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CMS NH DeficienciesCMS NH Health Deficiencies (per-citation)
U.S. Centers for Medicare and Medicaid Services · Tier-1 · research-only (never on individual profiles)
~419,400 individual deficiency citations across ~14,700 Medicare-certified nursing homes — each with scope (B–L) + severity letter, F-tag taxonomy, deficiency category, and Survey Event ID. NH Penalties dataset joins via Survey Event ID and exposes ~$480M in cumulative civil-money penalties.
How this source shows up on Fonteum.
Drives the brand-hub `/deficiencies` surface. Per-citation transparency layer; NH Penalties sub-join surfaces in audit-pack export only.
What this source does NOT mean
Citation rate is NOT a facility-quality signal at state aggregate. The 9× SD-vs-NV state-survey-rigor disparity is the dominant signal — methodology MD frames this explicitly.
Research and data questions this source supports.
- Build a nursing home deficiency heat map by state showing which states have the highest rates of Actual Harm (G-level and above) citations.
- Surface a facility's full deficiency history — citation category, date, scope/severity, and regulatory basis — on Care Compare brand-hub pages.
- Cross-reference deficiency data with CMS star ratings to identify facilities with high star ratings but recent serious citations.
- Power a regulatory compliance study that tracks deficiency trends over time for facilities under the same ownership chain.
- Build an automated flag system that alerts payers or referral managers when a contracted nursing home receives a new G+ deficiency citation.
Dataset size: 418,148 citation records (3-year dataset, 14,635 facilities)
Per-field display contract.
Every field below has a `display_allowed` flag in the §94 provenance schema. Write-locked fields are captured to provenance for audit but never rendered on profile pages.
Renders on profile
5 fieldsWhat we can’t infer from this source.
- 9× SD-vs-NV citation-rate disparity is a state-survey-system signal, not a facility-quality signal.
- iQIES July 2025 migration changed legacy schema; pre/post-migration citations not directly comparable for some F-tags.
- CMS February 2026 schema change removed complaint-allegation counts.
- F-tag definitions changed for some categories (e.g., F689 falls expanded January 2017); time-series comparison requires explicit cohort flagging.
Authority, license, refresh cadence.
Authority
U.S. Centers for Medicare and Medicaid Services
Tier
Tier-1 · research-only (never on individual profiles)
Refresh cadence
Quarterly (citation backlog ~6 months; iQIES July 2025 migration affected legacy schema; CMS February 2026 schema change removed complaint-allegation counts).
License
U.S. government public-domain works (17 U.S.C. § 105). Attribution required: 'Source: CMS NH Health Deficiencies · Snapshot {YYYY-MM-DD}'. License ↗
Attribution requirement
Source: CMS NH Health Deficiencies · Snapshot {YYYY-MM-DD}
What the source allows.
U.S. government public-domain works. PDC publishes the dataset at data.cms.gov with explicit redistribution rights.
What a single field looks like in the graph.
A worked example. Every field surfaced from this source carries this shape of provenance line — source · last checked · display rule · confidence (when applicable).
Field
Per-citation row (display)
Sample value
F689 falls · scope/severity G · 2025-08-12 survey · facility CCN 015XXX
Provenance line
Source: CMS NH Health Deficiencies · Snapshot {YYYY-MM-DD} · Display rule: per-citation F-tag + scope/severity + survey-date render on /deficiencies module + per-facility pages
Official API, bulk download, and Fonteum endpoints.
Official API / download
Fonteum surface
Common questions about CMS NH Deficiencies.
- What is the CMS Nursing Home Health Deficiencies dataset?
- The CMS Care Compare Nursing Home Health Deficiencies dataset contains every deficiency citation issued to Medicare- and Medicaid-certified nursing homes by state survey agencies during CMS-mandated health inspections. Each row represents one citation and includes: CCN, facility name, survey date, deficiency tag (F-tag), scope (isolated/pattern/widespread), severity (potential harm through immediate jeopardy), regulatory citation, and correction status.
- What are the scope and severity levels for nursing home deficiency citations?
- CMS uses a scope-severity grid ranging from A (isolated, no actual harm) to L (widespread, immediate jeopardy). Fonteum's nursing home deficiency study found that G+ citations (Actual Harm and above) represent 5.59% of all citations nationally. The most severe levels — Immediate Jeopardy (J, K, L) — trigger mandatory enforcement actions including civil monetary penalties and temporary management.
- What is an F-tag and how are nursing home deficiencies categorized?
- An F-tag (regulatory tag) is the CMS code identifying the specific regulatory requirement that was violated. F-tags are organized by CFR subpart: resident rights (F550–F600), quality of care (F675–F699), pharmacy services (F755–F800), physical environment (F800–F835), and others. Fonteum's deficiency surface groups F-tags by regulatory category to enable pattern analysis across facilities.
- How often does the CMS nursing home deficiency data update?
- The CMS Nursing Home Health Deficiencies dataset is updated quarterly as new inspection cycles complete. Fonteum pulls the quarterly update and attests the SHA-256 hash to the provenance chain. Individual facility pages on Care Compare reflect citations from approximately the past 3 years.
- What is the Fonteum Nursing Home Deficiency and Harm Rate study?
- Fonteum's published research study on nursing home deficiency and harm rates covers 418,148 citations across 14,635 facilities in a 3-year dataset. Key findings: 5.59% G+ citation rate nationally; Illinois has 4.57 G+ citations per facility versus New Hampshire's 0.31 — a 14.7x disparity. The full study and methodology are at fonteum.com/research/nursing-home-deficiency-harm-rate-2026.
Where this source already shows up.
Related sources in the graph
- /sources → The full source library — every dataset Fonteum cites.
- /data-provenance → The provider graph — pipeline diagram, source-family clusters, field-level provenance examples, display rules.
- /methodology → Network-wide sourcing, refresh cadence, and corrections policy.
- /editorial-policy → Independence, sourcing, conflicts, corrections, retractions.