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F684: Provide appropriate treatment and care according to orders, resident’s preferences and goals

F684 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Provide appropriate treatment and care according to orders, resident’s preferences and goals. It sits in CMS's quality of life and care category.

16,456citations in the CMS files
8,337homes cited at least once
4,014in the 12 months to September 2026
12.6%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). 48.1% of F684 citations came from a complaint visit rather than a routine inspection.

  • Immediate jeopardy (J, K, L)737 (4.5%)
  • Actual harm (G, H, I)1,334 (8.1%)
  • Potential for more than minimal harm (D, E, F)14,371 (87.3%)
  • Potential for minimal harm (A, B, C)14 (0.1%)

By letter: B 14, D 12,231, E 2,132, F 8, G 1,299, H 35, J 598, K 136, L 3.

What inspectors wrote

Three recent F684 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 observation, interview, and record review, the facility failed to ensure a sleeve protector was provided in accordance with the comprehensive care plan for 1 of 1 residents (R12) reviewed for pressure ulcers.

St. Anthony Park Home Inc, Saint Paul, MN

Inspectors wrote, August 7, 2026, scope and severity EBased on review of facility policy, clinical record review, and staff interviews, it was determined that the facility failed to make certain that residents were provided appropriate treatment and care in accordance with professional standards of practice for four of six residents (Residents R2, R14, R135, and R155).

Providence Health & Rehab Center, Beaver Falls, PA

Inspectors wrote, August 5, 2026, scope and severity EBased on facility's Bowel Management - Clinical Protocol, record review, and staff interview, it was determined the facility failed to follow facility bowel care Clinical Protocol of delivering specific medications when residents do not have BM within 72 hours for 3 of 6 Residents (#4, #31 and #56) who records were reviewed for bowel and bladder care. This failed practice created the potential for residents to experience discomfort when medications were not administered according to the physician's order.

Mini-Cassia Care Center, Burley, ID

Most recent F684 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 27, 2026Madison Health and Rehabilitation CenterRichmond, KY GComplaint
July 27, 2026Palms Care CenterChowchilla, CA GComplaint
July 24, 2026Majestic Care of GoshenGoshen, IN JComplaint
July 24, 2026California TerraceChicago, IL GComplaint
July 23, 2026The Hills Nursing & RehabilitationDecatur, TX JComplaint
July 23, 2026Brookfield Health Care CenterBrookfield, MO GComplaint
July 23, 2026Heritage Rehabilitation CenterTorrance, CA GComplaint
July 22, 2026Rainbow Rehab and HealthcareBartlett, TN JComplaint
July 22, 2026The MerrimanAkron, OH GComplaint
July 22, 2026Ridge Crest Nursing CenterWarrensburg, MO JComplaint
July 22, 2026Arden Park Post AcuteSacramento, CA GComplaint
July 20, 2026Mason City Area Nursing HomeMason City, IL GComplaint
July 17, 2026Normandy Terrace Nursing & Rehabilitation CenterSan Antonio, TX JComplaint
July 17, 2026Cortland Acres Health and RehabilitationThomas, WV GComplaint
July 17, 2026MaluhiaHonolulu, HI GComplaint
July 15, 2026Complete Care at Lehigh LLCMacungie, PA JComplaint
July 15, 2026Lake Orion Nursing CenterLake Orion, MI GComplaint
July 15, 2026Oceana County Medical Care FacilityHart, MI GComplaint
July 14, 2026Kimes Nursing and Rehab LLCAthens, OH JComplaint
July 14, 2026Bethel Pointe Health and RehabMuncie, IN GComplaint
July 14, 2026Touchpoints at BloomfieldBloomfield, CT GComplaint
July 13, 2026The Oaks Rehabilitation and Healthcare CenterZanesville, OH GComplaint
July 10, 2026Envive of AndersonAnderson, IN GComplaint
July 10, 2026Metropolis Rehab & HCCMetropolis, IL GComplaint
July 9, 2026Tri Cities Rehabilitation and Healthcare CenterCumberland, KY GComplaint
July 9, 2026Bradford House Nursing and Rehab, LLCBentonville, AR KComplaint
July 8, 2026Arc at KankakeeKankakee, IL GComplaint
July 8, 2026Arcadia Care JacksonvilleJacksonville, IL GComplaint
July 8, 2026California Post-Acute CareLynwood, CA GComplaint
July 8, 2026Dermott City Nursing HomeDermott, AR JComplaint
July 7, 2026Worland Health and RehabilitationWorland, WY GComplaint
July 6, 2026Fair Havens Senior LivingDecatur, IL GComplaint
July 2, 2026Dunbar CenterDunbar, WV JComplaint
July 2, 2026Valle Vista Rehabilitation and Nursing LLCLewistown, MT GComplaint
July 2, 2026Generations at ApplewoodMatteson, IL GComplaint
July 2, 2026Broadway Villa Post AcuteSonoma, CA GComplaint
July 1, 2026Meadow Wind Health Care CenterMassillon, OH GComplaint
July 1, 2026Generations at ApplewoodMatteson, IL GComplaint
June 29, 2026Park Valley Inn Health CenterRound Rock, TX KComplaint
June 29, 2026Avenue at North RidgevilleNorth Ridgeville, OH GComplaint

Most recent F684 citations

InspectionHomeTownLetter
August 13, 2026St. Anthony Park Home IncSaint Paul, MN D
August 12, 2026Lake City Healthcare and Rehabilitation CenterLake City, FL D
August 7, 2026Providence Health & Rehab CenterBeaver Falls, PA E
August 6, 2026Casselman Healthcare and Rehabilitation CenterMeyersdale, PA E
August 5, 2026Heritage Living CenterPark Rapids, MN D
August 5, 2026Shawnee Gardens Healthcare & Rehab CenterShawnee, KS D
August 5, 2026Mini-Cassia Care CenterBurley, ID E
July 31, 2026Garden Park Care CenterGarden Grove, CA D
July 31, 2026Landmark Care and RehabilitationYakima, WA D
July 31, 2026Gardens at Orangeville, theOrangeville, PA E
July 31, 2026Sunnyview Nursing and Rehabilitation CenterButler, PA D
July 31, 2026Centre Care Rehabilitation and Wellness ServicesBellefonte, PA E
July 31, 2026Saint Mary's Villa Nursing HomMoscow, PA D
July 31, 2026Independence Health and RehabilitationIndependence, OR D
July 31, 2026Biltmore Haven Nursing and RehabilitationArden, NC D
July 31, 2026Seagate Rehabilitation and Nursing CenterBrooklyn, NY D
July 31, 2026Heritage ManorChisholm, MN D
July 31, 2026Mayo Clinic Health System - Lake CityLake City, MN D
July 31, 2026Regency at LivoniaLivonia, MI D
July 31, 2026Autumn Lake Healthcare at Glen BurnieGlen Burnie, MD D
July 31, 2026South Coast Post AcuteSanta Ana, CA D
July 31, 2026Cupertino Healthcare & Wellness CenterCupertino, CA E
July 31, 2026Haven of CottonwoodCottonwood, AZ D
July 30, 2026Alta Gardens Care CenterGarden Grove, CA D
July 30, 2026Morgantown Heights of JourneyMorgantown, WV D

F684 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
California2,119
Illinois1,273
Pennsylvania1,267
Ohio1,251
Indiana777
Michigan740
Florida707
Texas677
Connecticut486
Washington472
Missouri458
Virginia446
Minnesota445
New York435
Maryland431
Wisconsin397
Iowa370
West Virginia289
Oregon261
Massachusetts212
North Carolina210
Oklahoma204
Kansas202
Nebraska199
Colorado165
New Jersey151
Georgia144
Tennessee143
Maine134
Arizona131
Arkansas125
Idaho115
Nevada107
Rhode Island107
Louisiana98
New Mexico95
Utah76
South Dakota66
Delaware63
Kentucky61
Mississippi53
Hawaii52
South Carolina46
North Dakota43
District of Columbia35
Montana28
Wyoming23
Alabama21
Alaska18
Vermont17
New Hampshire8
Puerto Rico2
Guam1

By inspection year: 2018 53, 2019 341, 2020 132, 2021 374, 2022 825, 2023 2,428, 2024 4,845, 2025 4,649, 2026 2,809.

Common questions

What is F684 in a nursing home inspection?
F684 is the federal requirement to "provide appropriate treatment and care according to orders, resident’s preferences and goals". CMS files it under quality of life and care. A home cited under F684 did not meet that requirement at the inspection.
How often is F684 cited?
The CMS files as of September 1, 2026 list 16,456 F684 citations at 8,337 nursing homes, 4,014 of them in the 12 months to that date. 12.6% were rated as actual harm or immediate jeopardy.
Is a F684 citation serious?
It depends on the letter. Most F684 citations (87.3%) were rated as potential for more than minimal harm, D to F. 737 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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