F923: Have enough outside ventilation via a window or mechanical ventilation, or both
F923 is one of the federal requirements every Medicare and Medicaid certified nursing home must meet. CMS describes it as: Have enough outside ventilation via a window or mechanical ventilation, or both.
It sits in CMS's environmental 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). 21.3% of F923 citations came from a complaint visit rather than a routine inspection.
By letter: B 1, C 1, D 31, E 81, F 22.
What inspectors wrote
Three recent F923 citations from different states, quoted from the inspectors' statements of deficiencies (CMS form 2567). Names are removed by CMS.
Inspectors wrote, June 4, 2026, scope and severity FBased on observation and interview, the facility failed to maintain the building mechanical ventilation in good working order, resulting in stagnant air and odors. This deficient practice had the potential to affect all residents, staff and visitors.
The Orchards at Roseville, Roseville, MI
Inspectors wrote, June 3, 2026, scope and severity EBased on observation, review of facility documentation and interviews the facility failed to ensure adequate ventilation by means of opened windows, or mechanical ventilation, or a combination of the two was in place consistently in the building.
Trinity Hill Care Center, Hartford, CT
Inspectors wrote, May 15, 2026, scope and severity DBased on observation and interview with facility staff, it was determined that the facility failed to ensure proper airflow in the soiled laundry rooms. This was evident from the tours of the soiled laundry rooms conducted during the annual survey.
Moran Nursing and Rehabilitation Center, Westernport, MD
Most recent F923 citations
F923 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 |
|---|---|
| Nebraska | 35 |
| Missouri | 22 |
| Maryland | 18 |
| Colorado | 16 |
| Michigan | 13 |
| Utah | 8 |
| Georgia | 4 |
| New York | 4 |
| Illinois | 3 |
| Kansas | 2 |
| California | 1 |
| Connecticut | 1 |
| Delaware | 1 |
| Florida | 1 |
| Iowa | 1 |
| Ohio | 1 |
| Oregon | 1 |
| Pennsylvania | 1 |
| Vermont | 1 |
| West Virginia | 1 |
| Wyoming | 1 |
By inspection year: 2019 7, 2020 5, 2021 4, 2022 7, 2023 23, 2024 27, 2025 37, 2026 26.
Common questions
- What is F923 in a nursing home inspection?
- F923 is the federal requirement to "have enough outside ventilation via a window or mechanical ventilation, or both". CMS files it under environmental. A home cited under F923 did not meet that requirement at the inspection.
- How often is F923 cited?
- The CMS files as of September 1, 2026 list 136 F923 citations at 129 nursing homes, 41 of them in the 12 months to that date. 0.0% were rated as actual harm or immediate jeopardy.
- Is a F923 citation serious?
- It depends on the letter. Most F923 citations (98.5%) 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