documentation and interview it was determined that the laboratory failed to conduct temperature alarm checks for the freezer in which fresh -- 2 of 4 -- frozen plasma (FFP) and cryoprecipitate (cryo) were stored. Findings follow: A) During a tour of the laboratory on 2/16/23 at 10:30 am eight units of FFP and three units of cryo were observed in the Blood Bank freezer. B) No record of quarterly alarm checks for the Blood Bank freezer were found during review of the Blood Bank refrigerator and freezer quarterly alarm checks. C) In an interview on 2/16/23 at 10:30 am the laboratory staff member (# 2 on the CMS 209 form) confirmed that the laboratory had not performed quarterly alarm checks of the freezer in which FFP and cryo were stored. D5793 ANALYTIC SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1289(b)(c) (b) The analytic systems quality assessment must include a review of the effectiveness of

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Survey - May 13, 2021

Survey Type: Standard

Survey Event ID: ZX0211

Deficiency Tags: D5317 D5445 D5781 D5209 D5413 D5481 D5783

Summary:

Summary Statement of Deficiencies D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES CFR(s): 493.1235 As specified in the personnel requirements in subpart M, the laboratory must establish and follow written policies and procedures to assess employee and, if applicable, consultant competency. This STANDARD is not met as evidenced by: Through review of the CMS 209 form, personnel records and confirmed by interview it was determined that the competency of one of ten testing personnel reviewed was not performed at least on an annual basis and competency evaluations did not contain documentation that competency evaluations were performed utilizing the six required elements of competency evaluations , i.e. through direct observation of test performance, reveiw of test results, review of maintenance and quality control files, direct observation of maintenance procedures, review of intermediate test results and assessment of test performance through proficiency testing or blind samples. Findings follow: 1. Competency evaluations were not performed on an annual basis. A) Review of personnel files for the testing personnel, identified as number sixteen on the CMS 116 form, revealed that the employees date of hire was 12/18/18.. B) Review of personnel files revealed documentation of annual evaluation of the competency of the testing personnel, identified as number sixteen on the CMS 209 form, were dated 12 /23/18 and the last competency evaluation was dated 7/19/19 and no other competency evaluations were present . C) Upon request, the laboratory was unable to provide an additional competency evaluation of the testing personnel, identified as number sixteen on the CMS 209 form, since 7/19/19 . D) In an interview on 5/4/21 at 01:45 PM, the laboratory staff member, identified as number six on the CMS 209 form. stated the the date of hire of the testing personnel, identified as number two on the CMS 209 form, was in December of 2018 and competency evaluation had not been performed for the testing personnel since 7/19/19. 2. Competency evaluations were not performed utilizing the required elements of assessing testing personnel Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 6 -- competency. A) Review of the competency evaluation of the testing personnel, identified as number sixteen on the CMS 209 form, revealed that competency was assessed as " 1- below standard, 2- meets standard. 3-above standard" but does not confirm the methods used in determining the assessment. B) In an interview on 5/4/21 at 01:45 PM, the laboratory staff member, identified as number six on the CMS 209 form, confirmed that documentation does not specify the required elements of competency evaluation. D5317 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL CFR(s): 493.1242(d) If the laboratory accepts a referral specimen, written instructions must be available to the laboratory's clients and must include, as appropriate, the information specified in paragraphs (a)(1) through (a)(7) of this section. This STANDARD is not met as evidenced by: Through interview and lack of documentation and review of specimen logs it was determined that the laboratory did not provide clients with written instructions for specimen submission, handling, and referral as specified in CFR 493.1242 paragraphs (a)(1) through (a)(7). A. In an interview on 5/4/21 at 11:03, AM the laboratory staff member, identified as number six on the CMS 209 form, said that the laboratory received and tested specimens referred from "two or three" outside home health agencies. B. Upon request, the laboratory could not provide a copy of a client services manual or evidence of instructions for specimen collection and handling that is provided to clients . C. In an interview on 5/4/21 at 11:03 the laboratory staff member identified as number six on the CMS 209 form confirmed that the laboratory did not provide instruction manuals for specimen submission, handling and referral to outside clients . D) Review of the laboratory's "Sign-In Log For Specimens Brought" revealed that sixteen spcimens were received from three outside agencies for testing between the dates of 4/26/21 to 5/5/21. 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: Through observation, review of the manufacturer's instrument user's manual and package inserts, the laboratory's

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Survey - September 28, 2018

Survey Type: Standard

Survey Event ID: EL0N11

Deficiency Tags: D0000 D5415 D6046 D5413 D5783 D6107

Summary:

Summary Statement of Deficiencies D0000 This reflects findings of a recertification survey performed on 09/25/18 through 09/28 /18. Johnson County Regional Medical Center Laboratory is in compliance with the applicable Standards and conditions of 42 CFR Part 493, Laboratory Requirements. The following standard level deficiencies were cited on current survey: D5413: CFR 493.1252(b) - The laboratory failed to measure and record humidity levels in rooms in which instruments with an operating humidity requirement were in use, D5415: CFR 493.1252(c)- The laboratory failed to label coagulation controls with the date and time of preparation, D5503: CFR 493.1261(a)(2) - The laboratory failed to perform quality control for gram stains weekly, D5781: CFR.1282- The laboratory failed to document

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