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F656: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured

F656 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. It sits in CMS's resident assessment and care planning category.

14,656citations in the CMS files
8,407homes cited at least once
3,170in the 12 months to September 2026
3.2%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). 29.9% of F656 citations came from a complaint visit rather than a routine inspection.

  • Immediate jeopardy (J, K, L)213 (1.5%)
  • Actual harm (G, H, I)255 (1.7%)
  • Potential for more than minimal harm (D, E, F)14,107 (96.3%)
  • Potential for minimal harm (A, B, C)81 (0.6%)

By letter: B 72, C 9, D 11,253, E 2,809, F 45, G 247, H 8, J 158, K 54, L 1.

What inspectors wrote

Three recent F656 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 interview and record review, the facility failed to develop and implement a comprehensive care plan for 1 of 5 residents, Resident #11, reviewed for unnecessary medications.

Suwannee Valley Nursing Center, Jasper, FL

Inspectors wrote, August 6, 2026, scope and severity DBased on observations, interviews, and document review, the facility failed to ensure a comprehensive care plan was developed and maintained to include focus, goals, and interventions for dialysis for 1 of 2 residents (R1) who had a diagnosis of kidney failure and was receiving dialysis.

St. Benedicts Care Center, Saint Cloud, MN

Inspectors wrote, July 31, 2026, scope and severity DBased on interview and record review, the facility failed to develop and implement a comprehensive person-centered care plan for each resident, consistent with resident needs, that included measurable objectives and time frames to meet a resident's medical, nursing, and mental and psychosocial needs, for 1 of 5 residents (Resident #2) reviewed for care plans. The facility failed to ensure Resident #2's comprehensive care plan reflected his weight bearing status since admission on [DATE] and it was not initiated on his care plan until 07/09/26 (discharge date ). This failure could place the residents at risk of not receiving appropriate interventions and care to meet their needs.

Windsor Arbor View, Edinburg, TX

Most recent F656 citations at the harm or jeopardy level

Newest first, the latest 40 in the current files. Each home's page shows the citation in full context, with its correction status.

InspectionHomeTownLetterVisit
July 30, 2026North Star ManorWarren, MN GComplaint
July 29, 2026Avir at LancasterLancaster, TX GComplaint
July 7, 2026New Summit Rehabilitation and HealthcareArlington Heights, IL GComplaint
June 18, 2026Winston County Nursing HomeLouisville, MS GStandard
June 11, 2026Park Place Nursing FacilityMonroe, GA GComplaint
May 18, 2026Antlers ManorAntlers, OK KComplaint
May 14, 2026Signature Healthcare of McCreary County Rehab andPine Knot, KY GStandard
May 7, 2026Fairview ManorFairview, PA GComplaint
May 6, 2026First Shamrock Care CenterKingfisher, OK KStandard
May 5, 2026Diversicare of MeridianMeridian, MS GComplaint
April 28, 2026Lawton Post Acute & RehabLawton, OK KStandard
April 27, 2026Baptist Village, Inc.Waycross, GA JComplaint
April 23, 2026Diversicare of SouthavenSouthaven, MS GStandard
April 17, 2026Somerset Nursing and Rehabilitation FacilitySomerset, KY GComplaint
April 14, 2026Windsor Nursing and Rehabilitation Center of MorgaCorpus Christi, TX GComplaint
April 13, 2026Ranchwood Nursing CenterYukon, OK HComplaint
April 7, 2026Center for Extended Care at AmherstAmherst, MA GComplaint
April 2, 2026Quality Life Services - MarkleysburgMarkleysburg, PA GComplaint
March 31, 2026Middleton Oaks Health and RehabilitationWinona, MS GComplaint
March 30, 2026Balch Springs Nursing HomeBalch Springs, TX JComplaint
March 27, 2026Meridian Care of AliceAlice, TX JStandard
March 25, 2026Providence HealthcareThomaston, GA GComplaint
March 24, 2026Holly Hill HouseSulphur, LA GComplaint
March 20, 2026Park Manor of Cypress StationHouston, TX GComplaint
March 19, 2026Greenbriar Nursing CenterDiberville, MS GComplaint
March 12, 2026Oxford Health & Rehab CenterOxford, MS GStandard
March 10, 2026Pinewood Health and RehabilitationWhigham, GA JComplaint
March 9, 2026Chelsea GardensMissouri City, TX JComplaint
March 9, 2026Wurtland Nursing and RehabilitationWurtland, KY JComplaint
March 7, 2026Auburn Nursing and Rehabilitation CenterAuburn, KY JComplaint
March 4, 2026Van Duyn Center for Rehabilitation and NursingSyracuse, NY JComplaint
February 26, 2026Cambridge Health and Rehabilitation CenterRichmond, TX GComplaint
February 23, 2026The Springs of BrinkleyBrinkley, AR JComplaint
February 20, 2026Pruitthealth - RomeRome, GA GComplaint
February 12, 2026Harborview SatillaWaycross, GA GComplaint
February 11, 2026Linden PondsHingham, MA GComplaint
February 9, 2026Norwood HealthcareNorwood, MA JStandard
February 3, 2026The Grove at CarvalhoFall River, MA GComplaint
January 27, 2026Carlyle HouseFramingham, MA GComplaint
January 23, 2026Intercommunity Care CenterLong Beach, CA GComplaint

Most recent F656 citations

InspectionHomeTownLetter
August 13, 2026Suwannee Valley Nursing CenterJasper, FL D
August 13, 2026Shores Nursing and Rehab CenterPort Saint Joe, FL D
August 12, 2026Beaumont Nursing and RehabilitationBeaumont, TX D
August 12, 2026Val Verde Nursing and Rehabilitation CenterDel Rio, TX D
August 12, 2026Lake City Healthcare and Rehabilitation CenterLake City, FL D
August 6, 2026St. Benedicts Care CenterSaint Cloud, MN D
July 31, 2026Windsor Arbor ViewEdinburg, TX D
July 31, 2026Navasota Nursing & RehabilitationNavasota, TX D
July 31, 2026Richardson Nursing and RehabilitationRichardson, TX D
July 31, 2026Town and Country Nursing and Rehabilitation CenterBoerne, TX D
July 31, 2026Centre Care Rehabilitation and Wellness ServicesBellefonte, PA D
July 31, 2026Heritage ManorChisholm, MN D
July 31, 2026Sandstone of Tucson Rehab CentreTucson, AZ D
July 30, 2026Brush Country Nursing and RehabilitationAustin, TX D
July 30, 2026Marina Pointe Healthcare & SubacuteCulver City, CA D
July 30, 2026Shepherd of the Valley Rehabilitation and WellnessCasper, WY D
July 30, 2026White Settlement Nursing CenterWhite Settlement, TX D
July 30, 2026Glen Oaks Nursing CenterLucedale, MS D
July 30, 2026North Star ManorWarren, MN G
July 30, 2026Little Falls Care CenterLittle Falls, MN D
July 30, 2026Martin Luther Care CenterBloomington, MN D
July 30, 2026The Laurels of ColdwaterColdwater, MI D
July 30, 2026Mission Point Nursing & Physical Rehabilitation CeCedar Springs, MI D
July 30, 2026The Center at AdvocateEast Boston, MA D
July 30, 2026Ignite Medical Hanover ParkHanover Park, IL E

F656 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
California2,654
Texas1,829
Pennsylvania656
Ohio629
New York581
Florida498
Massachusetts479
Louisiana423
Virginia415
Missouri390
Georgia387
Maryland384
Mississippi376
Michigan354
Indiana306
Illinois298
Washington264
Connecticut248
Kentucky246
New Jersey238
Oklahoma234
West Virginia229
Minnesota226
Iowa224
North Carolina181
Wisconsin175
Tennessee169
Kansas156
Arkansas146
New Mexico113
Maine106
Oregon90
Nevada89
Alabama86
Hawaii80
Utah78
South Carolina75
Montana65
Idaho63
Nebraska63
Delaware54
District of Columbia52
Arizona45
Colorado43
Rhode Island33
Vermont33
Wyoming23
Alaska22
New Hampshire20
South Dakota18
Puerto Rico5
North Dakota3
Guam2

By inspection year: 2017 1, 2018 97, 2019 462, 2020 165, 2021 407, 2022 850, 2023 2,508, 2024 4,141, 2025 3,725, 2026 2,300.

Common questions

What is F656 in a nursing home inspection?
F656 is the federal requirement to "develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured". CMS files it under resident assessment and care planning. A home cited under F656 did not meet that requirement at the inspection.
How often is F656 cited?
The CMS files as of September 1, 2026 list 14,656 F656 citations at 8,407 nursing homes, 3,170 of them in the 12 months to that date. 3.2% were rated as actual harm or immediate jeopardy.
Is a F656 citation serious?
It depends on the letter. Most F656 citations (96.3%) were rated as potential for more than minimal harm, D to F. 213 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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