Memorial Health Partners Foundation

CLIA Laboratory Citation Details

1
Total Citation
2
Total Deficiencyies
2
Unique D-Tags
CMS Certification Number 11D0886093
Address 12978 North Main St, Trenton, GA, 30752
City Trenton
State GA
Zip Code30752
Phone(706) 657-4183

Citation History (1 survey)

Survey - January 30, 2018

Survey Type: Standard

Survey Event ID: CY7E11

Deficiency Tags: D0000 D5429

Summary:

Summary Statement of Deficiencies D0000 A Clinical Laboratory Improvement Amendments (CLIA) recertification survey was completed on January 30, 2018. The laboratory was not in compliance with all applicable CLIA requirements found at 42 CFR 493.1 through 42 CFR 493.1780. The following deficiency was cited: D5429 MAINTENANCE AND FUNCTION CHECKS CFR(s): 493.1254(a)(1) For unmodified manufacturer's equipment, instruments, or test systems, the laboratory must perform and document maintenance as defined by the manufacturer and with at least the frequency specified by the manufacturer. This STANDARD is not met as evidenced by: Based on hematology document review and staff interview, the laboratory failed to perform and document maintenance as required. Findings include: 1. Review of Coulter AcT diff 2 logs revealed the laboratory failed to perform and document required instrument maintenance for 2016, 2017, and 2018 thus far. 2. An interview with the Clinical Compliance coordinator in the conference room on 1/30/18 at approximately 2:00 p.m. confirmed the laboratory failed to perform and document required hematology instrument maintenance for 2016, 2017, and 2018 thus far. 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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