Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391

Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number 01D0300027 (X3) Date Survey Completed 07/28/2021
Name of Provider or Supplier Bibb Medical Center Street Address, City, State 208 Pierson Avenue, Centreville, 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
D5407 PROCEDURE MANUAL
CFR(s): 493.1251(d)

Procedures and changes in procedures must be approved, signed, and dated by the current laboratory director before use.


This STANDARD is not met as evidenced by:
Based on a review of the Individualized Quality Control Plan (IQCP) for MedTox and an interview with the General Supervisor, the Laboratory Director failed to approve the IQCP before used. The findings include: 1. A review of the IQCP revealed the Technical Supervisor signed the IQCP on 11/05/2019. 2. During an interview on 07/27/2021 at 03:15 PM, the General Supervisor stated they thought since the Technical Supervisor was a pathologist it had to be sign by them.