Village Dermatology

CLIA Laboratory Citation Details

2
Total Citations
18
Total Deficiencyies
8
Unique D-Tags
CMS Certification Number 45D2152458
Address 7575 San Felipe, Ste 300, Houston, TX, 77063
City Houston
State TX
Zip Code77063
Phone(713) 952-8400

Citation History (2 surveys)

Survey - May 1, 2024

Survey Type: Standard

Survey Event ID: QJFW11

Deficiency Tags: D0000 D5401 D5401 D5403 D5403

Summary:

Summary Statement of Deficiencies D0000 The laboratory was surveyed and found to be in compliance with the Conditions of the CLIA regulations found at 42 CFR 493.1 through 493.1780, and recertification is recommended. D5401 PROCEDURE MANUAL CFR(s): 493.1251(a) A written procedures manual for all tests, assays, and examinations performed by the laboratory must be available to, and followed by, laboratory personnel. Textbooks may supplement but not replace the laboratory's written procedures for testing or examining specimens. This STANDARD is not met as evidenced by: Based on a review of the laboratory's policies, the laboratory's records, and staff interview, the laboratory failed to have documentation of following its policy by ensuring four of five personnel performing Mohs procedures reviewed the laboratory's policies and procedures in 2023. Findings include: 1. A review of the laboratory's policy titled 'Document Control Policy' revealed the following: "The policies and procedures will be reviewed by the Mohs physician annually to ensure that policies are current. Review of policy and procedure will be part of the lab personnel evaluation and competency assessment." 2. A review of the laboratory's records revealed the laboratory had five physicians performing Mohs procedures in 2023. 3. Further review of the laboratory's records revealed the following four testing personnel failed to have documentation of reviewing the laboratory's policies and procedures in 2023: - Testing person #4 - Testing person #5 - Testing person #6 - Testing person #7 4. In an interview on 5/1/24 at 2:45 p.m. in the conference room, after review of the records, the medical assistant confirmed the above findings. D5403 PROCEDURE MANUAL CFR(s): 493.1251(b) 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 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. (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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Survey - September 29, 2020

Survey Type: Standard

Survey Event ID: 97PB11

Deficiency Tags: D5217 D5403 D5781 D5791 D6022 D0000 D5217 D5403 D5781 D5791 D6022 D6046 D6046

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. Note: The CMS-2567 (Statement of Deficiencies) is an official, legal document. All information must remain unchanged except for entering the

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