Winkler County Memorial Hospital

CLIA Laboratory Citation Details

4
Total Citations
21
Total Deficiencyies
11
Unique D-Tags
CMS Certification Number 45D0508911
Address 821 Jeffee Dr, Kermit, TX, 79745
City Kermit
State TX
Zip Code79745
Phone(432) 586-8299

Citation History (4 surveys)

Survey - February 12, 2025

Survey Type: Standard

Survey Event ID: IYUM11

Deficiency Tags: D5775 D5775

Summary:

Summary Statement of Deficiencies D5775 COMPARISON OF TEST RESULTS CFR(s): 493.1281(a)(c) (a) If a laboratory performs the same test using different methodologies or instruments, or performs the same test at multiple testing sites, the laboratory must have a system that twice a year evaluates and defines the relationship between test results using the different methodologies, instruments, or testing sites. This STANDARD is not met as evidenced by: Based on review of laboratory instruments, instrument comparisons and interview with facility personnel, the laboratory failed to evaluate and define the relationship between test results using different instruments or methodologies for analytes performed on both the iSTAT analyzer and the Dimension EXL Chemistry analyzer for two of two events in 2024. The findings included: 1. Based on review of laboratory instrumentation test menu documentation, the laboratory performed Sodium (Na), Potassium (K), Chloride (Cl), Total Carbon Dioxide (TCO2), Calcium (Ca), Glucose (Glu), Blood Urea Nitrogen (BUN) and Creatinine (Creat) tests using the Dimension EXL and the Abbott iSTAT. 2. Based on review of the instrument comparisons found the laboratory last performed instrument comparisons for the analytes between the Dimension EXL (serial number DR253128) and the iSTAT (serial number 350174) in August 2023. 3. During interview of the Technical Consultant conducted February 12, 2025 at 3:30 PM, he confirmed the laboratory failed to evaluate the relationship of the test results for Sodium (Na), Potassium (K), Chloride (Cl), Total Carbon Dioxide (TCO2), Calcium (Ca), Glucose (Glu), Blood Urea Nitrogen (BUN) and Creatinine (Creat) tests obtained using the Dimension EXL and the iSTAT at least twice in 2024. 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 - December 14, 2022

Survey Type: Standard

Survey Event ID: D2RD11

Deficiency Tags: D2121

Summary:

Summary Statement of Deficiencies D2121 HEMATOLOGY CFR(s): 493.851(a) Failure to attain a score of at least 80 percent of acceptable responses for each analyte in each testing event is unsatisfactory analyte performance for the testing event. This STANDARD is not met as evidenced by: Based on review of the Casper Report 155 Individual Laboratory Profile Proficiency testing records and interview of facility personnel, the laboratory failed to attain a satisfactory score of at least 80 percent for Hemoglobin in one of three Chemistry Core testing events in 2022. The findings included: 1. Review of the Casper Report 155 Individual Laboratory Profile found the laboratory had obtained a score of 0% in the 3rd testing event of 2022 for the analyte Hemoglobin as reported by the American Proficiency Institute (API). 2. Review of the American Proficiency Institute (API) Proficiency testing records for 2022 found: I. The laboratory participated in the American Proficiency Institute (API) Chemistry Core testing events for Blood Gas. II. The laboratory submitted results (due Wednesday, September 14, 2022 11:59 PM) for the 2022 Chemistry Core 3rd Event electronically on September 12, 2022 at 4:14 PM. III. Review of the API Hemoglobin results found on the API 2022 Chemistry - Core 3rd Event Comparative Evaluation found the laboratory submitted unacceptable responses for five of five proficiency samples as follows resulting in a score of 0%: BLX-11 - the laboratory reported a result of 14.1 g/dL with an expected result of 12.0- 13.9 g/dL BLX-12 - the laboratory reported a result of 12.5 g/dL with an expected result of 10.6-12.3 g/dL BLX-13 - the laboratory reported a result of 18.9 g/dL with an expected result of 16.1-18.7 g/dL BLX-14 - the laboratory reported a result of 15.8 g/dL with an expected result of 13.5-15.6 g/dL BLX-15 - the laboratory reported a result of 18.8 g/dL with an expected result of 16.1-18.6 g/dL 3. In interview of the General Supervisor conducted December 13, 2022 at 12:57 PM, the general supervisor confirmed that the laboratory did receive a score of 0% for Hemoglobin in the 2022 3rd testing event for Blood Gasses. He went on to say the laboratory scored 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 -- 100% in the American Association of Bioanalysts (AAB) Hematology testing event which they used to ensure accuracy of Hematology results. -- 2 of 2 --

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Survey - August 3, 2022

Survey Type: Special

Survey Event ID: OKJ211

Deficiency Tags: D0000 D2016 D2096 D6000 D6016 D0000 D2016 D2096 D6000 D6016

Summary:

Summary Statement of Deficiencies D0000 Based on a proficiency testing desk review survey performed on August 4, 2022, the laboratory was found to be out of compliance based on the following CONDITION LEVEL DEFICIENCIES: D2016 - 42 C.F.R. 493.803 Condition: Successful participation D6000 - 42 C.F.R. 493.1403 Condition: Laboratory Director, moderate complexity D2016 SUCCESSFUL PARTICIPATION CFR(s): 493.803(a)(b)(c) (a) Each laboratory performing nonwaived testing must successfully participate in a proficiency testing program approved by CMS, if applicable, as described in subpart I of this part for each specialty, subspecialty, and analyte or test in which the laboratory is certified under CLIA. (b) Except as specified in paragraph (c) of this section, if a laboratory fails to participate successfully in proficiency testing for a given specialty, subspecialty, analyte or test, as defined in this section, or fails to take remedial action when an individual fails gynecologic cytology, CMS imposes sanctions, as specified in subpart R of this part. (c) If a laboratory fails to perform successfully in a CMS- approved proficiency testing program, for the initial unsuccessful performance, CMS may direct the laboratory to undertake training of its personnel or to obtain technical assistance, or both, rather than imposing alternative or principle sanctions except when one or more of the following conditions exists: (1) There is immediate jeopardy to patient health and safety. (2) The laboratory fails to provide CMS or a CMS agent with satisfactory evidence that it has taken steps to correct the problem identified by the unsuccessful proficiency testing performance. (3) The laboratory has a poor compliance history. This CONDITION is not met as evidenced by: Based on review of the Certification and Survey Provider Enhanced Reporting (CASPER) Report 155 Individual Laboratory Profile and American Association of Bioanalysts evaluation reports, the laboratory failed to achieve successful 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 -- performance in two of three consecutive testing events for the specialty Routine Chemistry for the analyte Bilirubin, Total, resulting in unsuccessful performance. Refer to D2096. D2096 ROUTINE CHEMISTRY CFR(s): 493.841(f) Failure to achieve satisfactory performance for the same analyte or test in two consecutive testing events or two out of three consecutive testing events is unsuccessful performance. This STANDARD is not met as evidenced by: Based on review of the Certification and Survey Provider Enhanced Reporting (CASPER) Report 155 Individual Laboratory Profile and American Association of Bioanalysts evaluation reports, the laboratory failed to achieve successful performance in two of three consecutive testing events for the specialty Routine Chemistry for the analyte Bilirubin, Total, resulting in unsuccessful performance. The finding included: 1. Based on review of the American Association of Bioanalysts evaluation reports for the third event of 2021 and the second event of 2022, the laboratory received the following unsatisfactory scores for the analyte Bilirubin, Total: 1) Third event, 2021, Bilirubin, Total - score of 60 percent 2) Second event of 2022, Bilirubin, Total - score of 40 percent D6000 MODERATE COMPLEXITY LABORATORY DIRECTOR CFR(s): 493.1403 The laboratory must have a director who meets the qualification requirements of 493. 1405 of this subpart and provides overall management and direction in accordance with 493.1407 of this subpart. This CONDITION is not met as evidenced by: Based on desk review of the Certification and Survey Provider Enhanced Reporting (CASPER) Report 155 Individual Laboratory Profile and American Association of Bioanalysts evaluation reports, the laboratory director failed to ensure successful participation in an HHS approved proficiency testing program for analyte Bilirubin, Total in the specialty of Routine Chemistry for two of three events in 2021 and 2022. Refer to D6016. D6016 LABORATORY DIRECTOR RESPONSIBILITIES CFR(s): 493.1407(e)(4)(i) The laboratory director is responsible for the overall operation and administration of the laboratory, including the employment of personnel who are competent to perform test procedures, and record and report test results promptly, accurate, and proficiently and for assuring compliance with the applicable regulations. (e) The laboratory director must-- (e)(4)(i) Ensure that the proficiency testing samples are tested as required under Subpart H of this part; This STANDARD is not met as evidenced by: Based on desk review of the Certification and Survey Provider Enhanced Reporting -- 2 of 3 -- (CASPER) Report 155 Individual Laboratory Profile and American Association of Bioanalysts proficiency testing records, the laboratory director failed to ensure successful participation in a HHS approved proficiency testing program for analyte Bilirubin, Total, in the specialty of Routine Chemistry for two of three events in 2021 and 2022. Refer to D2096. -- 3 of 3 --

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Survey - January 31, 2019

Survey Type: Standard

Survey Event ID: EY9111

Deficiency Tags: D5403 D5421 D5429 D5465 D5403 D5421 D5429 D5465

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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