Skin And Vein Center Livonia

CLIA Laboratory Citation Details

2
Total Citations
2
Total Deficiencyies
2
Unique D-Tags
CMS Certification Number 23D0871369
Address 10984 Middlebelt Road, Livonia, MI, 48150
City Livonia
State MI
Zip Code48150
Phone(734) 762-0798

Citation History (2 surveys)

Survey - May 18, 2021

Survey Type: Standard

Survey Event ID: WE3X11

Deficiency Tags: D5803

Summary:

Summary Statement of Deficiencies D5803 TEST REPORT CFR(s): 493.1291(b) Test report information maintained as part of the patient's chart or medical record must be readily available to the laboratory and to CMS or a CMS agent upon request. This STANDARD is not met as evidenced by: . Based on record review and interview with the Laboratory Liaison (LL), the laboratory failed to produce the patient paper chart for 1 (#12) of 13 charts reviewed for 2 years. Findings include: 1. Record review for 1 (#12) of 13 patient charts reviewed, the laboratory was unable to locate the paper chart to verify the final dermatopathology report was maintained in the chart. 2. An interview on 5/18/2021 at 11:00 am, the LL confirmed patient #12 the paper chart was not located on the day of the survey for the surveyor to verify results for the dermatopathology report. 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 - April 16, 2019

Survey Type: Standard

Survey Event ID: XZ7W11

Deficiency Tags: D5209

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 record review, policy review, and interview with an office staff member, the Laboratory Director (LD) failed to review and evaluate the competency for Testing Personnel #2 (TP2) for 2 of 2 years. Findings include: 1. Record review for the "Quality Assurance Statement and Information" policy stated, "the Laboratory Director will hold bi-yearly staff evaluations for tests performed to assure employee competence." The laboratory had no documentation to show the bi-yearly competency evaluation was completed for TP2 in 2017 and 2018. 2. Interview with an office staff member on 4/16/19 at 11:30 am, the office staff acknowledged bi-yearly competency evaluations for 2017 and 2018 were not available for TP2. 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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