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CMS NH Deficiencies

CMS NH Health Deficiencies (per-citation)

U.S. Centers for Medicare and Medicaid Services · Tier-1 · research-only (never on individual profiles)

Research-only

~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. The July 12 production audit counted $467,344,898 in fines in the NH Penalties table.

What Fonteum uses it for

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.

What this dataset answers

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)

Fields used

Per-field display contract.

Fields listed below show their configured `display_allowed` flag from the §94 provenance schema. Fields marked write-locked are captured for audit and are not rendered on profile pages.

Renders on profile

5 fields
ccnCMS Certification Number
deficiency_tagF-tag
scope_severity_letterScope/Severity (B–L)
deficiency_categoryDeficiency category
survey_event_idSurvey Event ID (joins to Penalties)
Limitations

What 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.
Source metadata

Authority, license, publisher cadence.

Authority

U.S. Centers for Medicare and Medicaid Services

Tier

Tier-1 · research-only (never on individual profiles)

Publisher / configured cadence

Declared or configured cadence: Quarterly (citation backlog ~6 months; iQIES July 2025 migration affected legacy schema; CMS February 2026 schema change removed complaint-allegation counts). Not evidence of the latest loaded source date.

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}

ToS & usage notes

What the source allows.

U.S. government public-domain works. PDC publishes the dataset at data.cms.gov with explicit redistribution rights.

Sample provenance

What a single field looks like in the graph.

This worked example shows the provenance shape used when a surfaced field has populated source, last-checked, display-rule, and confidence metadata. Individual fields may omit unavailable values.

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

How to access

Official API, bulk download, and Fonteum endpoints.

Frequently asked

Common questions about CMS NH Deficiencies.

What is the CMS Nursing Home Health Deficiencies dataset?
The loaded CMS Care Compare Nursing Home Health Deficiencies file contains citation rows published for Medicare- and Medicaid-certified nursing homes. A row can include CCN, facility name, survey date, deficiency tag (F-tag), scope, severity, regulatory citation, and correction status; fields can be absent.
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. The loaded release date and any attestation must be inspected separately; the quarterly publisher cadence is not proof of a completed load. 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-correction-time.
See also
  • /sources → The generated source-catalog subset — documented datasets Fonteum cites.
  • /data-provenance → The provider graph — pipeline diagram, source-family clusters, field-level provenance examples, display rules.
  • /methodology → Documented sourcing, publisher cadence, observed freshness, and corrections policy.
  • /editorial-policy → Independence, sourcing, conflicts, corrections, retractions.

What’s on file, by the numbers

Platform snapshot · 2026-08-11

13.4Mproviders & companiesProviders, organizations, owners, and facilities on file
26.2Msource-linked factsSource-linked field facts in the dated platform snapshot
90sources with dataDistinct snapshot source IDs with at least one positive record count
73fresh sourcesDistinct source IDs whose latest positive-data snapshot falls within the preceding 45 days
111sources integratedActive registry rows; integration does not establish a load
13state Medicaid jurisdictionsDistinct states represented in the state-exclusions serving table

Integrated, with-data, and fresh-observation counts are separate. No platform-wide source-completeness count is published. Completeness is source-specific and must be evaluated against the named source's expected scope. State coverage is a separate jurisdiction measure.

Source authority is record-specific

Use the issuer named on the record.

Fonteum spans federal, state, and global public publishers. A source page or returned record identifies its issuer and dataset where that metadata is available. A platform registry count does not assign every page to one authority or establish loaded, fresh, or complete coverage.

Browse source records and their stated limitations →

Reproducible by design

Inspect the evidence each published figure actually supplies.

Source and date

Research pages expose the named public file and observation date where those fields are available. Source-file SHA-256 coverage is separate; facts do not currently link deterministically to signatures.

Available derivation

Studies with a retained release and committed derivation link the SQL or method used. Other studies state the evidence and reproduction limits they actually have.

Daily observations

Dated table row-count observations can detect local drift. They do not imply that an upstream publisher released or Fonteum ingested new data that day.

Named medical review

Reviewed by Jennifer Montecillo, MD, medical reviewer. Non-practicing medical reviewer.

Read the full provenance and attestation methodology →

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