Uuhc Midvalley Dermatology - Mohs Laboratory

CLIA Laboratory Citation Details

3
Total Citations
10
Total Deficiencyies
6
Unique D-Tags
CMS Certification Number 46D0523585
Address 243 East 6100 South, Murray, UT, 84107
City Murray
State UT
Zip Code84107
Phone(801) 581-2955

Citation History (3 surveys)

Survey - May 1, 2023

Survey Type: Standard

Survey Event ID: 6OFL11

Deficiency Tags: D5209 D5609 D6168 D5609 D6168 D6171 D6171

Summary:

Summary Statement of Deficiencies D5209 PERSONNEL COMPETENCY ASSESSMENT POLICIES CFR(s): 493.1235 As specified in the personnel requirements in subpart M, the laboratory must establish and follow written policies and procedures to assess employee and, if applicable, consultant competency. This STANDARD is not met as evidenced by: Based on record review and interview with the Clinic Manager, the laboratory failed to establish a written policy to assess personnel competency for practitioners who conducted (potassium hydroxide) KOH testing as specified in subpart M since the last survey on 11/19/2020. Findings include: 1. Review of laboratory policies and procedures revealed the laboratory failed to establish and perform competency assessment as specified in subpart M for 27 of 27 testing personnel who were practitioners conducting KOH testing. 2. On 05/01/2023 at approximately 3:00 PM, the Clinic Manager confirmed there was no competency assessment policy established or performed for practitioners conducting KOH testing. D5609 HISTOPATHOLOGY CFR(s): 493.1273(e)(f) (e) The laboratory must use acceptable terminology of a recognized system of disease nomenclature in reporting results. (f) The laboratory must document all control procedures performed, as specified in this section. This STANDARD is not met as evidenced by: Based on review and interview by the Operations Manager, the laboratory failed to document the lot numbers and expiration dates of Hematoxylin and Eosin (H&E) stains in use since the last survey on 11/19/2020. The laboratory performed 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 -- approximately 2400 histopathology tests annually. Findings include: 1. Histopathology staining records review failed to include the lot number and expiration dates of H&E stains the laboratory used to stain histopathology controls and specimens since the last survey on 11/19/2020. 2. In an interview conducted on 05/01 /2023 at approximately 4:30 PM, the Operations Manager confirmed the histopathology staining records failed to include the lot number and expiration dates of H&E stains. D6168 TESTING PERSONNEL CFR(s): 493.1487 The laboratory has a sufficient number of individuals who meet the qualification requirements of 493.1489 of this subpart to perform the functions specified in 493. 1495 of this subpart for the volume and complexity of testing performed. This CONDITION is not met as evidenced by: Based on personnel records and interview with the testing personnel, the laboratory failed to employ qualified testing personnel that met the educational requirements for high complexity grossing examination in histopathology testing. (Refer to D6171) D6171 TESTING PERSONNEL QUALIFICATIONS CFR(s): 493.1489(b) (b) Meet one of the following requirements: (b)(1) Be a doctor of medicine, doctor of osteopathy, or doctor of podiatric medicine licensed to practice medicine, osteopathy, or podiatry in the State in which the laboratory is located or have earned a doctoral, master's or bachelor's degree in a chemical, physical, biological or clinical laboratory science, or medical technology from an accredited institution; (b)(2)(i) Have earned an associate degree in a laboratory science, or medical laboratory technology from an accredited institution or-- (b)(2)(ii) Have education and training equivalent to that specified in paragraph (b)(2)(i) of this section that includes-- (b)(2)(ii)(A) At least 60 semester hours, or equivalent, from an accredited institution that, at a minimum, include either-- (b)(2)(ii)(A)(1) 24 semester hours of medical laboratory technology courses; or (b)(2)(ii)(A)(2) 24 semester hours of science courses that include-- (b)(2) (ii)(A)(2)(i) Six semester hours of chemistry; (b)(2)(ii)(A)(2)(ii) Six semester hours of biology; and (b)(2)(ii)(A)(2)(iii) Twelve semester hours of chemistry, biology, or medical laboratory technology in any combination; and (b)(2)(ii)(B) Have laboratory training that includes either of the following: (b)(2)(ii)(B)(1) Completion of a clinical laboratory training program approved or accredited by the ABHES, the CAHEA, or other organization approved by HHS. (This training may be included in the 60 semester hours listed in paragraph (b)(2)(ii)(A) of this section.) (b)(2)(ii)(B)(2) At least 3 months documented laboratory training in each specialty in which the individual performs high complexity testing. (b)(3) Have previously qualified or could have qualified as a technologist under 493.1491 on or before February 28, 1992; (b) (4) On or before April 24, 1995 be a high school graduate or equivalent and have either-- (b)(4)(i) Graduated from a medical laboratory or clinical laboratory training program approved or accredited by ABHES, CAHEA, or other organization approved by HHS; or (b)(4)(ii) Successfully completed an official U.S. military medical laboratory procedures training course of at least 50 weeks duration and have held the military enlisted occupational specialty of Medical Laboratory Specialist (Laboratory Technician); (b)(5)(i) Until September 1, 1997-- (b)(5)(i)(A) Have earned a high school diploma or equivalent; and (b)(5)(i)(B) Have documentation of training -- 2 of 3 -- appropriate for the testing performed before analyzing patient specimens. Such training must ensure that the individual has-- (b)(5)(i)(B)(1) The skills required for proper specimen collection, including patient preparation, if applicable, labeling, handling, preservation or fixation, processing or preparation, transportation and storage of specimens; (b)(5)(i)(B)(2) The skills required for implementing all standard laboratory procedures; (b)(5)(i)(B)(3) The skills required for performing each test method and for proper instrument use; (b)(5)(i)(B)(4) The skills required for performing preventive maintenance, troubleshooting, and calibration procedures related to each test performed; (b)(5)(i)(B)(5) A working knowledge of reagent stability and storage; (b)(5)(i)(B)(6) The skills required to implement the quality control policies and procedures of the laboratory; (b)(5)(i)(B)(7) An awareness of the factors that influence test results; and (b)(5)(i)(B)(8) The skills required to assess and verify the validity of patient test results through the evaluation of quality control values before reporting patient test results; and (b)(5)(i)(B)(8)(ii) As of September 1, 1997, be qualified under 493.1489(b)(1), (b)(2), or (b)(4), except for those individuals qualified under paragraph (b)(5)(i) of this section who were performing high complexity testing on or before April 24, 1995; (b)(6) For blood gas analysis-- (b)(6) (i) Be qualified under 493.1489(b)(1), (b)(2), (b)(3), (b)(4), or (b)(5); (b)(6)(ii) Have earned a bachelor's degree in respiratory therapy or cardiovascular technology from an accredited institution; or (b)(6)(iii) Have earned an associate degree related to pulmonary function from an accredited institution; or (b)(7) For histopathology, meet the qualifications of 493.1449 (b) or (l) to perform tissue examinations. This STANDARD is not met as evidenced by: Based on an interview with the testing personnel and review of education records, the laboratory failed to employ qualified personnel to perform gross examinations for high complexity histopathology testing. The laboratory performed approximately 2400 histopathology tests annually. Findings include: 1. Review of education records for one of five histotechnician testing personnel revealed educational requirements were not met for high complexity grossing examination in histopathology testing. 2. In an interview with the testing personnel on 05/01/2023 at approximately 3:06 PM it was confirmed one of five testing personnel did not meet the high complexity educational requirements for grossing histopathology specimens. -- 3 of 3 --

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Survey - November 19, 2020

Survey Type: Standard

Survey Event ID: 0SRX11

Deficiency Tags: D5311 D5311

Summary:

Summary Statement of Deficiencies D5311 SPECIMEN SUBMISSION, HANDLING, AND REFERRAL CFR(s): 493.1242(a) The laboratory must establish and follow written policies and procedures for each of the following, if applicable: (1) Patient preparation. (2) Specimen collection. (3) Specimen labeling, including patient name or unique patient identifier and, when appropriate, specimen source. (4) Specimen storage and preservation. (5) Conditions for specimen transportation. (6) Specimen processing. (7) Specimen acceptability and rejection. (8) Specimen referral. This STANDARD is not met as evidenced by: Based on direct observation procedure manual review, and interview with staff, the laboratory lacked a procedure for preparation staff to follow for splitting frozen samples to embed, cut and stain prior to review by the dermatologist for determination of presence or absence of previously diagnosed tumor. Findings include: 1. Sample processing was reviewed on 11/19/2020 at approximately 8:40 A.M. for specimen M1495-20. Two staff members processed the specimen using two cryostat instruments. 2. Laboratory procedure manual included instructions for staff to label the specimen prior to placing the slide(s) into the Hematoxylin and Eosin stain processor. 3. Staff was observed labeling the slide with the specimen section after being through the stain processor. 4. In an interview with staff on 11/19/2020 at approximately 8:45 A.M. staff confirmed the procedure lacked instructions for a method to transfer information to both staff members splitting the sample for processing to ensure specimen integrity is maintained throughout specimen processing, 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 - April 17, 2018

Survey Type: Standard

Survey Event ID: UNQX11

Deficiency Tags: D6054

Summary:

Summary Statement of Deficiencies D6054 TECHNICAL CONSULTANT RESPONSIBILITIES CFR(s): 493.1413(b)(9) 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 lack of documentation, patient test record review, and interview with staff, the laboratory failed to document competency performance for 3 of 5 testing personnel (not including the director) performing moderate complexity tests at least annually after the first year of testing for competency evaluations reviewed from May 2016 to April 17, 2018. Findings include: 1. The laboratory technical consultant failed to record competency evaluations for 3 testing persons, (1, 2, and 6) performing potassium hydroxide preparations (KOH) using the required competency evaluation elements from May 2016 to April 17, 2018. 2. Patient record review includes documentation testing persons 1, 2, and 6 perform moderate complexity testing as evidenced by their signature as performing KOH testing for: Patient # 20457692 on 06 /15/2016 by testing person #1, Patient # 05667829 in September 2016 by testing person #2; and for Patient # 07056559 on 02/21/2018 by testing person #3. 3. In an interview conducted on 04/17/2018 at approximately 5:00 P.M., staff confirmed all staff members performing the moderately complex KOH did not have documentation of annual competency evaluations for testing performed in 2016 and 2017. 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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