Tareen Dermatology

CLIA Laboratory Citation Details

2
Total Citations
14
Total Deficiencyies
7
Unique D-Tags
CMS Certification Number 24D0995364
Address 1185 Town Center Drive #101, Eagan, MN, 55123
City Eagan
State MN
Zip Code55123
Phone(651) 633-6883

Citation History (2 surveys)

Survey - September 25, 2019

Survey Type: Standard

Survey Event ID: 97NU11

Deficiency Tags: D2005 D5401 D6053 D2005 D5401 D6053

Summary:

Summary Statement of Deficiencies D2005 ENROLLMENT CFR(s): 493.801(a)(4) Authorize the proficiency testing program to release to HHS all data required to-- (i) Determine the laboratory's compliance with this subpart; and (ii) Make PT results available to the public as required in section 353(f)(3)(F) of the Public Health Service Act. This STANDARD is not met as evidenced by: . Based on document review, the laboratory failed to ensure proficiency testing results for the sole regulated analyte were released to the Centers for Medicare and Medicaid Services (CMS) as required. Findings are as follows: 1. The laboratory performed Serum Human Chorionic Gonadotropin (hCG) testing as confirmed by the Nursing Director (ND) during a tour of the laboratory on 09/25/19, at 1:05 p.m. 2. Serum hCG proficiency testing (PT) results were not included in the CMS CASPER Report 0096D, CLIA Application and Survey Summary. Serum hCG PT results were not found during additional CMS database review. 3. In an email sent at 12:18 p.m. on 09 /26/19, the ND was informed of the deficiency. D5401 PROCEDURE MANUAL CFR(s): 493.1251(a) A written procedures manual for all tests, assays, and examinations performed by the laboratory must be available to, and followed by, laboratory personnel. Textbooks may supplement but not replace the laboratory's written procedures for testing or examining specimens. This STANDARD is not met as evidenced by: . Based on document review and interview with laboratory personnel, the laboratory 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 -- failed to include a procedure in the procedure manual for one or three tests performed by the laboratory. Findings are as follows: 1. The laboratory performed Parasitology (Scabies) testing as confirmed by the Nursing Director (ND) during a tour of the laboratory on 09/25/19, at 1:05 p.m. 2. A written procedure for Scabies microscopic examination was not found during review of the Lab Procedure Manual. The laboratory was unable to provide this procedure upon request. 3. In an interview at 3: 10 p.m. on 09/25/19, the ND indicated the procedure had been in place previously. The laboratory was given an opportunity to provide the missing procedure within two days of the survey. 4. In an email received at 11:39 a.m. on 09/26/19, the ND indicated a written procedure for Scabies microscopic examinations could not be found. D6053 TECHNICAL CONSULTANT RESPONSIBILITIES CFR(s): 493.1413(b)(9) The technical consultant is responsible for evaluating and documenting the performance of individuals responsible for moderate complexity testing at least semiannually during the first year the individual tests patient specimens. This STANDARD is not met as evidenced by: . Based on document review and interview with laboratory personnel, the technical consultant failed to ensure competency was assessed at least semiannually during the first year of patient specimen testing in 2018 for one of one new testing personnel. Findings are as follows: 1. The laboratory performed Serum Human Chorionic Gonadotropin (hCG) testing as confirmed by the Nursing Director (ND) during a tour of the laboratory on 09/25/19, at 1:05 p.m. 2. Laboratory records indicated Testing Personnel 7 (TP7) was trained and initially assessed for hCG testing competency in March 2018. A semiannual competency assessment for TP7 was not found in laboratory records. 3. The laboratory was unable to provide the missing semi-annual hCG competency documents upon request. 4. In an interview on 09/25/19, at 2:20 p. m., the ND confirmed the above findings. -- 2 of 2 --

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Survey - January 10, 2018

Survey Type: Standard

Survey Event ID: Q93011

Deficiency Tags: D5221 D5403 D5431 D5821 D5221 D5403 D5431 D5821

Summary:

Summary Statement of Deficiencies D5221 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(d) All proficiency testing evaluation and verification activities must be documented. This STANDARD is not met as evidenced by: . Based on document review and interview with laboratory personnel, the laboratory failed to establish and follow a written proficiency testing procedure. Findings are as follows: 1. The laboratory performed Serum HCG testing as confirmed by General Supervisor (GS) during a tour of the laboratory on 1/10/18 at 9:05 a.m. 2. The laboratory performed proficiency testing (PT) using the American Academy of Family Physicians (AAFP) as the PT provider. 3. A PT procedure was not found during review of laboratory policies and procedures. The laboratory was unable to provide a PT procedure upon request. 4. In an interview on 1/10/18 at 11:30 a.m., the GS confirmed the above findings. . D5403 PROCEDURE MANUAL CFR(s): 493.1251(b) The procedure manual must include the following when applicable to the test procedure: (1) Requirements for patient preparation; specimen collection, labeling, storage, preservation, transportation, processing, and referral; and criteria for specimen acceptability and rejection as described in 493.1242. (2) Microscopic examination, including the detection of inadequately prepared slides. (3) Step-by-step performance of the procedure, including test calculations and interpretation of results. (4) Preparation of slides, solutions, calibrators, controls, reagents, stains, and other materials used in testing. (5) Calibration and calibration verification procedures. (6) The reportable range for test results for the test system as established or verified in 493.1253. (7) Control procedures. (8)

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