CMS F-tag

F865: Administration

A quality assurance and performance improvement (QAPI) program must be in place. Cited 764 times at 687 nursing homes in the last three inspection cycles.

#93 of 242 tags3% caused harm51 statesLatest survey Jan 16, 2026

How F865 shows up in inspections

F-TAGF865#93 of 242 tagsOccasionally cited

How serious it usually is

  • Immediate jeopardyJ · K · L1.6%12
  • Actual harmG · H · I1.2%9
  • No actual harmD · E · F94.1%719
  • Minimal harmB · C3.1%24

3% of F865 citations involved actual harm or immediate jeopardy. Nationally, about 5% of all citations do.

By the numbers

  • 764Citations
  • 687Facilities cited5% of rated nursing homes

Citations by survey year

  • 20185
  • 201915
  • 20206
  • 202134
  • 202262
  • 2023173
  • 2024229
  • 2025238
  • 20262

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

Where F865 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 F865 citation.

States by share of facilities cited

  • California9% of homes110 citations · 101 of 1,154 facilities
  • Iowa17% of homes88 citations · 65 of 388 facilities
  • Missouri9% of homes50 citations · 44 of 479 facilities
  • Pennsylvania5% of homes35 citations · 31 of 653 facilities
  • Minnesota8% of homes32 citations · 27 of 337 facilities
  • Massachusetts8% of homes30 citations · 27 of 338 facilities
  • New Jersey8% of homes29 citations · 28 of 344 facilities
  • Arkansas12% of homes27 citations · 26 of 218 facilities
  • Florida4% of homes26 citations · 26 of 689 facilities
  • Ohio2% of homes23 citations · 17 of 911 facilities

Top 10 of 51 states. Every state page lists its most-cited tags.

Facilities cited most often

  1. Country Lane ManorKeosauqua, IA · Report card4 F865No harm
  2. Astoria Place of BarnesvilleBarnesville, OH · Report card3 F865No harm
  3. Azria Health Park PlaceDes Moines, IA · Report card3 F865No harm
  4. Bay Crest Care CenterTorrance, CA · Report card3 F865No harm
  5. Bettendorf Health Care CenterBettendorf, IA · Report card3 F865No harm
  6. Garden View Care CenterShenandoah, IA · Report card3 F865No harm
  7. Highland Manor of Fallon Rehabilitation LLCFallon, NV · Report card3 F865No harm
  8. Pioneer Valley Living and RehabSergeant Bluff, IA · Report card3 F865No harm
  9. South Lyon Medical CenterYerington, NV · Report card3 F865No harm
  10. Southside Care CenterMinneapolis, MN · Report card3 F865No harm
  11. Stone Cottage Care CenterSigourney, IA · Report card3 F865No harm
  12. Sunplex Sub-Acute CenterOcean Springs, MS · Report card2 F8651 with harm
  13. Arbor Post AcuteChico, CA · Report card2 F865No harm
  14. Arkansas Veterans Home at FayettevilleFayetteville, AR · Report card2 F865No harm
  15. Astoria Place of CambridgeCambridge, OH · Report card2 F865No harm

What to ask a facility about a F865 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 16, 2026. Counts are citations unless labeled facilities.

Frequently asked questions

What is F865 in a nursing home inspection?
F865 is the CMS F-tag for the requirement "Have a plan that describes the process for conducting QAPI and QAA activities." (Administration). Surveyors cite it when a facility is found out of compliance with that regulation during a standard survey or complaint investigation.
How common is F865?
F865 was cited 764 times at 687 facilities (5% of rated nursing homes) in the last three inspection cycles, ranking #93 of 242 tags. 21 of those citations involved actual harm or immediate jeopardy.
Does a F865 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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