F680: Ensure the activities program is directed by a qualified professional
F680 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Ensure the activities program is directed by a qualified professional.
It sits in CMS's quality of life and care 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). 23.5% of F680 citations came from a complaint visit rather than a routine inspection.
By letter: B 1, C 43, D 46, E 166, F 55.
What inspectors wrote
Three recent F680 citations from different states, quoted from the inspectors' statements of deficiencies (CMS form 2567). Names are removed by CMS.
Inspectors wrote, August 12, 2026, scope and severity EBased on interview and record review the facility failed to ensure the activities program was directed by a qualified professional who was a qualified therapeutic recreation specialist or an activities professional who was licensed or registered by the State for 1 of 1 facility reviewed for qualifications of activity professionals. The facility failed to have a qualified Activities Professional direct their activities program. This deficient practice could place residents at risk of not receiving approaches that were individualized to match the skills, abilities, and interests/preferences of each resident for activities.
Val Verde Nursing and Rehabilitation Center, Del Rio, TX
Inspectors wrote, July 1, 2026, scope and severity EBased on interview and record review, the facility failed to ensure that the activities program was directed by a qualified professional for a facility census of 106 residents.
Laconia Rehabilitation Center, Laconia, NH
Inspectors wrote, June 17, 2026, scope and severity EBased on interviews, the facility failed to employ a qualified Activity Director (AD) to manage resident centered activities for all residents (33 residents). On 6/17/26 at 12:30 p.m., during an interview with a surveyor, the Administrator stated that the initial Activities Director's last day was 3/6/26. The Administrator confirmed with the surveyor that the staff member that filled the role on 3/8/26 was not qualified for the position and was terminated on 6/8/26. At this time the surveyor confirmed the facility does not currently have a qualified Activities Director, and that the previous staff member had not completed the State-approved program and was not qualified to be the AD.
High View Rehabilitation and Living Center, Madawaska, ME
Most recent F680 citations
F680 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: 2019 2, 2020 2, 2021 10, 2022 17, 2023 65, 2024 94, 2025 77, 2026 44.
Common questions
- What is F680 in a nursing home inspection?
- F680 is the federal requirement to "ensure the activities program is directed by a qualified professional". CMS files it under quality of life and care. A home cited under F680 did not meet that requirement at the inspection.
- How often is F680 cited?
- The CMS files as of September 1, 2026 list 311 F680 citations at 299 nursing homes, 59 of them in the 12 months to that date. 0.0% were rated as actual harm or immediate jeopardy.
- Is a F680 citation serious?
- It depends on the letter. Most F680 citations (85.9%) 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