What a deficiency is
During a survey, inspectors check a facility against hundreds of federal requirements. When they find a violation, they cite a 'deficiency,' identified by an F-tag number (for example, F689 covers accident hazards). The average nursing home has several deficiencies per survey — a small number is normal; a large number or a severe one is a red flag.
Scope and severity
Every deficiency gets a letter grade from A to L based on two axes: how widespread it was (scope) and how much harm it caused or risked (severity). Levels A–C are minor with no actual harm. Levels D–F caused no or minimal harm but affected more residents. Levels G–I caused actual harm. Levels J–L are 'immediate jeopardy' — the most serious, meaning a resident was or could be seriously injured or killed.
Which findings should worry you
Focus on severity, not just count. Any deficiency in the G–L range (actual harm or immediate jeopardy) is worth asking the facility about directly. Repeated deficiencies of the same type across multiple surveys suggest a problem the facility has not fixed.
Ask what changed
A single serious deficiency is not always disqualifying — what matters is whether the facility corrected it. Every deficiency comes with a required plan of correction. Ask the administrator what happened, what they changed, and whether the fix held.