What is a Double G Citation? This refers to a CMS policy intended to identify and address facilities with a pattern of high-level noncompliance. Double G citations occur when a facility with a previous citation at a G level or higher is cited again at a G level or higher. It is an important indicator because facilities with Double G citations face automatic penalties.
What is a G Level Citation? G level citations refer to citations for violations of minimum standards in which the surveyors have found that the violation resulted in harm to one or more residents or put one or more resident in immediate jeopardy of serious harm. “G” denotes a specific category in the Scope and Severity Grid.
What is the Scope and Severity Grid? The Scope & Severity Grid is used by nursing home surveyors to classify the seriousness of nursing home deficiencies (i.e., of violations in minimum standards of care or other requirements). It is comprised of an alphabetic matrix, with the letters A – F indicating that a violation was minimal or had only the potential to cause harm and the letters G – L being used to indicate actual harm or immediate jeopardy to one or more residents.
Information on citations for all licensed nursing homes, including the scope and severity of those citations, is available on Nursing Home Care Compare. Note: When assessing a facility’s survey performance, it is important to keep in mind that numerous studies have found that surveyors often fail to identify nursing home problems adequately, including serious care problems.
LTCCC’s Double G Citations Dataset lists the number of Double G citations, by state and CMS Region, for calendar year 2024.
Updated: March 26, 2026.
Source: https://qcor.cms.gov/nh_wizard.jsp?which=0&report=report_doubleG.jsp