{"meta":{"dataset":"nursing-homes","title":"Nursing home fines and harm citations by county: CMS penalties, actual-harm, immediate-jeopardy and abuse citations","version":"1.0.0","doi":"10.5281/zenodo.23741901","doiUrl":"https://doi.org/10.5281/zenodo.23741901","conceptDoi":"10.5281/zenodo.23741900","license":"CC BY 4.0","licenseUrl":"https://creativecommons.org/licenses/by/4.0/","attribution":"Source: Probative, Nursing home fines and harm citations by county: CMS penalties, actual-harm, immediate-jeopardy and abuse citations, version 1.0.0, https://doi.org/10.5281/zenodo.23741901, licensed CC BY 4.0.","citation":"Probative. (2026). Nursing home fines and harm citations by county: CMS penalties, actual-harm, immediate-jeopardy and abuse citations (Version 1.0.0) [Data set]. Zenodo. https://doi.org/10.5281/zenodo.23741901","disclaimer":"Not legal advice. This is a count of public CMS inspection and penalty records, kept for marketing planning. A citation is an inspector's finding, not a court's; a fine can be reduced or withdrawn on appeal; and nothing here says any home or person did anything unlawful.","notice":"Probative is a marketing firm, not a law firm; not legal advice.","lastChecked":"2026-10-28","url":"https://probativegrowth.com/data/v1/nursing-homes/jurisdictions/US.json","humanUrl":"https://probativegrowth.com/data/nursing-homes/","statusCodes":{"P":"primary source","S":"secondary source","D":"ABA model default","U":"open question"}},"key":"US","records":[{"id":"nh-us","dataset":"nursing-homes","jurisdiction":"US","jurisdictionName":"United States","level":"us","county":null,"countyName":null,"status":"P","text":"United States: 14,686 Medicare- or Medicaid-certified nursing homes (1,567,009 certified beds). CMS fined 6,468 of them 12,638 times for $445.7 million between October 2023 and September 2026, and denied payment 2,369 times (64,360 days). Inspectors cited 22,249 deficiencies at the actual-harm level or worse (9,046 immediate jeopardy) and 31,295 abuse or neglect deficiencies in the inspections CMS publishes. 18.9% of rated homes have one star overall.","value":445738479,"unit":"dollars of CMS fines in the last three years","facilities":14686,"certified_beds":1567009,"rated_facilities":14560,"one_star_facilities":2753,"abuse_icon_facilities":1401,"fines_count":12638,"fines_total_usd":445738479,"facilities_fined":6468,"payment_denials":2369,"payment_denial_days":64360,"citations_total":418682,"citations_harm":22249,"citations_ij":9046,"citations_abuse":31295,"facilities_with_harm":8153,"facilities_with_ij":4334,"one_star_share_pct":18.9,"facilities_without_county":10,"cms_avg_fines_per_facility":0.9,"cms_avg_fine_amount_usd":30351,"cms_avg_cycle1_health_deficiencies":9.2,"penalty_from":"2023-10-17","penalty_to":"2026-09-23","survey_from":"2017-07-13","survey_to":"2026-09-23","sources":[{"label":"CMS Provider Data Catalog, Nursing homes: Provider Information (NH_ProviderInfo_Oct2026.csv)","url":"https://data.cms.gov/provider-data/sites/default/files/resources/0970c657767e40f8521187d02ba8d0ed_1792181744/NH_ProviderInfo_Oct2026.csv","kind":"primary","accessed":"2026-10-28"},{"label":"CMS Provider Data Catalog, Nursing homes: Penalties (NH_Penalties_Oct2026.csv)","url":"https://data.cms.gov/provider-data/sites/default/files/resources/4d0e526b8cf3d0b78294803291483073_1792181741/NH_Penalties_Oct2026.csv","kind":"primary","accessed":"2026-10-28"},{"label":"CMS Provider Data Catalog, Nursing homes: Health Deficiencies (NH_HealthCitations_Oct2026.csv)","url":"https://data.cms.gov/provider-data/sites/default/files/resources/327fc64eff7ccc64fd7d23c853bb1ade_1792181729/NH_HealthCitations_Oct2026.csv","kind":"primary","accessed":"2026-10-28"},{"label":"CMS Provider Data Catalog, Nursing homes: State US Averages (NH_StateUSAverages_Oct2026.csv)","url":"https://data.cms.gov/provider-data/sites/default/files/resources/e0c4bde60d7ad96dcb0e011dbb182112_1792181753/NH_StateUSAverages_Oct2026.csv","kind":"primary","accessed":"2026-10-28"}],"source":{"agency":"Centers for Medicare & Medicaid Services (CMS)","url":"https://data.cms.gov/provider-data/topics/nursing-homes","release":"Care Compare nursing home files, processed 2026-10-01","vintage":"2026-10-01","accessed":"2026-10-28","file":"NH_ProviderInfo_Oct2026.csv; NH_Penalties_Oct2026.csv; NH_HealthCitations_Oct2026.csv"},"flags":{"suppressed":false,"noise":false,"preliminary":false,"moe":null},"lastChecked":"2026-10-28","confidence":"high","confidenceBasis":"primary source; checked within 45 days; totals tie to the official file"}]}