Novant Health Forsyth Pediatrics Westgate

CLIA Laboratory Citation Details

2
Total Citations
4
Total Deficiencyies
3
Unique D-Tags
CMS Certification Number 34D0237582
Address 1351 Westgate Center Drive, Winston Salem, NC, 27103-2934
City Winston Salem
State NC
Zip Code27103-2934
Phone336 718-7777
Lab DirectorMELANIE ADAMS

Citation History (2 surveys)

Survey - November 22, 2019

Survey Type: Standard

Survey Event ID: U23011

Deficiency Tags: D6065 D6063 D6065

Summary:

Summary Statement of Deficiencies D6063 LABORATORY TESTING PERSONNEL CFR(s): 493.1421 The laboratory must have a sufficient number of individuals who meet the qualification requirements of 493.1423, to perform the functions specified in 493. 1425 for the volume and complexity of tests performed. This CONDITION is not met as evidenced by: Based on review of personnel records 11/22/19 and the deficiency cited at D6065, the laboratory failed to verify that 1 of 11 testing personnel (TP # 3) met the minimum education requirements for performing moderate complexity testing. D6065 TESTING PERSONNEL QUALIFICATIONS CFR(s): 493.1423(b)(1)(2)(3)(4)(i) (b) Meet one of the following requirements: (b)(1) Be a doctor of medicine or doctor of osteopathy licensed to practice medicine or osteopathy in the State in which the laboratory is located or have earned a doctoral, master's, or bachelor's degree in a chemical, physical, biological or clinical laboratory science, or medical technology from an accredited institution; or (b)(2) Have earned an associate degree in a chemical, physical or biological science or medical laboratory technology from an accredited institution; or (b)(3) Be a high school graduate or equivalent and have successfully completed an official military medical laboratory procedures course of at least 50 weeks duration and have held the military enlisted occupational specialty of Medical Laboratory Specialist (Laboratory Technician); or (b)(4)(i) Have earned a high school diploma or equivalent; and This STANDARD is not met as evidenced by: Based on review of personnel records and interview with the TC (technical 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 -- consultant) 11/22/19, the laboratory failed to verify that 1 of 11 testing personnel (TP # 3) met the minimum education requirements for performing moderate complexity testing. Review of personnel records for TP #3 revealed that TP#3 had a Bachelor of Science degree, but the degree did not indicate the major or area of study. During interview at approximately 10:40 a.m. the TC stated she thought TP #3's degree was a nursing degree. She confirmed the major was not listed on the degree. -- 2 of 2 --

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Survey - January 8, 2018

Survey Type: Standard

Survey Event ID: YWKU12

Deficiency Tags: D2121

Summary:

Summary Statement of Deficiencies No Tags No deficiency details available. 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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