Summary:
Summary Statement of Deficiencies D0000 A recertification survey conducted on 03/07/2024 found the NEAL M BULLOCK DPM PA clinical laboratory not in compliance with 42 CFR Part 493, Requirements for Laboratories. D6120 TECHNICAL SUPERVISOR RESPONSIBILITIES CFR(s): 493.1451(b)(7)(8) (7) The technical supervisor is responsible for identifying training needs and assuring that each individual performing tests receives regular in-service training and education appropriate for the type and complexity of the laboratory services performed; (8) Evaluating the competency of all testing personnel and assuring that the staff maintain their competency to perform test procedures and report test results promptly, accurately and proficiently. This STANDARD is not met as evidenced by: Based on record review and interview, the Technical Supervisor (TS) failed to evaluate the six months competency for one out of two testing personnel (TP) during 2023. Findings included: -Review of the FORM CMS-209 signed by the Laboratory Director (LD) on 03/04/2024 revealed that LD, Clinical Consultant (CC), TS, General Supervisor (GS) was the same person. The laboratory had two TP (TP#A, TP#B). - Review of personnel records revealed that TP#B had Initial Competency on 05/18 /2023. No record of six months competency found for TP#B. During an interview on 03/07/2024 at 10:45 AM with the Laboratory Consultant, he confirmed that the TS failed to perform the six months competency for TP#B. 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 --