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 B03922 (X3) Date Survey Completed 04/19/2023
Name of Provider or Supplier Minuteman Medicine Llc Street Address, City, State 17721 Ky Route 122, Hi Hat, KY
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)
E0000 An emergency preparedness survey was conducted on 04/19/2023. The facility was found to be in compliance with federal requirements.
J0000 An initial certification survey was conducted on 04/19/2023. The facility was found to not be in substantial compliance with federal certification requirements related to Rural Health Clinics, with deficiencies cited.
J0086 STAFFING AND STAFF RESPONSIBILITIES

491.8(a) Staffing. (6) . . . for RHCs, a nurse practitioner, physician assistant or certified nurse-midwife is available to furnish patient care services at least 50 percent of the time the RHC operates.


This STANDARD is not met as evidenced by:
Based on interview and record review, the facility failed to have a nurse practitioner (NP), physician assistant (PA) or certified nurse-midwife (CNM) available to furnish patient care services at least fifty percent (50%) of the time the Rural Health Clinic (RHC) operates. The findings include: Review of Form Centers for Medicare and Medicaid Services (CMS)-29 revealed the facility had two (2) physicians providing services as full time equivalents. Further review revealed there was not an NP, PA or CNM providing patient care services and personnel was being actively recruited. Further review revealed the facility's normal operating hours were Monday through Thursday from 10:00 AM to 6:00 PM and on Friday from 10:00 AM to 2:00 PM. Interview with Physician #1, on 04/19/2023 at 11:58 AM, revealed a physician is available to provide services full time during the facility's normal operating hours. However, no other providers furnish patient care services at the RHC and recruitment is ongoing to try and fulfill the requirement.