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Key Takeaways
- F0880 (infection control) was cited 23,538 times — appearing in 80.4% of all inspected U.S. nursing homes as of March 25, 2026.
- F0689 (accident hazards and supervision) had 7,045 citations at the actual harm or immediate jeopardy level — the highest harm count of any deficiency on the list.
- 417,725 total health citations were recorded across 14,689 nursing facilities in the CMS dataset.
- Food safety (F0812) was cited in 75.1% of facilities, and care planning failures (F0656) in 57.4% — both well above the halfway mark.
- Resident rights (F0550) and failure to report alleged violations (F0609) both appear in the top 10, signaling ongoing challenges with resident protections nationwide.
Choosing a nursing home for someone you love is one of the hardest decisions a family can face. Federal inspection data can help make that process a little clearer.
Every year, trained inspectors visit U.S. nursing homes and issue citations — formal notices of problems — using a system of codes called F-tags (federal citation codes). The Centers for Medicare & Medicaid Services (CMS) publishes this data so families can see how facilities are performing nationwide. This article breaks down the top 10 most-cited nursing home health deficiencies based on CMS data current as of March 25, 2026, covering 14,689 facilities and 417,725 total citations.
Understanding which problems come up most often — and how serious they are — gives you sharper questions to ask when you tour a facility. Here's what the numbers show.
What Are Nursing Home F-Tags and Why Do They Matter?
An F-tag is a federal citation code inspectors use when a nursing home falls short of a care standard set by Medicare and Medicaid. Each F-tag maps to a specific rule — things like infection control, fall prevention, or food safety. When inspectors find a violation, they record it with that code, and the data becomes public.
Citations are graded by how serious they are. The most urgent are those involving actual harm or immediate jeopardy — meaning a resident was hurt, or could have been hurt very quickly. When you look at a facility's inspection history, both the number of citations *and* the severity matter.
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The 10 Most-Cited Deficiencies in U.S. Nursing Homes (Data Through March 25, 2026)
Here are the ten F-tags cited most often across American nursing homes, along with what each one means in plain language:
- F0880 — Infection Control | 23,538 citations across 11,803 facilities (80.4% of all facilities inspected). 336 cases involved actual harm or immediate jeopardy.
- F0689 — Free from Accident Hazards / Supervision | 21,352 citations across 10,048 facilities (68.4%). A high-severity code: 7,045 citations — the most of any tag on this list — involved actual harm or immediate jeopardy.
- F0812 — Food Procurement, Storage, and Preparation | 19,906 citations across 11,035 facilities (75.1%). 75 involved actual harm or immediate jeopardy.
- F0684 — Quality of Care | 16,354 citations across 8,334 facilities (56.7%). 2,112 involved actual harm or immediate jeopardy.
- F0656 — Care Plans / Comprehensive Person-Centered Care Plan | 14,799 citations across 8,436 facilities (57.4%). 509 involved actual harm or immediate jeopardy.
- F0761 — Labeling of Drugs and Biologicals | 13,437 citations across 8,677 facilities (59.1%). 17 involved actual harm or immediate jeopardy.
- F0677 — Activities of Daily Living (ADL) Care | 10,244 citations across 6,386 facilities (43.5%). 82 involved actual harm or immediate jeopardy.
- F0695 — Respiratory / Tracheostomy Care and Suctioning | 9,389 citations across 6,754 facilities (46.0%). 176 involved actual harm or immediate jeopardy.
- F0550 — Resident Rights / Dignity and Respect | 9,011 citations across 6,269 facilities (42.7%). 156 involved actual harm or immediate jeopardy.
- F0609 — Reporting of Alleged Violations | 8,860 citations across 5,815 facilities (39.6%). 262 involved actual harm or immediate jeopardy.
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Which Deficiency Should Concern Families the Most?
Raw citation counts tell one story — but severity tells another. F0689 (accident hazards and supervision) stands out not just because it was cited 21,352 times, but because 7,045 of those citations involved actual harm or immediate jeopardy to a resident. That is by far the highest harm count of any code on this list. Falls, unsafe environments, and lack of supervision are leading causes of serious injury in nursing homes.
F0684 (quality of care) is also worth watching closely — 2,112 of its 16,354 citations reached the actual harm or jeopardy level.
By contrast, F0812 (food safety) was cited nearly 20,000 times but resulted in only 75 cases of actual harm or jeopardy, suggesting most of those violations were lower-severity technical issues. A high citation count alone doesn't always mean residents were in danger — context matters.
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Infection Control Is Still the Most Widespread Problem
F0880, the infection control standard, was cited in 80.4% of all inspected facilities — meaning roughly 4 out of every 5 nursing homes received this citation. With 23,538 total citations, it is the single most common deficiency in the dataset.
Infection control covers how a facility prevents the spread of germs, including hand hygiene, use of protective equipment, and isolation procedures. While 336 of these citations involved actual harm or jeopardy, the vast majority were at lower severity levels. Still, the sheer prevalence of this citation is a signal that infection prevention remains a systemic challenge across the industry.
What this means for you: When you tour a facility, ask staff how they handle infection outbreaks. Ask to see their most recent inspection report and look for F0880 citations — and more importantly, ask what corrective steps they took.
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Food Safety and Care Planning Are Also Common Issues
Two other citations appeared in more than half of all facilities inspected:
- F0812 (food safety) was cited in 75.1% of facilities — problems with food storage, temperature, labeling, or preparation.
- F0656 (care planning) was cited in 57.4% of facilities — failures to create or follow an individualized care plan for each resident.
A care plan is the written roadmap for how a facility will meet a specific resident's medical, personal, and emotional needs. When care plans are missing or ignored, residents may not get the tailored attention they need.
What this means for you: Ask the facility to walk you through how they create and update a care plan for a new resident. Ask who is involved in that process, and how often it is reviewed.
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Resident Rights and Reporting Problems
Two citations near the bottom of the top 10 touch on residents' fundamental protections:
- F0550 (dignity and respect) — cited in 42.7% of facilities, with 156 cases involving actual harm or jeopardy. This covers whether staff treat residents with courtesy and preserve their autonomy and dignity.
- F0609 (reporting of alleged violations) — cited in 39.6% of facilities, with 262 cases at the harm or jeopardy level. Facilities are required to report suspected abuse, neglect, or exploitation. Failures here can mean serious incidents go uninvestigated.
What this means for you: Ask facilities how residents or family members can report a concern, and who oversees those complaints. Ask whether the facility has a resident council.
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How to Use This Data When Researching a Nursing Home
This national snapshot shows patterns across 14,689 facilities and can help you know what to look for — but it does not replace looking at the inspection history of a specific facility. You can find individual facility reports at the CMS Care Compare website (medicare.gov/care-compare). When reviewing a facility's report:
1. Look for the F-tags on this list, especially F0689 and F0684, and check whether they were cited at the actual harm or jeopardy level. 2. Ask about corrections — a citation is not automatically disqualifying if the facility fixed the problem quickly and thoroughly. 3. Check how often the same problem appears across multiple inspections. A pattern is more concerning than a one-time issue. 4. Compare to peers — one or two citations may be typical; a facility with dozens of harm-level citations warrants extra scrutiny.
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Frequently Asked Questions
What is the most commonly cited nursing home deficiency in the U.S.?
Based on CMS data current as of March 25, 2026, F0880 (infection control) is the most cited health deficiency, with 23,538 citations recorded across 11,803 facilities — about 80.4% of all inspected nursing homes.
Which deficiency caused the most actual harm to nursing home residents?
F0689 (free from accident hazards and supervision) had the highest number of citations at the actual harm or immediate jeopardy level: 7,045 out of 21,352 total citations reached that severity threshold, far more than any other deficiency on the top 10 list.
How many nursing home citations were issued in total?
The CMS dataset current as of March 25, 2026 includes 417,725 total health deficiency citations across 14,689 nursing facilities nationwide.
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 Senior Care Report Card 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 →