Common Deficiencies in Nursing Homes: Understanding the Most Cited F-Tags

When it comes to survey readiness and regulatory compliance, understanding which deficiencies occur most often, and why, is essential. In nursing homes, certain F-tags appear year after year on citation reports, signaling areas where facilities nationwide continue to face challenges.

These aren’t obscure or highly technical issues, they reflect real, everyday situations that staff encounter routinely. That’s what makes them so important to understand, and so critical to address proactively.

At Qsource, we help nursing homes recognize these common deficiencies not as isolated mistakes, but as patterns that can be corrected with the right systems, training, and oversight.

The Most Frequently Cited F-Tags in Nursing Homes

While every facility and survey is different, the following five F-tags consistently top the list of deficiencies:

• F689 – Free of Accident Hazards / Adequate Supervision
  This tag covers resident safety and supervision. Citations often involve preventable falls, unsafe equipment, or inadequate interventions for high-risk residents.
• F880 – Infection Prevention and Control
  A closely monitored standard that includes hand hygiene, PPE usage, isolation precautions, and overall infection control practices across departments.
• F684 – Quality of Care
  A broad tag that applies when the care provided doesn’t meet professional standards. It often surfaces in cases of delayed response to changes in condition, poor documentation, or lack of coordination among care teams.
• F812 – Food Safety and Sanitary Conditions
  This tag applies to the storage, preparation, and handling of food. Citations commonly stem from improper temperature control, cross-contamination, or failure to follow sanitation protocols.
• F600 – Abuse and Neglect
  One of the most serious citations, F600 relates to resident rights and protection from harm. Deficiencies may involve unreported allegations, lack of investigation, or failure to implement appropriate safeguards.

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How These Deficiencies Show Up in Daily Practice

What makes these citations persistent is that they often result from routine practices that slip out of alignment, not major incidents.

• A resident left unsupervised in the bathroom experiences a fall (F689).
• A CNA forgets to change gloves between residents, despite good intentions (F880).
• A nurse delays contacting the physician after a resident shows signs of infection (F684).
• Kitchen staff misinterpret expiration labels, leading to improper food use (F812).
• A staff member fails to escalate a witnessed incident of rough handling (F600).

Each of these scenarios reflects breakdowns in communication, supervision, or adherence to protocol. And in many cases, staff were unaware that their actions (or inactions) could result in a citation.

Why These Deficiencies Persist

Even well-staffed, high-performing nursing homes struggle with these F-tags. Several factors contribute to their recurrence:

• High staff turnover, which leads to inconsistent knowledge and gaps in training
• Workflow fatigue, where staff are stretched too thin to follow every step perfectly
• Lack of real-time accountability, such as peer checks or supervisor rounding
• Misalignment between written policy and daily operations
• Insufficient communication across departments

Citations are not always about neglect, they often point to systems that haven’t kept up with the complexity of today’s care environment.

Proactive Strategies That Make a Difference

Facilities that perform well in these areas tend to share a few key characteristics: they monitor proactively, reinforce expectations consistently, and involve staff at all levels in quality improvement efforts.

Qsource supports this work by offering:

• Mock survey preparation, which helps identify vulnerabilities before a surveyor does
• Hands-on coaching around infection prevention, resident safety, and abuse prevention
• Simplified audit tools and visual job aids tailored to the facility's workflows
• Customized training refreshers, often based on real citations and actual resident scenarios
• QAPI coaching, to ensure that root causes are addressed, not just symptoms

Our consulting is designed to help teams focus not only on “what to do,” but how to sustain it across departments, shifts, and staff changes.

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A Smarter Path to Compliance

Understanding the most commonly cited F-tags is more than a survey prep tactic, it’s a lens for evaluating where a facility’s systems may be vulnerable. By focusing attention on these key areas, nursing homes can strengthen care quality, boost staff confidence, and prevent regulatory setbacks before they occur.

At Qsource, we don’t just help facilities react to deficiencies, we help build cultures of awareness, prevention, and performance. When teams are supported with the right tools, the right training, and the right mindset, compliance becomes a natural part of care delivery, not just a box to check during survey week.