Based on review of facility policy, observation, and interview, the facility failed to ensure that the dishwashing machine properly sanitized the dishes for 1 of 1 dishwasher reviewed.On 07/22/26 at 12:35 PM, the State Agency (SA) determined that the facility's non-compliance with one or more federal health, safety, and/or quality regulations has caused or was likely to cause serious injury, serious harm, serious impairment, or death.On 07/22/26 at 12:45 PM, the Survey Team provided the Administrator with a copy of the CMS Immediate Jeopardy (IJ) Template and informed the facility IJ existed as of 07/22/26. The IJ was related to 42 CFR 483.90 - Physical Environment.On 07/22/26 at approximately 4:30 PM, the facility provided an acceptable IJ Removal Plan. …
F908 · Equipment in safe condition
Environmental Deficiencies
Keep all essential equipment working safely.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Every F908 citation surveyors wrote nationally that year.
Distinct nursing homes with at least one F908 finding.
The harm level
How severely F908 is cited
0.8% of citations found actual harm or worse (level G and above).
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J30.1% | K20.1% | L60.3% |
| Actual harm | G60.3% | H— | I— |
| No harm, potential for more than minimal | D80939.7% | E66932.8% | F50024.5% |
| No harm, potential for minimal | A— | B221.1% | C201.0% |
In the surveyor’s words
What an F908 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.
Based on interview and record review, it was determined that the facility did not maintain all mechanical, electrical, and patient care equipment in a safe and operating condition. Specifically, a ventilator did not alarm when a resident's tracheostomy tube's flange broke and dislodged and the resident went into cardiac arrest and died. This will be cited at a harm level. Resident identifier: 9. Resident 9 was admitted to the facility on [DATE] with diagnoses which included anoxic brain damage, acute and chronic respiratory failure, tracheostomy status, and pneumonia due to pseudomonas. …
Based on observation, interview and record review the facility failed to maintain all mechanical, electrical, and patient care equipment in safe operating condition for 1 of 1 facility reviewed for safe and functioning equipment. 1. The facility failed to maintain 2 of 2 vans used for resident transportation with one van in the shop and the other one not having adequate air conditioning.2. The facility failed to maintain 1 of 2 reach in refrigerators in the kitchen for an unknown period and used it for dry goods storage.3. …
Based on observation, interviews, and Facility policy, the facility failed to ensure a kitchen steamer unit was maintained in safe operating condition, and the facility failed to visibly tag equipment as out of use. The findings include:Observation of the kitchen on 6/09/2026 at 11:58 AM identified the steamer unit located next to the gas stove, had the upper pot 1/3 full of water, and water from the steamer unit's faucet was dripping into the pot. A dirty cloth rag was wrapped around and tied to the junction of the upper pot and the steamer's water pipe, and a cloth rag was intertwined between electrical wires within the steamer unit's electrical box. …
By state — 2025
Where F908 is cited more, and less, than expected
Each state is measured against its own expected share, not against other states.
- California1.76× · 126 citations
- Pennsylvania1.57× · 47 citations
- Texas1.19× · 52 citations
- Illinois1.02× · 31 citations
Co-occurrence
Cited alongside F908
Of the 2025 surveys that cited F908, these tags appeared in the same inspection more often than chance would predict.
- F9259.1% of F908 surveys · 5.0× chance
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
- F8148.3% of F908 surveys · 4.6× chance
Dispose of garbage and refuse properly.
- F80416.7% of F908 surveys · 4.4× chance
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- F80311.0% of F908 surveys · 4.3× chance
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
- F8066.9% of F908 surveys · 4.2× chance
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Cited in the same inspection, not caused by one another.
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