F566: 1) Protect residents from being forced to work at the nursing home, or 2) let residents work if they want to
F566 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: 1) Protect residents from being forced to work at the nursing home, or 2) let residents work if they want to.
It sits in CMS's resident rights 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). 9.1% of F566 citations came from a complaint visit rather than a routine inspection.
By letter: D 6, E 1, F 4.
What inspectors wrote
Three recent F566 citations from different states, quoted from the inspectors' statements of deficiencies (CMS form 2567). Names are removed by CMS.
Inspectors wrote, May 1, 2026, scope and severity DBased on observation, interview and record review, the facility failed to ensure a resident who had expressed the need/desire to work, had previously worked and agreed to the work arrangements, was given the choice to perform voluntary services at the facility for 1 of 2 residents (Resident 44) reviewed for resident rights. This failure placed the resident at risk of confusion/frustration with facility staff and an increased risk of behaviors regarding their choice/arrangement to work.
Yakima Valley School, Selah, WA
Inspectors wrote, December 19, 2024, scope and severity DBased on record review and interviews, the facility failed to ensure one (#13) of one resident out of 41 sample residents was compensated for paid services at or above prevailing rates. Specifically, the facility failed to ensure Resident #13 was paid in a timely manner.
Thornton Care Center, Thornton, CO
Inspectors wrote, October 2, 2024, scope and severity FBased on the review of policy and procedure with the insititutional program director (employee #6), it was determined that facility failed to establish the structure to comply with the resident right to choose or refuse to perform services for the facility.
Centro De Cuidado Prolongado San Lucas, Rio Piedras, PR
Most recent F566 citations
| Inspection | Home | Town | Letter |
|---|---|---|---|
| May 1, 2026 | Yakima Valley School | Selah, WA | D |
| May 16, 2025 | Normandy Nursing Center | Saint Louis, MO | D |
| December 19, 2024 | Thornton Care Center | Thornton, CO | D |
| October 2, 2024 | Centro De Cuidado Prolongado San Lucas | Rio Piedras, PR | F |
| September 25, 2024 | Multy Medical Skilled Nursing Facility | Rio Piedras, PR | F |
| September 12, 2024 | Hospital De La Concepcion Inc | San German, PR | F |
| December 6, 2023 | Azria Health Prairie Ridge | Mediapolis, IA | D |
| October 26, 2023 | Thornton Care Center | Thornton, CO | D |
| September 14, 2023 | Burlington Health and Rehabilitation Center | Burlington, WI | F |
| October 27, 2022 | Center at Lowry, LLC | Denver, CO | E |
| July 21, 2022 | Thornton Care Center | Thornton, CO | D |
F566 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 |
|---|---|
| Colorado | 4 |
| Puerto Rico | 3 |
| Iowa | 1 |
| Missouri | 1 |
| Washington | 1 |
| Wisconsin | 1 |
By inspection year: 2022 2, 2023 3, 2024 4, 2025 1, 2026 1.
Common questions
- What is F566 in a nursing home inspection?
- F566 is the federal requirement to "1) protect residents from being forced to work at the nursing home, or 2) let residents work if they want to". CMS files it under resident rights. A home cited under F566 did not meet that requirement at the inspection.
- How often is F566 cited?
- The CMS files as of September 1, 2026 list 11 F566 citations at 9 nursing homes, 1 of them in the 12 months to that date. 0.0% were rated as actual harm or immediate jeopardy.
- Is a F566 citation serious?
- It depends on the letter. Most F566 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