March 13, 2026 – The Long Term Care Community Coalition is pleased to release two new data reports:  Nursing Home Citations and Nursing Home Penalties. These user-friendly datasets allow consumers to identify when their facility has been cited for failing to meet minimum standards and enable journalists, policymakers, and researchers to identify patterns in deficiencies, harm-level citations, and enforcement actions across states and regions.

These reports are derived from federal provider databases which cover approximately three years of oversight activities. They include a wide range of violations, from failure to report resident abuse and neglect to failure to implement effective infection control protocols. Fines ranged from $344 to $713,795.

Nursing Home Citations:

This dataset provides information on the deficiencies (citations) for identified failures to meet minimum standards, including:

  • Date of Citation
  • Category of Citation (F-tag, indicating the requirement which the facility failed to meet)
  • Level of Scope and Severity (state surveyors use a Scope & Severity Matrix to identify the extent to which – if any – a deficiency harmed residents. This is important because, in the absence of a surveyor finding of resident harm or immediate jeopardy, it is extremely unlikely that a facility will face any penalty for the violation).

Key findings (past three years):

  • Total Deficiencies: 419,400
  • Harm-Level Deficiencies (scope & severity of G or above): 23,830 (5.7%)
  • Immediate Jeopardy Deficiencies (scope & severity of J or above): 10,041 (2.4%)
  • Nevada has the lowest rate of harm citations (1.6%) while South Dakota has the highest (14.0%).

Nursing Home Penalties:

This dataset provides detailed information on fines and payment denials received by nursing homes in the past three years, including:

  • Number of Fines
  • Total Fines in Dollars
  • Total Payment Denials (Denial of Payment for New Admissions (DOPNA) is an enforcement mechanism in which the federal government refuses to pay for new admissions to a facility due to noncompliance with federal minimum standards. Because most nursing home income comes from Medicare and Medicaid, DOPNA can be a formidable tool for getting a facility to comply with federal requirements).

Key findings (past three years):

  • Total Fines Nationwide: $480 million
  • Average Fine: $32,364
  • Total Number of Payment Denials: 2,627.

The data also highlight major disparities in enforcement across states and regions:

  • Texas nursing homes received the highest total fines ($65 million) while Vermont facilities had the highest amount per fine ($80,000).
  • Alaska imposed the lowest total fines of any state ($492,000) and South Carolina was lowest in respect to dollars per fine ($14,000).

Payment denials – as noted above, one of the strongest enforcement tools available to regulators – remain relatively rare compared to fines, raising questions about whether the most effective penalties are being used consistently when nursing homes provide substandard care.

For more information and insights:

Note: LTCCC’s deficiencies and penalties datasets are based on data published by the federal Centers for Medicare & Medicaid Services (CMS). CMS Health Deficiencies: https://data.cms.gov/provider-data/dataset/r5ix-sfxw. CMS Penalties: https://data.cms.gov/provider-data/dataset/g6vv-u9sr.