Sabetha Community Hospital

CLIA Laboratory Citation Details

3
Total Citations
6
Total Deficiencyies
6
Unique D-Tags
CMS Certification Number 17D0449989
Address 603 South 14th Street, Sabetha, KS, 66534
City Sabetha
State KS
Zip Code66534
Phone(785) 284-2121

Citation History (3 surveys)

Survey - October 22, 2024

Survey Type: Standard

Survey Event ID: M3Y011

Deficiency Tags: D5447 D5449 D5537

Summary:

Summary Statement of Deficiencies D5447 CONTROL PROCEDURES CFR(s): 493.1256(d)(3)(i)(g) Unless CMS Approves a procedure, specified in Appendix C of the State Operations Manual (CMS Pub. 7), that provides equivalent quality testing, the laboratory must-- At least once a day patient specimens are assayed or examined perform the following for-- Each quantitative procedure, include two control materials of different concentrations; (g) The laboratory must document all control procedures performed. This STANDARD is not met as evidenced by: Based on review of quality control (QC) documentation and lack of QC data for an unsubstantiated Individualized Quality Control Plans (IQCP)s for Quidel Triage D- Dimer testing, and interview, the laboratory failed to have acceptable QC data for IQCP documentation to allow QC to be performed at the manufacturer's number and frequency and failed to perform a negative and positive control on each day of patient testing from 4/18/2022 to time of survey. Findings: 1. Review of the facility's IQCP documents of the Quidel Triage D-Dimer testing revealed the laboratory only performed QC new lot, new shipment or every thrity (30) days. No substantiated QC data of new lot, new shipment or every thirty (30) could be presented per the IQCP. Two (2) levels of QC were not performed every day of patient testing. 5. Interview with general supervisor #2 (GS#2) on 10/22/2024 at 10:50 a.m. confirmed the laboratory failed to have acceptable IQCP documentation to allow QC to be performed at the manufacturer's number and frequency from 4/18/2022 to time of survey, therefore requiring performing QC at least once each day of patient testing for quantitative procedures, which includes two control materials. D5449 CONTROL PROCEDURES CFR(s): 493.1256(d)(3)(ii)(g) Unless CMS Approves a procedure, specified in Appendix C of the State Operations 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 -- Manual (CMS Pub. 7), that provides equivalent quality testing, the laboratory must-- At least once a day patient specimens are assayed or examined perform the following for-- Each qualitative procedure, include a negative and positive control material; (g) The laboratory must document all control procedures performed. This STANDARD is not met as evidenced by: Based on review of quality control (QC) documentation and lack of QC data for an unsubstantiated Individualized Quality Control Plans (IQCP)s, the Quidel QuickView One-Step hCG-Combo, Cepheid GeneXpert COV-2/Flu/RSV Plus, Cepheid GeneXpert Chlamydia trachomatis/Neisseria gonorrhoeae (CT/NG) and Cepheid GeneXpert Express Streptococcus pyrogenes (Strep A), and interview, the laboratory failed to have acceptable substantiated QC data for IQCP documentation to allow QC to be performed at the manufacturer's number and frequency and failed to perform a negative and positive control on each day of patient testing at time of survey. Findings: 1. Review of the facility's IQCP documents of the Quidel QuickView One- Step hCG-Combo (serum only) testing revealed the laboratory performed QC new lot or new shipment. No substantiated QC data of new lot or new shipment was presented per the IQCP. Two levels of QC were not performed every day of patient testing. 2. Review of the facility's IQCP documents of the Cepheid GeneXpert for COV-2/Flu /RSV Plus testing revealed the laboratory performed QC every sixty (60) days, new lot or new shipment. Six (6) days of COV-2/Flu/RSV Plus QC was performed, no other QC data was presented for the IQCP. Sixty (60) days, new lot or new shipment could not be substantiated per the QC data for the IQCP. Two levels of QC were not performed every day of patient testing from 4/18/2022 to time of survey. 3. Review of the facility's IQCP documents of the Cepheid GeneXpert for Cepheid GeneXpert CT /NG testing revealed the laboratory performed QC every sixty (60) days, new lot or new shipment. Twelve (12) days of Cepheid GeneXpert CT/NG QC was performed, no other QC data was presented for the IQCP. Sixty (60) days, new lot or new shipment could not be substantiated per the QC data for the IQCP. Two levels of QC were not performed every day of patient testing from 8/19/2024 to time of survey. 4. Review of the facility's IQCP documents of the Cepheid GeneXpert for Express Streptococcus pyrogenes (Strep A) testing revealed the laboratory performed QC every sixty (60) days, new lot or new shipment. Eleven (11) days of Express Streptococcus pyrogenes (Strep A) QC was performed, no other QC data was presented for the IQCP. Sixty (60) days, new lot or new shipment could not be substantiated per the QC data for the IQCP. Two levels of QC were not performed every day of patient testing from 2/19/2024 to time of survey. 8. Interview with general supervisor # 2 (GS#2) on 10/22/2024 at 10:52 a.m. confirmed the laboratory failed to have acceptable substantiated QC data for IQCP documentation to allow QC to be performed at the manufacturer's number and frequency, therefore failed to perform a negative and positive control on each day of patient testing at time of survey. D5537 ROUTINE CHEMISTRY CFR(s): 493.1267(b)(d) For blood gas analyses, the laboratory must perform the following: (b) Test one sample of control material each 8 hours of testing using a combination of control materials that include both low and high values on each day of testing. (d) Document all control procedures performed, as specified in this section. -- 2 of 3 -- This STANDARD is not met as evidenced by: Based on review of the laboratory's Abbott i-STAT procedure, quality control (QC) requirements, QC records, the facility's unsubstantiated Individual Quality Control Plan (IQCP) and interview with general supervisor #2 (GS#2), the laboratory failed to perform required QC every eight hours using the Abbott CG4+ cartridge for Lactate, pO2, pCO2 and pH testing on the i-STAT system. Findings: 1. Review of the laboratory's i-STAT IQCP states under QC: "A positive and negative external control shall be run by new personnel during training and any time the technologist doubts a test result." 2. Review of the IQCP records for i-STAT CG4+ Lactate, pO2, pCO2 and pH showed no supportive data of QC performed from 12/28/2015 to time of survey. No QC was performed every eight hours prior to or after 12/28/2015. 3. Interview with GS#2 on 10/22/2024 at 10:52 a.m. confirmed the laboratory failed to have acceptable IQCP documentation to allow QC to be performed at the manufacturer's number and frequency from 12/28/2015 to time of survey, therefore requiring performing QC of two control materials performed every eight hours for pO2, pCO2 and pH testing on the i-STAT system. -- 3 of 3 --

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Survey - April 27, 2022

Survey Type: Standard

Survey Event ID: 3HYD11

Deficiency Tags: D2009 D6117

Summary:

Summary Statement of Deficiencies D2009 TESTING OF PROFICIENCY TESTING SAMPLES CFR(s): 493.801(b)(1) The individual testing or examining the samples and the laboratory director must attest to the routine integration of the samples into the patient workload using the laboratory's routine methods. This STANDARD is not met as evidenced by: Based on a review of proficiency testing (PT) from the provider American Proficiency Institute (API) performed in 2021 and interview with Technical Consultant #1 (TC#1) revealed that the Laboratory Director (LD) or approved designee failed to attest on two events that proficiency testing samples were handled in the same manner as patient samples at time of survey. Findings: 1. Review of the attestation pages for PT from API revealed no signature of the LD or approved designee was present on API 2021 events: a. Immunology/Immunohematology 1st Event, the designee signature on attestation was not qualified per CFR 493.1449(q)(2)(i) b. Immunology /Immunohematology 3rd Event 2. Interview with the TC#1 on 4/27/2022 at 11:40 a. m. confirmed, the LD or approved designee failed to attest on two events that proficiency testing samples were handled in the same manner as patient samples at time of survey. D6117 TECHNICAL SUPERVISOR RESPONSIBILITIES CFR(s): 493.1451(b)(4) The technical supervisor is responsible for establishing a quality control program appropriate for the testing performed and establishing the parameters for acceptable levels of analytic performance and ensuring that these levels are maintained throughout the entire testing process from the initial receipt of the specimen, through sample analysis and reporting of test results. 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 the review of immunohematology records from 1/3/22 to date of survey for the thermographic temperature chart recordings for blood unit storage and interview with Technical Consultant #1 (TC#1), the technical supervisor (TS) for immunohematology failed to evaluate the QC program, ensure analytical performance, and ensure storage of blood units were maintained at acceptable levels. Findings: 1. No documentation of review by the TS of immunohematology for QC and thermographic temperature chart recordings for blood unit storage, and emergency release requests were available for 1/3/22 to date of survey. 2. Review of the thermographic chart recordings was not performed by a TS qualified by CFR 493.1449(q)(2)(i). 3. Interview with TC#1 on 4/27/22 at 14:45 a.m. confirmed, the TS for immunohematology failed to evaluate the QC program, ensure analytical performance, and ensure storage of blood units were maintained at acceptable levels. -- 2 of 2 --

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Survey - December 28, 2018

Survey Type: Standard

Survey Event ID: T90M11

Deficiency Tags: D5403

Summary:

Summary Statement of Deficiencies 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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