Piedmont Family Clinic

CLIA Laboratory Citation Details

2
Total Citations
7
Total Deficiencyies
7
Unique D-Tags
CMS Certification Number 26D0442444
Address #1 Hals Plaza Drive, Piedmont, MO, 63957
City Piedmont
State MO
Zip Code63957
Phone(573) 223-4800

Citation History (2 surveys)

Survey - November 5, 2019

Survey Type: Standard

Survey Event ID: CQS711

Deficiency Tags: D5775 D5217 D6018

Summary:

Summary Statement of Deficiencies D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(c)(1) At least twice annually, the laboratory must verify the accuracy of any test or procedure it performs that is not included in subpart I of this part. This STANDARD is not met as evidenced by: Based on review of 2018, 2019 proficiency testing (PT) and interview with the technical consultant the laboratory failed to verify accuracy for one of thirteen urine drug screen analytes in 2018. Findings: 1. Review of 2018 PT for urine barbiturates showed the laboratory failed to verify accuracy twice annually. 2. Interview with the technical consultant on November 5, 2019 at 2:00 PM confirmed the laboratory failed to verify accuracy for urine barbiturates twice annually in 2018. D5775 COMPARISON OF TEST RESULTS CFR(s): 493.1281(a)(c) (a) If a laboratory performs the same test using different methodologies or instruments, or performs the same test at multiple testing sites, the laboratory must have a system that twice a year evaluates and defines the relationship between test results using the different methodologies, instruments, or testing sites. (c) The laboratory must document all test result comparison activities. This STANDARD is not met as evidenced by: Based on review of 2018, 2019 instrument comparison documentation and interview with the technical consultant, the laboratory failed to perform instrument comparisons for two medtox instruments two times a year. Findings: 1. Review of two medtox instrument comparisons showed the laboratory failed to document comparisons for amphetamine, barbiturate, benzodiazepine, buprenorphine, cannabinoid, cocaine 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 -- metabolites, methadone, methamphetamine, opiate, oxycodone, phencyclidine, propoxyphene and TCA two times a year for 2018 and 2019. 2. Interview with the technical consultant on November 5, 2019 at 2:00 PM confirmed, the laboratory failed to perform instrument comparisons for two medtox instruments two times a year for 2018 and to date 2019. D6018 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(4)(iii) 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)(iii) Ensure that all proficiency testing reports received are reviewed by the appropriate staff to evaluate the laboratory's performance and to identify any problems that require

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Survey - January 17, 2018

Survey Type: Standard

Survey Event ID: W8E711

Deficiency Tags: D5211 D5439 D6013 D5403

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 review of chemistry proficiency testing (PT) record and interview with the technical consultant, the laboratory failed to review and evaluate unacceptable results for second PT event of 2016. Findings. 1. Review of chemistry PT records for second event 2016 revealed the laboratory obtained unacceptable results for total bilirubin (sample CH-07) and urea nitrogen (sample CH-08). 2. The laboratory did not have documentation to show review and evaluation of the unacceptable results. 3. Interview with the technical consultant on January 17, 2018 at 11;15 AM confirmed, the laboratory failed to review and evaluate the unacceptable PT results obtained for second chemistry event of 2016. D5403 PROCEDURE MANUAL CFR(s): 493.1251(b) The procedure manual must include the following when applicable to the test procedure: (1) Requirements for patient preparation; specimen collection, labeling, storage, preservation, transportation, processing, and referral; and criteria for specimen acceptability and rejection as described in 493.1242. (2) Microscopic examination, including the detection of inadequately prepared slides. (3) Step-by-step performance of the procedure, including test calculations and interpretation of results. (4) Preparation of slides, solutions, calibrators, controls, reagents, stains, and other materials used in testing. (5) Calibration and calibration verification procedures. (6) The reportable range for test results for the test system as established or verified in 493.1253. (7) Control procedures. (8)

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