CMS F-tag

F578: Resident rights

Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. Cited 4,456 times at 3,705 nursing homes in the last three inspection cycles.

#26 of 242 tags3% caused harm53 statesLatest survey Jan 9, 2026

How F578 shows up in inspections

F-TAGF578#26 of 242 tagsOften cited

How serious it usually is

  • Immediate jeopardyJ · K · L2.2%99
  • Actual harmG0.4%16
  • No actual harmD · E · F96.8%4,313
  • Minimal harmB0.6%28

3% of F578 citations involved actual harm or immediate jeopardy. Nationally, about 5% of all citations do.

By the numbers

  • 4,456Citations
  • 3,705Facilities cited25% of rated nursing homes

Citations by survey year

  • 20171
  • 201861
  • 2019237
  • 202086
  • 2021275
  • 2022643
  • 20231,000
  • 20241,201
  • 2025950
  • 20262

Partial years reflect the rolling three-cycle window, not a change in enforcement.

Where F578 is cited most

Survey agencies differ in what they emphasize, so compare a facility with its own state. Shares are the portion of each state’s rated nursing homes with at least one F578 citation.

States by share of facilities cited

  • California50% of homes816 citations · 581 of 1,154 facilities
  • Ohio31% of homes335 citations · 283 of 911 facilities
  • Texas17% of homes237 citations · 204 of 1,167 facilities
  • Michigan37% of homes189 citations · 155 of 420 facilities
  • Illinois24% of homes188 citations · 161 of 665 facilities
  • Missouri25% of homes153 citations · 122 of 479 facilities
  • Maryland52% of homes153 citations · 114 of 219 facilities
  • Washington54% of homes150 citations · 104 of 192 facilities
  • Pennsylvania20% of homes141 citations · 128 of 653 facilities
  • Oklahoma41% of homes141 citations · 116 of 282 facilities

Top 10 of 53 states. Every state page lists its most-cited tags.

Facilities cited most often

  1. Desert Springs Post AcutePalm Desert, CA · Report card4 F578No harm
  2. Arvada Care and Rehabilitation CenterArvada, CO · Report card3 F5781 with harm
  3. Alamitos West Health & RehabilitationLos Alamitos, CA · Report card3 F578No harm
  4. Alcott Rehabilitation HospitalLos Angeles, CA · Report card3 F578No harm
  5. Anaheim PointAnaheim, CA · Report card3 F578No harm
  6. Aspire Senior Living Pleasant HillPleasant Hill, MO · Report card3 F578No harm
  7. Auburn Post AcuteAuburn, WA · Report card3 F578No harm
  8. Beaufont Health and Rehabilitation CenterRichmond, VA · Report card3 F578No harm
  9. Belleview Valley Nursing HomeBelleview, MO · Report card3 F578No harm
  10. Berkley East Healthcare CenterSanta Monica, CA · Report card3 F578No harm
  11. Beverly Hills Rehabilitation CentreLos Angeles, CA · Report card3 F578No harm
  12. Bridgepoint Sub-Acute & Rehab National HarborsideWashington, DC · Report card3 F578No harm
  13. Butler Rehab and Healthcare CenterButler, MO · Report card3 F578No harm
  14. Capitol City Rehab and Healthcare CenterWashington, DC · Report card3 F578No harm
  15. Checotah Nursing CenterChecotah, OK · Report card3 F578No harm

What to ask a facility about a F578 citation

  1. What exactly did the surveyor find, and on what date? The report card shows the date and the severity letter.
  2. What was the plan of correction, and was it accepted by the state on the first submission?
  3. Has the same tag been cited in more than one cycle? Repeat citations matter more than a single one.
  4. If the letter was G or higher: what happened to the resident, and what changed in staffing or process?

Source: CMS Provider Data Catalog, Nursing Home Health Citations, current three inspection cycles, most recent survey Jan 9, 2026. Counts are citations unless labeled facilities.

Frequently asked questions

What is F578 in a nursing home inspection?
F578 is the CMS F-tag for the requirement "Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive." (Resident rights). Surveyors cite it when a facility is found out of compliance with that regulation during a standard survey or complaint investigation.
How common is F578?
F578 was cited 4,456 times at 3,705 facilities (25% of rated nursing homes) in the last three inspection cycles, ranking #26 of 242 tags. 115 of those citations involved actual harm or immediate jeopardy.
Does a F578 citation mean the facility is unsafe?
Not on its own. Read the scope and severity letter: D through F means no actual harm was found, G through I means a resident was harmed, and J through L means immediate jeopardy. Ask the facility what was cited, what was corrected, and when.

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