Tarrant County Public Health Dept

CLIA Laboratory Citation Details

2
Total Citations
9
Total Deficiencyies
4
Unique D-Tags
CMS Certification Number 45D0659873
Address 1101 South Main Street, Fort Worth, TX, 76104
City Fort Worth
State TX
Zip Code76104
Phone(817) 248-6299

Citation History (2 surveys)

Survey - May 7, 2021

Survey Type: Standard

Survey Event ID: WSND11

Deficiency Tags: D0000 D6127 D0000 D6127

Summary:

Summary Statement of Deficiencies D0000 Noted deficiencies and plans of correction were discussed with the laboratory representative(s) at the exit conference. The facility representative(s) were given an opportunity to provide evidence of compliance with the noted deficiencies, and no such evidence was provided prior to survey exit. The facility was found to be in compliance with applicable Conditions of Participation in the CLIA program, and recertification is recommended. D6127 TECHNICAL SUPERVISOR RESPONSIBILITIES CFR(s): 493.1451(b)(9) The technical supervisor is responsible for evaluating and documenting the performance of individuals responsible for high complexity testing at least semiannually during the first year the individual tests patient specimens. This STANDARD is not met as evidenced by: Based on review of CMS-209 form signed by the Laboratory Director (LD), testing personnel (TP) initial competency assessments from 2020, competency assessment policy/procedure, and confirmed in an interview revealed the Technical Supervisor (TS) failed to document compelete competeny assessmnts for 4 of 13 TP's (TP5, TP9, TP10, and TP11). The findings were: 1. Review of CMS-209 form revealed TP5, TP9, TP10, and TP11 listed for high complexity tests including Hologic Panther APTIMA SARS-CoV-2 Assay. 2. Review of initial competency assessments of Hologic Panther APTIMA SARS-CoV-2 Assay from 2020 for the above TPs failed to include 3 of 6 required competency components as follows: a) Review of intermediate quality control records, proficiency testing results, and preventive maintenance records; b) direct observation of performance of instrument maintenance and function checks; c) assessment of problem solving skills. TP5, hired on 9/28/95 Competency Assessment for Hologic Panther APTIMA SARS-CoV-2 Assay revealed proficiency testing (PT), quality control records reviews, maintenance and function checks, and problem solving skills components documented as Not Applicable (NA), and was signed by TS 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 -- on 6/29/20. TP9, hired on 10/15/12 Competency Assessment for Hologic Panther APTIMA SARS-CoV-2 Assay revealed proficiency testing (PT), quality control records reviews, maintenance and function checks, and problem solving skills components documented as Not Applicable (NA), and was signed by TS on 6/29/20. TP10, hired on 6/14/16 Competency Assessment for Hologic Panther APTIMA SARS- CoV-2 Assay revealed proficiency testing (PT), quality control records reviews, maintenance and function checks, and problem solving skills components documented as Not Applicable (NA), and was signed by TS on 6/29/20. TP11, hired on 5/18/16 Competency Assessment for Hologic Panther APTIMA SARS-CoV-2 Assay revealed proficiency testing (PT), quality control records reviews, maintenance and function checks, and problem solving skills components documented as Not Applicable (NA), and was signed by TS on 6/29/20. 3. Review of competency assessment policy /procedure under IX. OBJECTIVE revealed, "To establish a systematic method of assessing competency that includes all elements of a CLIA Competency Assessment program. The following six procedures are the minimal regulatory requirements for assessment for competency for all personnel performing laboratory testing....... Competency assessment, which includes the six procedures above, must be performed for testing personnel for each test that the individual is approved by the laboratory director to perform." 4. An interview with the technical supervisor on 5/6/21 at 1430 in the office confirmed all testing personnel (TP) reported patient results. -- 2 of 2 --

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Survey - November 7, 2018

Survey Type: Standard

Survey Event ID: R18K11

Deficiency Tags: D5393 D5393 D5411 D0000 D5411

Summary:

Summary Statement of Deficiencies D0000 The Laboratory Director, Technical Supervisor-8 (TS-8), Testing Person-7 (TP-7), TS- 7, TP-4, TP-2, TP-1, LIMS Admin, and TS-5 were at the entrance conference conducted 11/05/2018. The survey process was discussed. An opportunity for questions and comments was given. Exit conference was held with the Laboratory Director, TS-8, TP-3, TP-2, TP-1, TP-8, and TS-5 on 11/07/2018. The laboratory was found to be in substantial compliance for the specialties/subspecialties for which it was surveyed. The standard level deficiencies cited were discussed. The process for submitting the corrections was explained. CMS form 2567 will be emailed from the Texas Department of State Health Services, Health Facility Compliance Arlington Group. D5393 PREANALYTIC SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1249(b)(c) The preanalytic systems assessment must include a review of the effectiveness of

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