| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 05P001 | (X3) Date Survey Completed 04/11/2018 |
| Name of Provider or Supplier Lifesharing | Street Address, City, State 7436 Mission Valley Road, San Diego, CA | |
| 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) |
| Z0174 | POTENTIAL DONOR EVALUATION CFR(s): 486.344(b)(4) [The OPO must do the following:] Review the potential donor's medical chart and perform a physical examination of the donor. This STANDARD is not met as evidenced by: Based on OPO personnel interview and donor record review on April 10, 2018, the OPO failed to perform a physical examination of a donor. Findings included: a. For one (ADAH241) of eleven randomly selected donor records from January 2016 to March 2018, the OPO donor record failed to indicate that a physical examination of a potential donor had been performed prior to organ recovery. OPO donor records for ADAH241 indicated that kidneys were recovered on January 9, 2016 without any documentation indicating that a physical examination of the potential donor had been performed. b. OPO documentation also indicated that the missing physical examination documentation for ADAH241 was discovered by the OPO during its quality assessment and performance improvement (QAPI) donor record review, and addressed appropriately. |