Reagan Medical Center Of Hamilton Mill

CLIA Laboratory Citation Details

4
Total Citations
16
Total Deficiencyies
12
Unique D-Tags
CMS Certification Number 11D1058704
Address 3685 Braselton Highway Suite 100, Dacula, GA, 30019
City Dacula
State GA
Zip Code30019
Phone(678) 940-5843

Citation History (4 surveys)

Survey - July 27, 2023

Survey Type: Standard

Survey Event ID: FGNU11

Deficiency Tags: D0000 D5203 D5211 D6018

Summary:

Summary Statement of Deficiencies D0000 A Clinical Laboratory Improvement Amendments (CLIA) recertification survey was completed on July 27, 2023. The laboratory was not in compliance with applicable CLIA requirements found at 42 CFR 493.1 through 42 CFR 493.1780. The following deficiencies were cited: 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 the laboratory tour and staff interview, the laboratory failed to ensure two identifiers were present on 3 out of 3 urine specimen's, during the time of the survey. The Findings include: 1. During the laboratory tour and observation, it was revealed that there were 3 out of 3 urine specimens with one identifer on the specimen urine cups. 2. During an interview with Testing Personnel #1(CMS-209) on July 27, 2023 at 12:35 PM, in the laboratory, confirmed there were 3 out of 3 specimens with one identifier on the specimen cups. 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: 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 -- Based on review of the American Proficiency Institute(API) proficiency test (PT) records and interview with the staff, the laboratory testing personnel and lab director failed to attest to performing the proficiency testing for hematology. The Findings include: 1. API(PT) document review revealed that the Testing Personnel and the Laboratory Director failed to sign the attestation statement document for hematology 2022 (2nd Event). 2. During an inteview with Testing Personnel #1 (CMS-209), on July 27, 2023, at approximately 11:25 AM, in the breakroom, confirmed that the laboratory failed to sign the attestation statement document for hematology 2022 (2nd Event). 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 - August 3, 2022

Survey Type: Special

Survey Event ID: VICZ11

Deficiency Tags: D0000 D2016 D2130 D6000 D6016

Summary:

Summary Statement of Deficiencies D0000 A proficiency testing desk review was completed on August 03, 2022. At the time of the review, the laboratory was not in compliance with the Clinical Laboratory Improvement Amendments of 1988, 42 CFR 493.1 through 42 CFR 493.1780. The following deficiencies were cited: 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 proficiency testing desk review using the Centers for Medicare and Medicaid (CMS) Casper Reports 155 and 153 and review of the laboratory's proficiency testing (PT) reports, the laboratory failed to maintain satisfactory performance in two of three consecutive events (2nd event of 2021 and 1st event of 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 -- 2022), resulting in the first unsuccessful occurrence for Hematology # 760 including: red blood cell count (RBC) #775. Findings include: Refer to D 2130 D2130 HEMATOLOGY CFR(s): 493.851(f) Failure to achieve satisfactory performance for the same analyte in two consecutive events or two out of three consecutive testing events is unsuccessful performance. This STANDARD is not met as evidenced by: Based on proficiency testing desk review using the Centers for Medicare and Medicaid (CMS) Casper Reports 155 and 153 and review of the laboratory's proficiency testing (PT) reports from the American Proficiency Institute (API), the laboratory failed to maintain satisfactory performance in two of three consecutive events (2nd event of 2021 and 1st event of 2022), resulting in the first unsuccessful occurrence for red blood cells (RBC), analyte # 775. Findings include: 1. Desk review of Casper Reports 153 and 155 disclosed the laboratory failed analyte #775 RBC on event 2 of 2021 with a score of 20% and event 1 of 2022 with a score of 0%. 2. Desk review of the laboratory's proficiency testing reports from API confirms the laboratory failed RBC on events 2 of 2021 and 1 of 2022 resulting in the first unsuccessful performance. 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 proficiency testing desk review using the Centers for Medicare and Medicaid (CMS) Casper Reports 155 and 153 and review of the laboratory's proficiency testing (PT) reports, the laboratory director failed to ensure the laboratory maintained satisfactory performance in two of three consecutive events (2nd event of 2021 and 1st event of 2022), resulting in the first unsuccessful occurrence for Red Blood Cell (RBC), analyte # 775. Findings include: Refer to D 6016 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 proficiency testing desk review using the Centers for Medicare and Medicaid (CMS) Casper Reports 155 and 153 and review of the laboratory's -- 2 of 3 -- proficiency testing (PT) reports, the laboratory director failed to ensure the laboratory maintained satisfactory performance in two of three consecutive events (2nd event of 2021 and 1st event of 2022), resulting in the first unsuccessful occurrence for red blood cell (RBC), analyte # 775. Findings include: 1. Desk review of Casper Reports 153 and 155 disclosed the laboratory failed analyte # 775 , RBC on event 2 of 2021 with a score of 20% and event 1 of 2022 with a score of 0%. 2. Desk review of the laboratory's proficiency testing reports from American Proficiency Institute (API) confirmed the laboratory failed RBC on Events 2 of 2021 and 1 of 2022, resulting in the first unsuccessful performance. -- 3 of 3 --

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Survey - November 22, 2021

Survey Type: Standard

Survey Event ID: KOIV11

Deficiency Tags: D0000 D2000 D5401 D6017

Summary:

Summary Statement of Deficiencies D0000 A Clinical Laboratory Improvement Amendments (CLIA) recertification survey was completed on November 22, 2021. The laboratory was not in compliance with applicable CLIA requirements found at 42 CFR 493.1 through 42 CFR 493.1780. The following deficiencies were cited: D2000 ENROLLMENT AND TESTING OF SAMPLES CFR(s): 493.801 Each laboratory must enroll in a proficiency testing (PT) program that meets the criteria in subpart I of this part and is approved by HHS. The laboratory must enroll in an approved program or programs for each of the specialties and subspecialties for which it seeks certification. The laboratory must test the samples in the same manner as patients' specimens. For laboratories subject to 42 CFR part 493 published on March 14, 1990 (55 FR 9538) prior to September 1, 1992, the rules of this subpart are effective on September 1, 1992. For all other laboratories, the rules of this subpart are effective January 1, 1994. This CONDITION is not met as evidenced by: Based on the review of Proficiency Testing (PT) documents and an interview with the office manager, the laboratory failed to enroll in a CMS approved PT program for Cardiac Enzyme testing in the specialty of Chemistry. Findings include; 1.) PT documents review revealed no enrollment or participation in 2020 American Proficiency Institute (API) Events #1 and #2, while doing patient testing. 2.) An interview with the office manager on 11/22/2021 in the break room at approximately 12:30 PM confirmed no Proficiency Testing for cardiac enzyme testing in the 1st and 2nd quarter of 2020. D5401 PROCEDURE MANUAL CFR(s): 493.1251(a) 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 -- A written procedures manual for all tests, assays, and examinations performed by the laboratory must be available to, and followed by, laboratory personnel. Textbooks may supplement but not replace the laboratory's written procedures for testing or examining specimens. This STANDARD is not met as evidenced by: Based on review of the laboratory procedure manual (SOP) and staff interview, the laboratory director (LD) failed to approve a Standard Operating Procedure (SOP) specific to Alere-Triage Meterpro Chemistry analyzer. Findings include: 1.) Review of current SOP revealed no signature and date from the laboratory director as to when it was approved and put into effect. 2.) No normal ranges and panic values were found in the (SOP) at the time of survey. 3.) Interview with the laboratory manager at approximately 12:00 PM on 11/22/2021 in the break room confirmed the above findings. D6017 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(4)(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)(4)(ii) Ensure that results are returned within the timeframes established by the proficiency testing program. This STANDARD is not met as evidenced by: Based on the review of Proficiency Testing (PT) documents and an interview with the office manager, the laboratory failed to participate in the 2020 1st quarter of the American Proficiency Institute(API) Proficiency Testing(PT) in Hematology. Findings include; 1.) PT documents review revealed the laboratory did not submit API results in time during 2020 American Proficiency Institute (API) Events #1 resulting in "failure to participate" in CBC Hematology testing. 2.) An interview with the office manager on 11/22/2021 in the break room at approximately 12:45 PM confirmed failure to participate in Event #1 of 2020. -- 2 of 2 --

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Survey - April 29, 2019

Survey Type: Standard

Survey Event ID: PPKC11

Deficiency Tags: D0000 D6017 D6054

Summary:

Summary Statement of Deficiencies D0000 A Clinical Laboratory Improvement Amendments (CLIA) recertification survey was completed on April 29, 2019. The laboratory was not in compliance with applicable CLIA requirements found at 42 CFR 493.1 through 42 CFR 493.1780. The following deficiencies were cited: D6017 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(4)(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)(4)(ii) Ensure that results are returned within the timeframes established by the proficiency testing program. This STANDARD is not met as evidenced by: Based on review of the 2019 API (American Proficiency Institute) Proficiency Testing (PT) documents and an interview with the laboratory manager, the laboratory director failed to ensure Proficiency Testing results were submitted within the timeframes established by the PT program. Findings include: 1.) A review of the 2019 API (PT) records revealed Event #1 of the Hematology survey received a score of 0% "Failure to Participate" because results were not submitted to API on a timely basis. 2.) An interview with the laboratory manager, at approximately 12:15 pm on April 29, 2019 in the review room confirmed the laboratory failed to submit PT results(1st Event 2019) before the cut off date. D6054 TECHNICAL CONSULTANT RESPONSIBILITIES CFR(s): 493.1413(b)(9) The technical consultant is responsible for evaluating and documenting the 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 -- performance of individuals responsible for moderate complexity testing at least annually, after the first year. This STANDARD is not met as evidenced by: Based on testing personnel (TP) competency reviews and interview with the laboratory manager, the technical consultant (TC) who is also the laboratory director failed to perform TP annual competencies as required in 2018. Findings include: 1. TP competency document review revealed the TC did not perform 2018 annual competencies for the following Staff #s 1, 2, 3, 4, 5 and 6 on (CMS 209). 2. An interview with the laboratory manager on April 29, 2019 in the review room at approximately 12:30 p.m. confirmed the 2019 annual competencies for the aforementioned Testing Personnel were not performed by the TC in 2018. -- 2 of 2 --

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