F637: Assess the resident when there is a significant change in condition
F637 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Assess the resident when there is a significant change in condition
It sits in CMS's resident assessment and care planning 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). 10.1% of F637 citations came from a complaint visit rather than a routine inspection.
By letter: B 41, C 2, D 973, E 54, F 1, G 2, J 1.
What inspectors wrote
Three recent F637 citations from different states, quoted from the inspectors' statements of deficiencies (CMS form 2567). Names are removed by CMS.
Inspectors wrote, July 30, 2026, scope and severity DBased on observation, medical record review, staff interview, and CMS RAI manual review, the facility failed to complete a significant change MDS assessment for 1 of 5 sample residents (#123) reviewed for a significant change.
Shepherd of the Valley Rehabilitation and Wellness, Casper, WY
Inspectors wrote, July 24, 2026, scope and severity DBased on interview and record review it was determined the facility failed to complete a Significant Change MDS within the required timeframe for 1 of 1 sampled resident (#2) reviewed for hospice. This placed residents at risk for unassessed needs.
Salem Transitional Care, Salem, OR
Inspectors wrote, July 22, 2026, scope and severity DBased on clinical record review, Center for Medicare and Medicaid (CMS) Long-Term Care (LTC) Resident Assessment Instrument (RAI) Manual review, and staff interview the facility failed to complete a Minimum Data Set (MDS) Significant Change in Status Assessment (SCSA) within 14 days of hospice election for 1 of 2 residents receiving hospice services (Resident #30). The facility identified a census of 74 residents.
The Highlands, Decorah, IA
Most recent F637 citations at the harm or jeopardy level
Newest first, all 3 in the current files. Each home's page shows the citation in full context, with its correction status.
| Inspection | Home | Town | Letter | Visit |
|---|---|---|---|---|
| September 1, 2023 | Chesaning Nursing and Rehabilitation Center | Chesaning, MI | G | Complaint |
| August 25, 2022 | Prairie Manor Nrsg & Rehab Ctr | Chicago Heights, IL | G | Standard |
| February 18, 2022 | Laurelbrook Nursing Home | Dayton, TN | J | Standard |
Most recent F637 citations
F637 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.
By inspection year: 2018 8, 2019 38, 2020 9, 2021 26, 2022 83, 2023 238, 2024 271, 2025 260, 2026 141.
Common questions
- What is F637 in a nursing home inspection?
- F637 is the federal requirement to "assess the resident when there is a significant change in condition". CMS files it under resident assessment and care planning. A home cited under F637 did not meet that requirement at the inspection.
- How often is F637 cited?
- The CMS files as of September 1, 2026 list 1,074 F637 citations at 1,017 nursing homes, 188 of them in the 12 months to that date. 0.3% were rated as actual harm or immediate jeopardy.
- Is a F637 citation serious?
- It depends on the letter. Most F637 citations (95.7%) 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