Physicians Immunodiagnostic

CLIA Laboratory Citation Details

3
Total Citations
13
Total Deficiencyies
13
Unique D-Tags
CMS Certification Number 05D0887857
Address 512 S Verdugo Dr, Burbank, CA, 91502
City Burbank
State CA
Zip Code91502
Phone(818) 955-8477

Citation History (3 surveys)

Survey - August 12, 2024

Survey Type: Special

Survey Event ID: 0U5C11

Deficiency Tags: D2016 D2085 D6000 D0000 D2055 D2097 D6016

Summary:

Summary Statement of Deficiencies D0000 A proficiency testing desk review survey was performed on 8/12/2024, the laboratory was found not in compliance with the following CONDITION LEVEL DEFICIENCIES D2016 - 42 C.F.R. 493.803 Condition: Successful participation [proficiency testing]; D6000 - 42 C.F.R. 493.1403 Condition: Laboratories performing moderate complexity testing; laboratory director. D2016 SUCCESSFUL PARTICIPATION CFR(s): 493.803(a)(b)(c) (a) Each laboratory performing nonwaived testing must successfully participate in a proficiency testing program approved by CMS, if applicable, as described in subpart I of this part for each specialty, subspecialty, and analyte or test in which the laboratory is certified under CLIA. (b) Except as specified in paragraph (c) of this section, if a laboratory fails to participate successfully in proficiency testing for a given specialty, subspecialty, analyte or test, as defined in this section, or fails to take remedial action when an individual fails gynecologic cytology, CMS imposes sanctions, as specified in subpart R of this part. (c) If a laboratory fails to perform successfully in a CMS- approved proficiency testing program, for the initial unsuccessful performance, CMS may direct the laboratory to undertake training of its personnel or to obtain technical assistance, or both, rather than imposing alternative or principle sanctions except when one or more of the following conditions exists: (1) There is immediate jeopardy to patient health and safety. (2) The laboratory fails to provide CMS or a CMS agent with satisfactory evidence that it has taken steps to correct the problem identified by the unsuccessful proficiency testing performance. (3) The laboratory has a poor compliance history. This CONDITION is not met as evidenced by: Based on review of the Certification and Survey Provider Enhanced Reporting (CASPER) - 0155D and AAB-Medical Laboratory Evaluation / College of American Pathologists/EXCEL ) records (2023-2, 2023-3) and (2024-1), the laboratory failed to 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 -- successfully participate in a proficiency testing program approved by HHS for each specialty, subspecialty and analyte or test in which the laboratory is certified under CLIA, the laboratory failed to successfully participate in the subspecialty of Parasitology, General Immunology analyte C4, and Routine Chemistry analyte BUN resulting in unsuccessful performances. Refer to D2. D2055 PARASITOLOGY CFR(s): 493.829(e) Failure to achieve an overall testing event score of satisfactory performance for two consecutive testing events or two out of three consecutive testing events is unsuccessful performance. This STANDARD is not met as evidenced by: Based on desk review of Certification and Survey Provider Enhanced Reporting (CASPER) Report 0155D Individual Laboratory Profile and AAB-Medical Laboratory Evaluation / College of American Pathologists/EXCEL ) reports, the laboratory failed to achieve satisfactory performance for two of three events proficiency events in 2023 and 2024 for Parasitology. The finding include 1. The laboratory received the following scores: 0% on the 2023 Parasitology third event 75% on the 2024 Parasitology first event 2. A review of the 2023 and 2024 proficiency Testing scores from AAB and CAP confirmed the above findings. D2085 GENERAL IMMUNOLOGY CFR(s): 493.837(g) Failure to achieve an overall testing event score of satisfactory performance for two consecutive testing events or two out of three consecutive testing events is unsuccessful performance. This STANDARD is not met as evidenced by: Based on desk review of Certification and Survey Provider Enhanced Reporting (CASPER) Report 0155D Individual Laboratory Profile and AAB-Medical Laboratory Evaluation / College of American Pathologists/EXCEL ) reports, the laboratory failed to achieve satisfactory performance for two of three events proficiency events in 2023 and 2024 for C4. The finding include 1. The laboratory received the following scores: 0% on the 2023 C4 third event 60% on the 2024 C4 first event 2. A review of the 2023 and 2024 proficiency Testing scores from AAB and CAP confirmed the above findings. D2097 ROUTINE CHEMISTRY CFR(s): 493.841(g) Failure to achieve an overall testing event score of satisfactory performance for two consecutive testing events or two out of three consecutive testing events is unsuccessful performance. This STANDARD is not met as evidenced by: Based on desk review of Certification and Survey Provider Enhanced Reporting (CASPER) Report 0155D Individual Laboratory Profile and AAB-Medical -- 2 of 3 -- Laboratory Evaluation / College of American Pathologists/EXCEL ) reports, the laboratory failed to achieve satisfactory performance for two of three events proficiency events in 2023 and 2024 for BUN. The finding include 1. The laboratory received the following scores: 0% on the 2023 BUN third event 75% on the 2024 BUN second event 2. A review of the 2023 and 2024 proficiency Testing scores from AAB and CAP confirmed the above findings. D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR CFR(s): 493.1403 The laboratory must have a director who meets the qualification requirements of 493. 1405 of this subpart and provides overall management and direction in accordance with 493.1407 of this subpart. This CONDITION is not met as evidenced by: Based on a proficiency testing desk review of the CASPER 155 report API records for 2023-2, 2023-3 and 2024-1 events, the laboratory director failed to provide overall management and a direction of the laboratory services. Refer to D6016. D6016 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(4)(i) 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)(4)(i) Ensure that the proficiency testing samples are tested as required under Subpart H of this part; This STANDARD is not met as evidenced by: Based on a proficiency testing desk review of CASPER 155 report, AAB & CAPI records for 2023-2 and 2024-1 events, the laboratory director failed to ensure successful participation in an HHS approved proficiency testing program. Refer to D2055, D2085, and D2097.. -- 3 of 3 --

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Survey - March 29, 2023

Survey Type: Standard

Survey Event ID: 73OK11

Deficiency Tags: D6082 D5393

Summary:

Summary Statement of Deficiencies D5393 PREANALYTIC SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1249(b)(c) The preanalytic systems assessment must include a review of the effectiveness of

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Survey - April 27, 2022

Survey Type: Special

Survey Event ID: VPSJ11

Deficiency Tags: D5209 D6115 D5629 D9999

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 laboratory policies and procedures, lack of laboratory records and interview it was determined that the laboratory failed to establish written policies and procedures to assess the competency of technical supervisors. The laboratory failed to assess the competency of two of two technical supervisors in 2020, 2021 and to the date of the survey in 2022. Findings include: 1. The Survey Team requested and the laboratory failed to provide written policies and procedures to describe the process to assess the competency of technical supervisors. 2. The Survey Team requested and the laboratory failed to provide documentation of competency assessments for two of two technical supervisors during 2020, 2021 and to the date of the survey in 2022. Technical Supervisors include: - Laboratory Director/Technical Supervisor #1 - Technical Supervisor #2 3. During an interview on April 26, 2022 at 10:00 AM, Laboratory Director/Technical Supervisor #1 confirmed these findings. D5629 CYTOLOGY CFR(s): 493.1274(c)(5) (c) Control procedures. The laboratory must establish and follow written policies and procedures for a program designed to detect errors in the performance of cytologic examinations and the reporting of results. The program must include the following: (c) (5) An annual statistical laboratory evaluation of the number of - (c)(5)(i) Cytology cases examined; (c)(5)(ii) Specimens processed by specimen type; (c)(5)(iii) Patient cases reported by diagnosis (including the number reported as unsatisfactory for 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 -- diagnostic interpretation); (c)(5)(iv) Gynecologic cases with a diagnosis of HSIL, adenocarcinoma, or other malignant neoplasm for which histology results were available for comparison; (c)(5)(v) Gynecologic cases where cytology and histology are discrepant; and (c)(5)(vi) Gynecologic cases where any rescreen of a normal or negative specimen results in reclassification as low-grade squamous intraepithelial lesion (LSIL), HSIL, adenocarcinoma, or other malignant neoplasms. This STANDARD is not met as evidenced by: Based on review of laboratory policies and procedures, laboratory records and interview it was determined that the laboratory failed to follow written policies and procedures for an annual statistical evaluation of two of six required gynecologic laboratory statistics. The laboratory failed to document two of six required gynecologic annual statistics for 2020 and 2021. Findings include: 1. The laboratory failed to follow the procedure LABORATORY'S OVERALL STATISTICS AND EVALUATION REPORTS which states: "Statistical evaluation items: - Gyn cases where any rescreen of a normal or neg specimen results in reclassification of LSIL, HSIL, adenocarcinoma or other malignant neoplasms. - Gyn cases where cytology and histology findings are discrepant." 2. The Survey Team requested and the laboratory failed to provide two of six required gynecologic annual statistics for 2020 and 2021. Statistics include: - The number of gynecologic cases where cytology and histology are discrepant - The number of gynecologic cases where any rescreen of a normal or negative specimen results in reclassification as low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), adenocarcinoma, or other malignant neoplasms. 3. During an interview on April 26, 2022 at 10:00 AM, Laboratory Director/Technical Supervisor #1 confirmed these findings. D6115 TECHNICAL SUPERVISOR RESPONSIBILITIES CFR(s): 493.1451(b)(2) The technical supervisor is responsible for verification of the test procedures performed and establishment of the laboratory's test performance characteristics, including the precision and accuracy of each test and test system. This STANDARD is not met as evidenced by: Based on microscopic review of 387 random negative gynecologic cases/slides and the corresponding final test reports from March 31, 2022 through April 12, 2022 and confirmation by Laboratory Director/Technical Supervisor #1 on April 27, 2022 it was determined that the Technical Supervisor failed to verify the accuracy of one gynecologic cytology test. 1. 22 03561 04/07/2022 ThinPrep Pap Test LABORATORY DIAGNOSIS: Negative for Intraepithelial Lesion and Malignancy SURVEY TEAM DIAGNOSIS: Unsatisfactory. Scant Cellularity, Obscuring Inflammation LABORATORY DIRECTOR/TECHNICAL SUPERVISOR #1 DIAGNOSIS: Unsatisfactory With Clusters of Inflammatory Cells D9999 By agreement between ASCT Services, Inc. and CMS, information provided for CMS's completion of CMS Form 670 are ASCT Services, Inc. averages only. This information is confidential and proprietary to ASCT Services, Inc., is exempt under the Freedom of Information Act (5 U.S.C. 552 et seq.), and shall be used for federal government purposes only. -- 2 of 2 --

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