Everything published on this site is derived from federal public-records data released by the Centers for Medicare & Medicaid Services (CMS) on a quarterly cadence. We do not add, infer, or speculate beyond what CMS itself publishes. This page explains how to read the resulting pages — what the numbers mean, and what they do not mean.
Severity and scope
Every citation carries a single scope/severity letter from A through L that encodes two independent axes used by federal surveyors:
- Severity — levels 1 through 4: potential for minimal harm, no actual harm but more than minimal potential, actual harm, and Immediate Jeopardy.
- Scope — Isolated, Pattern, or Widespread.
Letters J, K, and L are Immediate Jeopardy — the most serious classification CMS issues, indicating the facility's non-compliance has caused or is likely to cause serious harm, injury, or death to a resident.
Citations vs. penalties
A citation is a deficiency finding issued by a state survey team. A penalty is a separate federal enforcement action — a civil money penalty (fine) or a denial of Medicare/Medicaid payment. Citations attach at the deficiency level; penalties attach at the facility level. CMS does not publish a direct one-to-one mapping between a specific penalty and a specific citation, so this site never claims that a particular citation "caused" a particular fine.
What a citation is and is not
A citation is a finding by a state survey team working under contract to CMS. It records that at the time of inspection, the facility was not meeting a specific federal standard. It is not a court judgment, a criminal charge, or an admission of wrongdoing. Facilities may contest citations through the federal Informal Dispute Resolution (IDR) and Independent IDR (IIDR) processes.
Limitations to keep in mind
- Federal data is published on a quarterly cadence; there is always some lag between an event at a facility and its appearance on this site.
- A citation on record was already corrected in most cases by the time the data is published. Past citations do not necessarily describe current conditions.
- Severity is assigned by the state survey team at the time of the survey; similar findings may receive different letters in different states.
- Some facilities may have closed, changed ownership, or changed their certification since the most recent federal release. Real-time operational data is not available here.
Corrections
If a specific figure on this site does not match the federal public record, please contact corrections@nursinghomeviolations.com and we will reconcile the page at the next publication.
Related consumer resource: Medicare Care Compare.