Savannah Primary Care Associates, Llc

CLIA Laboratory Citation Details

3
Total Citations
9
Total Deficiencyies
7
Unique D-Tags
CMS Certification Number 11D0264744
Address 4451 Paulsen Street, Savannah, GA, 31405
City Savannah
State GA
Zip Code31405
Phone(912) 350-7500

Citation History (3 surveys)

Survey - November 3, 2020

Survey Type: Standard

Survey Event ID: P7QV11

Deficiency Tags: D5429 D0000

Summary:

Summary Statement of Deficiencies D0000 A Clinical Laboratory Improvement Amendments (CLIA) recertification survey was completed on November 3, 2020. 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: D5429 MAINTENANCE AND FUNCTION CHECKS CFR(s): 493.1254(a)(1) For unmodified manufacturer's equipment, instruments, or test systems, the laboratory must perform and document maintenance as defined by the manufacturer and with at least the frequency specified by the manufacturer. This STANDARD is not met as evidenced by: Based on equipment maintenance document review, observation, and staff interview, the laboratory failed to perform and document equipment maintenance as required. Findings include: 1. Equipment maintenance document review revealed the lack of daily maintenance logs for the Accuscope microscope for the following dates: 2018 -- October through December, 2019, and 2020 thus far. 2. Observation during the laboratory tour on 11/3/2020 at approximately 1:30 p.m. revealed the following: Hamilton Bell centrifuge last calibrated 6/2018; Fisher-Scientific vortex mixer was due for calibration 6/2019; Fisher-Scientific AccuSpin 24C centrifuge last calibrated 6 /2018. 3. An interview with the laboratory supervisor in the laboratory on 11/3/2020 at approximately 1:30 p.m. confirmed the lack of microscope daily maintenance logs for the aforementioned dates. During the same interview, the laboratory supervisor confirmed the lack of required calibration for the aforementioned centrifuges and vortex mixer. 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 26, 2018

Survey Type: Special

Survey Event ID: LL6B11

Deficiency Tags: D2016 D6076 D0000 D2130 D6089

Summary:

Summary Statement of Deficiencies D0000 A proficiency testing desk review was completed on November 26, 2018. 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 review of the laboratory's proficiency testing (PT) reports, the laboratory failed to maintain satisfactory performance in two of three consecutive events (2nd and 3rd events of 2018), resulting in the first 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 -- unsuccessful occurrence for hemoglobin (HGB), analyte # 795. Findings include: Refer to D 2123 & 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 Report 155 and review of the laboratory's proficiency testing (PT) reports, the laboratory failed to maintain satisfactory performance in two of three consecutive events (2nd and 3rd events of 2018), resulting in the first unsuccessful occurrence for hemoglobin (HGB), analyte # 795. Findings include: 1. Desk review of Casper Reports 155 disclosed the laboratory failed analyte #795 HGB on events 2 and 3 of 2018 with scores of 0%. 2. Desk review of the laboratory's proficiency testing reports from the College of American Pathologist (CAP) confirms the laboratory failed HGB on event 2 of 2018 with unsatisfactory scores on samples FH9 6, 7, 8, 9, and 10 and failed event 3 of 2018 with a score of 0% for lack of response. D6076 LABORATORY DIRECTOR CFR(s): 493.1441 The laboratory must have a director who meets the qualification requirements of 493. 1443 of this subpart and provides overall management and direction in accordance with 493.1445 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 Report 155 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 and 3rd events of 2018), resulting in the first unsuccessful occurrence for hemoglobin (HGB), analyte # 795. Refer to D 6089 D6089 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1445(e)(4)(i) The laboratory director must ensure 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 Report 155 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 and 3rd events of 2018), resulting in the first unsuccessful occurrence for hemoglobin (HGB), analyte # 795. Findings include: 1. Desk review of Casper Reports 155 disclosed the laboratory failed analyte #795 HGB on events 2 and 3 of 2018 with scores of 0%. 2. Desk review -- 2 of 3 -- of the laboratory's proficiency testing reports from the College of American Pathologist (CAP) confirms the laboratory failed HGB on event 2 of 2018 with unsatisfactory scores on samples FH9 6, 7, 8, 9,and 10 and failed event 3 of 2018 with a score of 0% for lack of response. -- 3 of 3 --

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Survey - September 24, 2018

Survey Type: Standard

Survey Event ID: YS8O11

Deficiency Tags: D0000 D5469

Summary:

Summary Statement of Deficiencies D0000 A Clinical Laboratory Improvement Amendments (CLIA) recertification survey was completed on September 24, 2018. The laboratory was not in compliance with applicable CLIA requirements found at 42 CFR 493.1 through 42 CFR 493.1780. The following deficiency was cited: D5469 CONTROL PROCEDURES CFR(s): 493.1256(d)(10)(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-- Establish or verify the criteria for acceptability of all control materials. (i) When control materials providing quantitative results are used, statistical parameters (for example, mean and standard deviation) for each batch and lot number of control materials must be defined and available. (ii) The laboratory may use the stated value of a commercially assayed control material provided the stated value is for the methodology and instrumentation employed by the laboratory and is verified by the laboratory. (iii) Statistical parameters for unassayed control materials must be established over time by the laboratory through concurrent testing of control materials having previously determined statistical parameters. (g) The laboratory must document all control procedures performed. This STANDARD is not met as evidenced by: Based on review of the laboratory's 2017 and 2018 quality control (QC) records for testing performed on the Beckman Access 2 endocrinology analyzer and the Beckman DxC 600 chemistry analyzer , review of the package inserts for controls used to determine analyzer performance and staff interview, the laboratory failed to establish criteria for acceptability of the controls. Findings include: 1. Review of Levey Jennings (LJ) charts revealed control values for most analytes fall within plus or minus 1 standard deviation (SD) of the mean. Review of LJ charts, statistics calculated from results obtained by the laboratory and results of control values 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 -- obtained during testing of controls on the Beckman Access 2 endocrinology analyzer revealed the standard deviation calculated on testing performed in their laboratory is much lower for most analytes than the standard deviation used to determine acceptability of controls. Review also revealed the laboratory has not adjusted their QC ranges to reflect the standard deviation obtained by their laboratory. This caused acceptable ranges of plus or minus 2 standard deviations from the mean to be too broad. 2. Review of Levey Jennings charts revealed control values for most analytes fall within plus or minus 1 standard deviation from the mean. Review of LJ charts, Beckman Coulter UniCel DxC Synchron control assay sheets and results of control values obtained during testing of controls on the Beckman DxC 600 chemistry analyze revealed the laboratory uses an assigned standard deviation and has not adjusted their QC ranges to reflect the standard deviation obtained by their laboratory. Review of control values obtained by the laboratory revealed the standard deviation calculated on testing in their laboratory is much lower than the values used to determine acceptability of patient results. This caused acceptable ranges of plus or minus 2 standard deviations from the mean to be too broad. . 3. Interview with the technical consultant and laboratory director (see CMS 209) on September 24, 2018 at 4:30 pm in the laboratory confirmed the laboratory does not use the standard deviation calculated from testing performed in their laboratory to set the 2 SD ranges on LJ charts , most control values fall within plus or minus 1 standard deviation (SD) of the mean and using the SD values showing on the LJ charts causes the acceptable ranges of controls to be too broad . -- 2 of 2 --

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