F644: Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed
F644 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
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). 11.2% of F644 citations came from a complaint visit rather than a routine inspection.
By letter: B 23, C 1, D 2,332, E 268, F 7, G 4, J 1.
What inspectors wrote
Three recent F644 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 record review and interview, the facility failed to ensure residents with newly evident or known diagnosis of serious mental disorders have a coordinated Preadmission Screening and Resident Review (PASRR) for 1 of 3 residents, Resident #31, reviewed for PASRR.
Suwannee Valley Nursing Center, Jasper, FL
Inspectors wrote, August 12, 2026, scope and severity DBased on interview and record review, the facility failed to incorporate the recommendations from PASARR level II determination and the PASARR evaluation report into a resident's assessment, care planning, and transitions of care. for 1 of 3 (Resident #57) PASRR resident in that:Resident #57's PASRR II recommendations for a customized manual wheelchair (10/10/2025) and Occupational Therapy (8/4/2025)/Physical Therapy (7/28/2025) NFSS was submitted after 20 days. This could affect all residents on PASRR services and could result in residents on PASRR services not provided with DME or specialized services.
Val Verde Nursing and Rehabilitation Center, Del Rio, TX
Inspectors wrote, August 7, 2026, scope and severity DBased on a review of clinical records and staff interviews, it was determined that the facility failed to refer residents with newly evident or possible serious mental disorders, intellectual disabilities, or related conditions for a Preadmission Screening and Resident Review (PASRR) level II resident review for one of 27 residents reviewed (Resident R10).
Rouse Warren County Home, Youngsville, PA
Most recent F644 citations at the harm or jeopardy level
Newest first, all 5 in the current files. Each home's page shows the citation in full context, with its correction status.
| Inspection | Home | Town | Letter | Visit |
|---|---|---|---|---|
| December 24, 2025 | Centennial Post Acute | Anchorage, AK | G | Complaint |
| October 29, 2024 | Crystal Lake Healthcare and Rehabilitation | Bayville, NJ | G | Complaint |
| September 11, 2023 | Cleveland Community Care Center | Cleveland, MS | J | Complaint |
| August 16, 2023 | Sandy Health and Rehab | Sandy, UT | G | Standard |
| April 13, 2022 | Spring Creek Healthcare Center | Salt Lake City, UT | G | Standard |
Most recent F644 citations
F644 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 |
|---|---|
| Texas | 376 |
| California | 250 |
| Ohio | 242 |
| Florida | 166 |
| Iowa | 147 |
| Illinois | 147 |
| Louisiana | 103 |
| North Carolina | 88 |
| West Virginia | 87 |
| Oklahoma | 81 |
| Washington | 75 |
| Georgia | 69 |
| Indiana | 69 |
| Tennessee | 64 |
| Michigan | 59 |
| Connecticut | 55 |
| Missouri | 43 |
| Massachusetts | 36 |
| New Jersey | 34 |
| Colorado | 31 |
| Mississippi | 29 |
| Delaware | 28 |
| Idaho | 27 |
| Nebraska | 27 |
| Wisconsin | 25 |
| Arkansas | 24 |
| Virginia | 24 |
| Arizona | 23 |
| Minnesota | 23 |
| Nevada | 23 |
| Pennsylvania | 22 |
| South Carolina | 17 |
| Maine | 16 |
| New York | 16 |
| Oregon | 11 |
| Utah | 11 |
| Maryland | 10 |
| North Dakota | 10 |
| Kentucky | 9 |
| Alabama | 8 |
| Montana | 7 |
| South Dakota | 7 |
| Kansas | 6 |
| Wyoming | 4 |
| Alaska | 3 |
| New Hampshire | 3 |
| Hawaii | 1 |
By inspection year: 2018 9, 2019 33, 2020 10, 2021 25, 2022 135, 2023 534, 2024 775, 2025 691, 2026 424.
Common questions
- What is F644 in a nursing home inspection?
- F644 is the federal requirement to "coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed". CMS files it under resident assessment and care planning. A home cited under F644 did not meet that requirement at the inspection.
- How often is F644 cited?
- The CMS files as of September 1, 2026 list 2,636 F644 citations at 2,334 nursing homes, 577 of them in the 12 months to that date. 0.2% were rated as actual harm or immediate jeopardy.
- Is a F644 citation serious?
- It depends on the letter. Most F644 citations (98.9%) 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