F323: Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents
F323 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents.
It sits in CMS's environmental 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 F323 citations came from a complaint visit rather than a routine inspection.
By letter: D 2, E 1, K 1.
What inspectors wrote
Three recent F323 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 observation, resident interview, staff interview, facility documentation review, clinical record review the facility staff failed to ensure safety measures to prevent a potential accident of cutting a Resident's skin, were utilized when cutting off a soiled dressing using pointed tipped scissors and not bandage scissors for 1 Resident, (Resident #11) in the survey sample size of 29.
Nassawadox Rehabilitation and Nursing, Nassawadox, VA
Inspectors wrote, August 17, 2017, scope and severity EBased on observations, record review, and interviews, the facility failed to ensure: 1) the residents and/or their representatives were informed of the risks and benefits related to the use of side rails prior to installation; and 2) Resident Identifier (RI) #8 did not have a full side rail up on the room/exit side of the bed on 08/15/2017 and a fall mat was placed at the bedside. These failures affected RI #s 1, 2, 3, 8, 10, and 11, six of six residents reviewed for side rail use, and had the potential to affect all 57 of 92 residents residing in the facility, identified by the facility as using side rails.
Northside Health Care, Gadsden, AL
Most recent F323 citations at the harm or jeopardy level
Newest first, all 1 in the current files. Each home's page shows the citation in full context, with its correction status.
| Inspection | Home | Town | Letter | Visit |
|---|---|---|---|---|
| March 23, 2017 | Potomac Falls Health & Rehab Center | Sterling, VA | K | Standard |
Most recent F323 citations
| Inspection | Home | Town | Letter |
|---|---|---|---|
| November 9, 2017 | Nassawadox Rehabilitation and Nursing | Nassawadox, VA | D |
| August 17, 2017 | Northside Health Care | Gadsden, AL | E |
| July 13, 2017 | Portsmouth Health and Rehab | Portsmouth, VA | D |
| March 23, 2017 | Potomac Falls Health & Rehab Center | Sterling, VA | K |
Common questions
- What is F323 in a nursing home inspection?
- F323 is the federal requirement to "ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents". CMS files it under environmental. A home cited under F323 did not meet that requirement at the inspection.
- How often is F323 cited?
- The CMS files as of September 1, 2026 list 4 F323 citations at 4 nursing homes, 0 of them in the 12 months to that date. 25.0% were rated as actual harm or immediate jeopardy.
- Is a F323 citation serious?
- It depends on the letter. Most F323 citations (75.0%) were rated as potential for more than minimal harm, D to F. 1 were immediate jeopardy, the most serious 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