Novant Health Kernersville Family Medicine

CLIA Laboratory Citation Details

2
Total Citations
3
Total Deficiencyies
2
Unique D-Tags
CMS Certification Number 34D0981573
Address 291 Broad Street, Kernersville, NC, 27284
City Kernersville
State NC
Zip Code27284
Phone(336) 993-8181

Citation History (2 surveys)

Survey - November 2, 2021

Survey Type: Standard

Survey Event ID: GFLH11

Deficiency Tags: D2007 D2007

Summary:

Summary Statement of Deficiencies D2007 TESTING OF PROFICIENCY TESTING SAMPLES CFR(s): 493.801(b)(1) The samples must be examined or tested with the laboratory's regular patient workload by personnel who routinely perform the testing in the laboratory, using the laboratory's routine methods This STANDARD is not met as evidenced by: Based on review of 2019, 2020, and 2021 API (American Proficiency Institute) proficiency testing records and interview with testing personnel (TP #1) 11/2/21, the laboratory failed to ensure all testing personnel who routinely tested patient specimens participated in proficiency testing for 22 of 23 events in 2019, 2020, and 2021. Review of API proficiency testing records for 2019, 2020, and 2021 revealed TP #1 routinely participated in all proficiency testing events. TP #2 and TP #3 participated in 1 of 23 events during this time: the 2021 chemistry miscellaneous 2nd event. During interview at approximately 11:05 a.m., TP #1 confirmed that TP #2, TP #3, TP #4, and TP #5 do perform patient testing. She verified that they had not participated in proficiency testing in the past. 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 - December 18, 2018

Survey Type: Standard

Survey Event ID: JH2211

Deficiency Tags: D5437

Summary:

Summary Statement of Deficiencies D5437 CALIBRATION AND CALIBRATION VERIFICATION CFR(s): 493.1255(a) Unless otherwise specified in this subpart, for each applicable test system the laboratory must perform and document calibration procedures-- (1) Following the manufacturer's test system instructions, using calibration materials provided or specified, and with at least the frequency recommended by the manufacturer; (2) Using the criteria verified or established by the laboratory as specified in 493.1253(b) (3)-- (2)(i) Using calibration materials appropriate for the test system and, if possible, traceable to a reference method or reference material of known value; and (2)(ii) Including the number, type, and concentration of calibration materials, as well as acceptable limits for and the frequency of calibration; and (3) Whenever calibration verification fails to meet the laboratory's acceptable limits for calibration verification. This STANDARD is not met as evidenced by: Based on review of manufacturer's instructions, review of the laboratory's policies and procedures, review of 2016, 2017, and 2018 Vitros 250 calibration records, and interview with TP (testing personnel) 12/18/18, the laboratory failed to perform and document calibration at least once every six months as required. The Vitros 250 Chemistry System Operator's Manual states on page 6-1 "6 Calibrating You must properly calibrate all tests performed by the analyzer using Vitros calibrators along with Vitros Slides. ... You should calibrate every six months ..." The laboratory's procedure manual states "... Frequency of Calibration ... Calibration or calibration verification must be performed at least once every 6-months. ..." Review of 2016, 2017, and 2018 Vitros 250 calibration records revealed the laboratory failed to perform and document calibration at least once every six months for the following analytes: 1. albumin - calibration performed 6/27/16, 2/3/17, 2/14/17, 6/14/17, 3/16 /18; 2. alkaline phosphatase - calibration performed 12/29/16, 2/7/17, 6/27/17, 3/9/18; 3. BUN (blood urea nitrogen) - calibration performed 12/14/16, 1/27/17, 2/27/17, 6/28 /17, 2/27/18; 4. total bilirubin - calibration performed 11/18/16, 2/14/17, 4/3/17, 8/4 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 -- /17, 6/11/18; 5. total protein - calibration performed 12/29/16, 2/3/17, 5/12/17, 6/14 /17, 8/4/17, 5/18/18. During interview at approximately 3:15 p.m., TP #1 stated that Vitros 250 calibrations are performed when the slide lot number changes. She stated that they did not realize that some of the calibrations were performed at intervals that exceeded six months. -- 2 of 2 --

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