CMS F-tag

F604: Abuse, neglect & exploitation

Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. Cited 1,553 times at 1,390 nursing homes in the last three inspection cycles.

#60 of 242 tags6% caused harm52 statesLatest survey Jan 14, 2026

How F604 shows up in inspections

F-TAGF604#60 of 242 tagsOccasionally cited

How serious it usually is

  • Immediate jeopardyJ · K · L3.1%48
  • Actual harmG2.9%45
  • No actual harmD · E · F94%1,460
  • Minimal harmA–C0%0

6% of F604 citations involved actual harm or immediate jeopardy. Nationally, about 5% of all citations do.

By the numbers

  • 1,553Citations
  • 1,390Facilities cited10% of rated nursing homes

Citations by survey year

  • 201822
  • 201969
  • 202023
  • 202164
  • 2022137
  • 2023398
  • 2024448
  • 2025391
  • 20261

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

Where F604 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 F604 citation.

States by share of facilities cited

  • California19% of homes275 citations · 214 of 1,154 facilities
  • Massachusetts28% of homes112 citations · 95 of 338 facilities
  • Illinois14% of homes102 citations · 90 of 665 facilities
  • New York16% of homes101 citations · 92 of 593 facilities
  • Ohio9% of homes86 citations · 83 of 911 facilities
  • Texas6% of homes80 citations · 74 of 1,167 facilities
  • Pennsylvania8% of homes58 citations · 53 of 653 facilities
  • Missouri12% of homes58 citations · 56 of 479 facilities
  • Michigan12% of homes58 citations · 52 of 420 facilities
  • Washington21% of homes50 citations · 40 of 192 facilities

Top 10 of 52 states. Every state page lists its most-cited tags.

Facilities cited most often

  1. Studio City Rehabilitation CenterStudio City, CA · Report card4 F604No harm
  2. Gracelen Care CenterPortland, OR · Report card3 F6041 with harm
  3. Regalcare at Courtyard-MedfordMedford, MA · Report card3 F6041 with harm
  4. Coler Rehabilitation and Nursing Care CenterRoosevelt Island, NY · Report card3 F604No harm
  5. Coral Cove Post AcuteLong Beach, CA · Report card3 F604No harm
  6. Golden Haven Care CenterGlendale, CA · Report card3 F604No harm
  7. Imperial Care CenterStudio City, CA · Report card3 F604No harm
  8. Indiana Veterans HomeWest Lafayette, IN · Report card3 F604No harm
  9. Intercommunity Care CenterLong Beach, CA · Report card3 F604No harm
  10. Linden Grove Health Care CenterPuyallup, WA · Report card3 F604No harm
  11. Los Feliz Healthcare & Wellness Center, LPLos Angeles, CA · Report card3 F604No harm
  12. Meadow Creek Post-AcuteParamount, CA · Report card3 F604No harm
  13. Morgantown Woods of JourneyMorgantown, IN · Report card3 F604No harm
  14. Newport Subacute Healthcare CenterCosta Mesa, CA · Report card3 F604No harm
  15. Providence Holy Cross Med Ctr D/P SNFMission Hills, CA · Report card3 F604No harm

What to ask a facility about a F604 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 14, 2026. Counts are citations unless labeled facilities.

Frequently asked questions

What is F604 in a nursing home inspection?
F604 is the CMS F-tag for the requirement "Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment." (Abuse, neglect & exploitation). Surveyors cite it when a facility is found out of compliance with that regulation during a standard survey or complaint investigation.
How common is F604?
F604 was cited 1,553 times at 1,390 facilities (10% of rated nursing homes) in the last three inspection cycles, ranking #60 of 242 tags. 93 of those citations involved actual harm or immediate jeopardy.
Does a F604 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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