Preventing Accidents Before They Happen: A Deep Dive into F689

In a long-term care setting, even one fall or accident can change a resident’s life forever. F689, Free of Accident Hazards / Supervision / Devices, is one of the most frequently cited deficiencies in nursing homes, and with good reason: it touches every part of care, from physical safety to staff attentiveness to environmental risks.

At Qsource, we work with nursing homes to not only prevent accidents but to create a culture where safety is integrated into every task, every shift, and every team.

What F689 Requires, And Why It’s So Often Cited

F689 mandates that facilities ensure:

• The environment remains as free from accident hazards as possible
• Residents receive adequate supervision and assistance devices to prevent accidents
• Interventions are individualized and updated as residents’ needs change

Yet many citations stem from situations like:

• Residents falling while trying to self-transfer
• Inadequate or improperly used assistive devices (e.g., walkers, bed alarms)
• Wet floors, loose cords, or cluttered walkways
• Delayed response times or failure to supervise high-risk residents
• Failure to update care plans following an accident

These issues are rarely isolated. They often reflect system-level gaps in communication, staffing, or risk assessment.

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Why F689 Matters

Accidents in nursing homes are not just compliance issues, they have real, human costs:

• Resident injury or hospitalization
• Emotional trauma for the resident, their family, and staff
• Increased liability and risk exposure
• Citations or penalties during surveys
• Loss of trust from families and community partners

For many facilities, recurring falls or supervision concerns are not due to indifference, but rather a lack of proactive, team-driven prevention strategies.

Creating a Safer Environment Through Prevention

A strong accident prevention program involves more than checklists. It demands ongoing awareness, team communication, and timely follow-through.

Here’s how successful facilities reduce F689 risk:

Proactive Risk Identification

• Regular risk assessments for falls, choking, elopement, or equipment-related hazards
• Resident-specific care plans that include mobility, cognition, and behavior patterns
• Daily shift handoffs that flag high-risk individuals and environments

Assistive Devices and Equipment

• Ensuring proper fit, use, and placement of walkers, wheelchairs, bed rails, alarms
• Staff training on safe transfer techniques and device maintenance
• Removing or updating outdated or broken equipment promptly

Environmental Rounds

• Identifying trip hazards, lighting issues, or high-traffic bottlenecks
• Bathroom safety checks, handrail placement, and grab-bar reviews
• Collaborating with housekeeping and maintenance for timely fixes

Staff Engagement and Supervision

• Reinforcing the importance of presence and awareness during routines
• Empowering CNAs to report unsafe conditions or emerging risks
• Creating a team-based approach to monitor high-risk residents across departments

How Qsource Supports Facilities in Strengthening F689 Compliance

Preventing accidents requires more than reactive fixes. Qsource helps nursing homes build the systems, accountability, and awareness needed for long-term safety improvements.

We support facilities through:

• Environmental safety audits with actionable recommendations
• Care plan reviews focused on supervision and fall prevention
• Staff training on observation, safe transfer techniques, and device use
• Tools for tracking and trending incidents as part of QAPI
• Leadership coaching on building a safety-forward culture

Our approach meets facilities where they are, and helps them build toward where they want to be.

Safety Is Everyone’s Responsibility

F689 reflects more than a policy, it reflects your culture. When safety is embedded in your daily work, not just your survey prep, residents thrive, staff feel confident, and the risk of harm goes down drastically.

At Qsource, we help nursing homes take practical, team-driven steps toward accident prevention, creating an environment where safety is not just expected, it’s owned.

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