F804: Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature
F804 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
It sits in CMS's nutrition and dietary 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). 28.7% of F804 citations came from a complaint visit rather than a routine inspection.
By letter: B 21, C 5, D 1,032, E 2,286, F 627, G 4, H 1.
What inspectors wrote
Three recent F804 citations from different states, quoted from the inspectors' statements of deficiencies (CMS form 2567). Names are removed by CMS.
Inspectors wrote, August 14, 2026, scope and severity DBased on observation, interview, and record review, the facility failed to ensure food was served at a safe temperature for 2 residents (#15 and #24), out of 2 residents reviewed for reheated food. Specifically, the facility failed to ensure that food temperatures were checked after reheating food in the microwave. The facility served microwave-reheated chicken noodle soup to Resident #15 at 190.4 F (degrees Fahrenheit) and almond milk to Resident #24 at 182 F without ensuring the food and beverage had cooled to a safe temperature before being served. This failed practice placed Residents #15 and #24 at risk for scalding and burn injuries from consuming excessively hot food and beverages.
Maple Springs of Palmer, Palmer, AK
Inspectors wrote, August 6, 2026, scope and severity EBased on review of facility policies, observations, and staff interviews, it was determined that the facility failed to serve food that was palatable and at safe and appetizing temperatures for one of 34 residents reviewed (Resident 51).
Casselman Healthcare and Rehabilitation Center, Meyersdale, PA
Inspectors wrote, August 3, 2026, scope and severity FLicensure Reference Number 175 NAC 12-006.11(D)Based on observation, record reviews and interviews, the facility failed to serve foods to the residents based on the serving sizes in the recipes to ensure all residents received the correct amounts of protein and other nutrients. This had the potential to affect all residents. The facility showed a census of 27.
Wauneta Care and Therapy Center, Wauneta, NE
Most recent F804 citations at the harm or jeopardy level
Newest first, all 5 in the current files. Each home's page shows the citation in full context, with its correction status.
| Inspection | Home | Town | Letter | Visit |
|---|---|---|---|---|
| May 1, 2026 | Brickyard Healthcare - Elkhart Care Center | Elkhart, IN | G | Complaint |
| February 27, 2025 | Ardmore Center for Rehabilitation and Healthcare | Ardmore, OK | G | Complaint |
| February 7, 2025 | Summit Square | Waynesboro, VA | G | Complaint |
| June 7, 2024 | Pearl of Elk Grove, the | Elk Grove Village, IL | H | Complaint |
| September 12, 2018 | Sitter and Barfoot Veterans Care Center | Richmond, VA | G | Standard |
Most recent F804 citations
F804 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 |
|---|---|
| California | 475 |
| Ohio | 317 |
| Texas | 293 |
| Missouri | 257 |
| Pennsylvania | 253 |
| Illinois | 224 |
| New York | 188 |
| Michigan | 140 |
| Iowa | 126 |
| Indiana | 110 |
| Massachusetts | 107 |
| Wisconsin | 97 |
| Virginia | 93 |
| West Virginia | 90 |
| New Jersey | 86 |
| Arkansas | 82 |
| Maryland | 79 |
| Washington | 79 |
| Colorado | 73 |
| Georgia | 73 |
| Kansas | 68 |
| Florida | 60 |
| Oklahoma | 53 |
| Minnesota | 46 |
| Connecticut | 45 |
| Utah | 44 |
| Oregon | 42 |
| Nebraska | 39 |
| North Carolina | 38 |
| Kentucky | 36 |
| Louisiana | 30 |
| Mississippi | 27 |
| New Mexico | 26 |
| Idaho | 20 |
| Montana | 18 |
| Alabama | 17 |
| Arizona | 17 |
| South Carolina | 16 |
| Tennessee | 13 |
| South Dakota | 11 |
| North Dakota | 9 |
| Puerto Rico | 9 |
| District of Columbia | 7 |
| Maine | 7 |
| Nevada | 7 |
| Alaska | 6 |
| Delaware | 5 |
| Vermont | 5 |
| Wyoming | 5 |
| Hawaii | 3 |
| Rhode Island | 3 |
| New Hampshire | 2 |
By inspection year: 2018 13, 2019 85, 2020 38, 2021 101, 2022 265, 2023 694, 2024 1,165, 2025 998, 2026 617.
Common questions
- What is F804 in a nursing home inspection?
- F804 is the federal requirement to "ensure food and drink is palatable, attractive, and at a safe and appetizing temperature". CMS files it under nutrition and dietary. A home cited under F804 did not meet that requirement at the inspection.
- How often is F804 cited?
- The CMS files as of September 1, 2026 list 3,976 F804 citations at 3,099 nursing homes, 845 of them in the 12 months to that date. 0.1% were rated as actual harm or immediate jeopardy.
- Is a F804 citation serious?
- It depends on the letter. Most F804 citations (99.2%) 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