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Health inspections for nursing homes

Nursing homes must meet standards to protect residents. Examples include:

  • Hiring enough quality staff to provide adequate care
  • Managing medications properly
  • Protecting residents from physical and mental abuse
  • Storing and preparing food properly

State survey agencies conduct nursing home health inspections a once a year, and may inspect nursing homes more often if the nursing home is performing poorly, or if there are complaints or facility reported incidents.

The inspection team looks at many aspects of life in the nursing home including:

  • The care of residents and the processes used to give that care
  • How the staff and residents interact
  • The nursing home environment

Inspectors also review the residents' clinical records, interview residents and family members, as well as caregivers and administrative staff.

What are citations?

If an inspection team finds that a nursing home doesn't meet a specific federal standard, it issues a citation. The federal government may impose penalties on nursing homes for serious citations or for citations that the nursing home doesn't correct for a long time. State governments may also impose penalties on nursing homes. Information about them may be available on state websites.

What is the informal dispute resolution process?

The Informal Dispute Resolution (IDR) process gives nursing homes that don’t meet a specific federal standard a chance to dispute citations. In situations when CMS imposes a fine, nursing homes can request an Independent IDR (IIDR). Citations under IDR/IIDR are posted publicly on Medicare.gov. These citations aren’t included in the star rating calculation until the process is finished.

What are complaints?

A complaint is filed when a nursing home resident or family member has a concern about the quality of care they or their family member got, and didn't get a satisfactory resolution from the nursing home. Inspectors may visit a nursing home when a complaint is registered. Get more information about how to file a complaint.

What are infection control inspections?

Infection control inspections are an abbreviated type of inspection that allow the inspection team to focus specifically on a nursing home's infection control policies and practices. These infection control inspections, can identify serious risks to resident health and safety through the spread of communicable disease, and review areas like these:

  • Proper staff use of Personal Protective Equipment (PPE)
  • Performance of hand hygiene including hand washing and the use of alcohol based hand rubs (ABHR)
  • Emergency preparedness procedures
  • Staff education, monitoring and screening for infection control
  • Appropriate cleaning and disinfection of surfaces
Health inspection star rating calculations

The health inspection score is calculated using each provider's current health inspection and the last 2 prior inspections, as well as findings from the most recent 3 years of complaints or facility reported incident inspections, and infection control inspections. Points are assigned for each citation given, and are based on how widespread and how severe the issue is. Additional points are added to a citation if the issue was identified during a previous inspection and the nursing home didn't fix it.

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