Summary:
Summary Statement of Deficiencies D6054 TECHNICAL CONSULTANT RESPONSIBILITIES CFR(s): 493.1413(b)(9) (b)(9) Thereafter, evaluations must be performed at least annually This STANDARD is not met as evidenced by: Based on a review of the annual competency assessment records and an interview with the Laboratory Supervisor (LS), the Laboratory Director (LD)/Technical Consultant (TC) failed to assess annual competency for Testing Personnel performing moderate complexity testing. The surveyor noted one of the four Testing Personnel (TP) listed on the CMS-209 (Laboratory Personnel Report) had no documentation of the annual competency in 2025. The findings include: 1. A review of personnel evaluation records for the TP listed on the CMS-209 Form (Laboratory Personnel Report) revealed the LD/TC failed to perform and document the annual competency assessment for TP4 due in September 2025. 2. During the exit conference on 02-05- 2026 at 1:30 PM, the LS confirmed the above findings. 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 --