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F561: Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice

F561 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. It sits in CMS's resident rights category.

1,863citations in the CMS files
1,668homes cited at least once
331in the 12 months to September 2026
1.1%rated actual harm or immediate jeopardy

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). 23.2% of F561 citations came from a complaint visit rather than a routine inspection.

  • Immediate jeopardy (J, K, L)7 (0.4%)
  • Actual harm (G, H, I)13 (0.7%)
  • Potential for more than minimal harm (D, E, F)1,834 (98.4%)
  • Potential for minimal harm (A, B, C)9 (0.5%)

By letter: B 8, C 1, D 1,516, E 310, F 8, G 13, J 4, K 3.

What inspectors wrote

Three recent F561 citations from different states, quoted from the inspectors' statements of deficiencies (CMS form 2567). Names are removed by CMS.

Inspectors wrote, August 13, 2026, scope and severity DBased on observation, interview, and document review, the facility failed to honor a request for different room lighting for 1 of 1 resident (R5), reviewed for self-determination.

St. Anthony Park Home Inc, Saint Paul, MN

Inspectors wrote, July 31, 2026, scope and severity DBased on observation, record review, and interviews conducted during a survey, the facility failed to ensure that a resident was able to exercise their autonomy regarding choices that are important to their life. This is evident in one out of seven residents sampled. Specifically, on 02/15/2026 at 5:00 PM, Resident #1 who was alert and oriented times three, attempted to leave the dining room and Certified Nursing Assistant #1 stood in front of their wheelchair and placed both their hands on the armrests of the wheelchair preventing Resident #1 from leaving the dining room.

Holliswood Center for Rehabilitation and Healthcar, Hollis, NY

Inspectors wrote, July 30, 2026, scope and severity DBased on interview, record review, and policy review, the provider failed to ensure resident bathing choices were being followed for one of one sampled residents (105).

Firesteel Healthcare Center, Mitchell, SD

Most recent F561 citations at the harm or jeopardy level

Newest first, all 20 in the current files. Each home's page shows the citation in full context, with its correction status.

InspectionHomeTownLetterVisit
April 2, 2026Elon Manor Nursing and Rehabilitation CenterTampa, FL GComplaint
November 19, 2025St. Andrew's at Francis PlaceEureka, MO GComplaint
October 1, 2025Corewell Health Rehabilitation & Nursing Center -Stevensville, MI GComplaint
August 22, 2025Guam Memorial Hospital AuthorityBarrigada, GU GStandard
May 23, 2025Lacon Rehab and NursingLacon, IL GStandard
April 18, 2025Van Duyn Center for Rehabilitation and NursingSyracuse, NY KComplaint
April 4, 2025Karcher Post AcuteNampa, ID GComplaint
November 20, 2024Moweaqua Rehab & HCCMoweaqua, IL GStandard
August 20, 2024Good Samaritan Society CanistotaCanistota, SD GComplaint
August 19, 2024Allaire Rehab & NursingFreehold, NJ JComplaint
August 5, 2024Bedford Care Center of MendenhallMendenhall, MS GComplaint
July 29, 2024Sinai Post-Acute Nursing & Rehab CenterNewark, NJ KComplaint
June 30, 2024Windsor Park Rehab & Nursing CenterQueens Village, NY KComplaint
June 26, 2024Belle Care Nursing and Rehabilitation CenterTrenton, NJ JStandard
March 28, 2024Higher Call Nursing CenterQuapaw, OK JComplaint
September 28, 2023Carver Living CenterDurham, NC GComplaint
September 15, 2023Timberlyn Heights Nursing and RehabilitationGreat Barrington, MA GComplaint
September 12, 2023St. Francis Rehabilitation & Nursing CenterWorcester, MA GComplaint
August 10, 2023Kannapolis Health and RehabilitationKannapolis, NC GStandard
June 12, 2023Silver BluffCanton, NC JStandard

Most recent F561 citations

InspectionHomeTownLetter
August 13, 2026St. Anthony Park Home IncSaint Paul, MN D
July 31, 2026Holliswood Center for Rehabilitation and HealthcarHollis, NY D
July 30, 2026Firesteel Healthcare CenterMitchell, SD D
July 30, 2026Martin Luther Care CenterBloomington, MN D
July 30, 2026Ignite Medical Hanover ParkHanover Park, IL F
July 28, 2026Aspire Senior Living CarthageCarthage, MO D
July 23, 2026Kempton of CharlestonCharleston, SC D
July 23, 2026Sanford Health & Rehabilitation CoSanford, NC D
July 23, 2026Northeast Ctr for Rehabilitation and Brain InjuryLake Katrine, NY D
July 22, 2026Mason City Area Nursing HomeMason City, IL D
July 20, 2026Newark Nursing & RehabNewark, OH D
July 14, 2026Heritage Health Care CenterOakwood Village, OH D
July 13, 2026Windsor Health and RehabilitationSalem, OR D
July 10, 2026Cambridge Health and Rehabilitation CenterRichmond, TX E
July 9, 2026Valley Grande ManorWeslaco, TX D
July 9, 2026West Park Care Center LLCColumbus, OH D
July 9, 2026Good Shepherd Lutheran HomeSauk Rapids, MN D
July 2, 2026The Laurels of Summit RidgeAsheville, NC D
July 2, 2026Maquoketa Care CenterMaquoketa, IA D
July 1, 2026Water's EdgeHayward, WI D
July 1, 2026Life Care Center of Blount CountyLouisville, TN D
June 30, 2026Good Shepherd VillageSpringfield, OH D
June 30, 2026Treyburn Rehabilitation CenterDurham, NC D
June 30, 2026Harmony House Health Care CenterWaterloo, IA D
June 30, 2026Harmony DavenportDavenport, IA E

F561 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.

StateCitations
Ohio170
Missouri126
Florida120
California98
New York85
Maryland83
Michigan81
North Carolina76
Texas74
Colorado69
Indiana60
Minnesota53
Washington53
Mississippi49
Pennsylvania48
Connecticut47
West Virginia47
Virginia43
Illinois38
New Mexico32
Massachusetts28
Kansas26
Oregon24
Georgia23
Louisiana23
New Jersey21
Wisconsin21
Iowa20
Utah19
Nebraska18
Delaware15
Nevada15
Arkansas14
Maine14
Hawaii13
Kentucky12
Oklahoma11
South Dakota11
South Carolina10
Arizona9
Tennessee9
Idaho8
Montana8
Vermont7
Alaska6
Alabama6
New Hampshire5
Wyoming4
Puerto Rico3
Rhode Island3
District of Columbia2
North Dakota2
Guam1

By inspection year: 2018 8, 2019 65, 2020 25, 2021 64, 2022 171, 2023 382, 2024 500, 2025 416, 2026 232.

Common questions

What is F561 in a nursing home inspection?
F561 is the federal requirement to "honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice". CMS files it under resident rights. A home cited under F561 did not meet that requirement at the inspection.
How often is F561 cited?
The CMS files as of September 1, 2026 list 1,863 F561 citations at 1,668 nursing homes, 331 of them in the 12 months to that date. 1.1% were rated as actual harm or immediate jeopardy.
Is a F561 citation serious?
It depends on the letter. Most F561 citations (98.4%) were rated as potential for more than minimal harm, D to F. 7 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

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