South Fl Institute For Reproductive Medicine Llc

CLIA Laboratory Citation Details

1
Total Citation
2
Total Deficiencyies
2
Unique D-Tags
CMS Certification Number 10D2041572
Address 9960 S Central Park Blvd Ste 275, Boca Raton, FL, 33428
City Boca Raton
State FL
Zip Code33428
Phone(561) 549-9010

Citation History (1 survey)

Survey - February 26, 2020

Survey Type: Standard

Survey Event ID: XTQW11

Deficiency Tags: D0000 D5209

Summary:

Summary Statement of Deficiencies D0000 A recertification survey conducted on 02/26/2020 found that South Florida Institute for Reproductive Medicine clinical laboratory was not in compliance with 42 CFR Part 493, Requirements for Laboratories. 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 staff interview, the laboratory failed to have the annual competency assessment for 1 out of 1 Technical Supervisor (TS) signed by the laboratory director and for 1 out of 1 General Supervisor (GS) signed by the TS for 2019. Findings include: 1)Review of CMS 209 Laboratory Personnel Report dated and signed by the Laboratory Director (LD) on 02/21/2020 revealed that: -The Laboratory Director and Clinical Consultant was the same person, 1 TS, 1 GS and 4 testing personnel (A, B, C, D). - GS was Testing personnel (TP) A. 2) Review of TS and GS annual competency assessment for 2019 revealed that a person not listed on CMS form 209 signed both evaluations. During an interview on 02/26/202 at 11:00 AM, with GS, she confirmed that a person not listed on form 209 signed the annual competencies assessment listed above. 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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