F638: Assure that each resident’s assessment is updated at least once every 3 months
F638 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Assure that each resident’s assessment is updated at least once every 3 months.
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). 6.8% of F638 citations came from a complaint visit rather than a routine inspection.
By letter: B 61, C 7, D 420, E 259, F 14.
What inspectors wrote
Three recent F638 citations from different states, quoted from the inspectors' statements of deficiencies (CMS form 2567). Names are removed by CMS.
Inspectors wrote, August 6, 2026, scope and severity DBased on interview and document review the facility failed to ensure quarterly Minimum Data Set (MDS) was completed in a timely manner for 1 of 1 residents (R39) reviewed for MDS completion.
The Estates at Roseville LLC, Roseville, MN
Inspectors wrote, July 30, 2026, scope and severity DBased upon clinical record review, it was determined that the facility failed to ensure Minimum Data Set Assessments (MDS) were completed timely for three of 12 residents reviewed (Resident 23, Resident 33 and Resident 34).
Preston Residence, West Grove, PA
Inspectors wrote, July 15, 2026, scope and severity DBased on record review, staff interviews and the Resident Assessment Instrument (RAI) manual the facility failed to complete the quarterly Minimum Data Set (MDS) assessment in the required timeframe for 1 of 1 residents reviewed (Resident #34). The facility reported a census of 43 residents.
Oakview Nursing Home, Conrad, IA
Most recent F638 citations
F638 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 2, 2019 43, 2020 13, 2021 26, 2022 79, 2023 165, 2024 211, 2025 124, 2026 98.
Common questions
- What is F638 in a nursing home inspection?
- F638 is the federal requirement to "assure that each resident’s assessment is updated at least once every 3 months". CMS files it under resident assessment and care planning. A home cited under F638 did not meet that requirement at the inspection.
- How often is F638 cited?
- The CMS files as of September 1, 2026 list 761 F638 citations at 720 nursing homes, 123 of them in the 12 months to that date. 0.0% were rated as actual harm or immediate jeopardy.
- Is a F638 citation serious?
- It depends on the letter. Most F638 citations (91.1%) 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