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How to read a nursing home inspection
Every citation carries one letter from A to L. The letter says two things: how much harm inspectors found, and how many residents it touched.
The grid
Rows are severity, from the most serious at the top. Columns are scope. The share under each letter is every health citation in CMS's current file (418,947 citations, data as of September 1, 2026).
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
J1.6%
K0.5%
L0.1%
Actual harm
G3.1%
H0.1%
I0.0%
Potential for more than minimal harm
D63.2%
E22.3%
F6.9%
Potential for minimal harm
A0.0%
B1.1%
C1.1%
Severity
- Immediate jeopardy (J, K, L): Residents were harmed or at serious risk of injury, harm or death, and it needed fixing at once.
- Actual harm (G, H, I): At least one resident was hurt, but not at the level of immediate jeopardy.
- Potential for more than minimal harm (D, E, F): No one was found hurt, but the problem could cause more than minor harm. Most citations fall here.
- Potential for minimal harm (A, B, C): A problem that could cause only minor harm.
Scope
- Isolated: one or a very few residents or staff
- Pattern: more than a few, in more than one place
- Widespread: throughout the home
Other words on a citation
- Complaint inspection: a visit triggered by a complaint, outside the regular standard inspection.
- Infection control inspection: a focused visit on infection prevention.
- Corrected: the home gave a date by which it fixed the problem, and the state accepted its plan.
- Past noncompliance: found and fixed before the inspection.
- Disputed: the home challenged the citation through informal dispute resolution.
Common questions
- What does a J, K or L citation mean?
- It is immediate jeopardy, the most serious level: inspectors found residents were harmed or at serious risk of injury, harm or death. J affects one or a few residents, K a pattern, L the whole home.
- What is past noncompliance?
- A problem the home had already found and fixed before inspectors arrived. It is still cited, and still counts, but the home was in compliance by the time of the visit.
- What is an F-tag?
- The federal requirement a citation is filed under. F689, for example, covers accident hazards and supervision; F880 covers infection prevention and control.
Source: CMS State Operations Manual, chapter 7 (survey and enforcement process), and the CMS Health Deficiencies file.