| 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) |
| J0161 | PROGRAM EVALUATION ยง 491.11 Program evaluation. (a) The clinic or center carries out, or arranges for, a biennial evaluation of its total program. (b) The evaluation includes review of: (1) The utilization of clinic or center services, including at least the number of patients served and the volume of services; (2) A representative sample of both active and closed clinical records; and (3) The clinic's or center's health care policies. (c) The purpose of the evaluation is to determine whether: (1) The utilization of services was appropriate; (2) The established policies were followed; and (3) Any changes are needed. This STANDARD is not met as evidenced by: Based on review of Rural Health Clinic's (RHC) policy and interview, the RHC failed to complete or arrange for a biennial evaluation of the total program that included a review of policies and procedures and a sample review of active and closed clinical records. The findings included: Review of Rural Health Clinic's (RHC) policy, "Biennial Program Evaluation," reviewed 10/1/2021, revealed the RHC "...carries out a biennial program evaluation of its total program drawing upon any technical assistance resources that may be available ..." There was no documentation of biennial evaluations of the total program completed by the RHC. During an interview on 3/31/2026 at 12:30 PM, the President of the RHC stated there were no biennial evaluations available for review. |