Urology Associates, Pc - Franklin

CLIA Laboratory Citation Details

2
Total Citations
7
Total Deficiencyies
7
Unique D-Tags
CMS Certification Number 44D0306899
Address 4601 Carothers Parkway, Suite 475, Franklin, TN, 37067
City Franklin
State TN
Zip Code37067
Phone615 790-1660
Lab DirectorJOHN HASSAN

Citation History (2 surveys)

Survey - August 5, 2024

Survey Type: Standard

Survey Event ID: XS5V11

Deficiency Tags: D5787 D5301

Summary:

Summary Statement of Deficiencies D5301 TEST REQUEST CFR(s): 493.1241(a) The laboratory must have a written or electronic request for patient testing from an authorized person. This STANDARD is not met as evidenced by: Based on a review of patient records and staff interviews, the laboratory failed to have written or electronic test requests from an authorized person for three of six patient test requisitions reviewed in 2023 and 2024. The findings include: 1. A random review of six patient laboratory orders revealed the following: - Patient 1980560 had the test "Semen Analysis - Post Vas" ordered on 01/03/2024 by the testing person (TP) -5 "on behalf of FRNR Franklin Nurse." - Patient 1977550 had the test "Semen Analysis - Post Vas" ordered on 12/11/2023 by TP-4 "on behalf of FRNR Franklin Nurse." - Patient 767410 had the test "Semen Analysis - Post Vas" ordered on 10/13 /2023 by TP-4 "on behalf of FRNR Franklin Nurse." - The physician signature lines on the laboratory orders for 1980560, 1977550, and 767410 were blank. 2. An interview with the technical consultant (TC) on 08/05/2024 at 11:30 a.m. revealed that "FRNR Franklin Nurse" was a generic profile in their electronic medical record system and not a specified provider. The TC confirmed that the laboratory did not document the authorized provider who ordered qualitative semen analysis testing for patients 1980560, 1977550, and 767410. D5787 TEST RECORDS CFR(s): 493.1283(a) The laboratory must maintain an information or record system that includes the following: (a)(1) The positive identification of the specimen. (a)(2) The date and time of specimen receipt into the laboratory. (a)(3) The condition and disposition of specimens that do not meet the laboratory's criteria for specimen acceptability. (a)(4) 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 -- The records and dates of all specimen testing, including the identity of the personnel who performed the test(s). This STANDARD is not met as evidenced by: Based on a review of patient test records, lack of documentation, and staff interviews, the laboratory failed to document the identity of the person performing qualitative semen analysis testing for three out of three patient test results reviewed in 2023 and 2024. The findings include: 1. A random review of patient records revealed the laboratory performed "Semen Analysis - Post Vas" testing on 01/03/2024 (ID: 1980560), 12/11/2023 (ID: 1977550), and 10/13/2023 (ID: 767410). 2. The laboratory could not provide documentation indicating the person who performed qualitative semen analysis testing on patients 1980560, 1977550, and 767410. 3. An interview with the technical consultant on 08/05/2024 at 11:30 a.m. confirmed the laboratory does not document the identity of the testing person performing qualitative semen analysis testing. -- 2 of 2 --

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Survey - January 28, 2020

Survey Type: Standard

Survey Event ID: DOWD11

Deficiency Tags: D2007 D5891 D5217 D3011 D6054

Summary:

Summary Statement of Deficiencies D2007 TESTING OF PROFICIENCY TESTING SAMPLES CFR(s): 493.801(b)(1) The samples must be examined or tested with the laboratory's regular patient workload by personnel who routinely perform the testing in the laboratory, using the laboratory's routine methods This STANDARD is not met as evidenced by: Based on review of the personnel records, the 2018 and 2019 proficiency testing (PT) records and interview with the technical consultant, the laboratory failed to include all testing personnel to participate in the PT events in 2018 and 2019. The findings include: 1) Review of the 2018 and 2019 PT records and testing personnel records revealed no participation in the 2018 and 2019 PT urinalysis microscopic exams for testing personnel numbers two, three and four; and no participation in 2018 and 2019 vaginal wet prep for testing personnel number one; no participation in 2018 and 2019 for two of the providers for post vas sperm check. 2) Interview on January 28, 2020 at 2:55 p.m. with the technical consultant confirmed that in 2018 and 2019 the PT samples were not rotated among all the testing personnel. D3011 FACILITIES CFR(s): 493.1101(d) Safety procedures must be established, accessible, and observed to ensure protection from physical, chemical, biochemical, and electrical hazards, and biohazardous materials. This STANDARD is not met as evidenced by: Based on observation of the laboratory, review of the laboratory procedure manual and quality assessment (QA) procedures, and interview with the technical consultant, Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number (X3) Date Survey Completed Name of Provider or Supplier Street Address, City, State -- 1 of 3 -- the laboratory failed to establish and ensure protection from biohazardsous materials, in the laboratory. The findings include: 1) Observation of the laboratory on January 28, 2020 at 1:50 p.m. revealed the laboratory space in use for patient urine sample testing. Testing personnel number two had a bottle of disposable water on the counter for drinking. Testing personnel number three had a personnel beverage bottle on the counter for drinking. There were no biohazard signs and "no eating or drinking in the laboratory" signs. 2) Review of the laboratory procedure manual and QA procedures revealed there is no safety procedure established for biohazard in the laboratory. 3) Interview on January 28, 2020 at 2:00 p.m. with the technical consultant confirmed testing personnel had drinks in the laboratory, there were no biohazard signs in the laboratory and there were no established safety procedures for biohazard in the laboratory. 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 review of the proficiency testing (PT) records, the 2019 proficiency testing (PT) records, and interview with the technical consultant, the laboratory failed to verify the accuracy of the urine microscopic sediment and the vaginal wet prep at least twice a year in 2019. The findings include: 1. Review of the PT records revealed urine sediment failed the 2019 event three, resulting no accuracy twice per year in 2019; and, no participation in the vaginal wet prep resulting in no accuracy twice per year in 2019. 2. Interview on January 28, 2020 at 4:15 p.m. with the technical consultant confirmed the urine microscopic sediment and the vaginal wet prep were not verified for accuracy at least twice a year in 2019. D5891 POSTANALYTIC SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1299(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 postanalytic systems specified in 493.1291. This STANDARD is not met as evidenced by: Based on review of the quality assessment (QA) plan, the quarterly patient test management records and interview with the technical consultant, the laboratory failed to maintain a QA plan for the post-analytic process for the urine microscopic testing, in 2018 and 2019. The findings include: 1) Review of the QA plan revealed that quarterly review of patient results were to be performed and documented. 2) Review of the 2018 and 2019 quarterly patient test management records revealed the post vas sperm checks and vaginal wet prep were not included. 3) Interview on January 28, 2020 at 4:45 p.m. with the technical consultant confirmed the post vas sperm checks and vaginal wet prep were not included in the 2018 and 2019 quarterly patient test management reviews. D6054 TECHNICAL CONSULTANT RESPONSIBILITIES CFR(s): 493.1413(b)(9) -- 2 of 3 -- The technical consultant is responsible for evaluating and documenting the performance of individuals responsible for moderate complexity testing at least annually, after the first year. This STANDARD is not met as evidenced by: Based on review of the laboratory personnel records and interview with the technical consultant, the technical consultant failed to evaluate and document the performance of one testing personnel for vaginal wet prep in 2019. The findings include: 1. Review of the laboratory personnel records revealed testing personnel number one did not have vaginal wet prep competency documented in 2019. 2. Interview on January 28, 2020 at 2:30 p.m. confirmed testing personnel number one performed patient vaginal wet prep in 2019 and no annual competency was performed and documented. -- 3 of 3 --

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