F221: Keep each resident free from physical restraints, unless needed for medical treatment
F221 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Keep each resident free from physical restraints, unless needed for medical treatment.
It sits in CMS's freedom from abuse, neglect, and exploitation category.
CMS Health Deficiencies file, data as of September 1, 2026. The files hold each home's last three standard inspections and three years of complaint visits.
How seriously inspectors rate it
Every citation gets a letter for how much harm inspectors found and how many residents it touched (how to read the letters). 0.0% of F221 citations came from a complaint visit rather than a routine inspection.
By letter: D 1.
What inspectors wrote
Three recent F221 citations from different states, quoted from the inspectors' statements of deficiencies (CMS form 2567). Names are removed by CMS.
Inspectors wrote, November 9, 2017, scope and severity DBased on staff interview, clinical record review, and facility documentation review, the facility staff failed, for 1 resident (Resident #13) in the survey sample of 24 residents, to ensure that Resident #13 was free of a physical restraint. The facility staff failed to ensure that Resident #13 was free of being restrained by a bed sheet tied around a Geri-chair.
Colonial Heights Rehabilitation and Nursing Center, Colonial Heights, VA
Most recent F221 citations
| Inspection | Home | Town | Letter |
|---|---|---|---|
| November 9, 2017 | Colonial Heights Rehabilitation and Nursing Center | Colonial Heights, VA | D |
F221 citations by state
Counts depend on how many homes a state has and how often its inspectors visit, so a larger number is not by itself a worse record.
| State | Citations |
|---|---|
| Virginia | 1 |
By inspection year: 2017 1.
Common questions
- What is F221 in a nursing home inspection?
- F221 is the federal requirement to "keep each resident free from physical restraints, unless needed for medical treatment". CMS files it under freedom from abuse, neglect, and exploitation. A home cited under F221 did not meet that requirement at the inspection.
- How often is F221 cited?
- The CMS files as of September 1, 2026 list 1 F221 citations at 1 nursing homes, 0 of them in the 12 months to that date. 0.0% were rated as actual harm or immediate jeopardy.
- Is a F221 citation serious?
- It depends on the letter. Most F221 citations (100.0%) were rated as potential for more than minimal harm, D to F. None in the current files is at the immediate jeopardy level.
The interpretive guidance inspectors use for each F-tag is CMS's State Operations Manual, Appendix PP. NursingHomeClear reports the citations as CMS records them and is not affiliated with CMS. All F-tags · Methodology