Nick Sarrimanolis Md Llc

CLIA Laboratory Citation Details

2
Total Citations
5
Total Deficiencyies
4
Unique D-Tags
CMS Certification Number 02D1036810
Address 1867 Airport Way Suite 145b, Fairbanks, AK, 99701
City Fairbanks
State AK
Zip Code99701
Phone907 451-1174
Lab DirectorNICK SARRIMANOLIS

Citation History (2 surveys)

Survey - April 8, 2023

Survey Type: Special

Survey Event ID: XQRI11

Deficiency Tags: D2096 D2016

Summary:

Summary Statement of Deficiencies D2016 SUCCESSFUL PARTICIPATION CFR(s): 493.803(a)(b)(c) (a) Each laboratory performing nonwaived testing must successfully participate in a proficiency testing program approved by CMS, if applicable, as described in subpart I of this part for each specialty, subspecialty, and analyte or test in which the laboratory is certified under CLIA. (b) Except as specified in paragraph (c) of this section, if a laboratory fails to participate successfully in proficiency testing for a given specialty, subspecialty, analyte or test, as defined in this section, or fails to take remedial action when an individual fails gynecologic cytology, CMS imposes sanctions, as specified in subpart R of this part. (c) If a laboratory fails to perform successfully in a CMS- approved proficiency testing program, for the initial unsuccessful performance, CMS may direct the laboratory to undertake training of its personnel or to obtain technical assistance, or both, rather than imposing alternative or principle sanctions except when one or more of the following conditions exists: (1) There is immediate jeopardy to patient health and safety. (2) The laboratory fails to provide CMS or a CMS agent with satisfactory evidence that it has taken steps to correct the problem identified by the unsuccessful proficiency testing performance. (3) The laboratory has a poor compliance history. This CONDITION is not met as evidenced by: Based on an off-site desk review of the laboratory's 2022 and 2023 American Proficiency Institute (API) proficiency testing (PT) records and a telephone interview with the laboratory testing personnel on April 10, 2023, it was determined that the laboratory failed to attain a score of at least eighty (80) percent of acceptable responses for Total Bilirubin in two (2) out of three (3) Chemistry testing events resulting in unsuccessful PT performance. See D2096 D2096 ROUTINE CHEMISTRY CFR(s): 493.841(f) 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 -- Failure to achieve satisfactory performance for the same analyte or test in two consecutive testing events or two out of three consecutive testing events is unsuccessful performance. This STANDARD is not met as evidenced by: Based on an off-site desk review of the laboratory's 2022 and 2023 American Proficiency Institute (API) proficiency testing (PT) records, and a telephone interview with the testing person on April 10, 2023 it was determined that the laboratory failed to attain a score of at least eighty (80) percent of acceptable responses for Total Bilirubin in two (2) out of three (3) Chemistry events. Findings include: 1. Desk review of the laboratory's 2022 and 2023 API PT records revealed Total Bilirubin scores of less than eighty percent for the following chemistry events: 2022-2 score of 40% 2023-1 score of 60% 2. The testing person confirmed the laboratory was unsuccessful in the PT events listed above in a telephone interview on 4/10/2023 at 1: 30 PM. -- 2 of 2 --

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Survey - July 20, 2022

Survey Type: Standard

Survey Event ID: MI5S11

Deficiency Tags: D2099 D2016 D5413

Summary:

Summary Statement of Deficiencies D2016 SUCCESSFUL PARTICIPATION CFR(s): 493.803(a)(b)(c) (a) Each laboratory performing nonwaived testing must successfully participate in a proficiency testing program approved by CMS, if applicable, as described in subpart I of this part for each specialty, subspecialty, and analyte or test in which the laboratory is certified under CLIA. (b) Except as specified in paragraph (c) of this section, if a laboratory fails to participate successfully in proficiency testing for a given specialty, subspecialty, analyte or test, as defined in this section, or fails to take remedial action when an individual fails gynecologic cytology, CMS imposes sanctions, as specified in subpart R of this part. (c) If a laboratory fails to perform successfully in a CMS- approved proficiency testing program, for the initial unsuccessful performance, CMS may direct the laboratory to undertake training of its personnel or to obtain technical assistance, or both, rather than imposing alternative or principle sanctions except when one or more of the following conditions exists: (1) There is immediate jeopardy to patient health and safety. (2) The laboratory fails to provide CMS or a CMS agent with satisfactory evidence that it has taken steps to correct the problem identified by the unsuccessful proficiency testing performance. (3) The laboratory has a poor compliance history. This CONDITION is not met as evidenced by: Based on a review of the laboratory's 2022 American Proficiency Institute (API) evaluation of proficiency testing (PT) records and an interview with the testing person on July 20, 2022, it was determined that the laboratory failed to attain a score of at least eighty (80) percent of acceptable responses for 25-OH Vitamin D in two (2) out of three (3) testing events resulting in unsuccessful PT performance. See 2099 D2099 ENDOCRINOLOGY CFR(s): 493.843(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 2 -- Failure to attain an overall testing event score of at least 80 percent is unsatisfactory performance. This STANDARD is not met as evidenced by: Based on a review of the laboratory's 2022 American Proficiency Institute (API) proficiency testing (PT) records, and an interview with the testing person on July 20, 2022 it was determined that the laboratory failed to attain a score of at least eighty (80) percent of acceptable responses for 25-OH Vitamin D in two (2) out of three (3) testing events. Findings include: 1. Review of the laboratory's 2022 API PT records revealed 25-OH Vitamin D scores of less than eighty percent for the following Chemistry events: API Chemistry Core 2022 1st event -score of 50%, API Chemistry Core 2022 2nd event -score of 50% 2. There was no documentation or evidence of result review or remedial action taken for the unsatisfactory Vitamin D PT results. 3. The laboratory reports performing 550 25-OH Vitamin D tests annually. 4. The testing person confirmed these findings by interview on July 20, 2022 at 3:00 pm. D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(b) The laboratory must define criteria for those conditions that are essential for proper storage of reagents and specimens, accurate and reliable test system operation, and test result reporting. The criteria must be consistent with the manufacturer's instructions, if provided. These conditions must be monitored and documented and, if applicable, include the following: (1) Water quality. (2) Temperature. (3) Humidity. (4) Protection of equipment and instruments from fluctuations and interruptions in electrical current that adversely affect patient test results and test reports. This STANDARD is not met as evidenced by: Based on review of the manufacturer's package insert, patient test reports, and interview with the testing person, the laboratory failed to include follow the manufacturer's instructions for reporting the Total Prostate Specific Antigen (PSA) using the Siemens Dimension EXL analyzer. Findings: 1. The Siemens package insert for PSA, issue date 2019-07-29 states, 'The results reported by the laboratory to the physician must include the identity of the PSA assay used.' 2. A review of a test result report on patient #2087 revealed the PSA result did not include the identity of the Siemens Dimension EXL PSA assay. 3. The laboratory reports performing 475 PSA tests annually. 4. The testing person confirmed these findings by interview on July 20, 2022 at 3:00 pm. -- 2 of 2 --

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