Introduction
As we move through 2025, CMS continues to refine its survey process, and certain F-Tags consistently appear as the most cited deficiencies across skilled nursing facilities nationwide. Understanding these common citations is crucial for proactive compliance management.
Based on CMS data and industry analysis, here are the top 10 F-Tags that surveyors are citing most frequently this year.
1. F880 - Infection Prevention & Control
Why it's cited: Post-pandemic, infection control remains under intense scrutiny. Surveyors are looking for comprehensive infection prevention programs, proper hand hygiene practices, and appropriate use of personal protective equipment.
How to stay compliant:
- Conduct regular hand hygiene audits
- Ensure all staff complete infection control training
- Maintain an active infection surveillance program
- Document all infection control activities thoroughly
2. F689 - Free from Accidents/Hazards
Why it's cited: Falls remain the leading cause of injury in long-term care. This F-Tag covers environmental hazards, inadequate supervision, and failure to implement fall prevention interventions.
How to stay compliant:
- Conduct thorough fall risk assessments on admission and quarterly
- Implement individualized fall prevention care plans
- Address environmental hazards promptly
- Document all interventions and their effectiveness
3. F684 - Quality of Care
Why it's cited: This broad tag covers the facility's obligation to provide care that maintains or improves each resident's highest practicable physical, mental, and psychosocial well-being.
How to stay compliant:
- Ensure comprehensive assessments are completed accurately
- Develop individualized care plans based on assessment findings
- Monitor residents for changes in condition
- Document all care provided and resident responses
4. F686 - Treatment/Services to Prevent/Heal Pressure Ulcers
Why it's cited: Pressure ulcer prevention and treatment continues to be a major focus. Surveyors look for comprehensive skin assessments, appropriate interventions, and documentation of wound care.
How to stay compliant:
- Conduct thorough skin assessments on admission and weekly
- Implement pressure ulcer prevention protocols
- Document wound measurements, treatments, and healing progress
- Ensure adequate nutrition and hydration support
5. F812 - Food Procurement, Store, Prepare, Serve - Loss
Why it's cited: Food safety violations, including temperature control, storage practices, and sanitation, are common findings during kitchen inspections.
How to stay compliant:
- Maintain proper food storage temperatures
- Follow FIFO (First In, First Out) rotation
- Keep detailed temperature logs
- Ensure kitchen staff complete food safety training
6. F758 - Free from Unnecessary Psychotropic Medications
Why it's cited: CMS continues its focus on reducing unnecessary antipsychotic medication use. Surveyors examine documentation supporting the medical necessity of psychotropic medications.
How to stay compliant:
- Conduct gradual dose reductions when clinically appropriate
- Document behavioral symptoms requiring medication
- Implement and document non-pharmacological interventions first
- Review psychotropic medications quarterly
7. F656 - Comprehensive Care Plans
Why it's cited: Care plans must be comprehensive, individualized, and regularly updated. Common issues include generic care plans and failure to update plans when conditions change.
How to stay compliant:
- Develop individualized care plans within 7 days of assessment
- Include measurable goals and specific interventions
- Update care plans when resident needs change
- Involve residents and families in care planning
8. F842 - Resident Records - Identifiable Information
Why it's cited: Documentation must accurately reflect the care provided and the resident's condition. Incomplete, inaccurate, or illegible records lead to citations.
How to stay compliant:
- Document care at the time it's provided
- Ensure documentation is complete and accurate
- Train staff on proper documentation practices
- Conduct regular documentation audits
9. F725 - Nursing Services - Sufficient Staff
Why it's cited: Facilities must have sufficient nursing staff to meet resident needs. Surveyors examine staffing patterns, especially during evenings and weekends.
How to stay compliant:
- Maintain staffing levels appropriate for resident acuity
- Document staffing decisions based on resident needs
- Have contingency plans for call-offs
- Monitor and respond to staffing concerns
10. F867 - QAPI Program
Why it's cited: Facilities must have a comprehensive Quality Assurance and Performance Improvement program. Common issues include lack of systematic data analysis and failure to implement improvements.
How to stay compliant:
- Establish a functioning QAPI committee
- Use data to identify improvement opportunities
- Implement and monitor performance improvement projects
- Document all QAPI activities and outcomes
Conclusion
Staying ahead of these common citations requires ongoing vigilance, staff education, and systematic monitoring. By understanding what surveyors are looking for and implementing proactive compliance strategies, your facility can reduce the risk of deficiencies and provide better care for residents.
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