This week’s Ftag of the Week on the CMSCG Blog is F770 Laboratory Services, which is part of the Laboratory, Radiology, and Other Diagnostic Services regulatory group. This regulation has been in effect since November 28, 2017. The regulation states that the facility must provide or obtain laboratory services to meet the needs of its residents and the facility is responsible for the quality and timeliness of services provided. The requirements for facilities that are providing lab services themselves are included under F770 including having an appropriate CLIA certificate for the lab services being provided. Surveyors will simply determine compliance by assessing the following:
- If the facility has a CLIA certificate that reflects the lab testing being done
- Resident needs are being met with regard to the quality and/or timeliness of providing the services and reporting of lab results.
Failure to provide these services can result in potentially negative outcomes for residents, and when identified on survey, can rise to a Scope/Severity of Immediate Jeopardy or Actual Harm, so this regulation is not one to ignore.
Here are some actual citations identified under the LTCSP related to lab services:
- Facility administered IV antibiotics to multiple residents without the required laboratory testing to determine appropriate dosing (S/S: K) – don’t forget about the tie-in to the facility’s Antibiotic Stewardship Program and appropriate use of antibiotic therapy.
- Facility failed to notify the physician of elevated FSBS levels for 50% of residents sampled during survey for insulin administration. One resident developed uncontrollable diabetes and required IV insulin administration at the hospital (S/S: K) – don’t forget about the importance of notification of changes, either.
- Facility failed to obtain a physician-ordered STAT lab testing when a change in condition was identified, resulting in actual harm to a resident who was transferred to the hospital and admitted with high white blood cell count and septic shock (S/S: G)
- Facility did not obtain timely lab results for residents on anticoagulants and did not obtain a urine culture for a resident with a potential UTI (S/S: D)
If you are not conducting periodic reviews of all ordered labs being completed and results reported in a timely manner, you are making a mistake. Whether you have a provider lab or conduct testing within the facility sound systems needs to be in place for scheduling of lab tests and ensuring testing and reporting results are timely to best meet the needs of each resident.