Wasatch Pediatrics - Draper Office

CLIA Laboratory Citation Details

3
Total Citations
9
Total Deficiencyies
5
Unique D-Tags
CMS Certification Number 46D0969151
Address 114 E 12450 S Ste 100, Draper, UT, 84020
City Draper
State UT
Zip Code84020
Phone801 523-3001
Lab DirectorRACHEL WOODS

Citation History (3 surveys)

Survey - February 6, 2023

Survey Type: Standard

Survey Event ID: BS5011

Deficiency Tags: D6053 D6053

Summary:

Summary Statement of Deficiencies D6053 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 semiannually during the first year the individual tests patient specimens. This STANDARD is not met as evidenced by: Based on a review of competency evaluation documentation and an interview with the Office Manager, the laboratory failed to perform and document semi-annual competency evaluations during 2021-2022 for 5 of 5 Testing Personnel (TP) during their first year of performing moderately complex patient testing Piccolo chemistry analyzer. Findings include: 1. A review of competency evaluation records at approximately 12:00 PM on 2/6/23 revealed that 5 of 5 TP reviewed for 2021-2022, did not have documentation of a semi-annual competency assessment during their first year of performing moderately complex patient testing on the Piccolo chemistry analyzer. 2. An interview with the Office Manager at approximately 12:15 PM on 2/6 /2 confirmed that 5 of 5 TP reviewed for 2021-2022, did not have documentation of a semi-annual competency assessment during their first year of performing moderately complex patient testing on the Piccolo chemistry analyzer. 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 - January 14, 2020

Survey Type: Standard

Survey Event ID: FTSS11

Deficiency Tags: D5461 D5791 D6054 D5461 D5791 D6054

Summary:

Summary Statement of Deficiencies D5461 CONTROL PROCEDURES CFR(s): 493.1256(d)(6)(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-- Perform control material testing as specified in this paragraph before resuming patient testing when a complete change of reagents is introduced; major preventive maintenance is performed; or any critical part that may influence test performance is replaced. (g) The laboratory must document all control procedures performed. This STANDARD is not met as evidenced by: Based on patient testing records review, quality control records review, and interview with staff, the laboratory failed to perform control materials before resuming patient testing when a complete change of reagents is introduced for 1 of 11 new lot numbers of Piccolo Hepatic function test cartridges placed into use. The laboratory performed approximately 2 Hepatic function cartridge tests per day to report total and direct bilirubin tests. Findings include: 1. Patient test records reviewed included documentation patient #824 was tested on 06/18/2018 using lot number 8112AA3 for testing. 2. The quality control records review included documentation the laboratory performed quality control for lot number 8112AA3 on 06/19/2018. 3. In an interview with staff on 01/14/2020 staff confirmed the quality control was performed after the patient was tested and results were reported for the new lot number. D5791 ANALYTIC SYSTEMS QUALITY ASSESSMENT CFR(s): 493.1289(a)(c) (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 analytic systems specified in 493.1251 through 493.1283. (c) The laboratory must document all analytic systems assessment activities. 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 -- This STANDARD is not met as evidenced by: Based on Individual Quality Control Plan (IQCP) review, lack of documentation, and interview with staff, the laboratory failed to follow their IQCP to monitor Piccolo test records,in conjunction with the laboratory IQCP, to determine the reduced frequency of quality control performance was adequate for 1 of 2 years of total and direct bilirubin testing reviewed (2019). Findings include: 1. The laboratory IQCP failed to include documentation the director reviewed the IQCP in 2019. 2. In an interview with staff on 01/14/2020 at approximately 1:30 P.M. staff confirmed the director did not evaluate the IQCP in 2019 to ensure the laboratory's quality control performance provided sufficient information to continue a reduced quality control performance to once per lot number and/or once per month and still have confidence that the test system is functioning properly. 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 competency assessment records review, lack of documentation, and interview with staff, the technical consultant failed to ensure competency evaluations were performed annually for 1 of 2 years of competency evaluations reviewed (2019). Findings include: 1. Competency assessments records failed to include documentation competency evaluations were performed for 5 of 5 testing personnel in 2019. 2. The laboratory manager confirmed in an interview conducted on 01/14/2020 at approximately 1:30 P.M. competency evaluations for staff who had more than one year's experience performing moderate complexity testing did not have competency evaluations performed in 2019. -- 2 of 2 --

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Survey - February 2, 2018

Survey Type: Standard

Survey Event ID: HFR811

Deficiency Tags: D5403

Summary:

Summary Statement of Deficiencies 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. (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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