Sierra Hematology And Oncology

CLIA Laboratory Citation Details

3
Total Citations
11
Total Deficiencyies
9
Unique D-Tags
CMS Certification Number 05D0600646
Address 1580 Creekside Dr Ste 230, Folsom, CA, 95630-3888
City Folsom
State CA
Zip Code95630-3888
Phone916 984-6230
Lab DirectorRAM MD

Citation History (3 surveys)

Survey - March 12, 2025

Survey Type: Standard

Survey Event ID: N15Q11

Deficiency Tags: D5209 D6007 D2121 D5435 D6018 D6032

Summary:

Summary Statement of Deficiencies D2121 HEMATOLOGY CFR(s): 493.851(a) (a) Failure to attain a score of at least 80 percent of acceptable responses for each analyte in each testing event is unsatisfactory analyte performance for the testing event. This STANDARD is not met as evidenced by: Based on the surveyor's review of the American Proficiency Institute (API) proficiency testing (PT) records, interviews with the laboratory supervisor (LS) and testing personnel (TP), it was determined that the laboratory failed to attain at least 80 percent of the acceptable response resulting to an unsatisfactory performance for the Hematology second event in 2022 (Q2-2022) for the White Blood Cell (WBC) differential test. The findings include: 1. Based on the surveyor's review of the laboratory's PT records, API reported a 67% score for the WBC automated differential test for Q2-2022. Further review of the quality assessment documentation showed that this score was negatively impacted by the 0% score for Monocytes. 2. The LS and TP affirmed on March 12, 2025 at approximately 9:50 a.m. that the laboratory obtained the PT scores mentioned in statement #1. 3. According to the laboratory testing declaration submitted on the day of the survey, the laboratory performed approximately 16,412 samples annually for Hematology that included the WBC automated differential test in the Cell Blood Count panel. Thus, the reliability and quality of Hematology patient results reported could not be assured at the time when the laboratory failed to attain an unacceptable score of at least 80 percent. 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, Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 4 -- consultant competency. This STANDARD is not met as evidenced by: Based on the review of the laboratory's quality assessment policies and procedures, personnel competency documentation, seven (7) patient records, and an interview with the laboratory supervisor (LS) on March 12, 2025, at approximately 9:20 a. m., as specified in the personnel requirements in subpart M, it was determined that the laboratory failed to perform competency assessment for several laboratory personnel for the years 2022, 2023, and 2024. Findings include: 1. Based on the review of the laboratory's quality assessment policies and procedures, competency evaluation records, and 7 patient records, the laboratory is herein cited for the deficient practice for failure to perform competency assessment for several testing personnel (TP) for the years 2022, 2023, and 2024. a. KC was missing competency for 2021. b. OR was missing competencies for 2022, 2023, and 2024. c. HW was missing competency for 2024. 2. The LS affirmed by interview on March 12, 2025, at approximately 9:20 a. m. that the laboratory had no records of any competency assessment specified in statement #1 for the years 2022, 2023, and 2024 for the Folsom, CA location. 3. According to the laboratory's annual testing declaration submitted at the time of the survey, the laboratory reported and performed approximately 16,412 tests for Hematology for which competency assessments of several testing personnel were not performed. D5435 MAINTENANCE AND FUNCTION CHECKS CFR(s): 493.1254(b)(2) (b)(2)(i) Define a function check protocol that ensures equipment, instrument, and test system performance that is necessary for accurate and reliable test results and test result reporting. (b)(2)(ii) Perform and document the function checks, including background or baseline checks, specified in paragraph (b)(2)(i) of this section. Function checks must be within the laboratory's established limits before patient testing is conducted. This STANDARD is not met as evidenced by: Based on the surveyor's review of the laboratory's preventive maintenance (PM) documentation, observations during the tour, and an interview with the laboratory supervisor (LS), it was determined that the laboratory failed to ensure performed tests and function checks were documented properly prior to patient testing. The findings include: 1. Based on the review of the laboratory's PM documentation, no annual calibration records were found for the thermometer for the years 2022 and 2023. 2. The LS affirmed by interview at approximately 10:40 a.m. on March 12, 2025, that the laboratory missed to perform an annual calibration for the thermometer as mentioned in statement #1. 3. Based on the annual testing declaration form submitted at the time of the survey, the laboratory performed and reported approximately 16,412 patient tests for Hematology, including the time the missing annual PM for the thermometer occurred. D6007 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(1) (e) The laboratory director must-- (e)(1) Ensure that testing systems developed and used for each of the tests performed in the laboratory provide quality laboratory -- 2 of 4 -- services for all aspects of test performance, which includes the preanalytic, analytic, and postanalytic phases of testing; This STANDARD is not met as evidenced by: Based on the deficiencies cited, the Laboratory Director is herein cited for deficient practice in ensuring that systems for the preanalytic, analytic, and postanalytic phases of the laboratory were monitored and followed. Findings include: 1. The laboratory received unsatisfactory performance results for Hematology. See D2121. 2. Competency assessments were missed to be performed. See D5209. 3. Missing maintenance and function check documentation. See D5435. D6018 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(4)(iii) (e)(4)(iii) All proficiency testing reports received are reviewed by the appropriate staff to evaluate the laboratorys performance and to identify any problems that require

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Survey - June 23, 2021

Survey Type: Standard

Survey Event ID: 9I8Z11

Deficiency Tags: D2121

Summary:

Summary Statement of Deficiencies D2121 HEMATOLOGY CFR(s): 493.851(a) Failure to attain a score of at least 80 percent of acceptable responses for each analyte in each testing event is unsatisfactory analyte performance for the testing event. This STANDARD is not met as evidenced by: Based on review of the third quarter (Q3-2020) of the American Proficiency Institute (API) performance summary report, ten (10) randomly selected random patient sampling records from 12/03/2019 to 05/28/2021 and interview with the laboratory personnel on 06/23/2021 at 9:30 a.m., it was determined that the laboratory failed to attain a score of at least 80 percent of acceptable responses for Red Cell Counts (RBC). The findings included: 1. Q3-2020, API reported the following unsatisfactory proficiency testing scores. Analyte: Score: Event/Year: Performance: RBC 0% Q3 /2020 Unacceptable Sample Reported Results Expected Results HEM-11 3.75 3.80- 4.30 HEM-12 4.72 4.74-5.36 HEM-13 2.00 2.03-2.30 HEM-14 4.67 4.69-5.30 HEM- 15 3.36 3.38-3.82 2. The laboratory resulted and reported patient Red Cell Counts (RBC) tests during the approximate time the laboratory received the API (Q3-2020) unsatisfactory scores. 3. The testing personnel affirmed on 06/23/2021,11:00 a.m. (survey date) that the laboratory received the above unsatisfactory scores. 4. Based on the laboratory's annual testing declaration 06/21/2021 approximately 2,808 RBC patient tests were resulted and reported 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 - December 4, 2018

Survey Type: Standard

Survey Event ID: 5I5V11

Deficiency Tags: D2007 D6016 D2121 D6046

Summary:

Summary Statement of Deficiencies D2007 TESTING OF PROFICIENCY TESTING SAMPLES CFR(s): 493.801(b)(1) The samples must be examined or tested with the laboratory's regular patient workload by personnel who routinely perform the testing in the laboratory, using the laboratory's routine methods This STANDARD is not met as evidenced by: Based on review of laboratory personnel reports (CMS209, LAB116), patients test records, and laboratory hematology proficiency testing documents; and interview with laboratory personnel, the laboratory failed to include proficiency test samples with the regular patient workload to be tested by individuals routinely performing laboratory testing. Findings include: a. The Attestation documents stated the same person performed proficiency testing for 4 out of 4 consecutive events beginning in 2017; and that subsequent 2 out of 2 events in 2018 were performed by another. b. The laboratory personnel reports named two other individuals as testing persons. c. Laboratory personnel affirmed (12/04/18) that the proficiency testing samples had not been integrated into the regular workload to be tested by the individuals routinely testing patients specimen. d. The reliability and quality of results reported could not be assured when the individuals had not tested proficiency samples. Based on the stated annual tests volume (LAB144A Laboratory Testing Declaration, 12/04/18), laboratory testing personnel reported approximately 32,832 hematology results annually in 2017 - 2018. D2121 HEMATOLOGY CFR(s): 493.851(a) Failure to attain a score of at least 80 percent of acceptable responses for each analyte in each testing event is unsatisfactory analyte performance for the testing event. 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 -- This STANDARD is not met as evidenced by: Based on observation of the Celldyn Emerald hematology analyzer, review of proficiency testing reports from CMS (report 155, Individual Laboratory Profile) and MLE (Medical Laboratory Evaluation), laboratory proficiency records, and patients test records; and interview with laboratory personnel, the laboratory failed to attain the score of at least 80% in the 1st event of 2017, for unsatisfactory analyte performance. Findings include: a. CMS and MLE reported the unsatisfactory score of 60% for WBC Differential based on unacceptable elevated results for 2 out of 5 samples. b. Laboratory personnel affirmed (12/04/18) the aforementioned results and score; and thus, unsatisfactory test performances for Differentials. c. The reliability and quality of Differentials reported could not be assured when proficiency testing was unsatisfactory. Based on the stated annual tests volume (LAB144A Laboratory Testing Declaration, 12/04/18), the laboratory reported approximately 456 Differtials each month for the timeframe January to May 2017. 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 the deficiency cited (D2007), the Laboratory Director is herein cited for deficient practice in providing overall administration of the laboratory to ensure that proficiency testing samples are tested by persons testing patients specimen. D6046 TECHNICAL CONSULTANT RESPONSIBILITIES CFR(s): 493.1413(b)(8) (b) The technical consultant is responsible for-- (b)(8) Evaluating the competency of all testing personnel and assuring that the staff maintain their competency to perform test procedures and report test results promptly, accurately and proficiently. This STANDARD is not met as evidenced by: Based on the lack of laboratory documents and interview with a laboratory person, the Technical Consultant (Laboratory Director) failed to evaluate the competency of all testing personnel in 2017 and assure they maintain their competency to perform test procedures and report test results promptly, accurately and proficiently using the Celldyn Emerald. Findings include: a. The laboratory failed to provide for review competency assessments for personnel testing patients specimen in 2017. b. A laboratory person affirmed (12/04/18) the lack of aforementioned documents for 2017; and thus, the failure of the Technical Consultant (Laboratory Director) to assess competency by direct observation of routine testing performance including Celldyn Emerald instrument maintenance and function checks, monitoring the recording and reporting of test results, review of test results, quality control records, preventive maintenance records, and proficiency testing records; assessment of test performance -- 2 of 3 -- through proficiency testing, and assessment of problem solving skills. c. Based on the stated annual tests volume, testing personnel reported approximately 32,832 hematology results in 2017. -- 3 of 3 --

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