CMS · Survey deficiency reference

F925 Effective Pest Control Program (§483.90(i)(4))

Identifier and Official Title

F925 is the tag for 42 CFR §483.90(i)(4). The tag as printed in Appendix PP Rev. 232 reads, verbatim:

F925 (Rev. 173, Issued: 11-22-17, Effective: 11-28-17, Implementation: 11-28-17)

§483.90(i)(4) Maintain an effective pest control program so that the facility is free of pests and rodents.

The document is Rev. 232 (Issued 07-23-25; Effective 04-25-25; Implementation 04-28-25). Each tag in Appendix PP carries the revision in which its own text was last changed; the F925 text has not been revised since Rev. 173 (Issued 11-22-17), the revision that introduced the current F-tag numbering. F925 sits in the §483.90 Physical Environment group, under the F921 heading “§483.90(i) Other Environmental Conditions,” between F924 (handrails) and F926 (smoking policies).

This is the only place in the CMS long-term care requirements, and the only place in either the hospital or the long-term care survey manual, where pest control is named as a requirement. The hospital manual, Appendix A, contains no pest vocabulary at all; see A-0758 does not appear in Appendix A.

What It Enforces (Verbatim)

The full paragraph in which the mandate sits, from 42 CFR §483.90 (eCFR, Part 483, point-in-time 2026-09-08):

(i) Other environmental conditions. The facility must provide a safe, functional, sanitary, and comfortable environment for the residents, staff and the public. The facility must—

(1) Establish procedures to ensure that water is available to essential areas when there is a loss of normal water supply;

(2) Have adequate outside ventilation by means of windows, or mechanical ventilation, or a combination of the two;

(3) Equip corridors with firmly secured handrails on each side; and

(4) Maintain an effective pest control program so that the facility is free of pests and rodents.

(5) Establish policies, in accordance with applicable Federal, State, and local laws and regulations, regarding smoking, smoking areas, and smoking safety that also take into account non-smoking residents.

(The punctuation, with ”; and” after (3) and a period after (4), is as published.) Source citation for §483.90 as printed in eCFR: [56 FR 48876, Sept. 26, 1991, as amended … Redesignated and amended at 81 FR 68861, 68870, Oct. 4, 2016; 82 FR 32259, July 13, 2017; 86 FR 42524, Aug. 4, 2021; 87 FR 47618, Aug. 3, 2022].

Two things about the sentence matter for a facility answering a citation. It requires a program, not a service: “maintain an effective pest control program.” And it states the program’s required outcome: “so that the facility is free of pests and rodents.” The words “pest” and “rodent” occur nowhere else in Part 483 (2 occurrences of “pest” and 1 of “rodent” in the entire Part 483 eCFR XML, all in this paragraph).

CMS’s Definition of an Effective Pest Control Program (Verbatim)

The Guidance under the tag is one sentence, and it is the only definition CMS gives:

GUIDANCE: §483.90(i)(4) An “effective pest control program” is defined as measures to eradicate and contain common household pests (e.g., bed bugs, lice, roaches, ants, mosquitoes, flies, mice, and rats).

Three features of the definition:

• Two verbs. “Eradicate and contain.” A program that only reacts to sightings has no containment component; a program that only sets out devices has no eradication component. The definition asks for both.
• Eight named pests, expressly as examples. Bed bugs, lice, roaches, ants, mosquitoes, flies, mice, and rats. The “e.g.” makes the list illustrative, not exhaustive; “common household pests” is the category. Lice and bed bugs are on the list, which places human ectoparasites inside the pest control program, not only inside the infection control program (see F880’s pediculosis examples below).
• No method prescribed. CMS does not specify inspection frequency, device types, applicator credentials, or recordkeeping. Those come from state pesticide law, the state-adopted Food Code for the kitchen, and the standard of care (HICPAC, the EPA IPM framework).

Survey Procedures and Probes (Verbatim, Complete)

PROCEDURES: §483.90(i)(4) As part of the overall review of the facility, look for signs of vermin. Evidence of pest infestation in a particular space is an indicator of noncompliance.

PROBES: §483.90(i)(4) Ask staff, residents and their representatives if they have observed any pests/vermin?

That is the complete tag. F925 carries no INTENT section, no DEFINITIONS section beyond the one sentence above, no KEY ELEMENTS OF NONCOMPLIANCE, no DEFICIENCY CATEGORIZATION, and no POTENTIAL TAGS FOR ADDITIONAL INVESTIGATION. Its investigative pathway is therefore short, and it runs in two directions: outward, from the surveyor’s own tour and interviews (“as part of the overall review of the facility”), and inward, from the kitchen sanitation tag F812, whose investigation is instructed to route pest evidence to F925.

The Investigative Pathway and Its Relationship to F812

F812 (§483.60(i)(1)-(2), food procurement, storage, preparation, and service; tag text at Rev. 229, Issued 04-25-25) is the tag with the detailed kitchen investigation, and it is where most surveyor time in a food area is spent. Its text touches pests four times, verbatim:

In the Guidance on food receiving and storage:

Controlling temperature, humidity, and rodent and insect infestation helps prevent deterioration or contamination of the food.

In the Guidance on chemical contamination, which is where pesticide storage in a kitchen is written:

The most common chemicals that can be found in a food system are cleaning agents (such as glass cleaners, soaps, and oven cleaners) and insecticides. […] Chemical products and supplies, must be clearly marked as such and stored separately from food items.

In the Procedures, under “Storage of Food”:

• Look for evidence of pests, rodents and droppings and other sources of contamination in food storage areas; and

And in the list headed “POTENTIAL TAGS FOR ADDITIONAL INVESTIGATION §483.60(i)(1)-(2)”, which is the routing instruction:

• §483.90(i)(4), F925, Effective Pest Control Program o Determine if the facility has maintained an effective pest control program so that it remains free of pests and rodents. Determine whether there is evidence of insect larvae, roaches, ants, flies, mice, etc. in food storage, preparation and service areas.

So a kitchen pest observation produces two questions, at two tags. Under F812 the question is whether food was stored, prepared, and served safely with the pests present. Under F925 the question is whether the facility’s program is effective, given that pests were present. A facility can be cited at both for the same droppings, and the plan of correction has to answer both.

Three other tags feed the same pathway:

• F814 (§483.60(i)(4), garbage and refuse) asks in its probes: “Is the garbage storage area maintained in a sanitary condition to prevent the harborage and feeding of pests?”
• F584 (§483.10(i), safe, clean, comfortable, and homelike environment) directs the surveyor: “For kitchen sanitation, see §483.60(i), F812, Food Safety Requirements” and “For issues of cleanliness of areas of the facility used by staff only (such as the break room, medication room, laundry, kitchen, etc.) or the public only (such as the parking lot), see §483.90(h), F921, Other Environmental Conditions.” (The manual’s own cross-reference says §483.90(h); the “Other Environmental Conditions” heading is at §483.90(i) in the regulation.)
• F600 (§483.12, freedom from abuse, neglect, and exploitation) lists, among examples of neglect, failure to ensure environmental hazards are not present “including but not limited to: … Infestation by insects/rodents;” and its Severity Level 4 (immediate jeopardy) examples include a facility where “residents reported mice in their rooms,” “there was evidence of rodent infestation” in the kitchen, and “The administrator reported that the pest control company had visited the facility recently, but there was no record of the visit or proposal for remediation.”

That last sentence is the most instructive line about F925 anywhere in the manual, even though it appears under a different tag: the absence of a record of the vendor’s visit and of a remediation proposal is what the example counts against the facility.

What Surveyors Actually Examine

From the text of the tags above, the surveyor’s evidence for an F925 finding comes from four places:

1. The tour. “Look for signs of vermin” during “the overall review of the facility.” Live insects, droppings, gnaw marks, dead insects in light fixtures, bed bug evidence on mattress seams, flies in dining and kitchen areas.
2. Interviews. “Ask staff, residents and their representatives if they have observed any pests/vermin?” Resident and family interviews are a standing part of the long-term care survey; a resident who says “there are mice in my room” is evidence the surveyor is instructed to seek.
3. The kitchen. Under F812, “evidence of pests, rodents and droppings and other sources of contamination in food storage areas”; under F814, the garbage storage area and “harborage and feeding of pests.”
4. The program’s records, because the regulation requires a program to be maintained and the manual’s own example weighs the absence of a record against the facility: the pest control contract or in-house program, service reports, sighting logs, and the remediation proposals that followed sightings.

CMS’s procedure sets a low evidentiary threshold: “Evidence of pest infestation in a particular space is an indicator of noncompliance.” One space is enough to open the finding. The facility’s records are what determine whether the finding is written as an isolated lapse or as the absence of an effective program.

Where Facilities Fail

These are this reference’s observations from publicly posted long-term care survey reports and from the structure of the tag; they are not CMS text.

• A contract is treated as a program. The facility has a monthly service agreement and no sighting log, no thresholds, no follow-up records, and no one on staff who reads the vendor’s reports. When the surveyor finds droppings, the facility cannot show what its program did about the last sighting.
• No route from a sighting to the program. A nursing assistant sees a mouse; nothing is written down; the vendor learns of it at the next scheduled visit. The interview probe (“ask staff, residents and their representatives”) is designed to find exactly this gap.
• Bed bugs and lice are handled as clinical events only. They are on CMS’s list of pests. A facility that treats the resident and launders the linen but has no room inspection, no containment of adjacent rooms, and no record in the pest program has answered F880 and not F925.
• The kitchen and the building are separate programs. Dietary manages the kitchen vendor; maintenance manages the building; nobody manages harborage at the loading dock, the dumpster pad, or the wall penetrations between them.
• Exclusion is nobody’s job. Door sweeps, screens, and sealed penetrations are the containment half of “eradicate and contain,” and they are facilities work orders, not vendor tasks.
• Records exist but say nothing. Service reports that read “routine service performed” with no findings, no product, and no follow-up do not show an effective program; the F600 example’s “no record of the visit or proposal for remediation” is the failure mode.

Scope and Severity Context

F925 has no Deficiency Categorization section, so Appendix PP gives no F925-specific examples of the severity levels. Scope and severity for an F925 citation are assigned under the general long-term care enforcement grid in the State Operations Manual, Chapter 7, which was not in the verified source set for this page and is not paraphrased here. What the manual does show:

• Under F600, rodent infestation in the kitchen together with mice in resident rooms, with no record of the vendor’s visit, appears in an example of Severity Level 4, immediate jeopardy, as part of a broader neglect finding.
• Under F880 and F882, scabies and pediculosis (lice) cases in which the infestation spread to a roommate appear as examples of Severity Level 3, actual harm that is not immediate jeopardy.
• The F925 procedure’s own threshold, “evidence of pest infestation in a particular space is an indicator of noncompliance,” means a single confirmed space can support a citation; scope (isolated, pattern, widespread) then turns on how many spaces, and severity on the harm or potential for harm the surveyor can document.

Plan of Correction

Appendix PP itself restates the required elements of a plan of correction, citing the State Operations Manual, Chapter 7, §7317 (Acceptable Plan of Correction). The five elements, verbatim as they appear in Rev. 232:

• Address how corrective action will be accomplished for those residents found to have been affected by the deficient practice; • Address how the facility will identify other residents having the potential to be affected by the same deficient practice; • Address what measures will be put into place or systemic changes made to ensure that the deficient practice will not recur; • Indicate how the facility plans to monitor its performance to make sure that solutions are sustained; and • Include dates when corrective action will be completed.

How each element applies to a pest finding, the submission clock, and what separates an accepted plan from a rejected one are on F925 Plan of Correction.

Confidence Notes

HIGH confidence. The tag heading, regulation text, Guidance, Procedures, and Probes, and every F812, F814, F584, F600, F880, and F882 quotation, are transcribed from Appendix PP Rev. 232 (Issued 07-23-25), read in full from the reference’s archived copy of the CMS PDF on September 11, 2026. The §483.90(i) text was matched against the eCFR XML of 42 CFR Part 483. The “What Surveyors Actually Examine,” “Where Facilities Fail,” and scope-and-severity sections are the reference’s reading of the tag text and of publicly posted survey reports, and are labeled as such; nothing in them is presented as CMS text. The Chapter 7 enforcement grid is cited, not quoted, because it was not in the verified source set.