Rhea County Primary Care Center

CLIA Laboratory Citation Details

2
Total Citations
3
Total Deficiencyies
3
Unique D-Tags
CMS Certification Number 44D0904142
Address 8850 Rhea County Hwy, Dayton, TN, 37321
City Dayton
State TN
Zip Code37321
Phone(423) 775-1160

Citation History (2 surveys)

Survey - August 18, 2025

Survey Type: Standard

Survey Event ID: 7G2911

Deficiency Tags: D5209 D5417

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 a review of the Centers for Medicare and Medicaid Services Laboratory Personnel Report (Form CMS-209), laboratory policy, personnel records, and staff interview, the laboratory failed to follow the Quality Assurance policy for competency assessment of testing personnel who performed complete blood count (CBC) patient testing in 2023 and 2024. The findings include: 1. A review of Form CMS-209 provided by the laboratory on 08.18.2025 revealed two testing personnel (TP) who performed CBC patient testing. 2. A review of the laboratory policy titled "Quality Assurance - Employee Competency" revealed that "Evaluating and documenting the performance of individuals responsible for moderate complexity testing will be completed at least semiannually during the first year the individual tests patient specimens. Thereafter, evaluations will be completed at least annually." 3. A review of the laboratory's personnel records revealed no documentation of annual competency for TP1, as listed on the Form CMS-209, in 2024, and no semiannual competency assessment for TP2 in 2023. 4. An interview with the Chief Financial Officer on 08.18.2025 at 12:30 p.m. confirmed the above survey findings. D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(d) (d) Reagents, solutions, culture media, control materials, calibration materials, and other supplies must not be used when they have exceeded their expiration date, have deteriorated, or are of substandard quality. 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 laboratory observation and staff interview, the laboratory failed to ensure it did not use blood collection tubes for reference laboratory testing past their expiration date on the survey date, 08.18.2025. The findings include: 1. Laboratory observation on 08.18.2025 at 9:17 a.m. revealed the following: - 89 3.0 milliliter (mL) Becton Dickinson (BD) no additive blood collection tubes, lot number: 3222710, expiration date of 02.28.2025 -97 3.5mL BD Serum Separator Tube (SST) blood collection tubes, lot number: 3126854, expiration date of 04.30.2024 - 44 4mL Greiner Bio-One Lithium Heparin (LH) blood collection tubes, lot number: B24033NB, expiration date of 07.03.2025 - 11 4mL Greiner Bio-One LH blood collection tubes, lot number: B240333X, expiration date of 07.01.2025 - One 4mL Greiner Bio-One LH blood collection tube, lot number: B22063MB, expiration date of 10.08.2023 - One 4mL Greiner Bio-One LH blood collection tube, lot number: B230637N, expiration date of 10.04.2024 2. An interview with the Chief Financial Officer on 08.18.2025 at 9:25 a. m. confirmed the above survey findings. -- 2 of 2 --

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Survey - November 21, 2023

Survey Type: Standard

Survey Event ID: 5EQP11

Deficiency Tags: D5421

Summary:

Summary Statement of Deficiencies D5421 ESTABLISHMENT AND VERIFICATION OF PERFORMANCE CFR(s): 493.1253(b)(1) Each laboratory that introduces an unmodified, FDA-cleared or approved test system must do the following before reporting patient test results: (1)(i) Demonstrate that it can obtain performance specifications comparable to those established by the manufacturer for the following performance characteristics: (1)(i)(A) Accuracy. (1)(i) (B) Precision. (1)(i)(C) Reportable range of test results for the test system. (1)(ii) Verify that the manufacturer's reference intervals (normal values) are appropriate for the laboratory's patient population. This STANDARD is not met as evidenced by: Based on observation of the laboratory, review of final patient test reports, review of test system records, and staff interview, the laboratory failed to verify the reference ranges that were in use at the time of the survey (11.21.2023) for complete blood count (CBC) patient testing. The findings include: 1. Observation of the laboratory on 11.21.2023 at 9:15 a.m. revealed a Horiba ABX Micros 60 instrument (serial number 206CS91733) in use for CBC patient testing. 2. Review of four final patient test reports (two male patients and two female patients) revealed the following CBC analyte reference ranges in use for patient evaluation: Male -White Blood Cell count (WBC): 4-10.5 -Red Blood Cell count (RBC): 4.1-5.6 -Hemoglobin (HGB): 12.5-17 - Hematocrit (HCT): 36-50 -Platelet count (PLT): 140-415 -Mean corpuscular volume (MCV): 80-98 -Mean corpuscular hemoglobin (MCH): 27-34 -Mean corpuscular hemoglobin concentration (MCHC): 32-36 -Red cell distribution width (RDW): 11.7- 15 -Absolute granulocyte count (GRA#): 1.8-7.8 -Relative granulocyte count (GRA%): 40-74 -Absolute lymphocyte count (LYM#): 0.7 - 4.5 -Relative lymphocyte count (LYM%): 14-46 -Absolute monocyte count (MON#): 0.1-1 -Relative monocyte count (MON%): 4-13 Female -White Blood Cell count (WBC): 4-10.5 -Red Blood Cell count (RBC): 3.8-5.1 -Hemoglobin (HGB): 11.5-15 -Hematocrit (HCT): 34-44 - Platelet count (PLT): 140-425 -Mean corpuscular volume (MCV): 80-98 -Mean 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 -- corpuscular hemoglobin (MCH): 27-34 -Mean corpuscular hemoglobin concentration (MCHC): 32-36 -Red cell distribution width (RDW): 11.7-15 -Absolute granulocyte count (GRA#): 1.8-7.8 -Relative granulocyte count (GRA%): 40-74 -Absolute lymphocyte count (LYM#): 0.7-4.5 -Relative lymphocyte count (LYM%): 14-46 - Absolute monocyte count (MON#): 0.1-1 -Relative monocyte count (MON%): 4-13 3. Review of system records for CBC testing revealed no normal range validation of the reference intervals that were in use for evaluating the laboratory's patient test results. 4. Interview with the Quality Coordinator on 11.21.2023 at 12:15 p.m. confirmed there was no documentation of validation of the reference ranges that were in use for patient evaluation with an estimated annual testing volume of 2760 CBC test results. -- 2 of 2 --

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