Common Citations in Nursing Homes and Their Underlying Risks

For nursing home staff, staying informed about the most frequently cited deficiencies can be one of the most effective ways to prevent them. While each survey is unique, certain patterns emerge year after year, pointing to areas where facilities across the country struggle to maintain compliance. Recognizing these high-risk areas not only strengthens day-to-day operations, but also helps facilities stay survey-ready and resident-focused.

A Closer Look at Frequently Cited F-Tags

Despite ongoing improvements in long-term care, a handful of citations consistently appear at the top of CMS deficiency reports. These include:

• F880 – Infection Prevention and Control
• F689 – Free of Accident Hazards / Adequate Supervision to Prevent Accidents
• F684 – Quality of Care
• F812 – Food Safety and Sanitary Conditions
• F600 – Freedom from Abuse, Neglect, and Exploitation

While these tags are familiar to most nursing home teams, the frequency with which they appear highlights how difficult it can be to translate policy into consistent daily practice, especially under staffing pressures, leadership transitions, or shifting regulatory expectations.

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Factors Contributing to Recurrent Deficiencies

Many of the most common F-tags relate to core care principles: safety, hygiene, dignity, and overall health outcomes. Their continued presence in survey reports often signals system-level breakdowns rather than isolated mistakes. For example:

• Infection Control (F880) is frequently cited not because facilities lack policies, but because those policies aren’t always followed or monitored consistently.
• Accident Hazards (F689) often stem from missed environmental risks, inadequate supervision, or unclear protocols around high-risk residents.
• Food Safety (F812) deficiencies may reflect lapses in kitchen procedures, documentation, or training — even when staff are doing their best.

What may appear to be a minor oversight can quickly lead to a deficiency, particularly when documentation doesn't adequately support the care that was provided.

Survey Timelines and Risk Periods

These high-risk citations are most often cited during standard annual surveys, but they also commonly emerge during complaint investigations and targeted follow-ups. Issues tend to surface when facilities are operating under stress — such as during staffing shortages, periods of leadership turnover, or in the wake of outbreaks and regulatory changes.

Facilities that operate in a reactive mode are more likely to experience repeat citations. In contrast, those that embed compliance into everyday operations are better equipped to weather challenges and maintain consistency, regardless of when the next survey occurs.

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Recurring Challenges Across Facility Types

Whether large or small, urban or rural, for-profit or nonprofit, facilities across the care continuum have struggled with these common citations. At Qsource, we’ve supported teams who deliver excellent care but still face survey setbacks due to inconsistencies in training, communication, or documentation.

What stands out among facilities that turn things around is their willingness to view citations as part of a larger pattern. Rather than focusing solely on passing the next survey, these providers prioritize long-term improvements that address underlying risks.

A Strategic Focus on Prevention

Knowing which citations are most common enables teams to focus their energy where it matters most. Prioritizing these risk areas allows facilities to improve staff awareness, strengthen systems, and support compliance before surveyors arrive.

Qsource partners with facilities to build sustainable improvement strategies that go beyond short-term fixes. Through data-driven insights, coaching, and proven frameworks, we help teams recognize risk factors early, engage staff meaningfully, and foster a culture of continuous readiness.

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