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F841: Designate a physician to serve as medical director responsible for implementation of resident care policies and coordination of medical care in the facility

F841 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Designate a physician to serve as medical director responsible for implementation of resident care policies and coordination of medical care in the facility. It sits in CMS's nursing and physician services category.

112citations in the CMS files
109homes cited at least once
27in the 12 months to September 2026
14.3%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). 38.4% of F841 citations came from a complaint visit rather than a routine inspection.

  • Immediate jeopardy (J, K, L)12 (10.7%)
  • Actual harm (G, H, I)4 (3.6%)
  • Potential for more than minimal harm (D, E, F)93 (83.0%)
  • Potential for minimal harm (A, B, C)3 (2.7%)

By letter: C 3, D 28, E 17, F 48, G 2, H 2, J 5, K 3, L 4.

What inspectors wrote

Three recent F841 citations from different states, quoted from the inspectors' statements of deficiencies (CMS form 2567). Names are removed by CMS.

Inspectors wrote, June 12, 2026, scope and severity DBased on interview and record review the facility failed to carry out physician orders on two (Resident 1 and Resident 3) out of five residents reviewed for unnecessary drugs. These failures could have contributed to unsafe care and not following the physician orders for the treatment of medical problems.

Golden San Andreas Care Center, San Andreas, CA

Inspectors wrote, May 18, 2026, scope and severity EBased on observations, interviews, and record review conducted during a survey, the facility did not ensure the medical director was responsible for coordinating the medical care of one (1) (Westminster Unit) of seven (7) units. Specifically, the Medical Director was not involved in the facility assessment, quality assurance committee meetings, and did not oversee the development of facility policies and procedures to prevent abuse.

The Paramount at Somers Rehab and Nursing Center, Somers, NY

Inspectors wrote, May 6, 2026, scope and severity DBased on record review and interview, the facility failed to ensure the medical director verified the appropriateness of an antipsychotic medication for 1 (#4) of 5 sampled residents reviewed for unnecessary medications. The facility manager identified 37 residents resided in the facility.

First Shamrock Care Center, Kingfisher, OK

Most recent F841 citations at the harm or jeopardy level

Newest first, all 16 in the current files. Each home's page shows the citation in full context, with its correction status.

InspectionHomeTownLetterVisit
November 13, 2025Barre Gardens Nursing and Rehab, LLCBarre, VT LComplaint
September 30, 2025Bayshore Nursing & RehabGlendale, WI LStandard
September 2, 2025Falkville Rehabilitation and Healthcare CenterFalkville, AL JStandard
July 24, 2025St. Johnsbury Health & RehabSaint Johnsbury, VT LComplaint
June 5, 2025Magnolia RidgeGardendale, AL LComplaint
March 3, 2025Springfield Health & RehabSpringfield, VT GComplaint
December 4, 2024Life Care Center of Merrimack ValleyBillerica, MA HComplaint
December 5, 2023Cherokee Center for Nursing and Healing LLCCanton, GA KComplaint
November 2, 2023Burlington Health and Rehabilitation CenterBurlington, WI JComplaint
October 20, 2023Vineyard Court Nursing CenterColumbus, MS JStandard
September 11, 2023Cleveland Community Care CenterCleveland, MS JComplaint
June 10, 2023Stanford CrossingStanford, KY KStandard
April 19, 2022Winding Trails Post AcuteBoulder, CO GStandard
April 13, 2022Spring Creek Healthcare CenterSalt Lake City, UT HStandard
August 7, 2019Hanover Health and Rehabilitation CenterMechanicsville, VA JStandard
July 15, 2019Donalson Care CenterFayetteville, TN KStandard

Most recent F841 citations

InspectionHomeTownLetter
June 12, 2026Golden San Andreas Care CenterSan Andreas, CA D
May 18, 2026The Paramount at Somers Rehab and Nursing CenterSomers, NY E
May 6, 2026First Shamrock Care CenterKingfisher, OK D
April 24, 2026Shasta HealthcareWeed, CA D
April 17, 2026Harold and Grace Upjohn Community Care CenterKalamazoo, MI D
April 14, 2026La Crescent Health ServicesLa Crescent, MN D
March 27, 2026Crescent City Care CenterCrescent City, CA F
March 26, 2026Blackfeet Care CenterBrowning, MT D
March 3, 2026Bickford Health Care CenterWindsor Locks, CT F
February 24, 2026Grand Manor Nursing & Rehabilitation CenterBronx, NY E
February 19, 2026The Shores of WorthingtonWorthington, MN F
February 18, 2026Excelcare at Lewes LLCLewes, DE D
February 17, 2026Napa Post AcuteNapa, CA E
February 13, 2026Bickford Health Care CenterWindsor Locks, CT D
February 6, 2026Oakwood Heights VillageOil City, PA C
January 29, 2026Kaweah Health Skilled Nursing CenterVisalia, CA D
December 31, 2025Adviniacare Newton WellesleyWellesley, MA E
December 17, 2025Life Care Center of PlainwellPlainwell, MI D
December 12, 2025Veterans Home of California - West Los AngelesLos Angeles, CA F
November 21, 2025Ely ManorAllegan, MI F
November 20, 2025Sullivan County Adult Care CenterLiberty, NY D
November 13, 2025Barre Gardens Nursing and Rehab, LLCBarre, VT L
October 15, 2025Country Lane Gardens Rehab & Nursing CtrPleasantville, OH F
October 10, 2025Humboldt House Rehabilitation and Nursing CenterBuffalo, NY F
September 30, 2025Bayshore Nursing & RehabGlendale, WI L

F841 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
California21
New York9
Vermont9
Michigan5
Minnesota5
New Jersey5
Connecticut4
Massachusetts4
Ohio4
Kentucky3
Missouri3
Pennsylvania3
Tennessee3
Utah3
Alabama2
Colorado2
Mississippi2
Montana2
North Carolina2
New Mexico2
Oklahoma2
Virginia2
Wisconsin2
Alaska1
Arkansas1
Delaware1
Georgia1
Hawaii1
Kansas1
Maryland1
Nevada1
Puerto Rico1
Rhode Island1
South Carolina1
South Dakota1
Washington1

By inspection year: 2019 2, 2020 2, 2021 3, 2022 7, 2023 13, 2024 33, 2025 36, 2026 16.

Common questions

What is F841 in a nursing home inspection?
F841 is the federal requirement to "designate a physician to serve as medical director responsible for implementation of resident care policies and coordination of medical care in the facility". CMS files it under nursing and physician services. A home cited under F841 did not meet that requirement at the inspection.
How often is F841 cited?
The CMS files as of September 1, 2026 list 112 F841 citations at 109 nursing homes, 27 of them in the 12 months to that date. 14.3% were rated as actual harm or immediate jeopardy.
Is a F841 citation serious?
It depends on the letter. Most F841 citations (83.0%) were rated as potential for more than minimal harm, D to F. 12 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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