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 883835 (X3) Date Survey Completed 03/31/2026
Name of Provider or Supplier Premier Family Care, Inc Street Address, City, State 9458 Highway 100, Scotts Hill, TN
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)
E0029 Development of Communication Plan

§403.748(c), §416.54(c), §418.113(c), §441.184(c), §460.84(c), §482.15(c), §483.73(c), §483.475(c), §484.102(c), §485.68(c), §485.542(c), §485.625(c), §485.727(c), §485.920(c), §486.360(c), §491.12(c), §494.62(c). (c) The [facility] must develop and maintain an emergency preparedness communication plan that complies with Federal, State and local laws and must be reviewed and updated at least every 2 years [annually for LTC facilities].


This STANDARD is not met as evidenced by:
Based on review of the Rural Health Clinic's (RHC) policy, manual review and interview, the RHC failed to maintain and update every two years EP communication plan. The findings included: Review of the RHC's policy, "Emergency Preparedness", reviewed 10/1/1022, revealed, "... the RHC would maintain and update every two years EP communication plan..." Review of the RHC's manual, "Emergency Preparedness Plan (EPP) and Policies and Procedures," revealed RHC failed to maintain and update every two years EP communication plan. During an interview on 3/31/2026 at 9:15 AM, the President of the RHC stated the RHC did not have documentation of updates available for review, and they were not ready for the survey.