| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 01P001 | (X3) Date Survey Completed 04/18/2014 |
| Name of Provider or Supplier Legacy Of Hope | Street Address, City, State 516 20th Street South, 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
(Each deficiency should be preceded by full regulatory or LSC identifying information) |
| Z0058 | DESIGNATED REQUESTOR TRAINING - HOSP STAFF CFR(s): 486.322(b) The OPO must offer to provide designated requestor training on at least an annual basis for hospital and critical access hospital staff. This STANDARD is not met as evidenced by: Based on interview and record review of OPO Staff, training of Hospital Designated Requestors (HDRs) was not offered on an annual basis to those who required such training. The findings include: Interview of the Certified Procurement Transplant Coordinator (CPTC) on 4/18/14 at approximately 9:30 a.m., and record review of the HDR Training Lists provided on 4/18/14 at 9:00 a.m., revealed HDR training was not offered on an annual basis to all HDRs. The interview revealed there was no system in place to indicate training was offered on an annual basis for all HDRs. The CPTC stated training for the OPO trainers had been completed for the OPO designated requesters but stated HDR training had not been offered on an annual basis. |