Simple Laboratories

CLIA Laboratory Citation Details

2
Total Citations
6
Total Deficiencyies
5
Unique D-Tags
CMS Certification Number 14D0646644
Address 7444 W Wilson Ave, Harwood Heights, IL, 60706
City Harwood Heights
State IL
Zip Code60706
Phone(773) 775-6697

Citation History (2 surveys)

Survey - October 5, 2023

Survey Type: Special

Survey Event ID: WQNJ11

Deficiency Tags: D2016 D2028 D6076 D6087

Summary:

Summary Statement of Deficiencies 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 an off-site desk review of the Certification and Survey Provider Enhanced Reporting (CASPER) Report 0155D Individual Laboratory Profile, American Association of Bioanalysts (AAB) Proficiency Testing (PT) records, and email correspondence with the American Association of Bioanalysts (AAB) PT program representative confirmed the laboratory's initial unsuccessful PT performance for the subspecialty of bacteriology (See D2028) for two consecutive PT events in 2023 (events one and two). D2028 BACTERIOLOGY 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 -- CFR(s): 493.823(e) Failure to achieve an overall testing event score of satisfactory performance for two consecutive testing events or two out of three consecutive testing events is unsuccessful performance. This STANDARD is not met as evidenced by: Based on an off-site desk review of the Certification and Survey Provider Enhanced Reporting (CASPER) Report 0155D Individual Laboratory Profile, American Association of Bioanalysts (AAB) Proficiency Testing (PT) records, and email correspondence with the American Association of Bioanalysts (AAB) PT program representative the laboratory failed to achieve satisfactory performance for the subspecialty of bacteriology for two consecutive PT events in 2023 (events one and two) resulting in the initial unsuccessful PT performance for the subspecialty of bacteriology. Findings include: 1. Review of the CASPER Report 0155D, generated on 10-06-2023, and AAB PT records, the laboratory received the following unsatisfactory scores for the subspecialty of bacteriology. BACTERIOLOGY EVENT 1, 2023 75% Unsatisfactory EVENT 2, 2023 71% Unsatisfactory 2. An email with the AAB PT representative on 09-27-2023 at 3:58 PM, confirmed the initial unsuccessful performance for the subspecialty of bacteriology. 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 an off-site desk review of the Certification and Survey Provider Enhanced Reporting (CASPER) Report 0155D Individual Laboratory Profile, American Association of Bioanalysts (AAB) Proficiency Testing (PT) records, and email correspondence with an AAB PT program representative the laboratory director failed to ensure successful participation in an Health and Human Services (HHS) approved PT program for the subspecialty of bacteriology (see D6016) resulting in the laboratory's initial unsuccessful PT performance for the subspecialty of bacteriology for two consecutive PT events (event one and two) in 2023. D6087 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1445(e)(3)(iii) The laboratory director must ensure that laboratory personnel are performing the test methods as required for accurate and reliable results. This STANDARD is not met as evidenced by: Based on an off-site desk review of the Certification and Survey Provider Enhanced Reporting (CASPER) Report 0155D Individual Laboratory Profile, American Association of Bioanalysts (AAB) Proficiency Testing (PT) records, and email correspondence with an AAB PT program representative the laboratory director failed to ensure successful participation in an Health and Human Services (HHS) approved -- 2 of 3 -- PT program for the subspecialty of bacteriology (see D2028) resulting in the laboratory's initial unsuccessful PT performance for the subspecialty of bacteriology for two consecutive PT events (event one and two) in 2023. -- 3 of 3 --

πŸ”’ Unlock Deficiency Summary

Get full access to the detailed deficiency summary for this facility

One-time payment β€’ Lifetime access

Survey - December 6, 2021

Survey Type: Special

Survey Event ID: UVJY11

Deficiency Tags: D2016 D2107

Summary:

Summary Statement of Deficiencies 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 review of CASPER Report 0155D and interview with a College of American Pathologists (CAP) representative the laboratory failed to successfully participate in proficiency testing (PT) for the endocrinology analyte Triiodothyronine (T3) during events 1 and 3 of 2021. See D2107. D2107 ENDOCRINOLOGY CFR(s): 493.843(f) Failure to achieve satisfactory performance for the same analyte or test in two 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 -- consecutive testing events or two out of three consecutive testing events is unsuccessful performance. This STANDARD is not met as evidenced by: Based on review of CASPER Report 0155D (Individual Laboratory Profile) and interview with a College of American Pathologists (CAP) representative the laboratory failed to successfully participate in proficiency testing (PT) for the endocrinology analyte Triiodothyronine (T3) in PT events 1 and 3 of 2021. Findings include: 1. Review of the CASPER 0155D report revealed that the initial unsuccessful PT performance occurred during CAP PT event 1 and 3 of 2021, as listed below. ENDOCRINOLOGY EVENT -1, 2021 T3 - 0% Unsatisfactory EVENT -3, 2021 T3 - 0% Unsatisfactory 2. Interview via phone with the CAP representative on 12-6-21 at 10:56 am confirmed the initial unsuccessful PT performance for T3 in events 1 and 3 of 2021. -- 2 of 2 --

πŸ”’ Unlock Deficiency Summary

Get full access to the detailed deficiency summary for this facility

One-time payment β€’ Lifetime access