F727: Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis
F727 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
It sits in CMS's nursing and physician services 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). 29.0% of F727 citations came from a complaint visit rather than a routine inspection.
By letter: B 2, C 27, D 299, E 497, F 1,221, J 1, L 5.
What inspectors wrote
Three recent F727 citations from different states, quoted from the inspectors' statements of deficiencies (CMS form 2567). Names are removed by CMS.
Inspectors wrote, August 7, 2026, scope and severity FBased on interview and record review it was determined the facility failed to ensure a registered nurse was available for at least eight consecutive hours for 3 of 46 days reviewed for RN coverage. This placed residents at risk for delayed nursing assessments.
Belmont Care and Rehabilitation, Portland, OR
Inspectors wrote, July 31, 2026, scope and severity FBased on observation, interview, and record review, the facility failed to designate a Registered Nurse as a full time Director of Nursing. This failure has the potential to affect all fifty-five residents residing in the facility.
Arc at Hickory Point, Forsyth, IL
Inspectors wrote, July 30, 2026, scope and severity FBased on the nursing staffing schedule, staff time punches and staff interview, the facility failed to maintain the services of a registered nurse (RN) for at least eight consecutive hours a day, seven days a week. This had the potential to affect all 95 residents residing in the facility.
Avenue at Brooklyn, Brooklyn, OH
Most recent F727 citations at the harm or jeopardy level
Newest first, all 6 in the current files. Each home's page shows the citation in full context, with its correction status.
| Inspection | Home | Town | Letter | Visit |
|---|---|---|---|---|
| March 28, 2026 | Avina on Division | Fond Du Lac, WI | L | Complaint |
| January 15, 2026 | Heartland Health Care Center - Greenville East | Greenville, SC | L | Complaint |
| May 6, 2025 | Concordia Nursing & Rehab, LLC | Bella Vista, AR | L | Standard |
| October 2, 2024 | Centro De Cuidado Prolongado San Lucas | Rio Piedras, PR | L | Standard |
| September 19, 2022 | Jan Frances Care Center | Ada, OK | L | Standard |
| February 18, 2022 | Laurelbrook Nursing Home | Dayton, TN | J | Standard |
Most recent F727 citations
| Inspection | Home | Town | Letter |
|---|---|---|---|
| August 7, 2026 | Belmont Care and Rehabilitation | Portland, OR | F |
| July 31, 2026 | Arc at Hickory Point | Forsyth, IL | F |
| July 30, 2026 | Avenue at Brooklyn | Brooklyn, OH | F |
| July 30, 2026 | Cedar Falls Health Care Center | Cedar Falls, IA | E |
| July 27, 2026 | Avir at River Valley | Gainesville, TX | F |
| July 27, 2026 | Arcadia Care on the Hill | Springfield, IL | F |
| July 24, 2026 | Grace Healthcare Center | Fresno, CA | F |
| July 24, 2026 | The Lev at San Antonio | San Antonio, TX | F |
| July 24, 2026 | Eastwood Manor | Commerce, OK | F |
| July 24, 2026 | Splendido at Rancho Vistoso | Tucson, AZ | E |
| July 23, 2026 | Polaris Rehabilitation and Care Center | Cheyenne, WY | F |
| July 23, 2026 | Pine Acres Center for Nursing and Rehabilitation | Lexington, NC | F |
| July 22, 2026 | Locust Grove Village | La Crosse, KS | F |
| July 20, 2026 | Wadsworth Pointe | Wadsworth, OH | F |
| July 20, 2026 | Embassy of Woodview | Columbus, OH | F |
| July 20, 2026 | Westmoreland Place | Chillicothe, OH | F |
| July 17, 2026 | Lake Winona Manor | Winona, MN | F |
| July 17, 2026 | Keystone Post-Acute | Fresno, CA | F |
| July 16, 2026 | Peach Tree Place | Weatherford, TX | F |
| July 16, 2026 | Avir at Granbury | Granbury, TX | F |
| July 16, 2026 | Gateway Springs Health Campus | Hamilton, OH | F |
| July 15, 2026 | Avir at Bradburn | Grand Saline, TX | E |
| July 14, 2026 | Heritage Health Care Center | Oakwood Village, OH | F |
| July 14, 2026 | The Nursing and Rehab Center at Stadium Place | Baltimore, MD | F |
| July 13, 2026 | Windsor Health and Rehabilitation | Salem, OR | F |
F727 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.
| State | Citations |
|---|---|
| Texas | 287 |
| Illinois | 265 |
| Missouri | 167 |
| California | 160 |
| Ohio | 159 |
| Oklahoma | 84 |
| Indiana | 66 |
| Virginia | 64 |
| North Carolina | 63 |
| Kansas | 58 |
| Michigan | 48 |
| Iowa | 47 |
| Oregon | 47 |
| Minnesota | 44 |
| Massachusetts | 40 |
| New Jersey | 32 |
| Tennessee | 31 |
| New York | 26 |
| Wisconsin | 26 |
| Louisiana | 25 |
| Washington | 25 |
| Arizona | 24 |
| Georgia | 24 |
| Idaho | 18 |
| Maryland | 18 |
| West Virginia | 16 |
| Colorado | 15 |
| Nebraska | 15 |
| Arkansas | 14 |
| Florida | 14 |
| Pennsylvania | 13 |
| Montana | 12 |
| New Mexico | 11 |
| South Carolina | 11 |
| South Dakota | 10 |
| Kentucky | 9 |
| Maine | 9 |
| New Hampshire | 7 |
| Nevada | 7 |
| Wyoming | 7 |
| Connecticut | 6 |
| Mississippi | 6 |
| Alaska | 5 |
| Hawaii | 5 |
| Utah | 4 |
| North Dakota | 3 |
| Puerto Rico | 3 |
| Vermont | 2 |
By inspection year: 2018 1, 2019 27, 2020 12, 2021 32, 2022 135, 2023 484, 2024 649, 2025 464, 2026 248.
Common questions
- What is F727 in a nursing home inspection?
- F727 is the federal requirement to "have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis". CMS files it under nursing and physician services. A home cited under F727 did not meet that requirement at the inspection.
- How often is F727 cited?
- The CMS files as of September 1, 2026 list 2,052 F727 citations at 1,583 nursing homes, 356 of them in the 12 months to that date. 0.3% were rated as actual harm or immediate jeopardy.
- Is a F727 citation serious?
- It depends on the letter. Most F727 citations (98.3%) were rated as potential for more than minimal harm, D to F. 6 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