Per-citation health-deficiency records on every Medicare-certified nursing home — joined to the civil-money penalties.
Fonteum snapshot 2026-05-08: 418,148 per-citation health-deficiency records across 14,635 Medicare-certified nursing homes — each with scope (B–L) + severity letter, F-tag taxonomy, deficiency category. The NH Penalties dataset joins via CCN + Survey Date and exposes $467M in cumulative civil-money fines across 16,832 penalty records. State-level harm-citation rates vary by 4.81× (top vs. bottom: IL 4.57 vs. MD 0.95 per facility) — a state-survey-system signal, not a facility-quality signal.
See the Audit Pack →Per-Citation Health Deficiencies
Each citation carries scope (B–L scale) + severity letter + F-tag taxonomy + deficiency category + Survey Event ID. The most-actionable per-citation transparency layer in nursing-home regulation.
Cumulative Civil-Money Penalties
NH Penalties joins to Deficiencies via Survey Event ID. Exposes per-event civil-money penalty amounts and denial-of-payment events. Audit-pack export ships both as data_only sub-join.
IL-vs-MD Harm-Rate Disparity
State-survey rigor varies dramatically: top harm-rate state IL (4.57 G+ citations per facility) vs. bottom MD (0.95). That spread is a state-survey-system story, not a facility-quality story — Fonteum surfaces the variance explicitly so consumers don't mistake survey rigor for facility quality.
4.81× spread between top + bottom states (G+ citations per facility)
State-level harm-rate variation is a state-survey-system signal, not a facility-quality signal. 2.36% of all citations were Immediate Jeopardy (J/K/L) — 9,862 citations across the 2017-03-23 → 2026-03-25 window.