CMS F-tag

F921: Environment & safety

The facility must be safe, functional, sanitary, and comfortable. Cited 3,417 times at 2,549 nursing homes in the last three inspection cycles.

#31 of 242 tags1% caused harm51 statesLatest survey Jan 2, 2026

How F921 shows up in inspections

F-TAGF921#31 of 242 tagsOften cited

How serious it usually is

  • Immediate jeopardyJ · K · L0.5%16
  • Actual harmG0.1%4
  • No actual harmD · E · F97.2%3,320
  • Minimal harmB · C2.3%77

1% of F921 citations involved actual harm or immediate jeopardy. Nationally, about 5% of all citations do.

By the numbers

  • 3,417Citations
  • 2,549Facilities cited17% of rated nursing homes

Citations by survey year

  • 20173
  • 201830
  • 2019118
  • 202038
  • 2021143
  • 2022315
  • 2023932
  • 2024976
  • 2025861
  • 20261

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

Where F921 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 F921 citation.

States by share of facilities cited

  • Ohio36% of homes511 citations · 325 of 911 facilities
  • California30% of homes466 citations · 347 of 1,154 facilities
  • Texas23% of homes352 citations · 267 of 1,167 facilities
  • Michigan44% of homes290 citations · 183 of 420 facilities
  • Indiana34% of homes269 citations · 169 of 504 facilities
  • Illinois20% of homes200 citations · 134 of 665 facilities
  • Missouri24% of homes140 citations · 114 of 479 facilities
  • Pennsylvania11% of homes104 citations · 75 of 653 facilities
  • Florida11% of homes86 citations · 76 of 689 facilities
  • Maryland28% of homes81 citations · 62 of 219 facilities

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

Facilities cited most often

  1. Harborview Rehabilitation Care Center at DoylestowDoylestown, PA · Report card7 F921No harm
  2. Gardens of Euclid BeachCleveland, OH · Report card6 F921No harm
  3. Hillside Manor Nursing HomeWashington, IN · Report card6 F921No harm
  4. Kennedy Health & RehabLufkin, TX · Report card6 F921No harm
  5. Pasadena Nursing CenterPasadena, CA · Report card6 F921No harm
  6. Aperion Care VincennesVincennes, IN · Report card5 F921No harm
  7. Austin Oasis, theChicago, IL · Report card5 F921No harm
  8. Avalon View Health and WellnessLiberty, MO · Report card5 F921No harm
  9. Atrium Nursing and RehabilitationXenia, OH · Report card5 F921No harm
  10. Focused Care at MidlandMidland, TX · Report card5 F921No harm
  11. Grande OaksOakwood Village, OH · Report card5 F921No harm
  12. Inland Valley Care and Rehabilitation CenterPomona, CA · Report card5 F921No harm
  13. Santa Anita Convalescent HospitalTemple City, CA · Report card5 F921No harm
  14. The Pavilion Rehabilitation and Nursing CenterNorth Royalton, OH · Report card5 F921No harm
  15. Transcendent Healthcare of BoonvilleBoonville, IN · Report card5 F921No harm

What to ask a facility about a F921 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 2, 2026. Counts are citations unless labeled facilities.

Frequently asked questions

What is F921 in a nursing home inspection?
F921 is the CMS F-tag for the requirement "Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public." (Environment & safety). Surveyors cite it when a facility is found out of compliance with that regulation during a standard survey or complaint investigation.
How common is F921?
F921 was cited 3,417 times at 2,549 facilities (17% of rated nursing homes) in the last three inspection cycles, ranking #31 of 242 tags. 20 of those citations involved actual harm or immediate jeopardy.
Does a F921 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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