Dementia Care: How U.S. Nursing Homes Are Performing — June 2026

Federal inspectors documented 3,655 citations related to dementia and behavioral health care across U.S. nursing homes through May 21, 2026. These citations, recorded during routine health inspections, reflect instances where facilities failed to meet federal standards for caring for residents with Alzheimer's disease, other dementias, and behavioral health needs.

The data comes from the Centers for Medicare & Medicaid Services (CMS), which regularly inspects nursing homes that receive federal funding. When inspectors find problems, they issue citations using "F-tags"—codes that identify specific types of care deficiencies. This report examines six F-tags specifically related to dementia and behavioral care.

The findings show variation in both how often different violations occur and how frequently they result in actual harm to residents. Understanding these patterns can help families ask informed questions when evaluating nursing homes for a loved one with dementia.

Most Common Violation: Behavior Management and Modification

F0740, which covers requirements for behavior management and modification, accounted for 1,105 citations across 991 facilities—making it the most frequently cited dementia-care standard. Inspectors found 134 instances where these violations resulted in actual harm to residents. This F-tag addresses how facilities respond to challenging behaviors common in dementia, such as wandering, aggression, or agitation, and requires that interventions prioritize non-drug approaches when appropriate.

Psychotropic Medication Practices Draw Scrutiny

Two citations related to psychotropic medications—drugs that affect behavior, mood, or mental function—together accounted for 1,798 violations. F0744, covering general psychotropic medication requirements, was cited 967 times in 838 facilities, with 62 cases of actual harm. F0745, which specifically addresses gradual dose reductions of these medications, received 831 citations across 753 facilities, with 37 harm cases. Federal standards require that facilities regularly attempt to reduce or discontinue these medications when clinically appropriate, rather than using them indefinitely for behavioral management.

Mental and Psychosocial Needs

F0742, which ensures facilities meet residents' mental and psychosocial needs, appeared in 526 citations across 493 facilities. This violation resulted in actual harm in 83 cases—representing nearly 16% of these citations, a notably high harm rate. This standard requires facilities to provide activities, therapies, and environmental supports that address residents' cognitive and emotional wellbeing, not just their physical health needs.

Specialized Services and Trauma-Informed Care

F0741, covering specialized services for residents with mental illness or intellectual disabilities, received 207 citations in 190 facilities, with 26 resulting in actual harm. The least common citation, F0743, addresses trauma-informed care and appeared just 19 times in 19 facilities, with one case of actual harm. The low count for F0743 may reflect that this is a relatively newer regulatory focus, though all facilities are expected to provide trauma-informed approaches to care.

What 'Actual Harm' Means

The term "actual harm" in inspection reports means that a deficiency directly caused physical injury, pain, or psychological distress to one or more residents. Across all dementia-care citations, 343 cases—roughly 9% of the total—were classified as causing actual harm. The remaining violations represented potential for harm or patterns of practice that didn't meet federal standards. Families should note that even citations without documented harm indicate care practices that fall short of what federal regulations require.

Data source: Centers for Medicare & Medicaid Services (CMS). Data as of 2026-05-21.