How to read a nursing home inspection report
Every Medicare- and Medicaid-certified nursing home in the country is inspected by state surveyors, usually about once a year and again whenever someone files a complaint. The government publishes what they find. The record is public and free, but it is written for regulators, not families, so it can be hard to read. This guide walks through the parts that matter.
What an inspection actually is
A surveyor spends several days on site observing care, reviewing records, and interviewing residents and staff. When they find that a home has not met a federal requirement, they write it up as a citation, also called a deficiency. Each citation has a tag number (an F-tag) that identifies the specific rule, a short description of what was found, and a severity rating.
Scope and severity: the letter grid
The single most important thing on a citation is its scope and severity, shown as a letter from A to L. Two things are being measured at once: how serious the problem was (severity) and how many residents it affected (scope).
- A through C: no actual harm, with the potential for minimal harm. Often paperwork or process issues.
- D through F: no actual harm, but the potential for more than minimal harm. The most common band.
- G through I: actual harm. A resident was actually hurt.
- J through L: immediate jeopardy. The most serious level, meaning a resident was at risk of serious injury, harm, or death.
When you see a J, K, or L citation, read it carefully. Immediate jeopardy is the government saying a resident was in real danger. Note the date, and check whether the record shows it was corrected.
Was it corrected?
A citation is a snapshot of a specific date. Homes are required to submit a plan of correction, and most problems are fixed. A citation from three years ago that was corrected is a very different fact from an uncorrected immediate-jeopardy finding last month. Always look at two things together: how severe the finding was, and how recent. A single old, corrected, low-severity citation is normal. A pattern of recent, serious, repeated findings is what deserves your attention.
How many is normal?
There is no magic number. The national average is several citations per home, and a facility with zero is unusual. What matters more than the count is the severity mix and the trend. Ten low-level paperwork citations is a different picture than one actual-harm citation, even though the second home has fewer.
Staffing is reported separately, and it is not opinion
Alongside inspections, the government collects the actual hours nurses worked each day from facilities' payroll systems. This is stronger than the staffing estimates some ratings rely on, because it comes from payroll records. Look at nursing hours per resident per day, how the home compares with the state median, and the weekend gap, since many homes staff down on weekends.
Where to see it in plain English
You can look up any Medicare-certified nursing home free: search by name, city, or ZIP on the home page. The full official record is there at no cost, and we take no money from facilities.
Common questions
What does immediate jeopardy mean on a nursing home inspection?
Are nursing home inspection reports public?