Somerset Skin Centre

CLIA Laboratory Citation Details

4
Total Citations
9
Total Deficiencyies
5
Unique D-Tags
CMS Certification Number 23D1033208
Address 255 Kirts Blvd Suite 100, Troy, MI, 48084
City Troy
State MI
Zip Code48084
Phone(248) 244-8448

Citation History (4 surveys)

Survey - February 25, 2025

Survey Type: Standard

Survey Event ID: 5P2711

Deficiency Tags: D5417 D5417

Summary:

Summary Statement of Deficiencies D5417 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(d) (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 Testing Personnel (TP1), the laboratory failed to ensure 4 bottles of reagents were not used beyond their expiration date. Findings include: 1. The surveyor observed the following 4 bottles of reagents available for patient testing on 2/25/2025 at 9:30 am: a. 1 bottle of Mercedes Scientific Blue Tissue Marking Dye with an expiration date of 11/30/2024 b. 1 bottle of Mercedes Scientific Red Tissue Marking Dye with an expiration date of 1/31/2025 c. 1 bottle of 10% KOH Reagent with an expiration date of 1/11/2025 d. 1 bottle of Platinumline Eosin Y Stain with an expiration date of 09/27/2024 2. An interview conducted on 02/25/2025 at 9:45 am with the TP1 confirmed the reagents were expired and available for use. 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 - February 14, 2023

Survey Type: Standard

Survey Event ID: 93W911

Deficiency Tags: D5805 D5473 D5805 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: . A. Based on record review and interview with Testing Personnel #2 (TP2), the laboratory failed to establish a policy for personnel serving as the Clinical Consultant, Technical Supervisor, or General Supervisor for 2 (February 2021 to February 2023) of 2 years reviewed. Findings include: 1. A review of the laboratory's "Personnel Competency Testing" policy revealed it only addressed "Technical Personnel". 2. A review of the laboratory's competency assessment records revealed a lack of competency assessments performed for personnel serving the roles of Clinical Consultant, Technical Supervisor, or General Supervisor. 3. An interview on 2/14/23 at 1:09 pm with Testing Personnel #2 confirmed the laboratory had not established a policy for assessing competency for personnel serving as a Clinical Consultant, Technical Supervisor, or General Supervisor. B. Based on record review and interview with Testing Personnel #2, the laboratory failed to follow its established policy to assess testing personnel competency for 1 (Testing Personnel #2) of 2 testing personnel listed on Form CMS-209. Findings include: 1. A review of the laboratory's "Quality Assurance" policy revealed a section titled "Personnel Assessment" stating, "If the Laboratory has employees, the Laboratory Director will use personal observation to perform an ongoing evaluation of all employees of the laboratory to ensure competence in job performance. After 90 days upon hire, annually thereafter." 2. A review of the laboratory's competency assessment records revealed Testing Personnel #2 was hired in January 2022 and had one competency assessment performed on 4/11/22. 3. An interview on 2/14/23 at 1:09 pm with Testing Personnel #2 confirmed their competency was not assessed and documented according to the 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 -- laboratory's policy. ***This is a repeated deficiency from the 7/19/21 recertification survey*** D5473 CONTROL PROCEDURES CFR(s): 493.1256(e)(2)(g) (e) For reagent, media, and supply checks, the laboratory must do the following: (e) (2) Each day of use (unless otherwise specified in this subpart), test staining materials for intended reactivity to ensure predictable staining characteristics. Control materials for both positive and negative reactivity must be included, as appropriate. (g) The laboratory must document all control procedures performed. This STANDARD is not met as evidenced by: . Based on record review and interview with Testing Personnel #2, the laboratory failed to perform and document its assessment of staining intended reactivity each day of use for 476 of 476 patients that had been prepared at an outside laboratory prior to testing. Findings include: 1. A review of the laboratory's patient test records revealed all patient specimens were sent to an outside laboratory to be processed between November 2021 and January 2022. Slides were made and sent back for testing and reporting of results. A total of 476 patients were tested in this manner. 2. The surveyor requested documentation of stain quality assessed for the dates when the 476 patients had been tested on 2/14/23 at 11:30 pm and it was not made available. 3. An interview on 2/14/23 at 11:32 pm with Testing Personnel #2 revealed the laboratory had not performed and documented staining intended reactivity each day of use for slides that had been prepared at an outside laboratory. D5805 TEST REPORT CFR(s): 493.1291(c) The test report must indicate the following: (c)(1) For positive patient identification, either the patient's name and identification number, or a unique patient identifier and identification number. (c)(2) The name and address of the laboratory location where the test was performed. (c)(3) The test report date. (c)(4) The test performed. (c)(5) Specimen source, when appropriate. (c)(6) The test result and, if applicable, the units of measurement or interpretation, or both. (c)(7) Any information regarding the condition and disposition of specimens that do not meet the laboratory's criteria for acceptability. This STANDARD is not met as evidenced by: . Based on record review and interview with Testing Personnel #2, the laboratory failed to include the name and address of the laboratory where tissue specimen gross examinations were performed for 1 (Patient 22-53) of 13 patient test reports reviewed. Findings include: 1. A review of patient test records revealed Patient 22-53 had testing performed on 1/13/23 using a specimen that had been prepared and grossed at a reference laboratory. The test report included the grossing results from the reference laboratory but did not list the name and address of the laboratory where testing was performed. 2. An interview on 2/14/23 at 11:32 am with Testing Personnel #2 revealed patients that had specimens prepared at an outside laboratory between November 2021 and January 2022 had not included the grossing laboratory's information on the test report. ***This is a repeated deficiency from the 1/9/17 recertification survey*** -- 2 of 2 --

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Survey - July 19, 2021

Survey Type: Standard

Survey Event ID: JFE911

Deficiency Tags: D5209 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 and interview with Testing Personnel #2 (TP2), the laboratory failed to assess testing personnel competency according to laboratory policy for 1 (Testing Personnel #1) of 2 testing personnel listed on the CMS-209 form. Findings include: 1. A review of the laboratory's personnel competency documentation revealed Testing Personnel #1 had competency for scabies and Potassium Hydroxide (KOH) preparations assessed using the Michigan Dermatological Society for the following dates from July 2019 to July 2021: a. 7/15 /21 b. 7/19/21 2. A review of the laboratory's "PERSONNEL COMPETENCY TESTING" procedure revealed a section stating, "The competency of all dermatopathology personnel will be evaluated annually and performance documented on the dermatopathology Proficiency Checksheet form." 3. An interview on 7/19/21 at 11:20 am with TP2 confirmed Testing Personnel #1 did not have their competency evaluated at least annually in 2019 and 2020 for the testing of scabies and KOH preparations. 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 - July 23, 2019

Survey Type: Standard

Survey Event ID: T6SQ11

Deficiency Tags: D5801

Summary:

Summary Statement of Deficiencies D5801 TEST REPORT CFR(s): 493.1291(a) The laboratory must have an adequate manual or electronic system(s) in place to ensure test results and other patient-specific data are accurately and reliably sent from the point of data entry (whether interfaced or entered manually) to final report destination, in a timely manner. This includes the following: (a)(1) Results reported from calculated data. (a)(2) Results and patient-specific data electronically reported to network or interfaced systems. (a)(3) Manually transcribed or electronically transmitted results and patient-specific information reported directly or upon receipt from outside referral laboratories, satellite or point-of-care testing locations. This STANDARD is not met as evidenced by: . Based on document review and interview with Testing Personnel #2 (TP2), the office manager, and the Mohs technician, the laboratory failed to have the final mycology potassium hydroxide (KOH) result maintained as part of the patient's electronic medical record (EMR) for 1 (#3) of 40 patient charts audited. Findings include: 1. Document review for 1 (#3) of 40 patient charts audited revealed the final KOH test result was absent in the patient's EMR. 2. During the interview on July 23, 2019 at 1:00 PM with TP2, the office manager, and the Mohs technician confirmed the test was ordered, but no results were documented in the EMR. 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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