Choosing a Facility
Nursing Home Inspection Reports: How to Read Them
How Do You Read a Nursing Home Inspection Report?
Nursing home inspection reports list every federal rule inspectors found a home breaking, with a letter from A to L that shows how serious and how widespread each problem was. Focus on citations at G or higher, where residents were harmed or put in immediate jeopardy, and on whether the home corrected them. Every certified home must post its latest report and show you three years of reports on request; you can also read them on Medicare's Care Compare.
Star ratings tell you how a nursing home compares with others. The inspection report tells you what actually happened there. It’s the most detailed public record of a home’s care, and reading even one recent report can change which homes stay on your list.
What a Nursing Home Inspection Is
Every nursing home that takes Medicare or Medicaid gets a standard inspection, called a survey, from its state survey agency. Inspections are unannounced. A team of health care professionals spends several days in the building, watching care, talking with residents and staff, and reviewing records. They check residents’ rights, quality of life, medication management, skin care, resident assessments, administration, the building, and the kitchen and food service.
Federal rules set the timing:
- Standard inspections must happen no later than 15 months after the last one, and the statewide average must be 12 months or less.
- Complaint investigations happen whenever a complaint suggests a home may be breaking a federal rule and only an inspection can tell.
- Special inspections can follow within 60 days of a change in owner, management company, administrator or director of nursing.
Fire safety is checked in a separate life safety inspection. It doesn’t count toward the star rating, but it is part of the public record.
Where to Find Nursing Home Inspection Reports
You have three places to look:
- On Medicare’s Care Compare. Each nursing home profile has an inspections section listing citations from recent standard inspections and complaint investigations. The nursing home finder links every home to its Care Compare page.
- In the nursing home. A certified home must post the results of its most recent inspection where residents and families can easily see them, and post a notice that more reports are available.
- On request. The home must let anyone review its inspection, certification and complaint reports from the past three years, along with any plan of correction in effect.
The full federal report is the Statement of Deficiencies, CMS Form 2567. It lists each citation, the rule broken and what inspectors found. The home may not share information that identifies residents or the people who filed complaints. You can also ask your state survey agency for the full report of the last standard inspection or complaint investigation.
When you open a citation, read it in this order:
- The letter. Find it first, so you know how serious the finding was before you read the details.
- The summary of the rule. This tells you what the home was supposed to do, such as protect residents from falls or give medicines as ordered.
- What inspectors found. This part describes, without names, what inspectors saw happen to residents. It is often the most revealing part of the report.
- The dates. Check when the inspection happened, and whether a later inspection found the same problem again.
How to Read the Severity Letters
Every citation carries a letter from A to L. The letter combines two things: how serious the problem was (rows) and how many residents it affected or could affect (columns).
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy to resident health or safety | J | K | L |
| Actual harm, not immediate jeopardy | G | H | I |
| No actual harm, potential for more than minimal harm | D | E | F |
| No actual harm, potential for minimal harm | A | B | C |
How to use the grid:
- A to C are minor. A home doesn’t even have to file a plan of correction for an isolated, minimal-harm citation.
- D to F are the most common citations. No one was hurt, but the problem could have caused harm. A cluster of E and F citations in the same area, such as infection control or medication handling, suggests a habit rather than a slip.
- G to I mean residents were actually harmed. Read these in full.
- J to L mean immediate jeopardy: the home’s failure caused, or was likely to cause, serious injury, harm, impairment or death.
CMS says most nursing homes have some deficiencies, with an average of six to seven per standard health inspection. A home with a handful of D and E citations is normal. A home with repeated G-level or higher findings is not.
Citations to Read Closely
Each citation names a federal rule by its tag number. You don’t need to memorize them, but a few deserve special attention when you read a report:
- Abuse and neglect tags. CMS’s abuse icon on Care Compare is triggered by citations under F600 (protecting residents from abuse and neglect), F602 (misappropriation of residents’ belongings or money) and F603 (involuntary seclusion). In August 2026 data, 1,426 homes carried the abuse icon.
- Care problems that touch your parent’s needs. If your parent is at risk of falls, pressure ulcers or weight loss, look for citations about those areas.
- Medication and psychotropic drugs. Citations about unnecessary drugs or antipsychotics matter most for a parent living with dementia. The antipsychotics guide explains the rules.
- Staffing. Citations for not having enough staff or not posting daily staffing are worth asking about. The staffing guide shows what to check.
Note the dates. A serious citation from three years ago, followed by clean inspections, tells a different story from one last month.
No Fines or Payment Denials: Nursing Homes by State
CMS Care Compare lists 7,915 nursing homes in this group (no fines or payment denials) across 52 states and territories, data from August 2026. Pick a state for its nursing homes, cities and senior care rules.
What Happens After a Home Is Cited
A citation starts a process, and the report shows where the home is in it.
Plan of correction. Except for isolated, minimal-harm citations, the home must submit a plan of correction for approval, explaining how it fixed the problem and how it will prevent it from happening again. Inspectors may return to confirm. Homes that need a second, third or fourth revisit to prove a fix lose more ground in the CMS star rating.
Penalties. For serious or uncorrected problems, CMS or the state can impose remedies, including:
- civil money penalties (fines);
- denial of payment for new admissions, or for all residents;
- a directed plan of correction or directed staff training;
- state monitoring or temporary management;
- transfer of residents, closure, or termination from Medicare and Medicaid.
In August 2026 data, 7,915 of 14,690 nursing homes had no fines or payment denials on record. A fine doesn’t mean a home is unsafe today. It means CMS recorded a serious finding, and the report explains what it was.
Disputes. A home can challenge a citation through informal dispute resolution. CMS shows disputed citations on Care Compare but leaves them out of the star rating until the dispute ends.
Special Focus. Homes with a long history of serious problems may be chosen for the Special Focus Facility program and inspected at least every six months. In August 2026 data, 525 homes were in the program. A home graduates after two straight standard inspections with 12 or fewer citations, none above level E.
How Inspection Reports Feed the Star Rating
The inspection report is the base of the CMS overall rating. CMS scores citations from the two most recent standard inspections and three years of complaint and infection control inspections, giving more weight to recent findings and more points to higher letters. It then ranks homes within each state. In August 2026 data, 4,953 homes had 4 or 5 stars for health inspections.
Two homes with the same stars can have very different reports, so read the citations, not just the rating. The star ratings guide explains the full formula.
Questions to Ask After You Read the Report
Bring the report to your tour and ask about what you found. Medicare’s checklist asks whether the report shows quality of care problems, whether the home corrected every deficiency on its last inspection, and whether it passed its most recent safety and fire inspections.
Good follow-up questions:
- What happened in the most serious citation, and what did you change?
- Has the same problem been cited more than once?
- Did a complaint investigation lead to any citation this year?
- Have the administrator or director of nursing changed since the last inspection?
- Can I see the plan of correction?
A home that answers openly and shows you the plan of correction is giving you useful information. The how to choose a nursing home guide has the rest of Medicare’s checklist.
When You See a Problem Yourself
If your parent is in immediate danger, call 911. For other concerns:
- File a complaint with the state survey agency. This is the office that inspects nursing homes, and it must investigate complaints that may show a federal rule was broken. CMS publishes a list of each state’s complaint page. Your state page covers each state’s long-term care contacts.
- Call the Long-Term Care Ombudsman. Ombudsman programs work in every state to resolve complaints made by or for residents. The residents’ rights and ombudsman guide explains how they help.
- Know the warning signs. The abuse and neglect guide lists what to watch for and how to report it.
Who Pays, and Why the Report Still Matters
Inspection results apply the same way whoever pays. Medicare covers short-term skilled stays, and long-term care is paid by Medicaid, private funds, long-term care insurance or VA benefits. If your parent will rely on Medicaid, you may have fewer homes with an open bed, which makes each report more important. The guide to paying for a nursing home and the Medicaid eligibility guide explain the options.
To read reports for homes near you, search the nursing home finder or start with a large city such as Houston, Brooklyn or Indianapolis, and compare up to three homes with the Nursing Home Comparison tool.
Frequently Asked Questions
How Often Are Nursing Homes Inspected?
Federal rules require the state survey agency to inspect each certified nursing home no later than 15 months after its last standard inspection, and the statewide average must be 12 months or less. Inspections are unannounced. States also investigate complaints, and may inspect within 60 days after a change of owner, management company, administrator or director of nursing.
Is It Normal for a Nursing Home to Have Deficiencies?
Yes. CMS says most nursing homes have some deficiencies, with an average of six to seven per standard health inspection. What matters is the severity. A short list of A to F citations is common; repeated G-level or immediate jeopardy citations deserve close questions.
Does a Citation Mean Someone Was Hurt?
Not always. Citations at levels A through F mean no resident was actually harmed, though D through F carried potential for more than minimal harm. Levels G through I mean actual harm, and J through L mean immediate jeopardy, where noncompliance caused or was likely to cause serious injury, harm, impairment or death.
Can a Nursing Home Dispute an Inspection Finding?
Yes, through informal dispute resolution. CMS displays citations under dispute on Care Compare but leaves them out of the inspection rating until the dispute is settled. If the dispute changes the severity, the rating can change too.
Are Fire Safety Inspections Part of the Star Rating?
No. Life safety (fire safety) inspections are separate, and CMS doesn't include them in the Five-Star rating. Medicare's checklist still suggests asking whether the home passed its most recent safety and fire inspections.
How Do I Report a Problem at a Nursing Home?
If someone is in immediate danger, call 911. Otherwise, file a complaint with your state survey agency, the office that inspects nursing homes; CMS publishes each state's complaint page. The Long-Term Care Ombudsman can also help resolve problems on a resident's behalf.
More on Choosing a Facility
- Choosing a Nursing HomeRatings, inspections, staffing and the questions to ask on a visit
- Star Ratings ExplainedWhat each Care Compare star rating measures and its limits
- Staffing and TurnoverNurse staffing hours, turnover and the federal staffing data
- Antipsychotic UseThe FDA warning for dementia, CMS's measure and what to ask
- Abuse Warning SignsWarning signs, CMS's abuse icon and who to call
- Residents' RightsFederal residents' rights and the free ombudsman program
This guide explains long-term care in plain language from official sources. It isn't medical, legal or financial advice; a doctor, your state Medicaid agency or an elder law attorney can advise on your situation.
Sources
- eCFR: 42 CFR 488.308, Survey frequency
- eCFR: 42 CFR 488.301, Definitions
- eCFR: 42 CFR 488.402, Plan of correction and notice
- eCFR: 42 CFR 488.406, Available remedies
- eCFR: 42 CFR 483.10, Resident rights
- CMS: Nursing Home Five-Star Quality Rating System, Technical Users' Guide (September 2026)
- CMS: Special Focus Facility Program with candidates list (September 2026)
- CMS: Contact information for filing a complaint with the state survey agency
- Medicare.gov: Nursing home checklist
- CMS: Five-Star Quality Rating System
- Medicare.gov: Your guide to choosing a nursing home (CMS Product No. 02174)
- Medicare.gov: Long-term care
- ACL: Long-Term Care Ombudsman Program
- CMS Provider Data Catalog: Nursing Home Provider Information (August 2026)