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F921: Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public

F921 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. It sits in CMS's environmental category.

3,406citations in the CMS files
2,548homes cited at least once
835in the 12 months to September 2026
0.4%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). 39.7% of F921 citations came from a complaint visit rather than a routine inspection.

  • Immediate jeopardy (J, K, L)12 (0.4%)
  • Actual harm (G, H, I)3 (0.1%)
  • Potential for more than minimal harm (D, E, F)3,323 (97.6%)
  • Potential for minimal harm (A, B, C)68 (2.0%)

By letter: B 28, C 40, D 1,221, E 1,416, F 686, G 3, J 2, K 5, L 5.

What inspectors wrote

Three recent F921 citations from different states, quoted from the inspectors' statements of deficiencies (CMS form 2567). Names are removed by CMS.

Inspectors wrote, August 6, 2026, scope and severity DBased on observation, interview, and document review, the facility failed to ensure resident rooms were kept in good working condition for 1 of 1 resident (R45) reviewed for a safe, clean, comfortable, and homelike environment.

The Estates at Roseville LLC, Roseville, MN

Inspectors wrote, July 31, 2026, scope and severity EBased on observation, interview and record review, the facility failed to maintain a clean and comfortable environment for 4 of 4 hallways (hallways 100, 200, 300, and 400) reviewed for physical environment. This failure placed residents at risk of unsanitary conditions, less than a homelike environment , and a diminished quality of life.

Gig Harbor Health and Rehabilitation, Gig Harbor, WA

Inspectors wrote, July 30, 2026, scope and severity EBased on observation, interview, and record review, it was determined that the facility failed to provide housekeeping and maintenance services necessary for a safe, functional, sanitary, and comfortable environment for residents, staff, and the public. Specifically, the facility failed to maintain the main sewer plumbing line in good repair, resulting in raw sewage containing urine and feces backing up through shower drains and toilet bases into resident rooms and corridors. This required the main building water supply to be shut off for over 6 hours, exposing residents to unsanitary conditions, hazardous biohazardous waste, and noxious fumes. Resident Identifiers: 2, 6, and 7. [...]

Spring Creek Healthcare Center, Salt Lake City, UT

Most recent F921 citations at the harm or jeopardy level

Newest first, all 15 in the current files. Each home's page shows the citation in full context, with its correction status.

InspectionHomeTownLetterVisit
February 3, 2026Lacon Rehab and NursingLacon, IL KComplaint
November 19, 2025Elevate Care WaukeganWaukegan, IL GComplaint
September 4, 2025Denton Nursing and RehabDenton, MD GComplaint
July 24, 2025Courtland, LLCBaltimore, MD KStandard
July 10, 2025The Benjamin Healthcare CenterBoston, MA KComplaint
June 19, 2025Monument Healthcare South Salt LakeSalt Lake City, UT KStandard
April 4, 2025Northvine Postacute CareSanta Rosa, CA LComplaint
February 28, 2025Vivo Healthcare LakelandLakeland, FL JComplaint
June 27, 2024Landmark of Oak Lawn Rehabilitation and Nursing CeOak Lawn, IL LComplaint
March 28, 2024Seacrest Post-Acute Care CenterSan Pedro, CA GComplaint
March 15, 2024Villa Maria Nursing CenterNorth Miami, FL LStandard
February 9, 2024Majestic Care of HopemontTerra Alta, WV LComplaint
February 7, 2024Rinaldi Convalescent HospitalGranada Hills, CA KComplaint
January 27, 2024Windsor Nursing and Rehabilitation Center of DuvalAustin, TX LComplaint
February 22, 2022The Shores Post-AcuteSan Diego, CA JStandard

Most recent F921 citations

InspectionHomeTownLetter
August 13, 2026Shores Nursing and Rehab CenterPort Saint Joe, FL D
August 6, 2026The Estates at Roseville LLCRoseville, MN D
July 31, 2026Gig Harbor Health and RehabilitationGig Harbor, WA E
July 30, 2026Spring Creek Healthcare CenterSalt Lake City, UT E
July 30, 2026Diablo Valley Post AcuteConcord, CA E
July 29, 2026Autumnwood Care CenterTiffin, OH E
July 29, 2026Accura Healthcare of NelighNeligh, NE F
July 28, 2026Focused Care at Hogan ParkMidland, TX E
July 28, 2026Green Acres Healthcare CenterRosemead, CA D
July 28, 2026Aria Nursing and RehabilitationLansing, MI F
July 28, 2026Arma Operator, LLCArma, KS C
July 27, 2026Liberty Retirement Community of Lima IncLima, OH E
July 27, 2026Embassy of WoodviewColumbus, OH F
July 27, 2026Arcadia Care on the HillSpringfield, IL F
July 23, 2026Mullican Care CenterSavoy, TX E
July 23, 2026Tygart Center at Fairmont CampusFairmont, WV E
July 23, 2026Towson Rehabilitation and Healthcare CenterTowson, MD E
July 23, 2026Haven of ChampaignChampaign, IL F
July 23, 2026The Orchard - Post Acute CareWhittier, CA E
July 22, 2026Avir at SeguinSeguin, TX D
July 22, 2026Riverwalk Post AcuteRiverside, CA E
July 22, 2026Avir at BeaumontBeaumont, TX E
July 22, 2026The MerrimanAkron, OH F
July 22, 2026Parkside HomesHillsboro, KS D
July 22, 2026Chatsworth Park Health Care CenterChatsworth, CA E

F921 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
Ohio533
California438
Texas343
Michigan304
Indiana242
Illinois210
Missouri139
Maryland105
Pennsylvania92
Florida85
Minnesota78
New York71
Kansas65
Washington63
Virginia53
Arkansas51
New Jersey44
Colorado43
Connecticut36
Georgia34
Louisiana34
Tennessee34
New Mexico30
Kentucky29
Rhode Island29
West Virginia27
Massachusetts22
Iowa19
Hawaii14
Oklahoma13
Idaho10
Oregon10
Puerto Rico10
Maine9
Mississippi9
Nebraska9
South Carolina9
Wisconsin9
Nevada8
Arizona7
Alabama6
North Carolina5
Delaware4
Montana4
North Dakota4
District of Columbia3
South Dakota3
Utah3
New Hampshire2
Wyoming2

By inspection year: 2018 9, 2019 70, 2020 21, 2021 98, 2022 165, 2023 560, 2024 966, 2025 918, 2026 599.

Common questions

What is F921 in a nursing home inspection?
F921 is the federal requirement to "make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public". CMS files it under environmental. A home cited under F921 did not meet that requirement at the inspection.
How often is F921 cited?
The CMS files as of September 1, 2026 list 3,406 F921 citations at 2,548 nursing homes, 835 of them in the 12 months to that date. 0.4% were rated as actual harm or immediate jeopardy.
Is a F921 citation serious?
It depends on the letter. Most F921 citations (97.6%) 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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