Every nursing home that takes Medicare or Medicaid is inspected by its state survey agency on behalf of CMS. The findings are public. Here is how to read them on this site.
Kinds of inspections
Standard health inspections are unannounced visits that look at resident care, rights, food, medications, cleanliness and more. Federal rules require one at least every 15 months for each nursing home, with a statewide average of about 12 months. Complaint inspections happen when someone reports a problem. Some findings come from infection control inspections. Each deficiency on a nursing home page says which kind of inspection found it.
What a deficiency is
A deficiency, also called a citation, means inspectors found the nursing home did not meet a federal requirement. Each one carries a tag: a letter and number that point to the regulation. Health tags start with F. For example, F0921 is described in the CMS file as: "Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public." The short descriptions on this site are the ones CMS publishes. The full written inspection report, with what inspectors saw, is available from the nursing home, the state survey agency, or Medicare's Care Compare site.
Scope and severity
Each deficiency gets a letter from A to L. The letter combines two things: how serious the harm or risk was (rows) and how many residents were or could be affected (columns). Counts are deficiencies cited in Texas and Florida nursing homes since Sep 30, 2023, from the CMS file released Sep 30, 2026.
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy to resident health or safety | J 1,565 cited | K 761 cited | L 62 cited |
| Actual harm | G 577 cited | H 84 cited | I 1 cited |
| No actual harm, potential for more than minimal harm | D 22,611 cited | E 10,321 cited | F 1,369 cited |
| No actual harm, potential for minimal harm | A 0 cited | B 159 cited | C 315 cited |
Few deficiencies in this file are at A to C, and A does not appear at all; most are at D or E. Letters G to L mean inspectors found that residents were actually harmed or were in immediate jeopardy. Those deserve the closest reading, and a question to the nursing home about what changed.
Was it fixed?
The status column repeats what CMS records about correction. In the Texas and Florida records since Sep 30, 2023, the statuses are:
| Deficient, Provider has date of correction | 36,595 |
|---|---|
| Past Non-Compliance | 863 |
| Deficient, Provider has no plan of correction | 196 |
| Deficient, Provider has plan of correction | 160 |
| Waiver has been granted | 9 |
| No revisit needed | 2 |
"Past non-compliance" means the problem had already been corrected by the time of the inspection. A citation marked as under informal dispute resolution (IDR or IIDR) is one the nursing home is formally disputing.
How the star ratings relate
The health inspection star rating is based on inspection results, including how many deficiencies were cited and how serious they were. The overall rating starts from it. CMS adds one star if the staffing rating is 5 stars and takes one away if it is 1 star; then adds one star if the quality measure rating is 5 stars and takes one away if it is 1 star. A nursing home with a 1-star health inspection rating can move up by no more than one star. The result stays between 1 and 5. We checked this rule against the Sep 30, 2026 file: it reproduces the overall rating of all 14,565 nursing homes that have both an overall and a health inspection rating.
That is why the health inspection rating weighs most: staffing and quality measures can move the overall rating at most two stars away from it, and only one star up when the inspection rating is 1 star.
Questions worth asking on a visit
- What was cited at the last inspection, and what did you change?
- How many nurses and aides work on each shift, including nights and weekends?
- How long have the director of nursing and the administrator been here?
- Can I see the most recent full inspection report? (Nursing homes must make it available.)
Visiting more than once, at different times of day, tells you things no dataset can. The resident's doctor can help weigh what you find.