Nursing Home Citations & Penalties
Citations and penalties show how often nursing homes break federal rules, how serious the violations are, and what happens when they do. Look up any U.S. nursing home to see its citations from the past three years and every fine and payment denial.
October 2026 enforcement data
Citations, fines and payment denials for 14,624 nursing homes.
Download the data
CMS last updated Oct 1, 2026 · Released Oct 28, 2026 · Downloaded Nov 9, 2026
All citations
Every health citation from the past three years, one per row, with tag, scope and severity, status and correction date.
All penalties
Every fine and payment denial from the past three years, plus a summary sheet with state and CMS region totals and ranks.
Citations summary
National, CMS region and state totals, with harm and immediate jeopardy rates and ranks, calculated by LTCCC.
What's in each file
Citations columns
State, CMS region, provider name, city, address, ZIP, CCN · survey date and type, inspection cycle · deficiency prefix, category, tag number and description · scope and severity code · corrected status and correction date · standard, complaint and infection control flags · IDR and IIDR flags · processing date.
Penalties columns
State, CMS region, provider name, city, address, ZIP, CCN · penalty date and type (fine or payment denial) · fine amount · payment denial start date and length in days · processing date.
Join the two files on CCN. Sources: CMS Provider Data, datasets r5ix-sfxw and g6vv-u9sr.
Enforcement by the numbers
Search citations & penalties
Look up any nursing home to see its citations, the serious ones in full, and every fine and payment denial. Or compare states side by side.
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State highlights
Where harm, immediate jeopardy and fines were highest. Compare every state under Compare states above.
Highest share: harm
- South Dakota14.1%
- Illinois11.9%
- Kentucky11.7%
- Utah11.3%
- U.S. average5.3%
Highest share: immediate jeopardy
- Kentucky7.2%
- Texas6.3%
- Alabama6.3%
- South Carolina6.1%
- U.S. average2.2%
Lowest share: harm
- Nevada1.6%
- Maine1.7%
- Maryland1.9%
Most in fines
- Illinois$72.6M
- Texas$50.6M
- California$27.2M
- Ohio$23.7M
- Missouri$17.9M
How to read a citation
Inspectors give each citation a letter from A to L. The letter combines severity (how badly residents were affected) with scope (how many residents were affected).
G or above means a resident suffered actual harm. J or above means immediate jeopardy: noncompliance that caused, or was likely to cause, serious injury, harm, impairment or death.
A citation's F-tag names the federal requirement that was violated, such as abuse prevention, infection control or sufficient staffing.
Why severity matters: it drives enforcement. A home is very unlikely to face any penalty unless inspectors cite harm or immediate jeopardy.
Scope & severity matrix (PDF)| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J | K | L |
| Actual harm | G | H | I |
| No actual harm, potential for more than minimal harm | D | E | F |
| No actual harm, potential for minimal harm | A | B | C |
Understanding enforcement
Research and tools on how nursing homes are inspected, cited and penalized.
About this data
Citations and penalties come from the CMS Provider Data Catalog (datasets r5ix-sfxw and g6vv-u9sr), last updated by CMS October 1, 2026, released October 28, 2026 and downloaded by LTCCC November 9, 2026. Each covers the past three years. National, CMS region and state summary figures, including harm and immediate jeopardy counts and percentages, are calculated by LTCCC from CMS data. “Harm” counts every citation at G or above, including immediate jeopardy.