Legacy Point Family Medicine

CLIA Laboratory Citation Details

2
Total Citations
22
Total Deficiencyies
10
Unique D-Tags
CMS Certification Number 46D1100997
Address 81 North 2000 West, Ste F2, West Point, UT, 84015
City West Point
State UT
Zip Code84015
Phone(385) 430-8440

Citation History (2 surveys)

Survey - August 22, 2019

Survey Type: Standard

Survey Event ID: CNC611

Deficiency Tags: D2000 D3037 D5291 D5407 D6015 D6018 D6021 D2000 D3037 D5291 D5407 D6000 D6000 D6015 D6018 D6021

Summary:

Summary Statement of Deficiencies D2000 ENROLLMENT AND TESTING OF SAMPLES CFR(s): 493.801 Each laboratory must enroll in a proficiency testing (PT) program that meets the criteria in subpart I of this part and is approved by HHS. The laboratory must enroll in an approved program or programs for each of the specialties and subspecialties for which it seeks certification. The laboratory must test the samples in the same manner as patients' specimens. For laboratories subject to 42 CFR part 493 published on March 14, 1990 (55 FR 9538) prior to September 1, 1992, the rules of this subpart are effective on September 1, 1992. For all other laboratories, the rules of this subpart are effective January 1, 1994. This CONDITION is not met as evidenced by: Based on lack of documentation and confirmation by the laboratory director, the laboratory failed to enroll in proficiency testing for the specialty of Hematology for 2019 testing. The laboratory did not enroll for the 1st and 2nd Hematology proficiency testing events. D3037 RETENTION REQUIREMENTS CFR(s): 493.1105(a)(4) Proficiency testing records. Retain all proficiency testing records for at least 2 years. This STANDARD is not met as evidenced by: Based on proficiency testing records review, lack of documentation, and interview with staff, the laboratory failed to retain proficiency testing attestation statements for 2 of 4 proficiency testing events reviewed from the 3rd American Proficiency Institute (API) event of 2017 through the 3rd event of 2018 (the last event participated in by the laboratory). Findings include: 1. The laboratory failed to retain the attesting 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 -- statement signed by the director and testing personnel from the 2nd and 3rd API Hematology events of 2018. 2. In an interview with staff on 08/22/2019 at approximately 11:30 A.M. staff confirmed the attestation statements signed by the director and testing personnel were not maintained for at least 2 years. D5291 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1239(a) The laboratory must establish and follow written policies and procedures for an ongoing mechanism to monitor, assess, and, when indicated, correct problems identified in the general laboratory systems requirements specified at 493.1231 through 493.1236. This STANDARD is not met as evidenced by: Based on lack of documentation and confirmation by the laboratory director, the laboratory failed to ensure they had a quality assurance plan to monitor proficiency testing records to ensure enrollment in an approved proficiency testing program and that

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Survey - February 8, 2018

Survey Type: Standard

Survey Event ID: Y5H611

Deficiency Tags: D5403 D5407 D5429 D5403 D5407 D5429

Summary:

Summary Statement of Deficiencies D5403 PROCEDURE MANUAL CFR(s): 493.1251(b) The procedure manual must include the following when applicable to the test procedure: (1) Requirements for patient preparation; specimen collection, labeling, storage, preservation, transportation, processing, and referral; and criteria for specimen acceptability and rejection as described in 493.1242. (2) Microscopic examination, including the detection of inadequately prepared slides. (3) Step-by-step performance of the procedure, including test calculations and interpretation of results. (4) Preparation of slides, solutions, calibrators, controls, reagents, stains, and other materials used in testing. (5) Calibration and calibration verification procedures. (6) The reportable range for test results for the test system as established or verified in 493.1253. (7) Control procedures. (8)

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