How to read a nursing home inspection
Every nursing home that takes Medicare or Medicaid is inspected by its state on Medicare's behalf. Each problem inspectors find gets a letter from A to L. Here's how to read them.
When inspections happen
A full "standard" inspection happens roughly once a year — federal rules allow up to 15 months between them, and a state-wide average of 12. Inspectors arrive unannounced and stay several days. They also visit to investigate complaints, and fire-safety inspectors check the building separately.
What the letters mean
Each finding (Medicare calls it a deficiency or a citation) is graded on two things: how serious it was, and how many residents it affected or could have affected.
| How serious | One or a few residents | A pattern | Widespread |
|---|---|---|---|
| Immediate jeopardySerious injury, harm or death happened or was likely | J | K | L |
| Residents were harmedActual harm, short of immediate jeopardy | G | H | I |
| Risk of harmNo one was hurt, but more than minimal harm could have followed | D | E | F |
| Minimal riskPotential for no more than minimal harm | A | B | C |
Most findings across the country are D, E or F. Findings of G or above are much less common, and they are the ones we list in full at the top of each nursing home's page.
Reading a finding
- The tag (for example, F 0689) is the federal rule the home didn't meet. F-tags are health and care rules; K-tags are fire safety; E-tags are emergency preparedness.
- Complaint investigation means the finding came from a visit made because someone reported a problem.
- Disputed means the home has challenged the finding through the official dispute process. We still show it, and say so, until the dispute is decided.
- Corrected is the date the home told inspectors the problem was fixed, in its plan of correction. Inspectors may or may not have revisited to check.
Putting it in context
- One D finding at a large home is ordinary. A pattern of G-level findings, or the same problem cited again and again, is worth asking about.
- Look at the dates. A home with problems three years ago and clean recent inspections may have changed — and so may a home that was sold since.
- Compare homes in the same state only. States inspect differently, and Medicare's star ratings are graded on a curve within each state.
Where to read the full report
Every nursing home must keep its most recent inspection results where residents and visitors can read them, and must tell you where they are. The full reports, called Statements of Deficiencies (form CMS-2567), describe what inspectors saw. In North Carolina many are posted on the Division of Health Service Regulation's site; each home's page here links to them where we have them.