| 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) |
| J0162 | PROGRAM EVALUATION 491.11(d) The clinic or center staff considers the findings of the evaluation and takes corrective action if necessary. This STANDARD is not met as evidenced by: Based on review of the Rural Health Clinic's (RHC) policy and interview, the RHC failed to provide documentation of any actions taken based on completed biennial evaluations. 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... The responsibility and purpose of the Biennial Program Evaluation Elements are to evaluate the utilization of clinic services, including at least the number of patients served and the volume of services to determine appropriateness of utilization; Evaluate all polices with regards to appropriateness and whether or not the policies were followed..." There was no documentation of any corrective action taken, if needed from the biennial evaluations of the total program. During an interview on 3/31/2026 at 12:30 PM, the President of the RHC stated the RHC did not have documentation of an annual/biennial evaluation available for review. |