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F699: Provide care or services that was trauma informed and/or culturally competent

F699 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Provide care or services that was trauma informed and/or culturally competent. It sits in CMS's quality of life and care category.

1,105citations in the CMS files
1,025homes cited at least once
265in the 12 months to September 2026
1.7%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). 11.1% of F699 citations came from a complaint visit rather than a routine inspection.

  • Immediate jeopardy (J, K, L)3 (0.3%)
  • Actual harm (G, H, I)16 (1.4%)
  • Potential for more than minimal harm (D, E, F)1,085 (98.2%)
  • Potential for minimal harm (A, B, C)1 (0.1%)

By letter: C 1, D 976, E 106, F 3, G 15, H 1, J 2, K 1.

What inspectors wrote

Three recent F699 citations from different states, quoted from the inspectors' statements of deficiencies (CMS form 2567). Names are removed by CMS.

Inspectors wrote, August 5, 2026, scope and severity DBased on observation, record review, and interview, the facility failed to identify trauma-based triggers related to Resident (R) 21's post-traumatic stress disorder (PTSD- a mental disorder characterized by an acute emotional response to a traumatic event or situation involving severe environmental stress) when staff failed to implement individualized interventions to prevent re-traumatization to R21.

Edwardsville Care and Rehab, Edwardsville, KS

Inspectors wrote, July 31, 2026, scope and severity DBased on record review, Resident, Responsible Party, and staff interviews, the facility failed to complete a comprehensive trauma screening assessment on a newly admitted resident. Failure to identify a history of trauma leaves residents vulnerable to re-traumatization from unknown triggers. This affected 1 of 3 residents reviewed for abuse (Resident #58).

Highland Farms, Black Mountain, NC

Inspectors wrote, July 30, 2026, scope and severity DBased on clinical record review and staff interview, it was determined that the facility failed to ensure that residents were assessed and received trauma-informed care to eliminate or mitigate triggers for residents with the diagnosis of Post Traumatic Stress Disorder (PTSD) (a mental and behavioral disorder that develops related to a terrifying event) for one of 38 residents reviewed (Resident 2).

Saint Anne Home, Greensburg, PA

Most recent F699 citations at the harm or jeopardy level

Newest first, all 19 in the current files. Each home's page shows the citation in full context, with its correction status.

InspectionHomeTownLetterVisit
June 11, 2026Kadima Rehabilitation & Nursing at CheswickCheswick, PA GComplaint
January 29, 2026Laurel CenterHamburg, PA GComplaint
November 21, 2025Bywood East Health CareMinneapolis, MN GComplaint
October 21, 2025Aviata at Lakeside OaksDunedin, FL GComplaint
August 27, 2025Accolade Hc of Paxton on PellsPaxton, IL GComplaint
May 20, 2025Legendary Health Care CenterMarshall, MO GStandard
March 17, 2025Community Health Care of GoreGore, OK GStandard
March 11, 2025Evergreen Care CenterFresno, CA GComplaint
November 1, 2024Sunflower Park Health CareKaufman, TX KComplaint
October 31, 2024Sanford Chamberlain Care CenterChamberlain, SD GComplaint
January 29, 2024Holton Health Care CenterHolton, KS JComplaint
December 19, 2023Adviniacare Newton WellesleyWellesley, MA HStandard
October 25, 2023Mount St. Rita Health CentreCumberland, RI GStandard
October 11, 2023Union House Nursing HomeGlover, VT GStandard
October 4, 2023North Bend Post AcuteNorth Bend, WA GComplaint
October 4, 2023Henrico Health & Rehabilitation CenterHighland Springs, VA GComplaint
August 25, 2023Avir at ParisParis, TX GStandard
April 6, 2023Parkview Julian Healthcare CenterBakersfield, CA GStandard
December 2, 2022Regency Oaks Health CenterClearwater, FL JStandard

Most recent F699 citations

InspectionHomeTownLetter
August 5, 2026Edwardsville Care and RehabEdwardsville, KS D
July 31, 2026Highland FarmsBlack Mountain, NC D
July 30, 2026Saint Anne HomeGreensburg, PA D
July 30, 2026Kittson HealthcareHallock, MN D
July 29, 2026Zumbrota Care CenterZumbrota, MN D
July 28, 2026Elgin Nursing and Rehabilitation CenterElgin, TX D
July 24, 2026Eden Nursing & Rehabilitation CenterBrackenridge, PA D
July 23, 2026Mountain Laurel Healthcare and Rehabilitation CtrClearfield, PA E
July 23, 2026La Grande Post Acute RehabLa Grande, OR D
July 23, 2026Ascend at AuroraAurora, MO D
July 22, 2026Heritage Grove EstatesTopeka, KS D
July 20, 2026Lincolnwood Rehabilitation and Healthcare CenterNorth Providence, RI D
July 17, 2026Bethany Home Society San Joaquin CountyRipon, CA D
July 16, 2026Bridgeville Rehabilitation & Care CenterBridgeville, PA D
July 10, 2026Lutheran Home, theCape Girardeau, MO D
July 9, 2026Northern Dauphin Nursing and Rehabilitation CenterMillersburg, PA E
July 9, 2026Ashtabula County Nursing HomeKingsville, OH E
July 9, 2026Blackfeet Care CenterBrowning, MT D
July 8, 2026Wickliffe Country PlaceWickliffe, OH D
July 7, 2026Cornerstone Nsg & Rehab CenterBagley, MN D
July 2, 2026Complete Care at Maple Grove LLCMadison, WI D
July 2, 2026Hillcrest HomeSumner, IA D
July 1, 2026Aria at Mitchell ManorWest Allis, WI D
July 1, 2026Avantara PierrePierre, SD D
June 26, 2026Rose City Nursing and RehabilitationPortland, OR D

F699 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
Pennsylvania151
Massachusetts113
Missouri78
California73
Ohio69
Texas51
Minnesota50
Washington46
Florida43
Oregon41
Kansas38
Michigan37
Wisconsin34
Indiana27
Illinois24
Maine19
Rhode Island17
Colorado16
Nebraska16
Mississippi15
Vermont15
Virginia14
Maryland13
South Dakota13
Montana11
West Virginia10
New Hampshire8
Hawaii6
Iowa6
Kentucky6
Louisiana5
North Dakota5
Idaho4
Nevada4
Tennessee4
Alaska3
Connecticut3
Oklahoma3
Georgia2
North Carolina2
New Mexico2
Puerto Rico2
Arkansas1
Arizona1
Delaware1
New York1
South Carolina1
Wyoming1

By inspection year: 2022 2, 2023 169, 2024 388, 2025 357, 2026 189.

Common questions

What is F699 in a nursing home inspection?
F699 is the federal requirement to "provide care or services that was trauma informed and/or culturally competent". CMS files it under quality of life and care. A home cited under F699 did not meet that requirement at the inspection.
How often is F699 cited?
The CMS files as of September 1, 2026 list 1,105 F699 citations at 1,025 nursing homes, 265 of them in the 12 months to that date. 1.7% were rated as actual harm or immediate jeopardy.
Is a F699 citation serious?
It depends on the letter. Most F699 citations (98.2%) were rated as potential for more than minimal harm, D to F. 3 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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