Southern Med Pediatrics Fort Mill

CLIA Laboratory Citation Details

2
Total Citations
6
Total Deficiencyies
6
Unique D-Tags
CMS Certification Number 42D2141062
Address 342 Patricia Ln, Suite 105, Fort Mill, SC, 29708
City Fort Mill
State SC
Zip Code29708
Phone(803) 431-7490

Citation History (2 surveys)

Survey - October 3, 2024

Survey Type: Special

Survey Event ID: VBRP11

Deficiency Tags: D2123 D0000 D2016 D2130

Summary:

Summary Statement of Deficiencies D0000 The following deficiencies are the result of a desk review of proficiency testing (PT) scores performed by the South Carolina Department of Public Health on 10/03/2024. The laboratory was surveyed under 42 CFR Part 493 CLIA requirements. PT scores obtained from the national database and verified with the proficiency testing company. The facility was found to be out of compliance with the CONDITIONS and STANDARDS of the CLIA program. The following CONDITION(S) and STANDRD (S) LEVEL DEFICIENCIES were found to be out of compliance: D2016-42 C.F.R. 493.803 Condition: Successful participation [proficiency testing] D2123-42 C.F.R. 493.851 Standard: Hematology D2130-42 C.F.R. 493.851 Standard; Hematology 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. 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 -- This CONDITION is not met as evidenced by: Based on the review of the Casper report 0155D and proficiency testing reports from the Wisconsin State Laboratory of Hygiene (WSLH) for Hematology events 1 and 2, the laboratory failed to successfully participate in a proficiency testing (PT) program approved by CMS. Findings included: 1. Review of Casper Report 0155D for events 2024-HemeReg1 and 2024 HemeReg 2 reveals scores of 0%. 2. Review of the WSLH- 2024 HemeReg1 and WSLH-2024 HemeReg2 reveals that the laboratory failed to submit results for both events. 3. Failure to successfully participate in 2 out of 3, or 2 consecutive PT events constitutes a Condition Level Deficiency. D2123 HEMATOLOGY CFR(s): 493.851(c) Failure to participate in a testing event is unsatisfactory performance and results in a score of 0 for the testing event. Consideration may be given to those laboratories failing to participate in a testing event only if-- (1) Patient testing was suspended during the time frame allotted for testing and reporting proficiency testing results; (2) The laboratory notifies the inspecting agency and the proficiency testing program within the time frame for submitting proficiency testing results of the suspension of patient testing and the circumstances associated with failure to perform tests on proficiency testing samples; and (3) The laboratory participated in the previous two proficiency testing events. This STANDARD is not met as evidenced by: Based on the review of the Casper Report 0155D and WSLH PT scores, the laboratory failed to participate in a testing event and resulting in unsatisfactory performance with a score 0% for the 2024 Hematology events 1 and 2. Findings included: 1. Review of Casper Report 0155D for events 2024-HemeReg1 and 2024 HemeReg 2 reveals scores of 0%. 2. Review of the WSLH-2024 HemeReg1 and WSLH-2024 HemeReg2 reveals that the laboratory failed to submit results for both events. 3. Failure to participate in a testing event is unsatisfactory performance and results in a score 0% for the testing event. D2130 HEMATOLOGY CFR(s): 493.851(f) Failure to achieve satisfactory performance for the same analyte in two consecutive events or two out of three consecutive testing events is unsuccessful performance. This STANDARD is not met as evidenced by: Based on review of the Casper Report 0155D and 2024 WSLH PT scores reveals failure to achieve satisfactory performance in two consecutive Hematology events. Findings included: 1. Review of Casper Report 0155D for events 2024-HemeReg1 and 2024 HemeReg 2 reveals scores of 0%. 2. Review of the WSLH-2024 HemeReg1 and WSLH-2024 HemeReg2 reveals that the laboratory failed to submit results for both events. 3. Failure to participate in a testing event is unsatisfactory performance and results in a score 0% for the testing event. -- 2 of 2 --

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Survey - January 10, 2020

Survey Type: Standard

Survey Event ID: ZZ0P11

Deficiency Tags: D5791 D5413

Summary:

Summary Statement of Deficiencies D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(b) The laboratory must define criteria for those conditions that are essential for proper storage of reagents and specimens, accurate and reliable test system operation, and test result reporting. The criteria must be consistent with the manufacturer's instructions, if provided. These conditions must be monitored and documented and, if applicable, include the following: (1) Water quality. (2) Temperature. (3) Humidity. (4) Protection of equipment and instruments from fluctuations and interruptions in electrical current that adversely affect patient test results and test reports. This STANDARD is not met as evidenced by: During an onsite initial survey on 1/10/2020, based on hematology quality control (QC) package insert review, laboratory refrigerator temperature record review, and staff interview, the laboratory failed to maintain acceptable refrigerator temperatures for 337 days reviewed in 2019 and 7 days in 2020. Findings include: 1. The hematology QC package insert review had a required refrigerator temperature range between 2 and 8 degrees Celsius (or 35 to 46 degrees Fahrenheit). 2. Review of the laboratory's temperature records revealed that refrigerator temperatures were recorded in Fahrenhet and recorded below 35 degrees Fahrenheit for 337 days in 2019 (January 2019 through December 2019) and 7 days in 2020 (January 2 and 3, 2020; January 6 through January 10, 2020). There was no

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