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If you're researching nursing homes for someone you love, understanding the most common health deficiencies can help you know what to look for during your search. Federal inspectors cite nursing homes when they find problems that could affect resident care, safety, or quality of life.
Based on data through March 2026, federal inspectors issued 417,725 total citations across 14,689 nursing homes nationwide. These citations range from minor paperwork issues to serious problems that caused actual harm to residents. Here are the 10 health deficiencies that appeared most frequently in nursing home inspections.
What was the most common nursing home violation?
F0880 (infection prevention and control) topped the list with 23,538 citations across 11,803 facilities — affecting 80.4% of all nursing homes inspected. This deficiency covers problems like inadequate handwashing, improper isolation procedures, or failure to prevent the spread of infectious diseases. While most F0880 citations were for minor issues, 336 cases resulted in actual harm or immediate jeopardy to residents.
The complete top 10 list
Here are the health deficiencies that appeared most often in nursing home inspections:
• F0880 (Infection Prevention): 23,538 citations at 11,803 facilities (80.4%) • F0689 (Quality of Care): 21,352 citations at 10,048 facilities (68.4%) • F0812 (Resident Behavior/Facility Practices): 19,906 citations at 11,035 facilities (75.1%) • F0684 (Quality of Life): 16,354 citations at 8,334 facilities (56.7%) • F0656 (Pharmacy Services): 14,799 citations at 8,436 facilities (57.4%) • F0761 (Dietary Services): 13,437 citations at 8,677 facilities (59.1%) • F0677 (Nursing Services): 10,244 citations at 6,386 facilities (43.5%) • F0695 (Resident Rights): 9,389 citations at 6,754 facilities (46.0%) • F0550 (Medical Director): 9,011 citations at 6,269 facilities (42.7%) • F0609 (Reporting): 8,860 citations at 5,815 facilities (39.6%)
Which violations caused the most serious harm?
Not all citations are created equal. Some represent minor compliance issues, while others indicate problems that actually harmed residents. F0689 (Quality of Care) resulted in the most serious cases, with 7,045 instances of actual harm or immediate jeopardy — far more than any other deficiency type.
F0684 (Quality of Life) ranked second for serious harm with 2,112 cases, followed by F0656 (Pharmacy Services) with 509 cases. These numbers suggest that when quality of care breaks down, residents are more likely to experience real consequences.
What this means for your nursing home search
These statistics reveal patterns you can investigate during facility tours. Ask potential nursing homes about their infection control procedures, how they ensure quality of care, and what systems they have in place to prevent the most common violations. Since 80% of facilities had infection control citations, this is particularly important to discuss.
You can also research a specific facility's citation history on Medicare's Nursing Home Compare website before scheduling visits.
Frequently asked questions
What does an F-tag mean?
An F-tag is a federal citation code that inspectors use when they find a nursing home violating specific care standards. Each F-tag corresponds to a different type of problem, from medication errors (F0656) to infection control issues (F0880).
How many nursing homes had no citations?
The data shows citations affected 14,689 facilities, but doesn't specify how many had zero violations. However, since F0880 affected 80.4% of inspected facilities, roughly 1 in 5 nursing homes avoided the most common citation type.
What's the difference between a citation and actual harm?
A citation means inspectors found a problem that violated federal standards. "Actual harm or immediate jeopardy" means the violation directly hurt a resident or created a dangerous situation. Most citations (like 23,202 of the 23,538 F0880 cases) don't reach the level of actual harm.
How to Read This
- Abuse & Neglect (citations: F609)
- Inspectors found that a resident was mistreated, that the facility failed to prevent abuse, or that staff did not report or investigate allegations of abuse promptly.
- Accident Prevention (citations: F689)
- The facility failed to identify and remove physical hazards or provide adequate supervision that could lead to resident injuries such as burns, falls, or cuts.
- Activities & Social Engagement (citations: F677)
- The facility did not provide enough meaningful activities to keep residents socially connected and mentally engaged based on their interests and abilities.
- Care Planning (citations: F656)
- The facility did not create or maintain a personalized care plan that addresses each resident's specific health needs, goals, and preferences.
- Dignity & Respect (citations: F550)
- Staff did not consistently treat residents with the respect and courtesy they deserve, or residents were not given choices that allow them to maintain their sense of self.
- Fall Prevention (citations: F689)
- The facility failed to assess residents' fall risk or put a proper prevention plan in place, resulting in a resident falling and possibly being injured.
- Food Safety & Sanitation (citations: F812)
- Food was not stored, prepared, or served in a safe and sanitary way, creating a risk of foodborne illness for residents.
- Infection Control (citations: F880)
- The facility did not consistently follow hygiene and sanitation practices that prevent the spread of infections, including proper hand-washing, isolation procedures, and equipment cleaning.
- Medication Management (citations: F761)
- The facility had problems ensuring residents received the right medications at the right times, including errors in prescribing, dispensing, or monitoring for side effects.
- Nutrition & Hydration (citations: F695)
- The facility did not make sure residents were receiving enough food, fluids, or nutritional support to maintain their health and body weight.
- Pharmacy Services (citations: F761)
- The facility's pharmacy practices had problems — such as inaccurate medication records, missing reviews by a pharmacist, or drugs not being dispensed correctly.
- Quality of Care (citations: F684)
- Residents did not receive the medical treatments, therapies, or personal care services they needed to maintain or improve their health and well-being.
- Resident Rights (citations: F550)
- The facility did not fully respect residents' legal rights — such as privacy, the right to make decisions about their own care, or the right to raise concerns without fear of retaliation.
- Severity scale (A–L)
- CMS rates each citation A–L. A–C means no resident harm, D–F means potential for harm to residents, G–I means actual harm, and J–L means immediate jeopardy to resident health or safety.
Data source: Centers for Medicare & Medicaid Services (CMS). Data as of 2026-03-25.
Helpful resources
How we built this: Every Care Safety Insight is generated from the federal CMS Care Compare dataset and reviewed by our editorial team before publishing. We do not invent numbers, and we always tell you the date the data was collected. Read our methodology →