How we explain inspection results
Inspectors visit every certified nursing home about once a year, and also whenever someone files a complaint. When they find that a federal requirement wasn't met, they issue a citation (also called a deficiency).
Severity and scope
Each citation gets a letter from A to L. The letter shows how serious the problem was and how many residents it affected.
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J | K | L |
| Actual harm | G | H | I |
| Potential for more than minimal harm | D | E | F |
| Potential for minimal harm | A | B | C |
We call citations at levels G through L serious, because inspectors found that residents were actually harmed or placed in immediate jeopardy. This matches CMS's own definitions.
What we don't do
- We don't create our own safety score. The star ratings shown are calculated by CMS.
- We don't call a facility “unsafe” because of any single citation.
- We don't rewrite findings to sound worse or better. Official wording is shown with plain-English context about severity.
- Paying us never changes a facility's inspection results, ranking in safety filters, or the information shown.
Repeat findings and trends
A “repeat finding” is a requirement cited on more than one inspection date within the last three inspection cycles. Trends compare the number of citations in the most recent cycle with the previous one. Because complaint investigations vary, small changes may not be meaningful.
Disputed citations
Facilities can challenge citations through informal dispute resolution. When CMS marks a citation as under dispute, we note it.