Multi-state compact nursing license

Oh my, I have not heard of this.  May I ask, what state are you in?

Montana

Provided your mod complexity training protocol is robust enough and meets all the CLIA requirements, couldn't you revert to the fact they are high-school graduates with appropriate training, since that is the minimum educational requirement for mod-complexity testing?  Or is that not necessarily easier?

493.1423  Each individual performing moderate complexity testing must possess a current license issued by the State in which the laboratory is located, if such licensing is required.  It sounds like, per your state board of nursing, that this is not required.

Also, my understanding of the intent of that requirement is for states that require a license to be a lab scientist like California, New York, etc.

I would appeal this decision!

Check CMS website link - document listed on first page Appendix -C
Interpretive Guidelines for Laboratories | CMS
https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/som107ap_c_labpdf.pdf
I downloaded a copy and refer to it frequently!
Good Luck!

Monica, is the CLIA guideline they cited the same as what Danielle named above?  Or a different one?

I am not aware of clinical lab science licensing in Montana (unlike the New York, California, etc mentioned above).   If Montana does not have licensure,  your surveyor is confused.   I would contact the "head surveyor" at the state agency - call your state CLIA office for clarification.  AND/or  contact your CLIA regional office.   Phone numbers can be found on the CLIA website.  

If it were me, I would make HR aware of this.   
The nursing board should have sway over this. Your nurses do have a license appropriate for the state according to your state nursing board. They would not be working if they did not. 

It sounds to me like a literal (state inspectors) interpretation of the law-more the letter of the law than the spirit.

I would see if I could get a judgement from CLIA. They might hold the final word over a state inspection and could clarify this for the various states. It may be the first time that they might have heard of this type of an interpretation. 

Let us know what you decide to do and the outcome. This will impact everyone with state licensure. 

Out of curiosity, are the state of Montana lab laws different from CLIA? Do they just use CLIA as a base? There are a few states that have lab laws that supersede CLIA.  (FL and CA come to mind) 

Montana is a state that requires state licensure for lab.  

We were able to get ahold of an Executive Officer on the Board of Nursing at the Montana Dept of Labor and Industry.  She sent us the NLC (Nurse Licensure Compact) Rules which all compact (party) states must follow.  In there it states that "a party state shall not issue a single state licensure to a nurse who holds a multistate license in another party state".   Montana cannot issue a license to someone who holds a valid multistate license issued by another compact state.  She is going to reach out to our State CLIA inspector.

Wooo Executive Officer!  Calling in the big people.  Well done.  I'm sure I speak for most, if not all, when I type: Let us know how this turns out!

Here is the 493.1423 in its entirety if this is what was sited in their inspection:

I am a former CLIA inspector and I always told the labs that relied on nursing licenses that they did not apply to CLIA regulations.  The section that discusses state licensure only applies to states with laboratory personnel licensure.  All testing personnel that perform non-waived tests MUST have a record of at least a high school diploma or equivalent for moderate complexity.  CMS will accept 3rd party verifications but a nursing license will not provide that verification.