Pinnacle Dermatology, Sc

CLIA Laboratory Citation Details

3
Total Citations
4
Total Deficiencyies
3
Unique D-Tags
CMS Certification Number 03D0963550
Address 13640 N 99th Ave Ste 300, Sun City, AZ, 85351
City Sun City
State AZ
Zip Code85351
Phone(623) 875-2600

Citation History (3 surveys)

Survey - January 20, 2026

Survey Type: Standard

Survey Event ID: M83J11

Deficiency Tags: D5203

Summary:

Summary Statement of Deficiencies D5203 SPECIMEN IDENTIFICATION AND INTEGRITY CFR(s): 493.1232 The laboratory must establish and follow written policies and procedures that ensure positive identification and optimum integrity of a patient's specimen from the time of collection or receipt of the specimen through completion of testing and reporting of results. This STANDARD is not met as evidenced by: Based on review of Mohs test records and interview with the facility personnel on 1/20 /26 at 12:50 PM, the laboratory failed to ensure positive identification for 1 out of 2 patient's Mohs specimens from the time of collection through reporting of test results in the Electronic Medical Record (EMR). Findings include: 1. The laboratory performs the microscopic interpretation of Mohs specimens under the subspecialty of Histopathology, with an approximate annual test volume of 1,800. It is the practice of the laboratory to assign a unique accession number to each Mohs specimen. The unique accession number is documented on the laboratory's Mohs log, Mohs map, patient's slides and final test report maintained in the patient's EMR. 2. One out of two Mohs test reports reviewed in the EMR from testing performed on 2/12/25 failed to include the correct specimen ID number. The Mohs log, slides, and Mohs map indicated the accession number as 25-124, and the accession number indicated in the EMR was 25-125. 4. The facility personnel interviewed on 1/20/26 at 12:50 PM confirmed that the correct accession number for the Mohs case referenced above was 25-124, and acknowledged that test report maintained in the EMR contained the incorrect accession number of 25-125. 5. The laboratory performed testing on 8 patients on 2/12/25. 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 - November 13, 2024

Survey Type: Standard

Survey Event ID: MR7511

Deficiency Tags: D5203

Summary:

Summary Statement of Deficiencies D5203 SPECIMEN IDENTIFICATION AND INTEGRITY CFR(s): 493.1232 The laboratory must establish and follow written policies and procedures that ensure positive identification and optimum integrity of a patient's specimen from the time of collection or receipt of the specimen through completion of testing and reporting of results. This STANDARD is not met as evidenced by: Based on review of patient slides for 1 out of 4 dermatopathology cases reviewed during the survey and interview with the facility personnel, the laboratory failed to ensure positive identification on one out of three patient's slides from the time of collection of the specimen through completion of testing and reporting of test results. Findings include: 1. The laboratory performs Mohs and Frozen biopsy testing under the subspecialty of Histopathology, with an annual reported test volume of 420. 2. Review of the Mohs slides for case# 23-151 from 2/22/2023 indicated one out of three slides was labeled with the incorrect accession number (23-152). 3. The laboratory failed to ensure positive identification of a patient's specimen from the time of collection through the completion of testing and reporting of results for the case indicated above. 4. The facility personnel interviewed on 11/13/24 at 2:10 PM acknowledged that the laboratory labeled one out of three patient slides with the incorrect accession number on case# 23-151. 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 - September 1, 2022

Survey Type: Standard

Survey Event ID: U13W11

Deficiency Tags: D5891 D5311

Summary:

Summary Statement of Deficiencies D5311 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL CFR(s): 493.1242(a) The laboratory must establish and follow written policies and procedures for each of the following, if applicable: (1) Patient preparation. (2) Specimen collection. (3) Specimen labeling, including patient name or unique patient identifier and, when appropriate, specimen source. (4) Specimen storage and preservation. (5) Conditions for specimen transportation. (6) Specimen processing. (7) Specimen acceptability and rejection. (8) Specimen referral. This STANDARD is not met as evidenced by: Based on lack of written policies and procedures for review and interview with the facility personnel, the laboratory failed to establish policies and procedures for specimen/slide labeling. Findings include: 1. The laboratory performs patient testing in the sub-specialty of Histopathology, with an approximate annual test volume of 918. The laboratory reads and interprets slides in conjunction with Mohs testing and frozen biopsy testing. 2. No documentation was presented for review during the survey to indicate the laboratory had established policies in place for slide labeling with regard to Mohs testing. 3. No documentation was presented for review during the survey to indicate the laboratory had established policies in place for slide labeling with regard to Frozen Biopsy testing. 4. The facility personnel confirmed that the laboratory did not have the above referenced policies and procedures in place at the time of the survey conducted on September 1, 2022. D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1299(a) The laboratory must establish and follow written policies and procedures for an ongoing mechanism to monitor, assess and, when indicated, correct problems identified in the postanalytic systems specified in 493.1291. 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 -- This STANDARD is not met as evidenced by: Based on review of patient test reports and interview with the facility personnel, the laboratory failed to establish policies and procedures for signing off on pathology test reports in a timely manner. Findings include: 1. The laboratory performs Mohs testing on patient specimens under the sub-specialty of histopathology, with an approximate annual test volume of 918. The laboratory utilizes an electronic medical record (EMR) system to maintain patient records, including Mohs test reports which are electronically signed by the physician who made the diagnosis. 2. Review of Mohs test report for case# 22-041 indicated the date of service as 1-17-2022, and the test report was electronically signed by the physician who made the diagnosis on 2-13- 2022. 3. No documentation was presented for review during the survey to indicate the laboratory established a policy to indicate the acceptable amount of time the physician has to electronically sign the final Mohs test report. 4. On 9-01-2022 at approximately 11:00am, the facility personnel interviewed confirmed that the Mohs test report indicated above was not signed in a timely manner by the physician who made the diagnosis, and confirmed that the laboratory failed to establish a policy to indicate the acceptable timeframe for electronically signing off on Mohs test reports. -- 2 of 2 --

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