What a nursing home inspection citation means
By ParentNextStep Editors · Updated October 14, 2026
Inspectors cite nursing homes for problems all the time. Here's how to tell a minor citation from a serious one, and what happens after a home is cited.
Who inspects nursing homes, and how often
State inspectors check every Medicare- and Medicaid-certified nursing home against federal requirements on Medicare's behalf. Each home gets a full standard inspection at least every 15 months, and every 12 months on average across a state. Inspectors also come after complaints from residents, families or staff.
What a citation is
When inspectors find that a home didn't meet a requirement, they cite it. Each citation has a tag: health tags start with F (F689, for example, covers keeping the home free of accident hazards and supervising residents to prevent accidents). Our pages show Medicare's short description of each requirement, not the inspectors' full notes; the full report is on Medicare's Care Compare.
Citations are common: in Medicare's latest data, nursing homes averaged 9.2 health citations at their most recent standard inspection. What matters most is how serious they were.
How serious: the A to L grade
Every citation gets a letter for two things at once: how much harm it caused or could cause, and how many residents it affected. Care Compare shows the same grade as a level of harm and “residents affected” (few, some or many).
| Level of harm | Few residents | Some | Many |
|---|---|---|---|
| 1. Potential for minimal harm | A | B | C |
| 2. Minimal harm or potential for actual harm | D | E | F |
| 3. Actual harm | G | H | I |
| 4. Immediate jeopardy to resident health or safety | J | K | L |
Most citations are D or E: no one was hurt, but residents could have been. G and above mean a resident was actually harmed. J, K and L are immediate jeopardy: a failure that caused, or was likely to cause, serious injury, harm, impairment or death. Our pages mark actual harm and immediate jeopardy in red.
What happens after a citation
For every citation above the lowest level, the home must send a plan of correction within 10 days of receiving the inspectors' report, saying what it will fix and by when. Inspectors may come back to check. Serious or repeated problems can bring fines, or Medicare can stop paying for new admissions for a time; our pages list both as fines and payment denials.
How citations affect the star rating
Medicare turns citations into points, more for higher grades (from none for A, B or C to 150 for L), weighting recent inspections more. Those points decide the health inspection rating, which is the starting point for the overall rating. See how to read a nursing home's star ratings.
What to do with this
- Look at the grades, not just the count: one G or J says more than several Ds.
- Look for patterns: the same kind of citation at more than one inspection.
- Ask the home about any serious citation on your visit: what happened and what changed.
Every nursing home page here lists its latest standard inspection and three years of complaint citations, and every city page lists the most recent problems across its homes. Start with nursing homes by state: