Thomas Dermatology

CLIA Laboratory Citation Details

2
Total Citations
12
Total Deficiencyies
11
Unique D-Tags
CMS Certification Number 03D2181294
Address 2350 Miracle Mile Ste 600, Bullhead City, AZ, 86442
City Bullhead City
State AZ
Zip Code86442
Phone(928) 377-4540

Citation History (2 surveys)

Survey - May 6, 2025

Survey Type: Standard

Survey Event ID: ZF8R11

Deficiency Tags: D5413

Summary:

Summary Statement of Deficiencies D5413 TEST SYSTEMS, EQUIPMENT, INSTRUMENTS, REAGENT CFR(s): 493.1252(b) (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: (b)(1) Water quality. (b)(2) Temperature. (b)(3) Humidity. (b)(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: Based on review of room temperature, cryostat temperature and laboratory humidity records from 2/02/2023 through the survey date of 5/06/2025 and interview with the facility personnel, the laboratory failed to 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. Findings include: 1. The laboratory performs testing in the subspecialty of Histopathology with a reported annual test volume of 450. 2. No documentation was presented for review to indicate the laboratory defined acceptable ranges for the room temperature, the cryostat and the ambient humidity of the room where test reagents are utilized and patient specimens are tested. 3. The facility personnel interviewed on 5/06/2025 at 2:15 PM confirmed the laboratory failed to define acceptable ranges for the room temperature, cryostat temperature and ambient humidity of the room where patient testing occurs. 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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Survey - February 2, 2023

Survey Type: Standard

Survey Event ID: 9LTN11

Deficiency Tags: D5291 D5403 D5413 D5791 D6020 D5217 D5400 D5407 D5473 D5891 D6021

Summary:

Summary Statement of Deficiencies D5217 EVALUATION OF PROFICIENCY TESTING PERFORMANCE CFR(s): 493.1236(c)(1) At least twice annually, the laboratory must verify the accuracy of any test or procedure it performs that is not included in subpart I of this part. This STANDARD is not met as evidenced by: Based on lack of accuracy verification documentation for review for Mohs testing and interview with the facility personnel, the laboratory failed to verify the accuracy of testing performed under the sub-specialty of Histopathology at least twice annually during 2020, 2021 and 2022. Findings include: 1. No documentation was presented for review during the survey conducted on February 2, 2023 to indicate the laboratory verified the accuracy of the microscopic interpretation (reading/diagnosis) of histopathology specimens which are read during the Mohs procedure at least twice annually during 2020, 2021 and 2022. 2. The facility personnel interviewed on February 2, 2023 at 11:45am confirmed that the laboratory failed to verify the accuracy of histopathology testing at least twice annually during 2020, 2021 and 2022. 3. The laboratory's approximate annual test volume under the sub-specialty of Histopathology is 360. D5291 GENERAL LABORATORY SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1239(a) The laboratory must establish and follow written policies and procedures for an ongoing mechanism to monitor, assess, and, when indicated, correct problems identified in the general laboratory systems requirements specified at 493.1231 through 493.1236. This STANDARD is not met as evidenced by: Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 7 -- Based on lack of established Quality Assessment (QA) policies and procedures for review and interview with the facility personnel, the laboratory failed to establish QA policies and procedures for the general laboratory systems, including but not limited to, policies and procedures related to the accuracy verification process for dermatopathology testing performed by the laboratory. Findings include: 1. The laboratory performs the microscopic interpretation (reading/diagnosis) of dermatopathology specimens which are read during the Mohs procedure. 2. No documenation was presented for review during the survey to indicate the laboratory established policies and procedures for an ongoing mechanism to monitor, assess, and, when indicated, correct problems identified in the general laboratory systems requirements specified at 493.1231 through 493.1236. 3. No documentation was presented for review during the survey to indicate the laboratory established policies and procedures related to the verification of accuracy process for Mohs testing, including but not limited to, information specific to the frequency of the review, number of cases reviewed, individual or laboratory performing the review and a remedial action plan in the event of a noted discrepancy. 4. The facilty personnel interviewed during the survey on February 2, 2023 at approximately 12:05pm confirmed that the laboratory failed establish a written policy and procedure specific to the verification of accuracy process for the microscopic interpretation of Mohs specimens and failed to establish policies and procedures for an ongoing mechanism to monitor, assess, and, when indicated, correct problems identified in the general laboratory systems requirements specified at 493.1231 through 493.1236. 5. The laboratory began patient testing on April 1, 2020. The laboratory's annual test volume is 360. D5400 ANALYTIC SYSTEMS CFR(s): 493.1250 Each laboratory that performs nonwaived testing must meet the applicable analytic systems requirements in 493.1251 through 493.1283, unless HHS approves a procedure, specified in Appendix C of the State Operations Manual (CMS Pub.7), that provides equivalent quality testing. The laboratory must monitor and evaluate the overall quality of the analytic systems and correct identified problems as specified in 493.1289 for each specialty and subspecialty of testing performed. This CONDITION is not met as evidenced by: Based on the severity and number of deficiencies cited for quality control practices identified during the survey conducted on February 2, 2023, it was determined that the laboratory failed to monitor the overall quality of the analytic systems and correct problems as specified in 493.1289 for patient testing performed by the laboratory in the sub-specialty of Histopathology. See D5403, D5407, D5413, D5473 and D5791 for 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. -- 2 of 7 -- (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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