F493: Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility
F493 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility
It sits in CMS's administration 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 F493 citations came from a complaint visit rather than a routine inspection.
By letter: E 1.
What inspectors wrote
Three recent F493 citations from different states, quoted from the inspectors' statements of deficiencies (CMS form 2567). Names are removed by CMS.
Inspectors wrote, August 17, 2017, scope and severity EBased on record review, interviews, and review of the job description for the [NAME] President of Quality Management and Clinical Services, corporate staff failed to ensure a policy was developed and/or the facility procedure was revised for side rail use. This had the potential to affect all 57 of 92 residents in the facility, identified as utilizing side rails.
Northside Health Care, Gadsden, AL
Most recent F493 citations
| Inspection | Home | Town | Letter |
|---|---|---|---|
| August 17, 2017 | Northside Health Care | Gadsden, AL | E |
F493 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 |
|---|---|
| Alabama | 1 |
By inspection year: 2017 1.
Common questions
- What is F493 in a nursing home inspection?
- F493 is the federal requirement to "establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility". CMS files it under administration. A home cited under F493 did not meet that requirement at the inspection.
- How often is F493 cited?
- The CMS files as of September 1, 2026 list 1 F493 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 F493 citation serious?
- It depends on the letter. Most F493 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