Summary:
Summary Statement of Deficiencies D5301 TEST REQUEST CFR(s): 493.1241(a) The laboratory must have a written or electronic request for patient testing from an authorized person. This STANDARD is not met as evidenced by: . Based on document review and interview, the laboratory failed to have a written request for the hematology patient testing from an authorized person for three (#2, #5, and #8) of nine patient charts audited. Findings include: 1. On May 30, 2018 at 11:30 AM, document review for three (#2, #5, and #8) of nine patient charts audited did not have a written request for the hematology complete blood cell count testing by an authorized person in the patient's paper chart. 2. During the interview on May 30, 2018 at 11:30 AM, the laboratory director as listed on the CMS-209 confirmed a written request for the hematology testing was not present in the patient's chart. 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 --