| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 01D0027451 | (X3) Date Survey Completed 10/08/2025 |
| Name of Provider or Supplier Grove Hill Memorial Hospital | Street Address, City, State 295 S Jackson St, Grove Hill, AL | |
| For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency. | ||
| (X4) ID Prefix Tag | Summary Statement of Deficiencies |
| D3031 | RETENTION REQUIREMENTS CFR(s): 493.1105(a)(3) Analytic systems records. Retain quality control and patient test records (including instrument printouts, if applicable) and records documenting all analytic systems activities specified in ยงยง493.1252 through 493.1289 for at least 2 years. In addition, retain the following: This STANDARD is not met as evidenced by: Based on a review of the Alere Triage Quality Control records for D-Dimer testing and an interview with the Chief Operating Officer and the General Supervisor (GS), the laboratory failed to provide the surveyor Quality Control records for 16 of the 25 months reviewed from September 2023 through September 2025. The findings include: 1. A review of the Alere Triage records revealed the laboratory performed and documented D-Dimer QC from January-September 2025. However, there was no D-Dimer QC documentation provided for review from September 2023 through December 2024. 2. The Chief Operating Officer and the GS confirmed the above findings during Day 2 exit conference on 10-08-2025 at 4:28 PM. |