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F676: Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason

F676 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. It sits in CMS's quality of life and care category.

1,474citations in the CMS files
1,333homes cited at least once
281in the 12 months to September 2026
0.9%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). 20.9% of F676 citations came from a complaint visit rather than a routine inspection.

  • Immediate jeopardy (J, K, L)1 (0.1%)
  • Actual harm (G, H, I)12 (0.8%)
  • Potential for more than minimal harm (D, E, F)1,460 (99.1%)
  • Potential for minimal harm (A, B, C)1 (0.1%)

By letter: B 1, D 1,296, E 162, F 2, G 10, H 2, J 1.

What inspectors wrote

Three recent F676 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 EBased on facility policy and clinical record review and staff interview, it was determined that the facility failed to complete a restorative nursing program for four of seven residents reviewed for ADLs (activities of daily living) concerns (Residents R23, R26, R91, and R99).

Asbury Health Center, Pittsburgh, PA

Inspectors wrote, August 5, 2026, scope and severity DBased on observation, interview, and document review, the facility failed to provide the necessary assistance with activities of daily living (ADL) to maintain oral hygiene for 1 of 1 resident (R36) reviewed for ADL assistance.

Laurels Peak Health Care, LLC, Mankato, MN

Inspectors wrote, July 30, 2026, scope and severity DBased on observation, interview, record review, and policy review, the provider failed to implement a physical therapist recommended walk-to-dine program for one of one sampled resident (48).

Good Samaritan Society - St. Martin Village, Rapid City, SD

Most recent F676 citations at the harm or jeopardy level

Newest first, all 13 in the current files. Each home's page shows the citation in full context, with its correction status.

InspectionHomeTownLetterVisit
August 16, 2025Bremond Nursing and Rehabilitation CenterBremond, TX JStandard
January 9, 2025Riverwood CenterJacksonville, FL GStandard
December 5, 2024Syringa Chalet Nursing FacilityBlackfoot, ID GComplaint
July 19, 2024Polaris Extended CareAnchorage, AK HStandard
June 14, 2024Cherokee Park RehabilitationLouisville, KY GComplaint
May 24, 2024Courtyard Health Care CenterDavis, CA GStandard
March 29, 2024Avir at LongviewLongview, TX GStandard
February 29, 2024St. Helena Parish Nursing HomeGreensburg, LA GComplaint
February 2, 2024Shores Nursing and Rehab CenterPort Saint Joe, FL GStandard
January 25, 2024Arcadia Care Peoria HeightsPeoria Heights, IL GComplaint
April 30, 2023Parkside Center for Nursing and Rehab at EllijayEllijay, GA GStandard
January 30, 2023Provo Rehabilitation and NursingProvo, UT GStandard
December 7, 2019Aventura at Humility HouseAustintown, OH HStandard

Most recent F676 citations

InspectionHomeTownLetter
August 6, 2026Asbury Health CenterPittsburgh, PA E
August 5, 2026Laurels Peak Health Care, LLCMankato, MN D
July 30, 2026Good Samaritan Society - St. Martin VillageRapid City, SD D
July 30, 2026Kittson HealthcareHallock, MN D
July 30, 2026Ignite Medical Hanover ParkHanover Park, IL F
July 29, 2026Princeton Medical LodgePrinceton, TX D
July 29, 2026The Canyons Post-AcuteColton, CA D
July 28, 2026Ojai Health & RehabilitationOjai, CA E
July 24, 2026Sweden Valley ManorCoudersport, PA D
July 17, 2026Lake Winona ManorWinona, MN D
July 17, 2026Autumn Lake Healthcare at HomewoodBaltimore, MD D
July 16, 2026Harker Heights Nursing & RehabilitationHarker Heights, TX E
July 16, 2026The Estates at Lynnhurst LLCSaint Paul, MN D
July 16, 2026Lakeshore Rehabilitation Center LLCWaseca, MN D
July 14, 2026Heritage Health Care CenterOakwood Village, OH D
July 14, 2026McPherson Operator, LLCMcPherson, KS D
July 14, 2026Amberwood Care CentreRockford, IL D
July 10, 2026Primrose Post-AcuteInglewood, CA D
July 9, 2026Allure of Mt CarrollMount Carroll, IL D
July 9, 2026Cottonwood Healthcare CenterWoodland, CA D
July 9, 2026Santa Paula Post Acute CenterSanta Paula, CA D
July 9, 2026Culver West Health CenterLos Angeles, CA D
July 6, 2026Autumn Lake Healthcare at OverleaBaltimore, MD D
July 2, 2026El Encanto Healthcare CenterCity of Industry, CA E
June 26, 2026Cedar Pine Post AcutePasadena, CA E

F676 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
California360
Ohio125
Florida78
Pennsylvania74
Illinois73
Minnesota57
Washington50
Colorado49
Maryland48
Michigan47
Kansas45
Utah42
New York39
Texas29
Massachusetts26
Missouri26
Indiana25
Iowa24
Virginia23
Oregon20
New Mexico18
Louisiana17
Wisconsin15
Connecticut14
New Jersey13
Georgia12
Arizona10
Hawaii10
West Virginia9
Idaho8
Kentucky8
Arkansas6
Delaware6
Montana6
Nevada6
District of Columbia5
Mississippi5
Nebraska5
New Hampshire5
Alabama4
Oklahoma4
Rhode Island4
Tennessee4
Alaska3
Maine3
North Carolina3
South Carolina3
South Dakota3
Wyoming3
North Dakota1
Puerto Rico1

By inspection year: 2018 11, 2019 54, 2020 13, 2021 55, 2022 107, 2023 252, 2024 440, 2025 321, 2026 221.

Common questions

What is F676 in a nursing home inspection?
F676 is the federal requirement to "ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason". CMS files it under quality of life and care. A home cited under F676 did not meet that requirement at the inspection.
How often is F676 cited?
The CMS files as of September 1, 2026 list 1,474 F676 citations at 1,333 nursing homes, 281 of them in the 12 months to that date. 0.9% were rated as actual harm or immediate jeopardy.
Is a F676 citation serious?
It depends on the letter. Most F676 citations (99.1%) 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

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