Kinder Pediatrics, Pc

CLIA Laboratory Citation Details

3
Total Citations
6
Total Deficiencyies
5
Unique D-Tags
CMS Certification Number 31D2087760
Address 1201 River Avenue, Lakewood, NJ, 08701
City Lakewood
State NJ
Zip Code08701
Phone732 775-0222
Lab DirectorWILLIAM FENSTER

Citation History (3 surveys)

Survey - January 21, 2025

Survey Type: Standard

Survey Event ID: 38NO11

Deficiency Tags: D5477

Summary:

Summary Statement of Deficiencies D5477 CONTROL PROCEDURES CFR(s): 493.1256(e)(4)(g) (e)(4) Before, or concurrent with the initial use-- (e)(4)(i) Check each batch of media for sterility if sterility is required for testing; (e)(4)(ii) Check each batch of media for its ability to support growth and, as appropriate, select or inhibit specific organisms or produce a biochemical response; and (e)(4)(iii) Document the physical characteristics of the media when compromised and report any deterioration in the media to the manufacturer. This STANDARD is not met as evidenced by: Based on surveyor review of Quality Control (QC) records and interview with the Testing Personnel (TP), the laboratory failed to check each batch of Selective Strep Agar (SSA) used for Throat Culture (TC) tests for sterility, its ability to support growth and select or inhibit specific organisms and document the physical characteristics of the media no the date of the survey. The findings include: 1. There was no documented evidence the above mentioned QC was performed on SSA lot # 648388. 2. Eight patients were run and reported. 2. The TP confirmed on 1/24/25 at 11:00 am that the laboratory did not perform QC as stated above. 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 --

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Survey - March 22, 2023

Survey Type: Standard

Survey Event ID: 2GVL11

Deficiency Tags: D3000 D1001

Summary:

Summary Statement of Deficiencies D1001 CERTIFICATE OF WAIVER TESTS CFR(s): 493.15(e) Laboratories eligible for a certificate of waiver must-- (1) Follow manufacturers' instructions for performing the test; and (2) Meet the requirements in subpart B, Certificate of Waiver, of this part. This STANDARD is not met as evidenced by: Based on surveyor observation of the Quidle QuickVue SARS Antigen Test system and interview with the Testing Personnel (TP), the laboratory failed to follow the Information for Use (IFU) when performing COVID tests from November 2021 to the date of the survey. The findings include: The laboratory did not follow the IFU as below: 1. The IFU states "Authorized laboratories using your product must have a process in place for reporting test results to healthcare providers and relevant public health authorities, as appropriate." 2. The Laboratory did not report positive SARS- CoV-2 results to the State of New Jersey. 3. The TP confirmed at 1:30 pm on 3/22/23 that the laboratory did not follow the IFU. D3000 FACILITY ADMINISTRATION CFR(s): 493.1100 Each laboratory that performs nonwaived testing must meet the applicable requirements under 493.1101 through 493.1105, unless HHS approves a procedure that provides equivalent quality testing as specified in Appendix C of the State Operations Manual (CMS Pub. 7). (a) Reporting of SARS-CoV-2 test results During the Public Health Emergency, as defined in 400.200 of this chapter, each laboratory that performs a test that is intended to detect SARS-CoV-2 or to diagnose a possible case of COVID-19 (hereinafter referred to as a "SARS-CoV-2 test") must report SARS-CoV-2 test results to the Secretary in such form and manner, and at such timing and frequency, as the Secretary may prescribe. 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 -- This CONDITION is not met as evidenced by: Based on surveyor review of the Quidle QuickVue SARS Antigen Test system, and interview with the Testing Personnel (TP) the laboratory failed to report all SARS- CoV-2 test results from November 2021 to the date of the survey. The findings include: 1. The laboratory did not report positive COVID-19 Antigen test results to the State of New Jersey. 2. The LD confirmed on 3/22/23 at 1:30 pm the laboratory failed to report the aforementioned test results. -- 2 of 2 --

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Survey - June 27, 2018

Survey Type: Standard

Survey Event ID: OP1I11

Deficiency Tags: D6029 D2015 D5477

Summary:

Summary Statement of Deficiencies 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 surveyor review of the Proficiency Testing (PT) records and interview with the Testing Personnel (TP), the laboratory failed to maintain the attestation statement for the Microbiology events 3-2017 & 1-2018 with the American Proficiency Institute. The TP # 1 listed on the CMS form 209 confirmed 6/27/18 at 11:00 am that all PT records were not maintained. D5477 CONTROL PROCEDURES CFR(s): 493.1256(e)(4)(g) (e) For reagent, media, and supply checks, the laboratory must do the following: (e) (4) Before, or concurrent with the initial use-- (e)(4)(i) Check each batch of media for sterility if sterility is required for testing; (e)(4)(ii) Check each batch of media for its ability to support growth and, as appropriate, select or inhibit specific organisms or produce a biochemical response; and (e)(4)(iii) Document the physical characteristics of the media when compromised and report any deterioration in the media to the 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 -- manufacturer. (g) The laboratory must document all control procedures performed. This STANDARD is not met as evidenced by: Based on surveyor review of Quality Control (QC) records and interview with the Testing Personnel (TP), the laboratory failed to check QC on each batch of Selective Strep Agar (SSA) used for Throat Culture testing from 1/3/17 to the date of the survey. The findings include: 1. The laboratory did not check SSA for: a. Ability to support growth. b. Ability to select or inhibit specific organisms c. Sterility 2. The TP # 1 listed on the CMS form 209 on 6/27/18 at 10:30 am that the laboratory did not perform the above-mentioned QC checks. D6029 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(11) 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)(11) Ensure that prior to testing patients' specimens, all personnel have the appropriate education and experience, receive the appropriate training for the type and complexity of the services offered, and have demonstrated that they can perform all testing operations reliably to provide and report accurate results. This STANDARD is not met as evidenced by: Based on surveyor review of the Personnel Files and interview with the Testing Personnel (TP), the Laboratory Director failed to have education documented for two out of four TP from 1/3/17 to the date of the survey. The TP # 1 listed on the CMS form 209 confirmed on 6/27/18 at 10:30 am that all TP did not have education records. -- 2 of 2 --

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