A nursing home inspection report is the document behind every star rating, and it tells you far more than the rating does. Federal surveyors visit each certified facility and record every requirement it failed to meet. Nationally, 134,665 health deficiencies are recorded across 14,666 facilities in the current CMS data. This guide explains how to read one.
- What a Nursing Home Inspection Report Contains
- Scope and Severity: The Grid That Matters Most
- What a Nursing Home Inspection Report Says About Revisits
- Complaint Findings Versus Routine Findings
- What the Report Cannot Tell You
- How Often Inspections Happen
- Using the Report When You Tour
- Reading Several Reports Together
- Frequently Asked Questions
- Official Sources
- Related Guides
What a Nursing Home Inspection Report Contains
Two kinds of inspection produce a nursing home inspection report. A standard survey is the routine, unannounced comprehensive inspection every certified facility receives. A complaint investigation happens when someone reports a specific problem, and it looks only at that allegation.
Both fill a nursing home inspection report with deficiencies. Each deficiency is tied to a specific federal requirement, cited by tag number, and described in the surveyor’s own words — usually including what was observed, what the facility’s own records showed, and what staff said when asked.
The narrative of a nursing home inspection report is the part most people skip and the part worth reading. A citation summarised as a care-planning failure might describe, in the full text, a resident who went without a prescribed treatment for days. The summary line rarely conveys that.
Scope and Severity: The Grid That Matters Most
Every deficiency in a nursing home inspection report carries a letter from A to L. That letter is the single most useful thing in the report, because it encodes both how serious the problem was and how many residents it touched.
| Letters | What it means | How to read it |
|---|---|---|
| A, B, C | No actual harm, potential for minimal harm | Administrative or minor; common and rarely alarming on its own |
| D, E, F | No actual harm, potential for more than minimal harm | The most common band. A pattern here is worth attention |
| G, H, I | Actual harm occurred | A resident was harmed. Read the narrative in full |
| J, K, L | Immediate jeopardy to health or safety | The most serious finding CMS issues. Requires immediate correction |
Within each band, the first letter means an isolated incident, the second a pattern, and the third a widespread problem. So an F is a widespread issue with potential for harm, while a G is actual harm to one resident. Neither is automatically worse than the other — they measure different things.
When you read a nursing home inspection report, look first for anything in the G to L range, then for repeated findings in the D to F band across multiple inspections. A single citation is normal. A pattern repeating year after year is the signal.
What a Nursing Home Inspection Report Says About Revisits
A deficiency in a nursing home inspection report is not the end of the story. The facility submits a plan of correction, and surveyors return to verify it. The revisit record shows whether the fix held.
Repeat visits are meaningful. A facility cited once that corrects the problem and passes its revisit is in a different position from one cited for the same failure across three consecutive inspection cycles. The nursing home inspection report shows both.
Complaint Findings Versus Routine Findings
A nursing home inspection report tracks complaint-driven deficiencies separately from those found on routine surveys, and the distinction is informative. Routine findings reflect what surveyors noticed on a scheduled visit. Complaint findings reflect what somebody cared enough to report, and they were substantiated by an investigator.
Nationally, 1,140 infection-control citations appear in the current data. Infection control has been one of the most frequently cited areas in recent years, which is worth knowing before you interpret a facility as unusual for having one.
What the Report Cannot Tell You
A nursing home inspection report is a snapshot taken on specific dates. It describes what surveyors observed then, under that management and that staffing. Nationally 1,023 facilities — 7% of the total — have not had a standard health inspection in more than two years, so the report you are reading may describe a building that has since changed hands.
It also cannot tell you how a place feels. Whether call lights get answered promptly, whether staff know residents by name, whether the dining room is calm at six in the evening — none of that appears in a citation. Read the report, then visit, more than once and at different hours.
How Often Inspections Happen
Every certified facility is meant to receive a standard survey roughly once a year, with the interval varying somewhat by state and by the facility’s history. Complaint investigations happen whenever an allegation warrants one, which is why some facilities have several inspection events in a year and others have none.
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The gap between intention and practice is large. Nationally 1,023 facilities are flagged as not having had a standard health inspection in more than two years. Before you weigh a nursing home inspection report heavily, check the date on it.
Facilities in the Special Focus Facility program are the exception in the other direction. They are surveyed roughly twice as often as normal, so their reports are both more recent and more numerous.
Using the Report When You Tour
The most useful thing you can do with a nursing home inspection report is take it with you. Pick two or three specific findings and ask the administrator directly what changed afterwards.
The answer tells you a great deal. A facility that can describe precisely what it altered — a staffing pattern, a protocol, a piece of equipment — is engaging with the problem. A facility that dismisses citations as paperwork, or seems surprised the report is public, is telling you something else.
Ask also about anything cited in the actual-harm band. Those findings carry names and dates in the narrative, and a facility should be able to explain what happened without defensiveness.
Reading Several Reports Together
One nursing home inspection report is a snapshot. Three consecutive ones are a trend, and the trend is the more useful object.
Look for whether the same tag numbers recur. A facility cited for the same failure in three straight cycles has a systemic problem that survived two rounds of correction plans. A facility with different minor findings each time is more likely experiencing ordinary variation.
Also compare the total against the state. Deficiency counts vary by state because survey practices differ, so a facility with eight findings in a strict state may be performing better than one with four in a lenient one.
Frequently Asked Questions
Where do I find a nursing home inspection report?
On Medicare’s Care Compare tool. Search the facility, open its listing, and look for the inspection or health citations section. The full surveyor narrative is available there at no cost.
How many deficiencies is normal?
Most facilities have some. Across the country the current data records 134,665 health deficiencies in total. What matters is severity and repetition rather than the raw count — several minor findings are less concerning than one finding of actual harm.
What is an immediate jeopardy citation?
It is the most serious category CMS issues, covering situations where a facility’s failure placed residents at risk of serious injury, harm or death. It requires immediate correction and often triggers enforcement action.
Do inspection reports show whether problems were fixed?
Yes. Each deficiency has a plan of correction and a revisit record showing whether surveyors verified the fix. A facility that corrects and sustains is in a different position from one cited repeatedly for the same issue.
Official Sources
- Medicare Care Compare — ratings, full inspection reports and penalty history for every certified facility
- CMS Provider Data Catalog — the underlying federal dataset behind the figures on this page
- National Consumer Voice — state Long-Term Care Ombudsman directory
Related Guides
- Nursing Home Ratings by State — All 50 States
- Nursing Home Ratings in Every State
- Special Focus Facility: What the Designation Means
- CMS Five Star Rating: How It Actually Works
- How to File a Nursing Home Complaint
- Nursing Home Staffing and Turnover Explained
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About this information. Figures on this page are reproduced from the federal CMS Provider Data Catalog dataset processed 2026-07-01, without adjustment. CMS ratings are comparative measures updated periodically. Nothing here establishes that any facility caused harm to any resident, and nothing here is legal or medical advice. Confirm any facility’s current standing with CMS, and contact your state Long-Term Care Ombudsman or survey agency with concerns about a resident.