Thedacare Physicians Darboy

CLIA Laboratory Citation Details

2
Total Citations
4
Total Deficiencyies
3
Unique D-Tags
CMS Certification Number 52D2002460
Address W5282 Amy Ave, Appleton, WI, 54915
City Appleton
State WI
Zip Code54915
Phone920 454-8612
Lab DirectorREBECCA BUELL-GUTBROD

Citation History (2 surveys)

Survey - September 10, 2020

Survey Type: Standard

Survey Event ID: ZR6U11

Deficiency Tags: D5783 D6046 D6046

Summary:

Summary Statement of Deficiencies D5783

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Survey - February 22, 2018

Survey Type: Standard

Survey Event ID: R4WX11

Deficiency Tags: D5447

Summary:

Summary Statement of Deficiencies D5447 CONTROL PROCEDURES CFR(s): 493.1256(d)(3)(i)(g) Unless CMS Approves a procedure, specified in Appendix C of the State Operations Manual (CMS Pub. 7), that provides equivalent quality testing, the laboratory must-- At least once a day patient specimens are assayed or examined perform the following for-- Each quantitative procedure, include two control materials of different concentrations; (g) The laboratory must document all control procedures performed. This STANDARD is not met as evidenced by: Based on surveyor review of laboratory quality control records and interview with the laboratory Technical Consultant the laboratory does not use an elevated serum bilirubin control for monitoring the abnormal range of neonatal bilirubin testing. Findings include: 1. Review of laboratory quality control (QC) records for the bilirubin assay show that two levels of QC are performed on a daily basis. The QC records for the bilirubin assay show that an elevated serum based bilirubin control for monitoring the abnormal range of neonatal bilirubin's is not assayed when performing neonatal bilirubin testing. 2. Interview with the Technical Consultant on February 22, 2018 at 12:30 PM confirms that an elevated serum based bilirubin control is not used to monitor the abnormal range of neonatal bilirubin's. 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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