Niobrara Community Hospital

CLIA Laboratory Citation Details

4
Total Citations
35
Total Deficiencyies
18
Unique D-Tags
CMS Certification Number 53D0519784
Address 921 S Ballencee Ave, Lusk, WY, 82225
City Lusk
State WY
Zip Code82225
Phone(307) 334-4000

Citation History (4 surveys)

Survey - March 27, 2025

Survey Type: Standard

Survey Event ID: NWG011

Deficiency Tags: D5209 D5209

Summary:

Summary Statement of Deficiencies D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES CFR(s): 493.1235 As specified in the personnel requirements in subpart M, the laboratory must establish and follow written policies and procedures to assess employee and, if applicable, consultant competency. This STANDARD is not met as evidenced by: Based on review of the CMS (Centers for Medicare and Medicaid Services) 209 Laboratory Personnel Report, review of personnel records, policy and procedure review, and staff interview, the laboratory failed to ensure the 6-month competency assessment was completed for 1 of 3 (TP #3) testing personnel; and a policy and procedure was developed for assessing the competency of the technical consultant. The findings were: 1. Review of the personnel file for TP #3 showed she was hired on 11/18/23. There was no evidence a 6-month competency assessment had been completed. 2. Review of the personnel file for the technical consultant showed no competency assessment had been completed in 2023 or 2024. 3. Review of the Quality Assurance Policy, last revised, 3/2023, showed "...2. Personnel Competency... All new employees will complete an orientation. They will be monitored through a series of training verification training check lists. New employees will undergo a bi- annual competency the first year and yearly competency thereafter." Review of the Laboratory Employee Competency policy, last revised 6/2024, showed "...B. New employees will be required to complete a semiannual competency evaluation." Further review of both policies showed no evidence a procedure had been developed to ensure the competency of the technical consultant. 4. Interview with the laboratory director on 3/26/25 at 2:59 PM confirmed the 6-month competency assessment had not been completed and a procedure had not been developed to assess the competency of the technical consultant. 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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Survey - March 9, 2023

Survey Type: Standard

Survey Event ID: 1A4211

Deficiency Tags: D2009 D5211 D5439 D5447 D5217 D5403 D5421 D5217 D5403 D5449 D5469 D6000 D6013 D6016 D6018 D5421 D5439 D5447 D5449 D5469 D6000 D6013 D6020 D6016 D6018 D6020

Summary:

Summary Statement of Deficiencies D2009 TESTING OF PROFICIENCY TESTING SAMPLES CFR(s): 493.801(b)(1) The individual testing or examining the samples and the laboratory director must attest to the routine integration of the samples into the patient workload using the laboratory's routine methods. This STANDARD is not met as evidenced by: Based on review of proficiency testing records, lack of documentation, and staff interview, the laboratory director or his designee failed to attest to the routine integration of the American Proficiency Institute (API) proficiency tests into the patient workload for 9 of 18 proficiency testing events reviewed from July 2021 through December 2022. The findings were: 1. Review of the proficiency testing records showed attestation statements with the following concerns: a. The 2022 API chemistry core event #2 was not signed by the laboratory director or his designee. b. The 2022 API chemistry core verification event #2 was not signed by the laboratory director or his designee. c. The 2022 API chemistry core event #3 was not signed by the laboratory director or his designee. d. The 2022 API hematology event #2 was not signed by the laboratory director or his designee. e. The 2022 API hematology event #3 was not signed by the laboratory director or his designee. f. The 2022 API microbiology event #2 was not signed by the laboratory director or his designee. g. The 2022 API microbiology event #3 was not signed by the laboratory director or his designee. h. The 2022 API immunology event #3 was not signed by the laboratory director or his designee. i. The 2022 API chemistry miscellaneous event #2 was not signed by the laboratory director or his designee. 2. Interview with the technical consultant on 3/8/23 at 12:52 PM revealed the previous technical consultant had resigned in June of 2022 and confirmed the attestation statements had not been signed. D5211 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(a) Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 9 -- The laboratory must review and evaluate the results obtained on proficiency testing performed as specified in subpart H of this part. This STANDARD is not met as evidenced by: Based on review of the API (American Proficiency Institute) proficiency testing (PT) records, lack of documentation, and staff interview, the laboratory director (LD) failed to review and evaluate proficiency testing results for 11 of 18 testing events reviewed from July 2021 to December 2022. The findings were: 1. Review of the API proficiency testing records failed to include documentation the laboratory director had evaluated the proficiency test results. The following concerns were identified: a. Review of the API 2021 miscellaneous core event #2 showed no documentation the LD had reviewed the results. b. Review of the API 2022 chemistry core event #1 showed no documentation the LD had reviewed the results. This proficiency testing event showed lipase scored a 20%. c. Review of the API 2022 chemistry core event #2 showed no documentation the LD had reviewed the results. This proficiency testing event showed lipase scored a 20%. d. Review of the API 2022 chemistry core verification event #2 showed no documentation the LD had reviewed the results. e. Review of the API 2022 hematology event #1 showed no documentation the LD had reviewed the results. f. Review of the API 2022 hematology event #2 showed no documentation the LD had reviewed the results. g. Review of the API 2022 hematology event #3 showed no documentation the LD had reviewed the results. h. Review of the API 2022 microbiology event #1 showed no documentation the LD had reviewed the results. i. Review of the API 2022 microbiology event #2 showed no documentation the LD had reviewed the results. j. Review of the API immunology event #3 showed no documentation the LD had reviewed the results. k. Review of the API miscellaneous chemistry event #1 showed no documentation the LD had reviewed the results. 2. Interview with the technical consultant on 3/8/23 at 12:52 PM revealed the previous technical consultant had resigned in June of 2022 and confirmed the PT records did not show documentation of the LD's review of the results. D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(c)(1) At least twice annually, the laboratory must verify the accuracy of any test or procedure it performs that is not included in subpart I of this part. This STANDARD is not met as evidenced by: Based on review of proficiency testing records and staff interview, the laboratory failed to at least twice annually verify the accuracy of the lipase analyte for 1 of 2 years (2022) reviewed. The laboratory performed approximately 72 patient lipase tests per year. The findings were: 1. Review of the American Proficiency Institute (API) proficiency testing records showed the laboratory failed 3 consecutive testing events for lipase; 2021 event #3, 2022 event #1, and 2022 event #3. Further review showed the error which caused the failures was resolved on 7/20/22; however, there was no evidence patient test results had been evaluated for accuracy. 2. Interview with the technical consultant (TC) on 3/9/23 at 11:18 AM revealed the failure of the lipase analyte on the proficiency testing events was due to the failure of the laboratory to enter a correlation factor into the test system. The error was corrected in July of 2022. The TC confirmed patient results had not been evaluated for accuracy. -- 2 of 9 -- 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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Survey - June 25, 2021

Survey Type: Standard

Survey Event ID: 98SI11

Deficiency Tags: D5211 D5413 D5403 D5413

Summary:

Summary Statement of Deficiencies D5211 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(a) The laboratory must review and evaluate the results obtained on proficiency testing performed as specified in subpart H of this part. This STANDARD is not met as evidenced by: Based on review of proficiency testing records, lack of documentation, and staff interview, the laboratory failed to review and evaluate proficiency testing results for 4 of 37 testing events from January 2019 through January 2021. The findings were: 1. Review of the American Proficiency Institute (API) proficiency testing (PT) report failed to include documentation the laboratory had evaluated test scores of less than 100%. The following concerns were identified: a. Review of the 2019 API hematology Event 1 PT results showed the laboratory scored an 80% on blood cell identification. There was no documentation the laboratory had evaluated the proficiency results. b. Review of the 2019 API hematology Event 3 PT results showed the laboratory scored an 80% on blood cell identification. There was no documentation the laboratory had evaluated the proficiency results. c. Review of the 2020 API routine chemistry Event 1 PT results showed the laboratory scored an 80% on the carbon dioxide analyte. There was no documentation the laboratory had evaluated the proficiency results. d. Review of the 2020 API hematology Event 3 PT results showed the laboratory scored an 80% on hematocrit. There was no documentation the laboratory had evaluated the proficiency results. 2. Interview with the laboratory manager on 6/25/21 at 10:30 AM confirmed the laboratory had failed to evaluate the reason for the 80% proficiency scores. D5403 PROCEDURE MANUAL CFR(s): 493.1251(b) The procedure manual must include the following when applicable to the test Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 3 -- 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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Survey - April 9, 2019

Survey Type: Standard

Survey Event ID: Q0L311

Deficiency Tags: D5473 D6091 D6091

Summary:

Summary Statement of Deficiencies D5473 CONTROL PROCEDURES CFR(s): 493.1256(e)(2)(g) (e) For reagent, media, and supply checks, the laboratory must do the following: (e) (2) Each day of use (unless otherwise specified in this subpart), test staining materials for intended reactivity to ensure predictable staining characteristics. Control materials for both positive and negative reactivity must be included, as appropriate. (g) The laboratory must document all control procedures performed. This STANDARD is not met as evidenced by: Based on patient test records review, lack of quality control (QC) documentation, and interview with staff, the laboratory failed to check Wright's stain each day of testing for intended reactivity and staining characteristics for two years of white blood cell (WBC) manual differentials reviewed. The laboratory performed approximately 7 manual differentials per year. Findings include: 1. Patient test records review included documentation the laboratory performed WBC differentials using a Wright's Quick stain for patient sample #14463, record number 8627 on 05/31/2018 for a manual slide review. 2. The laboratory quality control records did not include a Wright's quick stain adequacy of staining characteristics for the stained slide review on 05/31/2018. 3. In an interview conducted on 04/09/2019 at approximately 3:00 P.M., testing personnel confirmed the laboratory did not record Wright's stain quality assessment each day of use. D6091 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1445(e)(4)(iii) The laboratory director must ensure all proficiency testing reports received are reviewed by the appropriate staff to evaluate the laboratory's performance and to identify any problems that require

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