Partners In Pediatrics

CLIA Laboratory Citation Details

3
Total Citations
13
Total Deficiencyies
12
Unique D-Tags
CMS Certification Number 01D0695446
Address 8160 Seaton Place, Montgomery, AL, 36116
City Montgomery
State AL
Zip Code36116
Phone334 272-1799
Lab DirectorSUSAN BRANNON

Citation History (3 surveys)

Survey - December 9, 2025

Survey Type: Standard

Survey Event ID: WV5W11

Deficiency Tags: D5429 D5785 D6054

Summary:

Summary Statement of Deficiencies D5429 MAINTENANCE AND FUNCTION CHECKS CFR(s): 493.1254(a)(1) (a)(1) Maintenance as defined by the manufacturer and with at least the frequency specified by the manufacturer. This STANDARD is not met as evidenced by: Based on reviews of the Beckman Coulter (BC) DxH 500 Hematology maintenance records, BC DxH 500 Operator's manual and an interview with Testing Personnel 26 (TP26), the laboratory failed to perform monthly and annual maintenance, as per the manufacturer's instructions. There was no documentation of annual maintenance in 2024, or monthly maintenance for 18 of the 33 months in 2023-2025 review period. The findings include: 1. A review of the Hematology maintenance records revealed the BC DxH 500 analyzer had no documentation for the following required maintenance. A) No monthly maintenance for nine of the twelve months in 2024 B) No monthly maintenance for nine of the eleven months in 2025 C) No documentation of the annual maintenance in 2024. 2. A review of the BC DxH 500 Operator's Manual revealed the following maintenance instructions: A) Monthly or every 1,000 cycles (Bleach Cycle) B) Monthly (Cleaning the WBC Bath Filter) C) Yearly (Lubricating Pistons) D) Yearly or every 18,000 cycles (Replace Rinsing Head O- Ring) 3. The TP26 confirmed these findings during the exit conference on 12-09-2025 at 3:13 PM. D5785

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Survey - February 10, 2022

Survey Type: Standard

Survey Event ID: NJD511

Deficiency Tags: D2015 D3031 D5407 D6013 D6029 D6065

Summary:

Summary Statement of Deficiencies D2015 TESTING OF PROFICIENCY TESTING SAMPLES CFR(s): 493.801(b)(5)(6) (5) The laboratory must document the handling, preparation, processing, examination, and each step in the testing and reporting of results for all proficiency testing samples. The laboratory must maintain a copy of all records, including a copy of the proficiency testing program report forms used by the laboratory to record proficiency testing results including the attestation statement provided by the PT program, signed by the analyst and the laboratory director, documenting that proficiency testing samples were tested in the same manner as patient specimens, for a minimum of two years from the date of the proficiency testing event. (6) PT is required for only the test system, assay, or examination used as the primary method for patient testing during the PT event. This STANDARD is not met as evidenced by: Based on a review of the 2020 - 2021 MLE (Medical Laboratory Evaluation) proficiency testing (PT) records, and an interview with the Laboratory Director, the surveyor determined the Laboratory Director failed to sign attestation statements for three of seven surveys reviewed. The findings include: 1. A review of the 2020 - 2021 MLE PT records revealed the Laboratory Director failed to sign the attestation statements for the 2020-M3, 2021-M2, and 2021-M3 surveys. 2. In the Day 1 exit summation on 2/9/2022 at 4:00 PM the surveyor reviewed and confirmed the above noted findings. . D3031 RETENTION REQUIREMENTS CFR(s): 493.1105(a)(3) Analytic systems records. Retain quality control and patient test records (including instrument printouts, if applicable) and records documenting all analytic systems activities specified in 493.1252 through 493.1289 for at least 2 years. Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 4 -- This STANDARD is not met as evidenced by: Based on a review of Hematology and Chemistry records, and an interview with Testing Personnel #2, the laboratory failed to retain the manufacturer's package inserts for two of six Hematology analyzer calibrators, and the Bilirubin quality controls (QC) inserts except the current lot number in use. The findings include: 1. A review of Hematology records revealed no calibrator assay sheets for the calibrations performed on 1/30/2020 and 6/16/2020. 2. A review of Chemistry records revealed the laboratory retained the manufacturer's package insert for the current lot number of Bilirubin QC only. 3. During an interview on 2/9/2022 at 3:05 PM Testing Personnel #2 confirmed the above findings. . D5407 PROCEDURE MANUAL CFR(s): 493.1251(d) Procedures and changes in procedures must be approved, signed, and dated by the current laboratory director before use. This STANDARD is not met as evidenced by: Based on a review of Hematology records, a review of the User's Manual for the new Beckman Coulter DxH500 Hematology analyzer, and an interview with Testing Personnel #2 and the Laboratory Director, the surveyor determined the Laboratory Director failed to review, sign and date approval of the procedures before the Testing Personnel began using the instrument for patient testing. This affected procedures in use for one of one new instruments performing moderate-complexity tests. The findings include: 1. A review of Hematology records revealed validation records for the BC DxH500, installed in January 2021. Patient CBC (Complete Blood Count) testing began on 2/12/2021. 2. A review of the "Beckman Coulter Instructions for Use" Manual revealed no documentation of the Laboratory Director's review and approval (as indicated by a signature and date) of the procedures in use by the testing personnel. 3. In the Day 1 exit summation on 2/9/2022 at approximately 4:00 PM, the surveyor reviewed CLIA requirements, and confirmed the above noted findings with the Laboratory Director and Testing Personnel #2. . D6013 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(3)(ii) The laboratory director is responsible for the overall operation and administration of the laboratory, including the employment of personnel who are competent to perform test procedures, and record and report test results promptly, accurate, and proficiently and for assuring compliance with the applicable regulations. (e) The laboratory director must-- (e)(3) Ensure that-- (e)(3)(ii) Verification procedures used are adequate to determine the accuracy, precision, and other pertinent performance characteristics of the method; This STANDARD is not met as evidenced by: Based on a review of the installation and validation records for the Beckman Coulter (BC) DxH500 Hematology analyzer, and an interview with the Laboratory Director, the surveyor determined the Laboratory Director failed to document review and approval of the procedures as verification of the manufacturer's performance -- 2 of 4 -- specifications before patient testing began. This affected one of one new instruments performing moderate-complexity tests. The findings include: 1. A review of the validation records for the BC DxH500 revealed no documentation (signature and date) of the Laboratory Director's review and approval of the procedures verifying the manufacturer's performance specifications. Patient CBC (Complete Blood Count) testing began on 2/12/2021. 2. A further review of the installation records revealed CBC printouts from approximately 28 patients run on the BC DxH500 and the BC AcT diff (the previous analyzer) for a comparison study, however there was no documentation the data had been evaluated and values calculated to prove the accuracy of the new instrument. The surveyor also noted no documentation of the reference ranges verification. 3. In the Day 1 exit summation on 2/9/2022 at 3:50 PM, the surveyor reviewed the records with the Laboratory Director, and confirmed the above noted findings. . D6029 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(11) The laboratory director is responsible for the overall operation and administration of the laboratory, including the employment of personnel who are competent to perform test procedures, and record and report test results promptly, accurate, and proficiently and for assuring compliance with the applicable regulations. (e) The laboratory director must-- (e)(11) Ensure that prior to testing patients' specimens, all personnel have the appropriate education and experience, receive the appropriate training for the type and complexity of the services offered, and have demonstrated that they can perform all testing operations reliably to provide and report accurate results. This STANDARD is not met as evidenced by: Based on reviews of personnel files, Hematology records and an interview with Testing Personnel #2, the surveyor determined the Laboratory Director failed to ensure training on the new Beckman Coulter DxH500 (installed January 2021) was performed and documented for twelve of twelve Testing Personnel hired on or before January 2021. The findings include: 1. A review of Hematology records revealed the new Beckman Coulter (BC) DxH500 Hematology analyzer was installed in January 2021. 2. A review of personnel files and the installation records for the BC DxH500 revealed no documentation of training on the instrument for the twelve Testing Personnel who were on staff and performing patient testing in January 2021. 3. During an interview on 2/9/2022 at 2:45 PM, Testing Personnel #2 confirmed she had a training manual for the new DxH500, however there was no training documentation for the testing personnel working when the new analyzer was installed. . 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 -- 3 of 4 -- 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 reviews of personnel files, and an interview with Testing Personnel #2 and the Laboratory Director, the surveyor determined the laboratory failed to ensure four of twelve new Testing Personnel presented educational documentation, as required per CLIA regulations. The findings include: 1. A review of personnel files revealed four employees with no documentation of educational credentials (a high school diploma or equivalent, or a degree in a chemical, physical or biological science) as required for the position of moderate-complexity testing personnel, as follows: A) TP #4 had provided a Medical Assisting Diploma transcript only. B) TP #5 had provided a Certificate in Practical Nursing only C) TP #6 had provided a Certificate in Practical Nursing only D) TP #15 had no educational documentation 2. In the Day 1 exit summation on 2/9/2022 at 4:00 PM the surveyor reviewed educational requirements for moderate-complexity testing personnel, and confirmed the above noted findings with the Laboratory Director and Testing Personnel #2 The laboratory was unable to provide the required records during the survey. SURVEYOR ID#32558 Licensure and Certification Surveyor -- 4 of 4 --

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Survey - July 23, 2019

Survey Type: Standard

Survey Event ID: LUNR11

Deficiency Tags: D5211 D5217 D5221 D6029

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 a review of the MLE (Medical Laboratory Evaluation) proficiency testing records and an interview with Testing Personnel (TP ) #2 and #10 and the Laboratory Director (new director since April of 2019), the surveyor determined the laboratory failed to review and evaluate the results of proficiency testing for Event MLE M2 and Event MLE M3 of 2018. This affected two of six testing events reviewed by the surveyor. The findings include: 1. A review of the MLE proficiency testing records for Event MLE M2 of 2018 (Hematology, Routine Chemistry, and Microbiology) revealed the laboratory failed to review and evaluate the results returned by the program provider. The review/evaluation form failed to include the Laboratory Director's or delegate's signature, which would indicate a review of the results. The surveyor's review revealed the laboratory scored eighty percent (80 %) for Throat Culture Interpretations. Specimen TC #9 (one/five specimens) was reported as positive, but the expected and acceptable response was negative. 2. A review of the MLE proficiency testing records for Event MLE M3 of 2018 (Hematology, Routine Chemistry, and Microbiology) revealed the laboratory failed to review and evaluate the results returned by the program provider. The review/evaluation form failed to include the Laboratory Director's or delegate's signature, which would indicate a review of the results. 3. During the exit interview on 7/23/2019 at 1:30 PM, the surveyor discussed the above noted findings with TP #2 and #10 and the Laboratory Director. The surveyor further discussed the requirement for the laboratory to review and evaluate all proficiency testing results to ensure accuracy was verified and

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