CMS F-tag

F758: Pharmacy services

Psychotropic drugs must not be given without a diagnosis, monitoring, and gradual dose reductions. Cited 6,186 times at 4,895 nursing homes in the last three inspection cycles.

#19 of 242 tags1% caused harm53 statesLatest survey May 13, 2025

How F758 shows up in inspections

F-TAGF758#19 of 242 tagsVery often cited

How serious it usually is

  • Immediate jeopardyJ · K · L0.1%6
  • Actual harmG · H0.4%25
  • No actual harmD · E · F99.4%6,151
  • Minimal harmB0.1%4

1% of F758 citations involved actual harm or immediate jeopardy. Nationally, about 5% of all citations do.

By the numbers

  • 6,186Citations
  • 4,895Facilities cited34% of rated nursing homes

Citations by survey year

  • 20174
  • 2018122
  • 2019429
  • 2020146
  • 2021420
  • 2022982
  • 20231,553
  • 20241,840
  • 2025690

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

Where F758 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 F758 citation.

States by share of facilities cited

  • California57% of homes952 citations · 656 of 1,154 facilities
  • Ohio39% of homes446 citations · 351 of 911 facilities
  • Illinois41% of homes377 citations · 271 of 665 facilities
  • Kansas70% of homes285 citations · 205 of 294 facilities
  • Missouri41% of homes250 citations · 198 of 479 facilities
  • Texas18% of homes241 citations · 210 of 1,167 facilities
  • Pennsylvania30% of homes241 citations · 199 of 653 facilities
  • Michigan39% of homes207 citations · 164 of 420 facilities
  • Indiana33% of homes201 citations · 168 of 504 facilities
  • Massachusetts43% of homes194 citations · 146 of 338 facilities

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

Facilities cited most often

  1. Plaza Healthcare CenterSanta Ana, CA · Report card7 F758No harm
  2. Huntington Valley Healthcare CenterHuntington Beach, CA · Report card6 F758No harm
  3. Aventura at Terrace ViewPeckville, PA · Report card4 F758No harm
  4. Crystal Cove Care CenterNewport Beach, CA · Report card4 F758No harm
  5. Mirage Post AcuteLancaster, CA · Report card4 F758No harm
  6. Rock River Nursing & RehabFort Atkinson, WI · Report card4 F758No harm
  7. Sunnyvale Gardens Post AcuteSunnyvale, CA · Report card4 F758No harm
  8. The Pavilion at Ocean PointSan Diego, CA · Report card4 F758No harm
  9. Blaire House of MilfordMilford, MA · Report card3 F7581 with harm
  10. Schuyler County Nursing Home DistrictQueen City, MO · Report card3 F7581 with harm
  11. Sunny Hills Post AcuteLA Mirada, CA · Report card3 F7581 with harm
  12. Advanced Rehab Center of TustinSanta Ana, CA · Report card3 F758No harm
  13. Alhambra Post AcuteMartinez, CA · Report card3 F758No harm
  14. Alvarado Care CenterLos Angeles, CA · Report card3 F758No harm
  15. Anaheim Healthcare Center, LLCAnaheim, CA · Report card3 F758No harm

What to ask a facility about a F758 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 May 13, 2025. Counts are citations unless labeled facilities.

Frequently asked questions

What is F758 in a nursing home inspection?
F758 is the CMS F-tag for the requirement "Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited." (Pharmacy services). Surveyors cite it when a facility is found out of compliance with that regulation during a standard survey or complaint investigation.
How common is F758?
F758 was cited 6,186 times at 4,895 facilities (34% of rated nursing homes) in the last three inspection cycles, ranking #19 of 242 tags. 31 of those citations involved actual harm or immediate jeopardy.
Does a F758 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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