Nursing home deficiency tags explained
When inspectors find that a nursing home did not meet a federal requirement, they cite it under a tag number such as F880. Below are the 187 tags cited in Texas in the current CMS data, grouped by CMS category. Each entry shows the CMS description word for word, then a plain-English version and a question you can ask.
Severity letters (A to L) are explained on a separate page. Plain-English text is ours and is not legal or medical advice; the CMS description is the official wording.
Quality of Life and Care Deficiencies
This group has the most Texas citations and covers the hands-on care residents receive every day. These rules expect each resident to get the treatment and support needed to reach or keep their highest practicable physical, mental, and emotional well-being, following professional standards, their care plan, and their own choices.
Texas numbers for this category
F675 · Quality of life
CMS: Honor each resident's preferences, choices, values and beliefs.
Quality of life is a core principle for all care and services. Based on the resident's assessment and care plan, the home must provide what is needed to help each person reach or maintain their highest practicable physical, mental, and psychosocial well-being.
Ask: What does a typical day look like for residents here?
Cited 9 times in Texas in the current data · Regulation: 42 CFR 483.24.
F676 · Maintaining daily living abilities
CMS: Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
Residents must not lose the ability to bathe, dress, groom, move about, use the toilet, eat, or communicate unless their clinical condition shows the decline was unavoidable. The home must provide treatment and services to maintain or improve these abilities.
Ask: How does the home help residents keep doing as much for themselves as they can?
Cited 29 times in Texas in the current data · Regulation: 42 CFR 483.24(a)-(b).
F677 · Help with daily care
CMS: Provide care and assistance to perform activities of daily living for any resident who is unable.
Residents who can't carry out daily activities on their own must receive the services they need for good nutrition, grooming, and personal and oral hygiene.
Ask: How often do residents who need help get assistance with bathing, grooming, and mouth care?
Cited 919 times in Texas in the current data · Regulation: 42 CFR 483.24(a)(2).
F678 · CPR and basic life support
CMS: Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
Staff must provide basic life support, including CPR, to a resident who needs emergency care before paramedics arrive, following related physician orders and the resident's advance directives.
Ask: Are staff on every shift trained in CPR?
Cited 52 times in Texas in the current data · Regulation: 42 CFR 483.24(a)(3).
F679 · Activities program
CMS: Provide activities to meet all resident's needs.
An ongoing activities program, based on each resident's assessment, care plan, and preferences, must offer group, individual, and independent activities that support physical, mental, and psychosocial well-being and encourage both independence and community interaction.
Ask: Can residents and families see this month's activity calendar, including options for residents who stay in their rooms?
Cited 158 times in Texas in the current data · Regulation: 42 CFR 483.24(c)(1).
F680 · Qualified activities director
CMS: Ensure the activities program is directed by a qualified professional.
The activities program must be directed by a qualified professional, such as a therapeutic recreation specialist or activities professional who meets federal certification, experience, or training standards and any state licensing.
Ask: Who leads the activities program, and what is their background?
Cited 48 times in Texas in the current data · Regulation: 42 CFR 483.24(c)(2).
F684 · Quality of care
CMS: Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of care applies to all treatment residents receive. Based on the comprehensive assessment, each resident must receive care that follows professional standards of practice, the person-centered care plan, and the resident's own choices.
Ask: How does the home make sure doctor's orders are followed consistently across shifts?
Cited 677 times in Texas in the current data · Regulation: 42 CFR 483.25.
F685 · Vision and hearing services
CMS: Assist a resident in gaining access to vision and hearing services.
To help residents keep their vision and hearing, the home must, when needed, help them make appointments and arrange transportation to eye and hearing specialists or to providers of glasses and hearing aids.
Ask: How does the home arrange eye exams and hearing aid appointments for residents?
Cited 24 times in Texas in the current data · Regulation: 42 CFR 483.25(a).
F686 · Pressure ulcer prevention and care
CMS: Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Staff must give care that prevents pressure ulcers (bedsores) unless the resident's condition makes them unavoidable. A resident who has a pressure ulcer must receive treatment that promotes healing, prevents infection, and keeps new ulcers from forming.
Ask: How often are residents who spend a lot of time in bed or a wheelchair repositioned and checked for skin problems?
Cited 362 times in Texas in the current data · Regulation: 42 CFR 483.25(b)(1).
F687 · Foot care
CMS: Provide appropriate foot care.
To support mobility and foot health, the home must provide foot care that meets professional standards, including care to prevent complications from the resident's medical conditions, and help arrange appointments and transportation to a qualified foot care provider when needed.
Ask: Does a podiatrist visit the home, or how are foot care appointments arranged?
Cited 66 times in Texas in the current data · Regulation: 42 CFR 483.25(b)(2).
F688 · Range of motion and mobility
CMS: Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
The home must ensure residents do not lose range of motion or mobility unless their clinical condition shows it is unavoidable. Those with limited movement must receive treatment, equipment, and assistance to maintain or improve it with as much independence as practicable.
Ask: What restorative or exercise programs are offered to help residents stay mobile?
Cited 104 times in Texas in the current data · Regulation: 42 CFR 483.25(c).
F689 · Accident prevention and supervision
CMS: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
The home must keep the resident environment as free of accident hazards as possible and give each resident adequate supervision and assistive devices to prevent accidents, including falls.
Ask: How does the home assess each resident's fall risk and plan to prevent falls?
Cited 1,679 times in Texas in the current data · Regulation: 42 CFR 483.25(d).
F690 · Bladder, bowel, and catheter care
CMS: Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Residents who are continent must receive the services and assistance they need to stay continent, unless their clinical condition makes that impossible. A resident who enters the home without a catheter is not to be catheterized unless their clinical condition shows it is necessary, and a resident who has a catheter must be assessed for removal as soon as possible unless their clinical condition shows it is necessary. A resident with urinary incontinence must receive appropriate treatment and services to prevent urinary tract infections and to restore continence to the extent possible, and a resident with bowel incontinence must receive treatment and services to restore as much normal bowel function as possible.
Ask: How does the home support residents who need help with toileting or incontinence?
Cited 657 times in Texas in the current data · Regulation: 42 CFR 483.25(e).
F691 · Ostomy care
CMS: Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services.
Anyone with a colostomy, urostomy, or ileostomy must get ostomy care that meets professional standards and fits their care plan, goals, and preferences.
Ask: Are nurses on every shift trained in ostomy care?
Cited 14 times in Texas in the current data · Regulation: 42 CFR 483.25(f).
F692 · Nutrition and hydration
CMS: Provide enough food/fluids to maintain a resident's health.
The home must ensure each resident maintains acceptable nutrition, such as usual body weight, unless their condition shows this is not possible or their preferences indicate otherwise. Residents must be offered enough fluids to stay hydrated and a therapeutic diet when there is a nutritional problem and the provider orders one.
Ask: How often are residents weighed, and what happens if their weight changes?
Cited 192 times in Texas in the current data · Regulation: 42 CFR 483.25(g)(1)-(3).
F693 · Feeding tube use and care
CMS: Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
A resident who has been able to eat enough alone or with help is not to be tube-fed unless their clinical condition shows tube feeding is clinically indicated and the resident consents. Residents who are tube-fed must receive care to prevent complications such as aspiration pneumonia or dehydration, and to restore eating by mouth if possible.
Ask: How are residents with feeding tubes monitored, and is there a plan to try eating by mouth again?
Cited 324 times in Texas in the current data · Regulation: 42 CFR 483.25(g)(4)-(5).
F694 · IV fluid administration
CMS: Provide for the safe, appropriate administration of IV fluids for a resident when needed.
When a resident needs IV (parenteral) fluids, staff must give them as the physician ordered and in line with accepted professional practice, the care plan, and the resident's wishes.
Ask: Can the home give IV fluids or IV medications, and who does it?
Cited 122 times in Texas in the current data · Regulation: 42 CFR 483.25(h).
F695 · Respiratory and oxygen care
CMS: Provide safe and appropriate respiratory care for a resident when needed.
Breathing-related care, such as oxygen therapy, CPAP or BiPAP use, tracheostomy care, and suctioning, must be provided to residents who need it, following professional standards and their care plan and choices.
Ask: How are oxygen equipment and breathing treatments managed and checked?
Cited 1,038 times in Texas in the current data · Regulation: 42 CFR 483.25(i).
F696 · Prosthesis care
CMS: Provide appropriate care/assistance for a resident with a prosthesis.
A resident with a prosthetic device, such as an artificial limb, must receive care and assistance to wear and use it, following professional standards, the care plan, and the resident's goals and preferences.
Ask: How do staff help residents put on, care for, and use prosthetic devices?
Cited 1 times in Texas in the current data · Regulation: 42 CFR 483.25(j).
F697 · Pain management
CMS: Provide safe, appropriate pain management for a resident who requires such services.
When a resident needs pain management, the home must provide it in a way that follows professional standards and reflects the care plan and the resident's own goals.
Ask: How do staff check for pain in residents who have trouble describing it?
Cited 108 times in Texas in the current data · Regulation: 42 CFR 483.25(k).
F698 · Dialysis care
CMS: Provide safe, appropriate dialysis care/services for a resident who requires such services.
For residents on dialysis, the home must make sure they receive dialysis services and related care that meet professional standards and match their care plan and preferences.
Ask: How does the home coordinate with the dialysis center about medications, meals, and transport?
Cited 122 times in Texas in the current data · Regulation: 42 CFR 483.25(l).
F699 · Trauma-informed, culturally competent care
CMS: Provide care or services that was trauma informed and/or culturally competent.
Residents who are trauma survivors must receive culturally competent, trauma-informed care that follows professional standards and takes their experiences and preferences into account, so that triggers which could cause re-traumatization are eliminated or reduced.
Ask: How does the home learn about a resident's history and cultural needs when planning care?
Cited 51 times in Texas in the current data · Regulation: 42 CFR 483.25(m).
F700 · Bed rail safety
CMS: Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Before installing a bed rail, the home must try appropriate alternatives. If a rail is used, staff must assess the resident's entrapment risk, review risks and benefits with the resident or representative, get informed consent, make sure the bed's dimensions are appropriate for the resident's size and weight, and follow the manufacturer's instructions for installing and maintaining the rail.
Ask: What alternatives to bed rails does the home use, and how is consent obtained?
Cited 105 times in Texas in the current data · Regulation: 42 CFR 483.25(n).
F740 · Behavioral health care
CMS: Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Each resident must receive the behavioral health care and services they need, based on their assessment and care plan. Behavioral health covers a resident's whole emotional and mental well-being, including preventing and treating mental health and substance use disorders.
Ask: What mental health services, such as counseling or psychiatric visits, are available to residents?
Cited 25 times in Texas in the current data · Regulation: 42 CFR 483.40.
F741 · Staff skilled in behavioral health
CMS: Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents.
Direct care staff must have the competencies to meet residents' behavioral health needs, such as caring for people with mental and psychosocial disorders and using nondrug approaches to behavior, in line with the facility assessment.
Ask: What training do staff get in responding to residents with dementia-related or emotional distress?
Cited 2 times in Texas in the current data · Regulation: 42 CFR 483.40(a).
F742 · Treatment for mental health and trauma
CMS: Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.
A resident who shows or is diagnosed with a mental disorder or difficulty adjusting, or who has a history of trauma or PTSD, must receive appropriate treatment and services to correct the problem or reach their highest practicable mental and psychosocial well-being.
Ask: How are residents with depression, anxiety, or past trauma supported day to day?
Cited 16 times in Texas in the current data · Regulation: 42 CFR 483.40(b)(1).
F744 · Dementia care
CMS: Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
A resident who shows signs of dementia or has a dementia diagnosis must receive treatment and services suited to that condition, so they can reach or keep the highest physical, mental, and emotional well-being practicable for them.
Ask: How is care for residents with dementia individualized, and is there a memory care area?
Cited 12 times in Texas in the current data · Regulation: 42 CFR 483.40(b)(3).
F745 · Medically related social services
CMS: Provide medically-related social services to help each resident achieve the highest possible quality of life.
Medically related social services must be available to help each resident attain or maintain their highest practicable well-being, such as helping residents assert their rights, resolve grievances, arrange outside services, and handle financial matters.
Ask: Who is the social worker, and how can families reach them?
Cited 14 times in Texas in the current data · Regulation: 42 CFR 483.40(d).
F790 · Dental care in skilled nursing facilities
CMS: Provide routine and 24-hour emergency dental care for each resident.
For Medicare skilled nursing residents, the home must help obtain routine and 24-hour emergency dental care, assist with appointments and transportation, and refer residents with lost or damaged dentures within 3 days. It must also have a policy on when the home is responsible for denture loss or damage.
Ask: What happens if a resident's dentures are lost or broken?
Cited 30 times in Texas in the current data · Regulation: 42 CFR 483.55(a).
F791 · Dental services in Medicaid nursing facilities
CMS: Provide or obtain dental services for each resident.
In Medicaid nursing facilities, residents must be able to get routine dental services, to the extent the state plan covers them, and emergency dental services, with help scheduling appointments and transportation. Lost or damaged dentures must be referred for care within 3 days.
Ask: Does a dentist visit the home, and how are routine cleanings arranged?
Cited 53 times in Texas in the current data · Regulation: 42 CFR 483.55(b).
F825 · Therapy and rehabilitation services
CMS: Provide or get specialized rehabilitative services as required for a resident.
If a resident's care plan calls for specialized rehabilitation, such as physical, occupational, speech, or respiratory therapy, or rehabilitative services for mental illness or intellectual disability, the home must provide it or obtain it from a qualified outside source.
Ask: Which therapies are offered on site, and how many days a week are therapists here?
Cited 18 times in Texas in the current data · Regulation: 42 CFR 483.65(a).
F826 · Qualified therapists with a doctor's order
CMS: Provide specialized rehabilitative services by qualified personnel, when ordered for a resident by a doctor.
Specialized rehabilitative services must be given under a physician's written order and by qualified personnel.
Ask: Are therapy sessions provided by licensed therapists or therapy assistants?
Cited 1 times in Texas in the current data · Regulation: 42 CFR 483.65(b).
Resident Assessment and Care Planning Deficiencies
Federal rules require every resident to be assessed with a standard national tool soon after admission and at set times afterward. The results drive a written, person-centered care plan that the care team and the resident, along with the resident's representative where practicable, prepare and keep up to date.
Texas numbers for this category
F635 · Doctor's orders at admission
CMS: Provide doctor's orders for the resident's immediate care at the time the resident was admitted.
On the day a resident is admitted, the home must already have physician orders covering the resident's immediate care.
Ask: What information does the home need from the hospital or the resident's doctor before admission day?
Cited 60 times in Texas in the current data · Regulation: 42 CFR 483.20(a).
F636 · Full assessment at admission and yearly
CMS: Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Using the federal Resident Assessment Instrument, staff must complete a comprehensive assessment of each resident's needs, strengths, goals, life history, and preferences within 14 days of admission. It must be repeated at least once every 12 months.
Ask: Who completes the admission assessment, and how is the family's input included?
Cited 94 times in Texas in the current data · Regulation: 42 CFR 483.20(b).
F637 · Reassessment after a significant change
CMS: Assess the resident when there is a significant change in condition
When a resident's physical or mental condition declines or improves in a major way that won't resolve on its own, a new comprehensive assessment is due within 14 days after the home determines, or should have determined, that the change occurred.
Ask: How does the care team decide when a change in condition calls for a full reassessment?
Cited 58 times in Texas in the current data · Regulation: 42 CFR 483.20(b)(2)(ii).
F638 · Quarterly assessment reviews
CMS: Assure that each resident’s assessment is updated at least once every 3 months.
Between full assessments, every resident must be reviewed with the state-specified quarterly review instrument at least once every 3 months.
Ask: How are families updated after each quarterly review?
Cited 50 times in Texas in the current data · Regulation: 42 CFR 483.20(c).
F639 · Keeping 15 months of assessments
CMS: Maintain 15 months of resident assessments in the resident's active clinical record.
All resident assessments completed in the previous 15 months must stay in the resident's active record, and their results must be used to develop, review, and revise the care plan.
Ask: How are past assessments used when the care plan is updated?
Cited 1 times in Texas in the current data · Regulation: 42 CFR 483.20(d).
F640 · Submitting assessment data on time
CMS: Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Within 7 days of completing a resident assessment, the home must encode the data and be able to transmit it. Complete, accurate assessment data must be sent electronically to the CMS system within 14 days. (CMS's one-line description of this tag mentions 7 days; the regulation text at 42 CFR 483.20(f) separates encoding and being ready to transmit, within 7 days, from the actual electronic transmission, within 14 days.)
Ask: Who is responsible for completing and submitting resident assessment data?
Cited 134 times in Texas in the current data · Regulation: 42 CFR 483.20(f).
F641 · Accurate resident assessments
CMS: Ensure each resident receives an accurate assessment.
Each assessment must accurately reflect the resident's status. A registered nurse must conduct or coordinate it with the participation of appropriate health professionals and sign that it is complete, and each person who completes a portion must sign and certify that portion's accuracy. A person who willfully and knowingly certifies a material and false statement in a resident assessment, or causes another person to, is subject to civil money penalties. Clinical disagreement does not count as a material and false statement.
Ask: How does the home check that resident assessments match what staff actually observe?
Cited 709 times in Texas in the current data · Regulation: 42 CFR 483.20(g)-(j).
F642 · Qualified staff conduct assessments
CMS: Ensure a qualified health professional conducts resident assessments.
A registered nurse must conduct or coordinate each resident assessment with appropriate participation of health professionals, and certify that it is complete. Since April 2025, CMS cites this requirement under F641.
Ask: Which nurse coordinates a resident's assessments?
Cited 9 times in Texas in the current data · Regulation: 42 CFR 483.20(h)-(j).
F644 · Coordinating with PASARR screening
CMS: Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Assessments must be coordinated with the state's Preadmission Screening and Resident Review (PASARR) program, to the maximum extent practicable to avoid duplicative testing. The home must build PASARR recommendations into assessments and care plans, and refer all residents who already had a level II review, and all residents with a newly evident or possible serious mental disorder, intellectual disability, or related condition, for review after a significant change in status.
Ask: If a resident has a mental health condition or intellectual disability, how are PASARR recommendations included in their care?
Cited 376 times in Texas in the current data · Regulation: 42 CFR 483.20(e).
F645 · Pre-admission screening for mental disorder or intellectual disability
CMS: PASARR screening for Mental disorders or Intellectual Disabilities
A Medicaid-certified nursing facility may not admit a new resident who has a serious mental disorder or an intellectual disability (or a related condition) unless the appropriate state authority has determined, before admission, that the person needs the level of services a nursing facility provides and whether they need specialized services. The rule has exceptions, including readmission after a hospital transfer and, if the state chooses, certain stays of under 30 days for people admitted directly from a hospital.
Ask: How does the home confirm the pre-admission screening is done for new residents with a mental health condition or intellectual disability?
Cited 230 times in Texas in the current data · Regulation: 42 CFR 483.20(k).
F646 · Reporting changes for PASARR residents
CMS: Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.
If a resident with a mental illness or intellectual disability has a significant change in physical or mental condition, the home must promptly notify the state mental health or intellectual disability authority so the resident can be reviewed again.
Ask: How does the home coordinate with state agencies when a resident's needs change?
Cited 12 times in Texas in the current data · Regulation: 42 CFR 483.20(k)(4).
F655 · Baseline care plan within 48 hours
CMS: Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Within 48 hours of admission, a baseline care plan must be in place with the minimum information needed to care for the resident properly, such as initial goals, physician orders, dietary orders, therapy, and social services. The resident and representative receive a summary of it.
Ask: Can a resident or their family review the baseline care plan during the first few days?
Cited 372 times in Texas in the current data · Regulation: 42 CFR 483.21(a).
F656 · Comprehensive person-centered care plan
CMS: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
For every resident, the home must write and carry out a person-centered care plan with measurable objectives and timeframes for medical, nursing, mental, and psychosocial needs found in the assessment. It must reflect the resident's goals and preferences and note any care the resident has chosen to refuse.
Ask: How are a resident's goals and preferences written into the care plan?
Cited 1,829 times in Texas in the current data · Regulation: 42 CFR 483.21(b)(1).
F657 · Care plan timing and team review
CMS: Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
The comprehensive care plan is due within 7 days after the full assessment. An interdisciplinary team, including the attending physician, a registered nurse, a nurse aide, food service staff, and, where practicable, the resident and representative, prepares it and revises it after each assessment.
Ask: Who sits on the care planning team, and how are family members invited?
Cited 455 times in Texas in the current data · Regulation: 42 CFR 483.21(b)(2).
F658 · Professional standards in care
CMS: Ensure services provided by the nursing facility meet professional standards of quality.
Services the home provides or arranges under a resident's care plan must meet professional standards of quality.
Ask: How do nursing leaders check that daily care follows current clinical guidelines?
Cited 48 times in Texas in the current data · Regulation: 42 CFR 483.21(b)(3)(i).
F659 · Care by qualified staff per plan
CMS: Provide care by qualified persons according to each resident's written plan of care.
Care described in a resident's written plan must be delivered by qualified persons and carried out the way the plan says.
Ask: How do aides and nurses on each shift learn what is in a resident's care plan?
Cited 7 times in Texas in the current data · Regulation: 42 CFR 483.21(b)(3)(ii).
F660 · Discharge planning process
CMS: Plan the resident's discharge to meet the resident's goals and needs.
An effective discharge planning process must identify each resident's discharge needs and goals, be updated as things change, involve the care team, and consider the resident's preferences and available caregivers. This requirement moved to F627 in April 2025.
Ask: When does discharge planning start for a short-term rehab stay?
Cited 24 times in Texas in the current data · Regulation: 42 CFR 483.21(c)(1).
F661 · Discharge summary
CMS: Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
When a discharge is planned, the resident must have a discharge summary that recaps the stay, describes their status, reconciles medications before and after discharge, and includes a post-discharge plan of care. Since April 2025, CMS cites these items under F627 and F628.
Ask: Is a written discharge summary and medication list provided when a resident goes home?
Cited 32 times in Texas in the current data · Regulation: 42 CFR 483.21(c)(2).
F842 · Complete, confidential medical records
CMS: Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Medical records for each resident must be complete, accurately documented, readily accessible, and systematically organized. The home must keep them confidential except where release is permitted, protect them against loss or unauthorized use, and retain them for the period state or federal rules require.
Ask: Does the home use electronic health records, and can families get access through a portal?
Cited 958 times in Texas in the current data · Regulation: 42 CFR 483.20(f)(5); 483.70(h).
Resident Rights Deficiencies
Moving into a nursing home does not take away a person's rights. These rules protect each resident's dignity, privacy, and choices, their right to information and visitors, their control over their own money, and their protections when they are admitted, moved, or discharged.
Texas numbers for this category
F550 · Dignity and the right to exercise rights
CMS: Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Residents keep their rights as citizens when they move in. The home must treat each person with dignity, support their self-determination and their contact with people inside and outside the building, and let them use their rights without interference, pressure, discrimination, or retaliation.
Ask: How do staff learn about and respect each resident's personal routines and choices? Who can a resident talk to if they feel their rights are not being respected?
Cited 695 times in Texas in the current data · Regulation: 42 CFR 483.10(a)-(b).
F551 · Role of the resident's representative
CMS: Give the resident's representative the ability to exercise the resident's rights.
A resident may name a representative, such as a relative, as state law allows. The home must let that person exercise whatever rights the resident has delegated to them, while the resident keeps every right that was not delegated.
Ask: How does the home record who a resident's representative is and which decisions they can make?
Cited 25 times in Texas in the current data · Regulation: 42 CFR 483.10(b)(3)-(7).
F552 · Being informed about health and treatment
CMS: Ensure that residents are fully informed and understand their health status, care and treatments.
Each resident is entitled to full information about their health, advance notice of what care they will get and the type of caregiver or professional who will give it, and an explanation of the risks and benefits of treatment options, in a language and manner they understand.
Ask: How do doctors and nurses explain changes in treatment to residents and their families?
Cited 181 times in Texas in the current data · Regulation: 42 CFR 483.10(c)(1), (c)(4)-(5).
F553 · Taking part in care planning
CMS: Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Each resident may help shape their own person-centered care plan, including who joins planning meetings, what the goals are, and the type and amount of care. Residents can request meetings or revisions and must be told in advance about changes to the plan.
Ask: How often are care plan meetings held, and can family members attend?
Cited 56 times in Texas in the current data · Regulation: 42 CFR 483.10(c)(2)-(3).
F554 · Taking one's own medications
CMS: Allow residents to self-administer drugs if determined clinically appropriate.
A resident may manage and take their own medications when the interdisciplinary care team has assessed them and decided that this is clinically appropriate.
Ask: How does the care team decide whether a resident can keep and take their own medications?
Cited 18 times in Texas in the current data · Regulation: 42 CFR 483.10(c)(7).
F555 · Choosing an attending physician
CMS: Honor the resident's right to choose his or her attending physician.
Residents can choose their own attending physician, provided the doctor is licensed and meets federal requirements. The home must keep residents informed of their doctor's name, specialty, and how to reach them.
Ask: Can a resident keep their current doctor after moving in, and how would visits work?
Cited 5 times in Texas in the current data · Regulation: 42 CFR 483.10(d).
F557 · Respect and personal belongings
CMS: Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Residents must be treated with respect and dignity. They may keep and use their own possessions, including furniture and clothing, as space permits, unless doing so would infringe on the rights, health, or safety of other residents.
Ask: What personal items and furniture can residents bring for their rooms?
Cited 67 times in Texas in the current data · Regulation: 42 CFR 483.10(e)(2).
F558 · Accommodating individual needs and preferences
CMS: Reasonably accommodate the needs and preferences of each resident.
Within reason, care and living arrangements must be adapted to each resident's individual needs and preferences. The exception is an accommodation that would endanger the health or safety of that resident or others.
Ask: How does the home adapt rooms and routines for residents with limited mobility, vision, or hearing?
Cited 640 times in Texas in the current data · Regulation: 42 CFR 483.10(e)(3).
F559 · Roommate choice and room-change notice
CMS: Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.
Married residents may share a room when both agree, and residents may share with a roommate of their choice when practicable. Before changing a resident's room or roommate, the home must give written notice that includes the reason.
Ask: How are roommates matched, and how much notice is given before a room change?
Cited 24 times in Texas in the current data · Regulation: 42 CFR 483.10(e)(4)-(6).
F561 · Making everyday choices
CMS: Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Residents decide on their own activities, daily schedules, sleeping and waking times, and health care providers, consistent with their interests, assessments, and care plan, and the home must support those choices. Residents may also join social, religious, and community activities inside and outside the home.
Ask: Can residents choose when they wake up, go to bed, and bathe?
Cited 74 times in Texas in the current data · Regulation: 42 CFR 483.10(f)(1)-(3), (f)(8).
F562 · Access for officials and advocates
CMS: Provide immediate access to any resident.
Certain people must be given immediate access to any resident, including federal and state representatives, the long-term care ombudsman, the resident's own physician, protection and advocacy representatives, and the resident's representative.
Ask: How can residents and families contact the local long-term care ombudsman?
Cited 2 times in Texas in the current data · Regulation: 42 CFR 483.10(f)(4)(i).
F563 · Receiving visitors
CMS: Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing.
Residents may receive the visitors they choose at the times they choose, and may decline visits. Family members, and others visiting with the resident's consent, must be given immediate access, subject only to reasonable clinical and safety limits described in the home's written policies.
Ask: Are there any limits on when family can visit, and what are the reasons for them?
Cited 14 times in Texas in the current data · Regulation: 42 CFR 483.10(f)(4)(ii)-(v).
F564 · Explaining visitation rights
CMS: Inform each resident of his or her visitation rights and ensure that all visitors enjoy equal visitation privileges.
Every resident must be told about their visitation rights and any limits on them, along with the reasons. Visitors the resident chooses, such as a spouse, domestic partner, relative, or friend, must receive full and equal visitation privileges.
Ask: Is there a written visitation policy that residents and families can read before move-in?
Cited 2 times in Texas in the current data · Regulation: 42 CFR 483.10(f)(4)(vi).
F565 · Resident and family councils
CMS: Honor the resident's right to organize and participate in resident/family groups in the facility.
Residents may organize and join resident groups, and families may meet with other families. The home must offer these groups private space and a designated staff contact, consider their views, and act promptly on their grievances and recommendations.
Ask: Is there an active resident council or family council, and how often does it meet?
Cited 114 times in Texas in the current data · Regulation: 42 CFR 483.10(f)(5)-(7).
F567 · Managing personal money
CMS: Honor the resident's right to manage his or her financial affairs.
Money decisions belong to the resident, including the right to know in advance what charges may be taken from personal funds. A home cannot require residents to deposit money with it; if they choose to, it must hold and account for those funds on their behalf.
Ask: If a resident keeps money in a resident trust account, how can the resident or family check the balance?
Cited 25 times in Texas in the current data · Regulation: 42 CFR 483.10(f)(10)(i)-(ii).
F568 · Accounting for resident funds
CMS: Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
When a home holds a resident's money, it must keep a full, separate accounting of those funds, never mix them with the home's own money, and give the resident statements every quarter and whenever asked.
Ask: How often are statements for resident funds sent, and who receives them?
Cited 6 times in Texas in the current data · Regulation: 42 CFR 483.10(f)(10)(iii).
F569 · Balance notices and returning funds
CMS: Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
For residents on Medicaid, the home must give notice when their account comes within $200 of the SSI resource limit, because reaching it could affect eligibility. After a discharge, eviction, or death, the home must convey the funds and a final accounting within 30 days.
Ask: How are residents on Medicaid told when their account balance is nearing the limit?
Cited 4 times in Texas in the current data · Regulation: 42 CFR 483.10(f)(10)(iv)-(v).
F570 · Bonding for deposited funds
CMS: Assure the security of all personal funds of residents deposited with the facility.
A home that holds residents' money must buy a surety bond, or provide another assurance acceptable to the federal government, so that all personal funds residents deposit with it are secure.
Ask: How are resident funds held by the home bonded or otherwise protected?
Cited 6 times in Texas in the current data · Regulation: 42 CFR 483.10(f)(10)(vi).
F572 · Notice of rights, rules, and services
CMS: Give residents a notice of rights, rules, services and charges.
At or before admission, and again during the stay, residents must be told their rights, the services available, and the rules they are expected to follow. This information is given both orally and in writing, in a language the resident understands.
Ask: Can a resident or their family get a copy of the resident rights notice and admission packet before moving in?
Cited 9 times in Texas in the current data · Regulation: 42 CFR 483.10(g)(1), (g)(16).
F573 · Access to personal and medical records
CMS: Let each resident or the resident's legal representative access or purchase copies of all the resident's records.
Residents, or their legal representatives, may see their own records within 24 hours of asking, not counting weekends and holidays, and obtain copies with two working days' notice. The home may charge only a reasonable, cost-based fee for copies.
Ask: What is the process for requesting copies of a resident's medical records?
Cited 20 times in Texas in the current data · Regulation: 42 CFR 483.10(g)(2)-(3).
F574 · Notices in an understandable format
CMS: The resident has the right to receive notices in a format and a language he or she understands.
Required notices must be given both spoken and in writing, including Braille, in a format and language the resident understands. This includes a written description of legal rights, such as how personal funds are protected and how Medicaid eligibility is established.
Ask: Are admission documents and notices available in languages other than English?
Cited 2 times in Texas in the current data · Regulation: 42 CFR 483.10(g)(4).
F575 · Posting agency and advocate contacts
CMS: Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency.
Contact details for state agencies and advocacy groups, such as the state survey agency, adult protective services, and the long-term care ombudsman, must be posted where residents and representatives can access and understand them, along with a statement that residents may file a complaint with the state survey agency.
Ask: Where are the ombudsman and state agency phone numbers posted in the building?
Cited 17 times in Texas in the current data · Regulation: 42 CFR 483.10(g)(5).
F576 · Phone, mail, and internet access
CMS: Ensure residents have reasonable access to and privacy in their use of communication methods.
Residents must have reasonable access to a telephone in a place where calls can't be overheard, may keep their own cell phone, and must have reasonable access to the internet to the extent it is available to the home. They also have the right to send and promptly receive mail and packages.
Ask: Where can residents make private phone calls, and is Wi-Fi available to them?
Cited 63 times in Texas in the current data · Regulation: 42 CFR 483.10(g)(6)-(9).
F577 · Seeing inspection results
CMS: Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
Anyone living in the home may read the results of its most recent federal or state inspection and any plan of correction in effect. Those results must be posted where residents and families can easily find them, and residents must be able to contact client advocacy agencies.
Ask: Where can residents and families read the home's most recent inspection report and plan of correction?
Cited 71 times in Texas in the current data · Regulation: 42 CFR 483.10(g)(10)-(11).
F578 · Refusing treatment and advance directives
CMS: Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Residents may request, refuse, or stop treatment, and may decide whether to take part in experimental research. The right to request treatment does not mean a right to treatment that is medically unnecessary or inappropriate. The home must give adult residents written information about these rights and about making an advance directive, and follow federal advance directive rules.
Ask: How does the home record and follow a resident's advance directive?
Cited 241 times in Texas in the current data · Regulation: 42 CFR 483.10(c)(6), (c)(8), (g)(12).
F579 · Information on Medicare and Medicaid
CMS: Provide information about how to apply for and use Medicare and Medicaid benefits.
Information about how to apply for and use Medicare and Medicaid, and how to get refunds for earlier payments those programs cover, must be displayed in writing and explained to residents and applicants both orally and in writing.
Ask: Who at the home can explain how Medicare and Medicaid would cover a stay?
Cited 2 times in Texas in the current data · Regulation: 42 CFR 483.10(g)(13).
F580 · Telling residents and families about changes
CMS: Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
The home must immediately inform the resident, consult the resident's doctor, and notify the resident's representative when there is an accident that results in injury and could require a doctor's intervention, a significant change in the resident's physical, mental, or psychosocial status, a need to change treatment significantly, or a decision to transfer or discharge the resident. The home must also promptly notify the resident and representative of a change in room or roommate, or a change in resident rights under federal or state law.
Ask: How quickly is the family called if a resident falls or their condition changes?
Cited 463 times in Texas in the current data · Regulation: 42 CFR 483.10(g)(14).
F582 · Notice of covered and extra charges
CMS: Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Residents eligible for Medicaid must be told in writing which items and services are included and which cost extra, and how much. All residents must be informed, at admission and during the stay, about charges for services that Medicare, Medicaid, or the daily rate do not cover.
Ask: Which services and supplies are included in the daily rate, and which are billed separately?
Cited 60 times in Texas in the current data · Regulation: 42 CFR 483.10(g)(17)-(18).
F583 · Personal privacy and confidential records
CMS: Keep residents' personal and medical records private and confidential.
Residents have a right to privacy during personal care, medical treatment, visits, calls, and meetings, and to receive their mail unopened. The home must keep their personal and medical records confidential.
Ask: How do staff protect residents' privacy during bathing, dressing, and treatments?
Cited 428 times in Texas in the current data · Regulation: 42 CFR 483.10(h).
F584 · Safe, clean, homelike surroundings
CMS: Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
A safe, clean, comfortable, and homelike setting is a resident right, including the chance to use one's own belongings. It covers housekeeping and maintenance, clean linens, private closet space, adequate lighting, and comfortable temperatures and sound levels.
Ask: How often are rooms cleaned and bed linens changed?
Cited 745 times in Texas in the current data · Regulation: 42 CFR 483.10(i).
F585 · Grievances and how they are handled
CMS: Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Residents can raise complaints about their care, staff, other residents, or any part of their stay without fear of retaliation. The home must have a grievance policy, tell residents how to use it, name a grievance official, and make prompt efforts to resolve each concern.
Ask: Who is the grievance official, and how are complaints tracked and answered?
Cited 192 times in Texas in the current data · Regulation: 42 CFR 483.10(j).
F620 · Admissions policy rules
CMS: Not require residents to give up Medicare or Medicaid benefits, or pay privately as a condition of admission; and must tell residents what care they do not provide.
An admissions policy is required, and it cannot ask residents to waive their rights, give up Medicare or Medicaid, or have a third party guarantee payment as a condition of admission. The home may, however, ask a representative who has legal access to the resident's income or resources to sign a contract to pay from those funds, without taking on personal financial liability. Before admission, the home must disclose any special characteristics or limits on the services it provides.
Ask: Are there any care needs or conditions the home is not able to serve?
Cited 11 times in Texas in the current data · Regulation: 42 CFR 483.15(a).
F621 · Equal treatment regardless of payment
CMS: Treat residents equally regarding transfer, discharge, and provision of services for all residents, regardless of payment source
Transfer, discharge, and service policies must be identical for every resident, whether they pay privately or through Medicare or Medicaid.
Ask: How does the home handle a resident who changes from private pay to Medicaid?
Cited 1 times in Texas in the current data · Regulation: 42 CFR 483.15(b).
F622 · Permitted reasons for transfer or discharge
CMS: Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.
A home may transfer or discharge a resident only for specific reasons, such as needs it cannot meet, improved health, endangered health or safety of others, nonpayment after notice, or the home closing, and the reason must be documented. Since April 2025, CMS cites these rules under F627 and F628.
Ask: Under what circumstances would the home ask a resident to move out?
Cited 48 times in Texas in the current data · Regulation: 42 CFR 483.15(c)(1)-(2).
F623 · Written notice before a move
CMS: Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Before a transfer or discharge, the home must notify the resident and representative in writing, with the reason and appeal rights, in a language they understand, and copy the long-term care ombudsman. Notice generally comes at least 30 days ahead. In April 2025, CMS folded this requirement into F628.
Ask: How much notice is given before a discharge, and how can a resident appeal it?
Cited 68 times in Texas in the current data · Regulation: 42 CFR 483.15(c)(3)-(6), (c)(8).
F624 · Preparing residents for a move
CMS: Prepare residents for a safe transfer or discharge from the nursing home.
Residents must receive enough preparation and orientation for a transfer or discharge that the move is safe and orderly, explained in a way they can understand and documented by the home. Citations made after April 2025 use F627 instead.
Ask: How does the home help a resident get ready for a move to another setting?
Cited 23 times in Texas in the current data · Regulation: 42 CFR 483.15(c)(7).
F625 · Bed-hold notice
CMS: Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Before a resident goes to the hospital or on therapeutic leave, and again at the time of transfer, the home must give written notice of its bed-hold policy, including how long the bed is held and the right to return. Since April 2025, CMS cites this under F628.
Ask: If a resident is hospitalized, how long does the home hold their bed, and is there a charge?
Cited 11 times in Texas in the current data · Regulation: 42 CFR 483.15(d).
F626 · Returning after a hospital stay
CMS: Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy.
A home must have and follow a written policy on letting residents return after a hospital stay or therapeutic leave. If the stay or leave runs longer than the state bed-hold period, a resident who still needs the home's services and is eligible for Medicare skilled nursing facility or Medicaid nursing facility coverage must be allowed back into their previous room if it is available, or into the first available bed in a semi-private room. From April 2025 on, the same rule is cited as F627.
Ask: What happens if a hospital stay lasts longer than the bed-hold period?
Cited 20 times in Texas in the current data · Regulation: 42 CFR 483.15(e)(1)-(2).
F627 · Permitted transfers, discharge planning, and return rights
CMS: Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
Since April 2025, this tag covers whether a transfer or discharge was allowed and properly prepared. A resident may be moved out only for permitted reasons, and the home must plan the discharge around the resident's goals and needs, orient them for the move, and, when a hospital stay or therapeutic leave runs past the state bed-hold period, allow a resident who still needs the home's services and is eligible for Medicare skilled nursing or Medicaid nursing facility coverage to return.
Ask: How are residents and families involved in planning a discharge?
Cited 57 times in Texas in the current data · Regulation: 42 CFR 483.15(c)(1), (c)(2)(i)-(ii), (c)(7), (e); 483.21(c)(1), (c)(2)(iv).
F628 · Discharge paperwork, notices, and bed-hold information
CMS: Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Since April 2025, this tag covers the records and notices around a move. The home must document the transfer or discharge, send care information to the next provider, give written notice with the reason and appeal rights, provide bed-hold details, and prepare a discharge summary.
Ask: What information does the home send to the hospital or next facility when a resident leaves?
Cited 105 times in Texas in the current data · Regulation: 42 CFR 483.15(c)(2)(iii), (c)(3)-(6), (c)(8), (d); 483.21(c)(2)(i)-(iii).
F942 · Resident rights training for staff
CMS: Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.
Staff members must be educated on residents' rights and on the home's responsibilities for properly caring for its residents.
Ask: How often do staff receive training on resident rights?
Cited 33 times in Texas in the current data · Regulation: 42 CFR 483.95(b).
Pharmacy Service Deficiencies
These rules govern how medications are ordered, reviewed, given, and stored. They aim to make sure residents get the drugs they need, avoid drugs they don't need, and are protected from medication errors.
Texas numbers for this category
F755 · Pharmacy services and a consultant pharmacist
CMS: Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Residents must get the routine and emergency medications they need through procedures for accurately obtaining, receiving, dispensing, and giving drugs. A licensed pharmacist must advise on pharmacy services and keep records that allow controlled drugs to be accounted for and reconciled.
Ask: How are new medication orders filled, and how quickly can urgent medications arrive?
Cited 1,454 times in Texas in the current data · Regulation: 42 CFR 483.45(a)-(b).
F756 · Monthly pharmacist medication review
CMS: Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
A licensed pharmacist must review each resident's medications and medical chart at least once a month. Irregularities, such as unnecessary drugs, must be reported to the attending physician, medical director, and director of nursing, and those reports must be acted on.
Ask: How are the pharmacist's monthly recommendations shared with the doctor and family?
Cited 89 times in Texas in the current data · Regulation: 42 CFR 483.45(c).
F757 · Avoiding unnecessary drugs
CMS: Ensure each resident’s drug regimen must be free from unnecessary drugs.
A resident's medication regimen must be free of unnecessary drugs, meaning drugs given in excessive doses or duplicates, for too long, without adequate monitoring or a valid reason, or despite side effects that call for reducing or stopping them.
Ask: How often is a resident's full medication list reviewed for drugs that may no longer be needed?
Cited 122 times in Texas in the current data · Regulation: 42 CFR 483.45(d).
F758 · Psychotropic drug safeguards
CMS: Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Psychotropic drugs may be started only when needed for a specific diagnosed condition. Residents taking them must receive gradual dose reductions and behavioral interventions unless clinically contraindicated, and as-needed (PRN) orders are generally limited to 14 days, with stricter renewal rules for antipsychotics. In April 2025, CMS merged this tag into F605.
Ask: How does the home try non-drug approaches before using medications for mood or behavior?
Cited 185 times in Texas in the current data · Regulation: 42 CFR 483.45(c)(3), (e).
F759 · Medication error rate under 5 percent
CMS: Ensure medication error rates are not 5 percent or greater.
When inspectors observe medications being given, the error rate must stay below 5 percent. An error is any medication prepared or given differently from the prescriber's order, the manufacturer's specifications, or accepted professional standards.
Ask: How do nurses double-check medications before giving them?
Cited 378 times in Texas in the current data · Regulation: 42 CFR 483.45(f)(1).
F760 · No significant medication errors
CMS: Ensure that residents are free from significant medication errors.
Residents must be free of any significant medication error, meaning an error that causes the resident discomfort or jeopardizes their health and safety.
Ask: What happens when a medication error is discovered, and who is notified?
Cited 400 times in Texas in the current data · Regulation: 42 CFR 483.45(f)(2).
F761 · Drug labeling and secure storage
CMS: Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Medications must be labeled according to accepted professional principles, with any needed cautions and expiration dates. They must be stored in locked compartments at proper temperatures, with separately locked storage for certain controlled drugs and access limited to authorized staff.
Ask: How are medications stored and secured on each unit?
Cited 1,525 times in Texas in the current data · Regulation: 42 CFR 483.45(g)-(h).
Nutrition and Dietary Deficiencies
Food and nutrition rules cover what residents eat and drink, how it is prepared, and how safely it is handled. Meals are expected to be nourishing, appealing, suited to each person's medical needs and preferences, and served from a kitchen that follows food safety standards.
Texas numbers for this category
F800 · Nourishing, well-balanced diet
CMS: Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
Meals must be nourishing, palatable, and well balanced, meet each resident's daily nutritional and special dietary needs, and take their preferences into account.
Ask: Can residents and families see a sample weekly menu?
Cited 35 times in Texas in the current data · Regulation: 42 CFR 483.60.
F801 · Qualified dietitian and food staff
CMS: Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Food and nutrition services need enough competent staff, including a qualified dietitian or other clinically qualified nutrition professional, who may work full time, part time, or as a consultant. If that person isn't full time, the food service director must meet set qualifications.
Ask: How often does the dietitian see residents, especially those with weight changes?
Cited 75 times in Texas in the current data · Regulation: 42 CFR 483.60(a)(1)-(2).
F802 · Enough kitchen and dining support staff
CMS: Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
There must be enough support staff to carry out food and nutrition services safely and effectively, from preparing meals to serving them.
Ask: How many staff help in the dining room during meals?
Cited 46 times in Texas in the current data · Regulation: 42 CFR 483.60(a)(3).
F803 · Menus that meet nutritional needs
CMS: Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Menus must meet national nutrition guidelines, be planned in advance and actually followed, reflect residents' religious, cultural, and ethnic needs and their input, be updated periodically, and be reviewed by the dietitian. Residents can still make personal dietary choices.
Ask: How do residents give input on the menu?
Cited 182 times in Texas in the current data · Regulation: 42 CFR 483.60(c).
F804 · Palatable, attractive food at safe temperatures
CMS: Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Food must be prepared in ways that preserve its nutrition, flavor, and appearance, and food and drink must be palatable, attractive, and served at a safe and appetizing temperature.
Ask: How does the home keep meals at the right temperature when they are delivered to residents' rooms?
Cited 293 times in Texas in the current data · Regulation: 42 CFR 483.60(d)(1)-(2).
F805 · Food prepared for individual needs
CMS: Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Each resident must receive food prepared in a form suited to their needs, such as chopped, ground, or pureed food for someone who has trouble chewing or swallowing.
Ask: How are texture-modified diets prepared so they still look and taste appealing?
Cited 127 times in Texas in the current data · Regulation: 42 CFR 483.60(d)(3).
F806 · Allergies, preferences, and meal substitutes
CMS: Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Meals must accommodate each resident's food allergies, intolerances, and preferences. Residents who don't want what is served, or who ask for something different, must be offered an appealing alternative of similar nutritional value.
Ask: What are the options if a resident doesn't like the main meal?
Cited 99 times in Texas in the current data · Regulation: 42 CFR 483.60(d)(4)-(5).
F807 · Drinks and hydration
CMS: Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration.
Water and other drinks must be provided to suit each resident's needs and preferences, in amounts enough to keep them hydrated.
Ask: How do staff make sure residents who can't reach for drinks get enough fluids?
Cited 15 times in Texas in the current data · Regulation: 42 CFR 483.60(d)(6).
F808 · Physician-ordered therapeutic diets
CMS: Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
Therapeutic diets, such as a reduced-sodium diet or a texture-modified diet, must be prescribed by the attending physician, who may delegate diet orders to a registered or licensed dietitian where state law allows.
Ask: Who decides on special diets, and how are kitchen staff told about them?
Cited 52 times in Texas in the current data · Regulation: 42 CFR 483.60(e).
F809 · Meal times and snacks
CMS: Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
Residents must get at least three meals a day at regular times or as their needs and preferences require, with no more than 14 hours between dinner and breakfast (16 hours with a nourishing bedtime snack and resident group agreement). Nourishing alternatives must be available for those who want to eat at other times.
Ask: What food is available if a resident gets hungry between meals or late at night?
Cited 51 times in Texas in the current data · Regulation: 42 CFR 483.60(f).
F810 · Adaptive eating equipment and help
CMS: Provide special eating equipment and utensils for residents who need them and appropriate assistance.
Residents who need special eating equipment and utensils must have them, along with the assistance needed to use them during meals and snacks.
Ask: Are adaptive cups, plates, or utensils available, and who decides who needs them?
Cited 31 times in Texas in the current data · Regulation: 42 CFR 483.60(g).
F811 · Paid feeding assistants
CMS: Ensure that residents are assessed for appropriateness for a feeding assistant program, receive services as per their plan of care, and feeding assistants are trained and supervised.
A home may use paid feeding assistants only if they complete a state-approved training course, work under the supervision of a registered or licensed practical nurse, and help only residents assessed as having no complicated feeding problems, such as swallowing difficulty or tube feeding.
Ask: Who helps residents eat, and what training do they have?
Cited 3 times in Texas in the current data · Regulation: 42 CFR 483.60(h).
F812 · Food safety and sanitation
CMS: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Food must come from sources approved by federal, state, or local authorities, and must be stored, prepared, distributed, and served according to professional standards for food service safety.
Ask: When was the kitchen last inspected, and how are food temperatures checked?
Cited 2,116 times in Texas in the current data · Regulation: 42 CFR 483.60(i)(1)-(2).
F813 · Food brought in by visitors
CMS: Have a policy regarding use and storage of foods brought to residents by family and other visitors.
The home needs a policy on food that family and visitors bring for residents, so that it is stored, handled, and eaten in a safe and sanitary way.
Ask: Can families bring homemade food, and how is it labeled and stored?
Cited 140 times in Texas in the current data · Regulation: 42 CFR 483.60(i)(3).
F814 · Garbage disposal
CMS: Dispose of garbage and refuse properly.
Garbage and refuse must be disposed of properly, with containers kept in good condition and waste kept covered and contained.
Ask: How often is trash collected from resident areas and the kitchen?
Cited 175 times in Texas in the current data · Regulation: 42 CFR 483.60(i)(4).
Infection Control Deficiencies
Infection control rules require every nursing home to run a program that prevents, tracks, and contains infections among residents and staff. These rules also cover resident and staff vaccines and the responsible use of antibiotics.
Texas numbers for this category
F880 · Infection prevention and control program
CMS: Provide and implement an infection prevention and control program.
An infection prevention and control program must be in place to prevent, identify, report, investigate, and control infections. Its written procedures must cover surveillance, standard precautions such as hand hygiene, isolation when needed, keeping staff who have a communicable disease or infected skin lesions from direct contact with residents or their food when that contact would spread the disease, and handling linens to prevent spread.
Ask: How do staff track and report infections among residents? What steps are taken when a contagious illness is found in the building?
Cited 2,541 times in Texas in the current data · Regulation: 42 CFR 483.80(a), (e)-(f).
F881 · Antibiotic stewardship
CMS: Implement a program that monitors antibiotic use.
As part of infection control, the home must run an antibiotic stewardship program with protocols for antibiotic use and a system to monitor how antibiotics are prescribed and used.
Ask: How does the home make sure antibiotics are used only when needed?
Cited 38 times in Texas in the current data · Regulation: 42 CFR 483.80(a)(3).
F882 · Qualified infection preventionist
CMS: Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
One or more people must be designated to lead the infection control program. Each must have professional training in nursing, medical technology, microbiology, epidemiology, or a related field, complete specialized infection control training, and work at the home at least part time.
Ask: Who is the infection preventionist, and how much of their time is spent on that role?
Cited 13 times in Texas in the current data · Regulation: 42 CFR 483.80(b).
F883 · Flu and pneumonia vaccines
CMS: Develop and implement policies and procedures for flu and pneumonia vaccinations.
Before offering influenza and pneumococcal vaccines, the home must educate residents about their benefits and side effects. Flu vaccine is offered each year from October 1 through March 31, unless medically inappropriate or already received; residents may refuse, and records must show what was offered and decided.
Ask: Which vaccines are offered to residents each year, and how is consent handled?
Cited 32 times in Texas in the current data · Regulation: 42 CFR 483.80(d)(1)-(2).
F885 · Sharing COVID-19 information with families
CMS: Report COVID19 data to residents and families.
CMS's description for this older tag is "Report COVID19 data to residents and families." It does not appear in CMS's current inspection guidance (State Operations Manual Appendix PP, Rev. 232), and the federal rule it was based on, 42 CFR 483.80(g), now covers reporting of respiratory illness data instead, so citations under this tag come from older inspections.
Ask: How does the home let families know about infectious illness in the building?
Cited 1 times in Texas in the current data.
F887 · COVID-19 vaccine education and offering
CMS: Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
Before offering a COVID-19 vaccine, the home must educate residents, their representatives, and staff about its benefits, risks, and side effects. When the vaccine is available to the home, eligible residents and staff must then be offered it, may accept or refuse, and the home must document each person's vaccination status.
Ask: How are residents and staff offered COVID-19 vaccines, and how is their status recorded?
Cited 16 times in Texas in the current data · Regulation: 42 CFR 483.80(d)(3).
F945 · Infection control training
CMS: Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.
Mandatory infection control training must teach staff the written standards, policies, and procedures of the home's infection prevention and control program.
Ask: How often do staff get refresher training on hand hygiene and infection control?
Cited 32 times in Texas in the current data · Regulation: 42 CFR 483.95(e).
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Residents have the right to be free from abuse, neglect, exploitation, and misappropriation of their property. This group of rules sets out what nursing homes must do to prevent these problems, screen and train staff, and report and investigate any allegation.
Texas numbers for this category
F600 · Freedom from abuse and neglect
CMS: Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Every resident has the right to be free from abuse of any kind, including physical, verbal, mental, and sexual abuse, physical punishment, and neglect, whoever the source may be: staff, other residents, visitors, or anyone else.
Ask: How does the home screen, train, and supervise staff to protect residents?
Cited 644 times in Texas in the current data · Regulation: 42 CFR 483.12, 483.12(a)(1).
F602 · Protecting residents' money and belongings
CMS: Protect each resident from the wrongful use of the resident's belongings or money.
No one may deliberately misplace, wrongfully use, or take a resident's belongings or money without consent, or take advantage of a resident for personal gain. Federal rules call these misappropriation and exploitation, and residents have the right to be free from both.
Ask: How does the home keep track of residents' valuables and personal items?
Cited 131 times in Texas in the current data · Regulation: 42 CFR 483.12.
F603 · Freedom from involuntary seclusion
CMS: Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).
Residents must not be kept apart from other residents, removed from their room, or confined to their room against their will or the will of their representative.
Ask: Can residents move freely around common areas during the day?
Cited 18 times in Texas in the current data · Regulation: 42 CFR 483.12(a)(1).
F604 · Limits on physical restraints
CMS: Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Physical restraints may not be used on residents for discipline or staff convenience. A restraint is allowed only when needed to treat a medical symptom, and then the home must choose the least restrictive option for the shortest time and keep re-evaluating the need.
Ask: What is the home's policy on using physical restraints?
Cited 77 times in Texas in the current data · Regulation: 42 CFR 483.10(e)(1); 483.12(a)(2).
F605 · Limits on psychotropic drugs and chemical restraints
CMS: Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Medications may not be used for discipline or staff convenience instead of treating a medical symptom. Residents who have not taken psychotropic drugs, such as antipsychotics, antidepressants, anti-anxiety drugs, and sleep medications, may not be given them unless the medication is necessary to treat a specific condition diagnosed and documented in the clinical record. Residents who take them must receive gradual dose reductions and behavioral interventions, unless clinically contraindicated, in an effort to discontinue the drugs.
Ask: How does the care team review whether a resident still needs psychotropic medications?
Cited 67 times in Texas in the current data · Regulation: 42 CFR 483.10(e)(1); 483.12(a)(2); 483.45(c)(3), (d), (e).
F606 · Screening staff backgrounds
CMS: Not hire anyone with a finding of abuse, neglect, exploitation, or theft.
The home may not employ or otherwise engage anyone who has been found guilty of abuse, neglect, exploitation, misappropriation of property, or mistreatment by a court of law, anyone with such a finding entered in the state nurse aide registry, or anyone with a disciplinary action in effect against their professional license for such a finding. The home must also report to the state nurse aide registry or licensing authorities any court action it knows of against an employee that would indicate the person is unfit for service as a nurse aide or other facility staff.
Ask: What background and registry checks are done before staff are hired?
Cited 4 times in Texas in the current data · Regulation: 42 CFR 483.12(a)(3)-(4).
F607 · Abuse prevention policies
CMS: Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Written policies, actually put into practice, must prohibit and prevent abuse, neglect, exploitation, and misappropriation of resident property. They must cover investigating allegations, staff training, coordination with the quality program, and reporting crimes as federal law requires.
Ask: Can families get a summary of the home's abuse prevention and reporting policy?
Cited 365 times in Texas in the current data · Regulation: 42 CFR 483.12(b).
F609 · Reporting suspected abuse and crimes
CMS: Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Alleged abuse, neglect, exploitation, mistreatment, or misappropriation must be reported to the administrator and state officials immediately, and no later than 2 hours after the allegation is made if it involves abuse or results in serious bodily injury, otherwise no later than 24 hours. Investigation results go to the state within 5 working days, and suspected crimes must also be reported to law enforcement.
Ask: Who at the home is responsible for reporting incidents to the state?
Cited 752 times in Texas in the current data · Regulation: 42 CFR 483.12(b)(5), (c)(1), (c)(4).
F610 · Investigating and responding to allegations
CMS: Respond appropriately to all alleged violations.
When abuse, neglect, exploitation, or mistreatment is alleged, the home must investigate thoroughly, protect residents from further harm while the investigation is underway, and take corrective action if the allegation is verified.
Ask: What steps are taken to keep residents protected while an incident is being investigated?
Cited 233 times in Texas in the current data · Regulation: 42 CFR 483.12(c)(2)-(4).
F943 · Abuse prevention and dementia training
CMS: Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Staff training must cover what counts as abuse, neglect, exploitation, and misappropriation of resident property, how to report such incidents, and dementia management and abuse prevention.
Ask: What training do staff receive on caring for people with dementia?
Cited 45 times in Texas in the current data · Regulation: 42 CFR 483.95(c).
Environmental Deficiencies
Environmental rules deal with the building itself and the equipment in it. They expect resident rooms and shared spaces to be safe, clean, comfortable, and well maintained, with enough room and privacy for each resident.
Texas numbers for this category
F908 · Equipment kept in safe working order
CMS: Keep all essential equipment working safely.
All mechanical, electrical, and patient care equipment in the home must be maintained in safe operating condition.
Ask: How often are resident lifts and other equipment inspected and serviced?
Cited 179 times in Texas in the current data · Regulation: 42 CFR 483.90(d)(2).
F909 · Bed and bed rail inspections
CMS: Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.
Bed frames, mattresses, and any bed rails must be inspected regularly as part of a maintenance program to find gaps where a resident could become trapped. When rails and mattresses are bought separately from the bed, the home must make sure they are compatible.
Ask: How often are beds, mattresses, and rails checked for gaps or loose parts?
Cited 12 times in Texas in the current data · Regulation: 42 CFR 483.90(d)(3).
F910 · Rooms suited to care and comfort
CMS: Ensure resident rooms meet each resident's needs.
Resident rooms must be designed and equipped so that staff can give adequate nursing care and residents have comfort and privacy.
Ask: Can families see a resident room similar to the one a loved one would have?
Cited 3 times in Texas in the current data · Regulation: 42 CFR 483.90(e).
F912 · Minimum bedroom size
CMS: Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Bedrooms must measure at least 80 square feet per resident in shared rooms and at least 100 square feet in single rooms. The state survey agency or CMS may allow exceptions in individual cases when the home shows in writing that the variation is in accordance with the residents' special needs and will not adversely affect their health and safety.
Ask: How large are the shared and private rooms, and how many residents share a room?
Cited 86 times in Texas in the current data · Regulation: 42 CFR 483.90(e)(1)(ii), (e)(3).
F914 · Visual privacy in bedrooms
CMS: Provide bedrooms that don't allow residents to see each other when privacy is needed.
Bedrooms must be designed or equipped to give each resident full visual privacy. In homes first certified after March 31, 1992, beds in shared rooms need ceiling-suspended curtains that fully surround them together with the walls.
Ask: How is privacy provided in shared rooms during care and dressing?
Cited 44 times in Texas in the current data · Regulation: 42 CFR 483.90(e)(1)(iv)-(v).
F917 · Bed, bedding, furniture, and closet space
CMS: Make sure each resident has 1) at least one window to the outside in a room; 2) a room at or above ground level; 3) adequate bedding; 4) furniture that meets the resident's needs; or 5) adequate closet space.
Each resident must have a separate bed of proper size and height, a clean and comfortable mattress, bedding suited to the weather, functional furniture for their needs, and a private closet with racks and shelves they can reach. CMS's one-line description for this tag also mentions a window to the outside and a room at or above ground level; in the State Operations Manual those two requirements are guided under F915 and F916.
Ask: What furniture comes with the room, and how much closet space is there?
Cited 2 times in Texas in the current data · Regulation: 42 CFR 483.10(i)(4); 483.90(e)(2).
F919 · Working call system
CMS: Make sure that a working call system is available in each resident's bathroom and bathing area.
From each bedside and from toilet and bathing areas, residents must be able to call for staff help through a communication system that relays the call directly to a staff member or central work area.
Ask: How quickly are call lights usually answered, especially at night?
Cited 202 times in Texas in the current data · Regulation: 42 CFR 483.90(g).
F920 · Dining and activity rooms
CMS: Provide at least one room set aside to use as a resident dining room and for activities, that is a good size, with good lighting, air flow and furniture.
There must be one or more rooms set aside for resident dining and activities, and they must be well lighted, well ventilated, adequately furnished, and big enough for all activities.
Ask: Where do residents eat and gather for activities, and can families see those rooms?
Cited 2 times in Texas in the current data · Regulation: 42 CFR 483.90(h).
F921 · Safe, functional, sanitary building
CMS: Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
The environment throughout the home must be safe, functional, sanitary, and comfortable for residents, staff, and the public.
Ask: How are maintenance requests from residents and families handled?
Cited 343 times in Texas in the current data · Regulation: 42 CFR 483.90(i).
F922 · Backup water supply
CMS: Have enough backup water supply for essential areas of the nursing home.
Procedures must be in place to make sure water is available to essential areas of the home if the normal water supply is lost.
Ask: What is the plan if the building loses water service?
Cited 5 times in Texas in the current data · Regulation: 42 CFR 483.90(i)(1).
F924 · Handrails in corridors
CMS: Put firmly secured handrails on each side of hallways.
Corridors must have firmly secured handrails on each side.
Ask: Are handrails available along all hallways residents use?
Cited 6 times in Texas in the current data · Regulation: 42 CFR 483.90(i)(3).
F925 · Pest control
CMS: Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
An effective pest control program must keep the home free of insects, rodents, and other pests.
Ask: How often does a pest control service treat the building?
Cited 302 times in Texas in the current data · Regulation: 42 CFR 483.90(i)(4).
F926 · Smoking policies
CMS: Have policies on smoking.
Following federal, state, and local law, the home must set policies on smoking, smoking areas, and smoking safety that also take nonsmoking residents into account.
Ask: What is the smoking policy, and how are residents who smoke supervised?
Cited 103 times in Texas in the current data · Regulation: 42 CFR 483.90(i)(5).
Administration Deficiencies
Administration rules cover how a nursing home is run and overseen behind the scenes. They address leadership and licensing, outside services, quality improvement, staff training, required reporting, and the lab and imaging services residents depend on.
Texas numbers for this category
F770 · Timely laboratory services
CMS: Provide timely, quality laboratory services/tests to meet the needs of residents.
The home must provide or obtain lab services to meet residents' needs, and it is responsible for their quality and timeliness. An on-site lab must meet federal laboratory requirements.
Ask: How are blood draws and lab tests arranged for residents?
Cited 73 times in Texas in the current data · Regulation: 42 CFR 483.50(a)(1).
F771 · On-site lab and blood services standards
CMS: Ensure laboratory services, blood blanks and transfusion services provided on-site meet requirements for certified laboratories.
If the home runs its own blood bank or transfusion services, they must meet the same federal requirements that apply to certified laboratories.
Ask: Are any lab or transfusion services provided inside the building?
Cited 1 times in Texas in the current data · Regulation: 42 CFR 483.50(a)(1).
F772 · Agreement with an outside lab
CMS: Have an agreement with an approved laboratory to obtain services, if on-site laboratory services aren't provided.
A home without on-site laboratory services must have an agreement with an outside laboratory that meets federal requirements.
Ask: Which laboratory does the home use for resident tests?
Cited 1 times in Texas in the current data · Regulation: 42 CFR 483.50(a)(1).
F773 · Ordering labs and reporting results
CMS: Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.
Lab tests may be done only when ordered by a physician, physician assistant, nurse practitioner, or clinical nurse specialist. Results outside normal reference ranges must be reported promptly to the person who ordered them, following the home's notification policy.
Ask: How quickly are abnormal lab results passed on to the doctor?
Cited 28 times in Texas in the current data · Regulation: 42 CFR 483.50(a)(2).
F774 · Transportation to lab services
CMS: Help the resident with transportation to and from laboratory services outside of the facility.
If a resident needs help getting to an outside lab, the home must assist with arranging transportation there and back.
Ask: Who arranges rides to outside appointments, and is there a cost?
Cited 3 times in Texas in the current data · Regulation: 42 CFR 483.50(a)(2)(iii).
F775 · Filing lab reports
CMS: Keep complete, dated laboratory records in the resident's record.
Lab reports must be filed in the resident's clinical record, dated, and include the name and address of the lab that did the testing.
Ask: Can families request copies of recent lab results?
Cited 1 times in Texas in the current data · Regulation: 42 CFR 483.50(a)(2)(iv).
F776 · Radiology and diagnostic services
CMS: Provide timely, approved x-ray services, or have an agreement with an approved provider to obtain them.
X-rays and other diagnostic services must be provided or obtained to meet residents' needs, with the home responsible for their quality and timeliness. Services the home runs itself must meet hospital radiology standards; otherwise it must use an approved outside provider.
Ask: Can X-rays be done at the home, or do residents need to go out?
Cited 14 times in Texas in the current data · Regulation: 42 CFR 483.50(b)(1).
F777 · Ordering X-rays and reporting results
CMS: Provide or obtain x-rays/tests when ordered and promptly tell the ordering practitioner of the results.
Radiology and other diagnostic tests may be done only on the order of a physician or qualified practitioner, and results outside normal ranges must be promptly reported to whoever ordered them.
Ask: How are X-ray results communicated to the doctor and the family?
Cited 18 times in Texas in the current data · Regulation: 42 CFR 483.50(b)(2).
F778 · Transportation to radiology
CMS: Help the resident make transportation arrangements to and from radiology services.
When a resident needs help getting to an outside radiology or diagnostic appointment, the home must assist in arranging transportation to and from it.
Ask: Does a staff member go along to outside imaging appointments if a resident needs help?
Cited 1 times in Texas in the current data · Regulation: 42 CFR 483.50(b)(2)(iii).
F779 · Filing X-ray and diagnostic reports
CMS: Keep signed and dated reports of x-rays and other diagnostic services in the residents record.
Signed and dated reports of X-rays and other diagnostic services must be kept in the resident's clinical record.
Ask: How long does it take for imaging reports to reach the resident's chart?
Cited 1 times in Texas in the current data · Regulation: 42 CFR 483.50(b)(2)(iv).
F835 · Effective administration
CMS: Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Management must run the facility so that its resources are used effectively and efficiently to help each resident attain or maintain their highest practicable well-being.
Ask: How long have the administrator and director of nursing been in their roles?
Cited 35 times in Texas in the current data · Regulation: 42 CFR 483.70.
F836 · Licensure and following the law
CMS: Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards.
A nursing home must be licensed under state and local law and must operate in compliance with all applicable federal, state, and local laws, regulations, and codes, as well as accepted professional standards.
Ask: Is the home's state license current, and where is it displayed?
Cited 7 times in Texas in the current data · Regulation: 42 CFR 483.70(a)-(c).
F837 · Governing body and administrator
CMS: Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.
Every home needs a governing body that is legally responsible for its management policies. That body appoints a state-licensed administrator who manages the home and reports to it, and it is accountable for the quality improvement program.
Ask: Who owns and oversees the home, and how often does leadership visit?
Cited 21 times in Texas in the current data · Regulation: 42 CFR 483.70(d).
F838 · Facility-wide assessment of needs
CMS: Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
Each home must conduct and document an assessment of the resources it needs to care for its residents competently, day to day, including nights and weekends, and in emergencies. It must update it at least yearly, involve leadership and direct care staff, and consider input from residents and families.
Ask: How does the home decide how many staff and what skills it needs on each shift?
Cited 34 times in Texas in the current data · Regulation: 42 CFR 483.71.
F839 · Licensed and qualified staff
CMS: Employ staff that are licensed, certified, or registered in accordance with state laws.
The home must employ, full time, part time, or as consultants, the professionals needed to meet federal requirements, and those professionals must be licensed, certified, or registered as state law requires.
Ask: How does the home verify that nurses' and therapists' licenses are current?
Cited 38 times in Texas in the current data · Regulation: 42 CFR 483.70(e).
F840 · Using outside service providers
CMS: Employ or obtain outside professional resources to provide services in the nursing home when the facility does not employ a qualified professional to furnish a required service.
When the home does not employ a professional needed for a required service, it must arrange for that service from an outside person or agency under a written agreement, and it remains responsible for the quality and timeliness of those services.
Ask: Which services are provided by outside companies, such as therapy, pharmacy, or lab?
Cited 10 times in Texas in the current data · Regulation: 42 CFR 483.70(f).
F844 · Disclosing ownership and leadership changes
CMS: Follow rules about disclosure of ownership requirements and tell the state agency about changes in ownership and/or administrative personnel.
A home must follow federal ownership disclosure rules and notify the state licensing agency in writing when there is a change in owners, officers or managing employees, the management company, the administrator, or the director of nursing.
Ask: Has the home changed owners or management companies recently?
Cited 4 times in Texas in the current data · Regulation: 42 CFR 483.70(j).
F847 · Arbitration agreements must be optional
CMS: Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
If a home offers a binding arbitration agreement, it cannot require signing it to be admitted or to keep receiving care, and must say so. The agreement must be explained in a way the resident understands, allow 30 calendar days to cancel, and not discourage contact with officials such as surveyors or the ombudsman.
Ask: Is there an arbitration agreement in the admission paperwork, and is signing it optional?
Cited 11 times in Texas in the current data · Regulation: 42 CFR 483.70(m).
F848 · Neutral arbitrator and convenient venue
CMS: Provide a neutral and fair arbitration process and agree to arbitrator and venue.
An arbitration agreement must provide for a neutral arbitrator that both sides agree on and a location convenient to both. After a dispute is settled through arbitration, the home must keep the signed agreement and the arbitrator's decision for 5 years and make them available to CMS.
Ask: Can residents and families get a copy of the arbitration agreement in advance, and how is it explained?
Cited 5 times in Texas in the current data · Regulation: 42 CFR 483.70(m).
F849 · Hospice services
CMS: Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
A home may either arrange hospice care through a written agreement with a Medicare-certified hospice or help residents who want hospice transfer to a facility that offers it. With an agreement, it must make sure hospice services meet professional standards and are coordinated with the resident's care.
Ask: Which hospice providers work with the home, and can residents choose among them?
Cited 131 times in Texas in the current data · Regulation: 42 CFR 483.70(n).
F850 · Full-time social worker in larger homes
CMS: Hire a qualified full-time social worker in a facility with more than 120 beds.
A home with more than 120 beds must employ a qualified social worker full time, meaning someone with at least a bachelor's degree in social work or a related human services field and one year of supervised social work experience in a health care setting.
Ask: How many residents does each social worker support?
Cited 50 times in Texas in the current data · Regulation: 42 CFR 483.70(o).
F851 · Reporting staffing data to CMS
CMS: Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Homes must electronically submit complete and accurate direct care staffing information to CMS, including agency and contract staff, based on payroll and other verifiable, auditable records.
Ask: How many nurses and aides typically care for residents on a weekend shift?
Cited 66 times in Texas in the current data · Regulation: 42 CFR 483.70(p).
F865 · Quality improvement (QAPI) program
CMS: Have a plan that describes the process for conducting QAPI and QAA activities.
A home must run an ongoing, data-driven Quality Assurance and Performance Improvement (QAPI) program focused on outcomes of care and quality of life, keep evidence that it works, and present its QAPI plan to surveyors at each annual inspection or on request.
Ask: What quality improvement projects is the home working on right now?
Cited 9 times in Texas in the current data · Regulation: 42 CFR 483.75(a)-(b), (f).
F867 · Quality monitoring and improvement projects
CMS: Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
The home needs written systems to gather feedback from staff, residents, and families, track performance and adverse events, analyze problems, and carry out performance improvement projects, then take action and measure whether the changes work.
Ask: How are concerns from families used to make improvements?
Cited 20 times in Texas in the current data · Regulation: 42 CFR 483.75(c)-(e).
F868 · Quality committee membership and meetings
CMS: Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
The quality assessment and assurance committee must include at least the director of nursing, the medical director or a designee, the infection preventionist, and three other staff, one of them in leadership. It must meet at least quarterly and report to the governing body.
Ask: How often does the quality committee meet, and are family concerns brought to it?
Cited 30 times in Texas in the current data · Regulation: 42 CFR 483.75(g).
F895 · Compliance and ethics program
CMS: Have a Compliance and Ethics Program.
The operating organization must have a compliance and ethics program designed to prevent and detect criminal, civil, and administrative violations and promote quality of care. It must include written standards, a way to report concerns anonymously without fear of retaliation, responsible leaders, monitoring, and corrective action.
Ask: How can staff or families report a compliance concern confidentially?
Cited 1 times in Texas in the current data · Regulation: 42 CFR 483.85.
F940 · Staff training program
CMS: Develop, implement, and/or maintain an effective training program for all new and existing staff members.
An effective training program is required for all new and existing staff, contract workers, and volunteers, suited to their roles. The home decides the amount and types of training based on its facility assessment, and certain topics are mandatory.
Ask: What training do new staff complete before caring for residents?
Cited 62 times in Texas in the current data · Regulation: 42 CFR 483.95.
F941 · Communication training for caregivers
CMS: Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.
Training in effective communication is mandatory for direct care staff.
Ask: How are staff trained to communicate with residents who have hearing loss or memory problems?
Cited 41 times in Texas in the current data · Regulation: 42 CFR 483.95(a).
F944 · Quality program training
CMS: Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
All staff must receive mandatory training that explains the elements and goals of the home's QAPI quality improvement program.
Ask: How are front-line staff involved in the home's quality improvement work?
Cited 56 times in Texas in the current data · Regulation: 42 CFR 483.95(d).
F946 · Compliance and ethics training
CMS: Provide training in compliance and ethics.
The operating organization must communicate its compliance and ethics standards to staff through training or another practical method. Organizations operating five or more facilities must provide this training annually.
Ask: Do staff receive yearly compliance and ethics training?
Cited 40 times in Texas in the current data · Regulation: 42 CFR 483.95(f).
F949 · Behavioral health training
CMS: Provide behavior health training consistent with the requirements and as determined by a facility assessment.
Staff must receive behavioral health training consistent with federal behavioral health requirements and with the needs identified in the facility assessment.
Ask: What training do staff have in supporting residents with mental health needs?
Cited 38 times in Texas in the current data · Regulation: 42 CFR 483.95(i).
Nursing and Physician Services Deficiencies
These rules set expectations for the doctors and nursing staff who care for residents. They cover physician oversight and visit schedules, whether there are enough qualified nurses and aides on every shift, and how nurse aides are trained and checked.
Texas numbers for this category
F710 · Physician approval and supervision
CMS: Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care.
A physician must approve each admission in writing, and every resident must remain under a physician's care, with medical care supervised by a physician and another physician covering when the attending physician is unavailable.
Ask: Who covers for a resident's doctor on nights, weekends, and holidays?
Cited 12 times in Texas in the current data · Regulation: 42 CFR 483.30(a).
F711 · Physician review at each visit
CMS: Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.
At each required visit, the physician must review the resident's total program of care, including medications and treatments, write, sign, and date progress notes, and sign and date all orders (except influenza and pneumococcal vaccines given under approved facility policy).
Ask: How are families told about changes made during a doctor's visit?
Cited 11 times in Texas in the current data · Regulation: 42 CFR 483.30(b).
F712 · Required physician visits
CMS: Ensure that the resident and his/her doctor meet face-to-face at all required visits.
A physician must see each resident at least every 30 days for the first 90 days after admission and at least every 60 days after that. A visit counts as timely if it happens no later than 10 days after the date it was required.
Ask: How often does a doctor or nurse practitioner see residents in person?
Cited 20 times in Texas in the current data · Regulation: 42 CFR 483.30(c).
F725 · Enough nursing staff every shift
CMS: Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Around the clock, the home must have enough licensed nurses and other nursing staff, such as nurse aides, to give every resident the care in their care plan. A licensed nurse must be designated as charge nurse on each shift.
Ask: How many nurses and aides typically work on day, evening, and night shifts?
Cited 73 times in Texas in the current data · Regulation: 42 CFR 483.35(a).
F726 · Competent nurses and nurse aides
CMS: Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Licensed nurses must have the specific competencies needed for residents' needs as identified in assessments and care plans. Nurse aides must be able to demonstrate competency in the skills and techniques those needs require.
Ask: How does the home check that new nurses and aides are skilled before they work alone?
Cited 168 times in Texas in the current data · Regulation: 42 CFR 483.35.
F727 · RN coverage and director of nursing
CMS: Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Unless the requirement is waived, a registered nurse must be on duty at least 8 consecutive hours a day, 7 days a week, and a registered nurse must serve full time as director of nursing.
Ask: When is a registered nurse in the building, and how long has the director of nursing been here?
Cited 287 times in Texas in the current data · Regulation: 42 CFR 483.35.
F728 · Nurse aide training and competency
CMS: Ensure that nurse aides who have worked more than 4 months, are trained and competent; and nurse aides who have worked less than 4 months are enrolled in appropriate training.
No one may work as a nurse aide full time for more than 4 months unless they are competent and have completed a state-approved training and competency evaluation program (or a state-approved competency evaluation program), or have been deemed competent under federal rules. Aides still in training must be enrolled in such a program.
Ask: Are all nurse aides certified, and how are aides in training supervised?
Cited 24 times in Texas in the current data · Regulation: 42 CFR 483.35.
F729 · Checking the nurse aide registry
CMS: Verify that a nurse aide has been trained; and if they haven't worked as a nurse aide for 2 years, receive retraining.
Before someone starts as a nurse aide, the home must confirm through the state registry that they meet competency requirements and seek information from other state registries likely to hold records on them. An aide with 24 straight months of no paid nursing work must be retrained or re-evaluated.
Ask: Which registries does the home check before hiring a nurse aide?
Cited 13 times in Texas in the current data · Regulation: 42 CFR 483.35.
F730 · Nurse aide reviews and in-service training
CMS: Observe each nurse aide's job performance and give regular training.
Every nurse aide must get a performance review at least once every 12 months, and the home must provide regular in-service education based on what those reviews find.
Ask: What ongoing training do nurse aides receive each year?
Cited 21 times in Texas in the current data · Regulation: 42 CFR 483.35.
F731 · Nurse staffing waivers
CMS: Request a waiver if it can't meet the nurse staffing requirements.
A home that cannot meet the licensed nurse or registered nurse staffing requirements may operate below them only under a waiver. A state may grant one if the home shows it has been unable to recruit despite diligent efforts, including offering the prevailing wage in the community; a separate federal waiver exists for certain rural skilled nursing facilities.
Ask: Does the home currently operate under any staffing waiver?
Cited 1 times in Texas in the current data · Regulation: 42 CFR 483.35.
F732 · Daily posting of nurse staffing
CMS: Post nurse staffing information every day.
At the start of each shift, the home must post the number of registered nurses, licensed practical or vocational nurses, and certified nurse aides on duty, their actual hours, and the resident census, in a clear format and a prominent place visitors can see.
Ask: Where is the daily nurse staffing sheet posted?
Cited 188 times in Texas in the current data · Regulation: 42 CFR 483.35.
F947 · Ongoing nurse aide training
CMS: Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Nurse aides need at least 12 hours of in-service training each year, enough to keep them competent. It must include dementia management and abuse prevention, address weaknesses found in performance reviews, and, for aides caring for people with cognitive impairments, cover their care.
Ask: How many hours of training do nurse aides complete each year, and on what topics?
Cited 27 times in Texas in the current data · Regulation: 42 CFR 483.95(g).
Source
CMS Provider Data Catalog: Citation Code Look-up, Health Deficiencies. Processed by CMS Sep 1, 2026; next update Oct 28, 2026.