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)
E0032 Primary/Alternate Means for Communication

§403.748(c)(3), §416.54(c)(3), §418.113(c)(3), §441.184(c)(3), §460.84(c)(3), §482.15(c)(3), §483.73(c)(3), §483.475(c)(3), §484.102(c)(3), §485.68(c)(3), §485.542(c)(3), §485.625(c)(3), §485.727(c)(3), §485.920(c)(3), §486.360(c)(3), §491.12(c)(3), §494.62(c)(3). [(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]. The communication plan must include all of the following: (3) Primary and alternate means for communicating with the following: (i) [Facility] staff. (ii) Federal, State, tribal, regional, and local emergency management agencies. *[For ICF/IIDs at §483.475(c):] (3) Primary and alternate means for communicating with the ICF/IID's staff, Federal, State, tribal, regional, and local emergency management agencies.


This STANDARD is not met as evidenced by:
0032 Based on review of the Rural Health Clinic's (RHC) policy, manual review and interview, the RHC failed to maintain and update every 2 years a communication plan that included primary and alternate means for communication with facility staff, Federal, State and local emergency management agencies. The findings included: Review of the RHC's policy, "Emergency Preparedness", reviewed 10/1/1022, revealed, "... the RHC would update every 2 years a communication plan that included primary and alternate means for communication with facility staff, Federal, State and local emergency management agencies..." Review of the RHC's manual, "Emergency Preparedness Plan (EPP) and Policies and Procedures," revealed RHC did not update every 2 years a communication plan that included primary and alternate means for communication with facility staff, Federal, State and local emergency management agencies. During an interview on 3/31/2026 at 9:15 AM, the President of the RHC stated there was no documentation of updates available for review, and they were not ready for the survey.