Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
of F808 citations were written at actual harm or above. The mark is the share across all tags, 5.4%.
Citations in 2025158
Every F808 citation surveyors wrote nationally that year.
Facilities cited157
Distinct nursing homes with at least one F808 finding.
The harm level
How severely F808 is cited
1.1% of citations found actual harm or worse (level G and above).
Citations by CMS scope and severity. Rows are harm level, columns are how widespread the finding was.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
J71.0%
K10.1%
L—
Actual harm
G—
H—
I—
No harm, potential for more than minimal
D56376.7%
E15521.1%
F50.7%
No harm, potential for minimal
A—
B30.4%
C—
Every recorded F808 citation, by the harm level and scope the surveyor assigned.
In the surveyor’s words
What an F808 citation says
One finding from each severity level, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
J · Immediate jeopardy, isolatedJanuary 28, 2026
Based on observation, interview and document review the facility failed to ensure modified diet orders were served in accordance with physician's orders for 3 of 4 residents (R1, R2, R3) who were at risk of aspiration and choking. This resulted in an immediate jeopardy for R1 and R3 when R1 was served food despite a strict order for nothing by mouth (NPO) and R3 who had a history of dysphasia (difficulty swallowing) and was served non pureed meat, not in accordance with the prescribed diet. The IJ began on 1/19/26, when dining assistant (DA) served R1 a regular textured meal consisting of a sandwich against physician's orders for NPO. …
C#: NJ 1, NJ 5
Based on observations, interviews, medical record review, and review of other pertinent facility documents on [DATE] & [DATE], it was determined that the facility failed to (a) prepare a mechanical soft diet at the correct texture and consistency, (b) obtain a Physician's Order and notify the Physician of a change in diet and (c) follow the residents plan of care for a resident who had a history of Dysphagia. The facility also failed to follow its policies titled Care Plans, Therapeutic and Mechanically Altered Diets, the 2018 DHCC (Dietetics in Health Care Communities) Manual of NJ (New Jersey), Textured Modified Diets, Resident Nutrition Services, Change in Resident Condition and Physician Orders. …
D · No harm, potential for more than minimal, isolatedSeptember 3, 2026
Based on observations, interview and record review the facility failed to provide ordered nutrition supplements for 1 (Resident #26) of 6 residents reviewed for dining observations. Findings include: During an observation on 8/31/2026 at 1:48 PM Resident #26 was eating in room independently. The meal tray contain pasta salad, ground meat, milk, apple sauce. The tray did not include a magic cup. During an observation on 9/1/2026 at 12:57 PM Resident #26 was eating lunch in the common dining room of the unit. The tray contain mask potatoes, ground meat, milk and pudding. The meal tray did not contain a magic cup. and the Review of Resident #26 physician order dated 8/4/2026 read, Magic Cup Am ordered PO in add direct two times a day for MNA 8- malnutrition risk with lunch and dinner. …
B · No harm, potential for minimal, patternMay 13, 2025
Based on observation, interview, medical record review, facility document review and facility P&P review, the facility failed to ensure one final sampled resident (Resident 38) and one nonsampled resident (Resident 1) received the appropriate diet as ordered by the physician.
* The facility failed to ensure Resident 1 was served soup with lunch as ordered by the physician.
*The facility failed to ensure Resident 38's soup was the appropriate mechanically altered diet. In addition, the facility failed to ensure the extra entree was provided with meals as ordered by the physician. …
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Cited in the same inspection, not caused by one another.
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