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F678: Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives

F678 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives. It sits in CMS's quality of life and care category.

765citations in the CMS files
723homes cited at least once
185in the 12 months to September 2026
49.0%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). 56.2% of F678 citations came from a complaint visit rather than a routine inspection.

  • Immediate jeopardy (J, K, L)358 (46.8%)
  • Actual harm (G, H, I)17 (2.2%)
  • Potential for more than minimal harm (D, E, F)389 (50.8%)
  • Potential for minimal harm (A, B, C)1 (0.1%)

By letter: C 1, D 264, E 119, F 6, G 17, J 303, K 40, L 15.

What inspectors wrote

Three recent F678 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 a review of facility policy, employment records and staff interviews, it was determined that the facility failed to maintain documentation that facility nursing personnel have current education and certification to provide basic life support, including CPR (cardiopulmonary resuscitation), to a resident requiring such emergency care prior to the arrival of emergency medical personnel and subject to related physician orders and the resident's advance directives for 14 of 41 licensed nurses (Registered Nurse (RN) Employees E3, E4, E5, E6, and E7 and Licensed Practical Nurse (LPN) Employees E8, E9, E10, E11, E12, E13, E14, E15, and E16). Findings Include: [...]

Asbury Health Center, Pittsburgh, PA

Inspectors wrote, July 28, 2026, scope and severity FBased on interviews and record review, the facility failed to ensure that a nurse and CNA (Certified Nursing Assistant, CNA) maintained a current CPR (Cardiopulmonary Resuscitation) certification card while working in the facility which has the potential to affect all 149 residents residing in the facility.

Kenwood Vlge Nrsg and Rhb Ctr, Chicago, IL

Inspectors wrote, July 23, 2026, scope and severity DBased on interview and record review, the facility failed to confirm one of 26 sampled residents (Resident 96's) code status in an emergency, when Licensed Nurse (LN) 3 did not follow Resident 96's physician's order to do not attempt resuscitation (DNR). This failure resulted in delivering unwanted life-sustaining treatment that was inconsistent with Resident 96's wishes.

Rancho Seco Care Center, Galt, CA

Most recent F678 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 31, 2026Ohio Living Quaker HeightsWaynesville, OH JComplaint
July 27, 2026New Gouverneur Hospital SNFNew York, NY JComplaint
July 17, 2026Normandy Terrace Nursing & Rehabilitation CenterSan Antonio, TX JComplaint
July 17, 2026Oasis Nursing & Rehab of Green ValleyHenderson, NV JComplaint
July 10, 2026Metropolis Rehab & HCCMetropolis, IL JComplaint
July 8, 2026Laurel Creek Health CenterFairfield, CA GComplaint
July 1, 2026Edenbrook SheboyganSheboygan, WI JComplaint
July 1, 2026The Laurels of GalesburgGalesburg, MI JComplaint
June 24, 2026Majestic Care of Point PlaceToledo, OH JComplaint
June 17, 2026Bixby Towers Post-Acute RehabLong Beach, CA JComplaint
June 16, 2026Sunset Villa Post AcuteLong Beach, CA JComplaint
June 11, 2026Grove of Elmhurst, theElmhurst, IL JComplaint
June 9, 2026Watertown Health Care CenterWatertown, WI JComplaint
June 9, 2026Heights Rehabilitation and Healthcare Center, theBroadview Heights, OH JComplaint
June 8, 2026Sunnybrook Rehabilitation CenterRaleigh, NC JComplaint
June 8, 2026Parkway Operator LLCEdwardsville, KS JComplaint
June 3, 2026Optalis Health and Rehabilitation of Grand RapidsGrand Rapids, MI JComplaint
May 28, 2026Armour Oaks Senior Living CommunityKansas City, MO JComplaint
May 21, 2026Clement Manor Health Care CenterGreenfield, WI KStandard
May 21, 2026Kingsley Specialty CareKingsley, IA JComplaint
May 21, 2026Signature Healthcare of BremenBremen, IN JComplaint
May 21, 2026Parker Post AcuteParker, CO JComplaint
May 15, 2026Amelia Rehabilitation and Healthcare CenterAmelia, VA JComplaint
May 14, 2026Edgerton Care Center, IncEdgerton, WI KComplaint
May 14, 2026Altercare of Mayfield Village, IncMayfield Village, OH JComplaint
May 8, 2026Park Nursing HomeRockaway Park, NY JComplaint
May 6, 2026Shalom Gardens Health & RehabilitationRichmond, VA JComplaint
April 30, 2026Nexus at ColumbiaColumbia, IL JComplaint
April 23, 2026Country CourtMount Vernon, OH JComplaint
April 17, 2026Community Skilled HealthcareWarren, OH JComplaint
April 16, 2026Aviata at Santa BarbaraCape Coral, FL JComplaint
April 7, 2026Allure of GalesburgGalesburg, IL LComplaint
April 3, 2026Bixby Towers Post-Acute RehabLong Beach, CA JComplaint
April 2, 2026Ayden Court Nursing and Rehabilitation CenterAyden, NC JComplaint
March 26, 2026Grove Health & Rehab Ctr, theJacksonville, IL LComplaint
March 25, 2026Luling Living CenterLuling, LA LComplaint
March 25, 2026Griffith Park Healthcare CenterGlendale, CA JComplaint
March 16, 2026Laverna Manor Health & RehabilitationSavannah, MO JStandard
March 13, 2026Nexus at BerwynBerwyn, IL JComplaint
March 13, 2026Aviata at West Palm BeachWest Palm Beach, FL JComplaint

Most recent F678 citations

InspectionHomeTownLetter
August 6, 2026Asbury Health CenterPittsburgh, PA E
July 31, 2026Ohio Living Quaker HeightsWaynesville, OH J
July 28, 2026Kenwood Vlge Nrsg and Rhb CtrChicago, IL F
July 27, 2026New Gouverneur Hospital SNFNew York, NY J
July 24, 2026Terrace Health & Rehab CenterUniontown, PA E
July 23, 2026Rancho Seco Care CenterGalt, CA D
July 22, 2026Big Spring Care Center for Rehab and HealthcareHumansville, MO D
July 17, 2026Normandy Terrace Nursing & Rehabilitation CenterSan Antonio, TX J
July 17, 2026Oasis Nursing & Rehab of Green ValleyHenderson, NV J
July 16, 2026Bridgeville Rehabilitation & Care CenterBridgeville, PA E
July 10, 2026Metropolis Rehab & HCCMetropolis, IL J
July 8, 2026Laurel Creek Health CenterFairfield, CA G
July 8, 2026Coral Cove Post AcuteLong Beach, CA D
July 1, 2026Edenbrook SheboyganSheboygan, WI J
July 1, 2026Meadow Wind Health Care CenterMassillon, OH D
July 1, 2026The Laurels of GalesburgGalesburg, MI J
June 25, 2026Midway Neurological / Rehab CenterBridgeview, IL D
June 24, 2026Majestic Care of Point PlaceToledo, OH J
June 18, 2026Heartland Health Care Center - Greenville EastGreenville, SC D
June 18, 2026Heritage Park Health Center by HarborviewBradenton, FL D
June 18, 2026Tarzana Health and Rehabilitation CenterTarzana, CA D
June 17, 2026Bixby Towers Post-Acute RehabLong Beach, CA J
June 16, 2026Sunset Villa Post AcuteLong Beach, CA J
June 16, 2026Inglis HousePhiladelphia, PA D
June 16, 2026Medallion Post Acute RehabilitationColorado Springs, CO D

F678 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
Missouri106
California79
Texas52
Illinois48
Ohio33
Wisconsin30
Washington29
Michigan28
Florida27
Oklahoma26
Pennsylvania20
Louisiana19
Connecticut18
New Jersey18
New York18
Maryland17
Colorado16
Minnesota15
Virginia14
Kansas13
Nevada12
Tennessee12
Nebraska10
Iowa8
Indiana8
South Dakota8
West Virginia8
Kentucky7
North Carolina7
Georgia6
Massachusetts6
New Mexico6
South Carolina6
Alabama4
Maine4
Alaska3
Arkansas3
Arizona3
Mississippi3
Montana3
New Hampshire3
Oregon2
Wyoming2
District of Columbia1
Delaware1
Hawaii1
North Dakota1
Rhode Island1

By inspection year: 2018 2, 2019 6, 2020 5, 2021 12, 2022 38, 2023 122, 2024 255, 2025 196, 2026 129.

Common questions

What is F678 in a nursing home inspection?
F678 is the federal requirement to "provide basic life support, including cpr, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives". CMS files it under quality of life and care. A home cited under F678 did not meet that requirement at the inspection.
How often is F678 cited?
The CMS files as of September 1, 2026 list 765 F678 citations at 723 nursing homes, 185 of them in the 12 months to that date. 49.0% were rated as actual harm or immediate jeopardy.
Is a F678 citation serious?
It depends on the letter. Most F678 citations (50.8%) were rated as potential for more than minimal harm, D to F. 358 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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