Skin Cancer & Dermatology Institute-Gs Richards Bl

CLIA Laboratory Citation Details

4
Total Citations
19
Total Deficiencyies
7
Unique D-Tags
CMS Certification Number 29D0931553
Address 3950 Gs Richards Blvd, Carson City, NV, 89703
City Carson City
State NV
Zip Code89703
Phone(775) 882-8777

Citation History (4 surveys)

Survey - June 3, 2025

Survey Type: Standard

Survey Event ID: 5PJK11

Deficiency Tags: D0000 D5217 D5217 D5433 D6102 D0000 D5433 D6102 D6120 D6120

Summary:

Summary Statement of Deficiencies D0000 This Statement of Deficiencies was created as a result of an on-site CLIA recertification survey conducted at your facility on June 3, 2025. The findings and conclusions of any investigation by the Division of Public and Behavioral Health shall not be construed as prohibiting any criminal or civil investigations, actions or other claims for relief that may be available to any party under applicable federal, state, or local laws. D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(c)(1) At least twice annually, the laboratory must verify the accuracy of any test or procedure it performs that is not included in subpart I of this part. This STANDARD is not met as evidenced by: Based on a review of the 2023 and 2024 laboratory records for the twice per year verification of accuracy for Wet Mount and KOH testing, and an interview with the Senior Clinic Manager, the laboratory failed to ensure that twice per year verification of accuracy was performed for each provider performing Wet Mount and KOH testing in the laboratory. Findings include: 1. Testing personnel number two on the CMS-209 form did not have documentation of a second accuracy check in 2024. 2. Testing personnel number three on the CMS-209 form did not have documentation of a second accuracy check in 2024. 3. Testing personnel number four on the CMS-209 form did not have documentation of any accuracy checks in 2024. 4. Testing personnel number five on the CMS-209 form did not have documentation of a second accuracy check in 2024. 5. An interview with the Senior Clinic Manager on June 3, 2025 at approximately 10:00 AM confirmed these findings. The laboratory performs approximately 25 mycology and parasitology tests annually. D5433 MAINTENANCE AND FUNCTION CHECKS 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): 493.1254(b)(1) (b)(1)(i) Establish a maintenance protocol that ensures equipment, instrument, and test system performance that is necessary for accurate and reliable test results and test result reporting. (b)(1)(ii) Perform and document the maintenance activities specified in paragraph b(1)(i) of this section. This STANDARD is not met as evidenced by: Based on the laboratory's policies and procedures, lack of maintenance records, and an interview with the Senior Clinic Manager, the laboratory failed to ensure maintenance for the microscope was performed and documented. Findings include: 1. A review of the laboratory director approved policy titled "Laboratory Microscopes" states that "Microscopes are clean, adequate, optically aligned, and properly maintained with records of preventative maintenance at least annually". 2. There was no documentation of annual maintenance performed on the microscope that is used for Wet Mounts and KOH testing. 3. An interview with the Senior Clinic Manager on June 3, 2025 at approximately 10:30 AM confirmed these findings. The laboratory performs approximately 25 mycology and parasitology tests annually. D6102 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1445(e)(12) (e)(12) Ensure that prior to testing patients specimens, all personnel have the appropriate education and experience, receive the appropriate training for the type and complexity of the services offered, and have demonstrated that they can perform all testing operations reliably to provide and report accurate results; This STANDARD is not met as evidenced by: Based on a review of the roster provided on the CMS-209 form, a lack of documented initial training, an interview with the Senior Clinic Manager, the laboratory director failed to ensure that all testing personnel had documented initial trainings prior to performing Wet Mount and KOH. Findings include: 1. Testing personnel four (TP4) listed on the CMS-209 had no documentation of initial training for Wet Mount and KOH testing. TP4 was hired in December 2023. 2. An interview with the Senior Clinic Manager on June 3, 2025 at approximately 10:00 AM confirmed these findings. The laboratory performs approximately 25 mycology and parasitology tests annually. D6120 TECHNICAL SUPERVISOR RESPONSIBILITIES CFR(s): 493.1451(b)(7)(8) (b)(7) Identifying training needs and assuring that each individual performing tests receives regular in-service training and education appropriate for the type and complexity of the laboratory services performed; (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 a review of the roster provided on the CMS-209 form, a lack of annual competency assessments, an interview with the Senior Clinic Manager, the technical supervisor failed to ensure that all testing personnel had documented semi annual and -- 2 of 3 -- annual competency assessments. Findings include: 1. Testing personnel two listed on the CMS-209 had no annual competency assessments for Wet Mount and KOH testing in 2023 and 2024. 2. Testing personnel three the CMS-209 had no annual competency assessments for Wet Mount and KOH testing in 2023 and 2024. 3. Testing personnel four the CMS-209 had no semi annual or annual competency assessments for Wet Mount and KOH testing in 2024. 4. Testing personnel five the CMS-209 had no annual competency assessments for Wet Mount and KOH testing in 2023 and 2024. 5. An interview with the Senior Clinic Manager on June 3, 2025 at approximately 10:00 AM confirmed these findings. The laboratory performs approximately 25 mycology and parasitology tests annually. -- 3 of 3 --

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Survey - July 26, 2023

Survey Type: Standard

Survey Event ID: 807V11

Deficiency Tags: D5217 D0000 D5217

Summary:

Summary Statement of Deficiencies D0000 This Statement of Deficiencies was generated as a result of the onsite CLIA recertification survey conducted at your facility on July 26, 2023. The findings and conclusions of any investigation by the Division of Public and Behavioral Health shall not be construed as prohibiting any criminal or civil investigations, actions or other claims for relief that may be available to any party under applicable federal, state or local laws. D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(c)(1) At least twice annually, the laboratory must verify the accuracy of any test or procedure it performs that is not included in subpart I of this part. This STANDARD is not met as evidenced by: Based on a review of the laboratory's documentation of accuracy verification for provider performed microscopy (PPM) testing, and an interview with the practice manager, the laboratory failed to verify the accuracy of PPM tests for each provider least twice a year. Findings include: 1. A review of the laboratory's documentation of twice a year accuracy verification for PPM testing from January 2021 through July 2023 revealed there was only one accuracy check documented in 2022 for one of four providers. This provider is identified as number 4 on the CMS-209. 2. These findings were confirmed by the practice manager in an interview on July 26, 2023. The laboratory performs approximately 25 microbiology tests per year. 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 - May 12, 2021

Survey Type: Standard

Survey Event ID: N0VS11

Deficiency Tags: D0000 D5417

Summary:

Summary Statement of Deficiencies D0000 This Statement of Deficiencies was created as a result of an on-site CLIA recertification survey conducted at your facility on 5/12/2021. The findings and conclusions of any investigation by the Division of Public and Behavioral Health shall not be construed as prohibiting any criminal or civil investigations, actions or other claims for relief that may be available to any party under applicable federal, state, or local laws. D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(d) Reagents, solutions, culture media, control materials, calibration materials, and other supplies must not be used when they have exceeded their expiration date, have deteriorated, or are of substandard quality. This STANDARD is not met as evidenced by: Based on observation and interview with the Mohs technician, expired solutions were found in the flammable cabinet during a tour of the Mohs laboratory. Findings include: 1. An open gallon bottle of EverClear xylene substitute which expired in 2019 was available for use. 2. Four gallon-sized bottles of dehydrant, one of which was opened and in use, expired on 4/18/2021. The Mohs technician indicated during the on-site inspection on 5/12/2021 at approximately 11:30 AM that he was unaware that the bottles had already expired since he received the bottles from the supplier on 1 /14/2021. The laboratory performs approximately 780 histopathology tests annually. 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 - March 20, 2019

Survey Type: Standard

Survey Event ID: L51Q11

Deficiency Tags: D0000 D5203 D0000 D5203

Summary:

Summary Statement of Deficiencies D0000 This Statement of Deficiencies was created as a result of an on-site CLIA recertification survey conducted at your facility on March 20, 2019. The findings and conclusions of any investigation by the Division of Public and Behavioral Health shall not be construed as prohibiting any criminal or civil investigations, actions or other claims for relief that may be available to any party under applicable federal, state, or local laws. D5203 SPECIMEN IDENTIFICATION AND INTEGRITY CFR(s): 493.1232 The laboratory must establish and follow written policies and procedures that ensure positive identification and optimum integrity of a patient's specimen from the time of collection or receipt of the specimen through completion of testing and reporting of results. This STANDARD is not met as evidenced by: Based on review of the Mohs accession log, Mohs maps, slides and the electronic medical records (EMR), and interview with the laboratory manager, the laboratory failed to follow policies and procedures to ensure positive identification of a patient's specimen from collection to final report. Findings include: 1. A sample survey of 10 random Mohs cases from July 2017 to March 2019 revealed that for case, #MC17- 727, the Mohs accession number in the EMR did not match the accession number in the accession log, Mohs map and slides. The accession number referenced in the EMR was MC17-733. 2. The laboratory manager interviewed during the on-site survey on 3 /20/19 at approximately 2:30 PM confirmed the finding. The laboratory performs approximately 1,200 histopathology tests annually. 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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