Tareen Dermatology

CLIA Laboratory Citation Details

2
Total Citations
2
Total Deficiencyies
2
Unique D-Tags
CMS Certification Number 24D2176959
Address 2720 Fairview Ave N, Roseville, MN, 55113
City Roseville
State MN
Zip Code55113
Phone(651) 633-6883

Citation History (2 surveys)

Survey - November 29, 2021

Survey Type: Special

Survey Event ID: 7KB311

Deficiency Tags: D3000

Summary:

Summary Statement of Deficiencies D3000 FACILITY ADMINISTRATION CFR(s): 493.1100 Each laboratory that performs nonwaived testing must meet the applicable requirements under 493.1101 through 493.1105, unless HHS approves a procedure that provides equivalent quality testing as specified in Appendix C of the State Operations Manual (CMS Pub. 7). (a) Reporting of SARS-CoV-2 test results During the Public Health Emergency, as defined in 400.200 of this chapter, each laboratory that performs a test that is intended to detect SARS-CoV-2 or to diagnose a possible case of COVID-19 (hereinafter referred to as a "SARS-CoV-2 test") must report SARS-CoV-2 test results to the Secretary in such form and manner, and at such timing and frequency, as the Secretary may prescribe. This CONDITION is not met as evidenced by: . Based on record review, interview with laboratory personnel, and email communication, the laboratory failed to report SARS-CoV-2 positive and negative test results for 28 of 28 days of testing in September 2021 through November 2021. Findings are as follows: 1. The laboratory performed SARS-CoV-2 testing using the CareStart COVID-19 Antigen Test as confirmed by Testing Personnel 1 (TP1) during a tour of the laboratory at 10:05 a.m. on 11/23/21. TP1 indicated only employees were tested. 2. In an interview at 11:30 a.m. on 11/23/21, TP1 indicated SARS-CoV-2 results had not been reported to the appropriate health authorities from test implementation in September 2021 through October 2021. 3. Patient testing logs were not completed for the testing. A spreadsheet with November test results was reviewed on date of survey. TP1 indicated these results had been reported to the Minnesota Department of Health (MDH). The laboratory was given 5 days to provide additional testing information from September 2021 through October 2021. 4. A test record table, provided by TP1 via email on 11/29/21, was reviewed. The document included testing dates and the number of positive and/or negative results obtained each day of testing and was dated 09/16/21 - 11/21/21. The email indicated results obtained after 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 -- 11/21/21 had been reported to MDH. Days of non-reporting are indicated below. 2021 Days not reported September 5 October 14 November 9 5. A total of 60 SARS-CoV-2 test results were not reported as required from 09/22/21 through 11/19/21 as indicated on the test record table. 4 positive results and 56 negative results were not reported. 6. The laboratory performed 60 SARS-CoV-2 tests between 09/22/21 and 11/19/21 as indicated on the test record table. 7. In an interview at 11:50 a.m. on 11/23/21, TP1 confirmed the above findings. -- 2 of 2 --

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Survey - November 23, 2021

Survey Type: Standard

Survey Event ID: 9TDD11

Deficiency Tags: D5403

Summary:

Summary Statement of Deficiencies 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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