How to read a nursing home inspection record

What inspection findings mean: the four severity levels from A to L, how widespread a problem was, why the count alone misleads, and what fines show.

What an inspection is

Inspectors visit every Medicare-certified nursing home about once a year and also after complaints. Each requirement the home did not meet is written down as a finding, also called a deficiency.

Severity: four levels

Every finding gets a letter from A to L. A to C mean no harm and little risk. D to F mean no harm, but a risk of more than minimal harm. G to I mean a resident was actually harmed. J to L mean immediate jeopardy, the most serious level.

Scope: how many residents

The same letter also tells how far the problem went: an isolated case, a pattern, or widespread.

Why the count alone misleads

Large homes usually have more findings than small ones. One finding with actual harm matters more than ten findings about paperwork. Read what each finding was about.

Fines and payment denials

For serious or repeated problems Medicare can fine a home or stop paying for new admissions for a time. We list both for the last three years.

Corrections

Most findings show the date by which the home corrected the problem. If there is no date, ask the home about it.

Find a home

Guides

Nursing home or assisted living in California: what is the difference

Nursing homes give 24-hour nursing care and are inspected for Medicare. Assisted living helps with daily life and is licensed by the state. How they differ and how to check each.

How to choose a care home in California: a short checklist

Six steps for families: decide the kind of care, make a short list, read the official record, call, visit more than once, and check the agreement before signing.