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 01D0300241 (X3) Date Survey Completed 09/20/2018
Name of Provider or Supplier Bbh P & Scn Forestdale Street Address, City, State 1480 Forestdale Boulevard, Birmingham, 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
D2130 HEMATOLOGY
CFR(s): 493.851(f)

Failure to achieve satisfactory performance for the same analyte in two consecutive events or two out of three consecutive testing events is unsuccessful performance.


This STANDARD is not met as evidenced by:
Based on a review of the CMS Casper reports (#153, #155), a review of API (American Proficiency Institute) performance evaluations and an interview with the Technical Consultant (TC), the surveyor determined the laboratory failed to achieve satisfactory performance of proficiency testing for three consecutive testing events for RBC (Red Blood Cell Count, Hematology testing). These failures resulted in non-initial, unsuccessful proficiency testing participation for the laboratory. The findings include: 1. Refer to D2016.