What does “Deficiency” mean?
Short answer
A deficiency is a failure to meet a Medicare or Medicaid rule. A surveyor, or inspector, lists it on Form CMS-2567 and nursing homes get a score.
Also known as: survey deficiency, citation, survey finding
What counts
Under 42 CFR 488.301, a nursing home deficiency is a failure to meet a rule in the Act or in 42 CFR Part 483, Subpart B.
Noncompliance is a failure big enough that the home is not in substantial compliance. Substantial compliance means any gaps pose no more than a potential for minimal harm.
Other providers have standard-level and condition-level gaps. A condition is a broad rule. Standards are the details under it. A gap reaches condition level based on how well the provider meets the standards (42 CFR 488.26).
How it is scored
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy (level 4) | J | K | L |
| Actual harm, not immediate jeopardy (level 3) | G | H | I |
| No actual harm, potential for more than minimal harm (level 2) | D | E | F |
| No actual harm, potential for minimal harm (level 1) | A | B | C |
Level A is not listed on Form CMS-2567 and needs no plan of correction. All other levels need one. Example: a resident falls and breaks a bone because a care-plan step was missed. In one resident, that scores G.
Mix-up: a deficiency is not automatically a fine. The remedy depends on the score and history.
Frequently asked questions
What is the difference between a deficiency and noncompliance?
Noncompliance (42 CFR 488.301) is a deficiency that keeps a nursing home from substantial compliance. A level A deficiency can leave a home in substantial compliance.
What is a standard-level versus a condition-level deficiency?
Conditions are broad rules. Standards are the details beneath. With only standard-level gaps, a provider may keep taking part if it files an acceptable plan of correction.
Does every deficiency require a plan of correction?
Almost. Nursing homes with findings above scope and severity level A must file one. Other providers with standard-level findings must file one to keep taking part.
Sources
- 42 CFR 488.301: Definitions (nursing home survey and enforcement)
- 42 CFR 488.26: Determining compliance
- 42 CFR 488.28: Providers or suppliers, other than SNFs, NFs, HHAs and hospices, with deficiencies
- CMS State Operations Manual, Chapter 7: Survey and Enforcement Process for Skilled Nursing Facilities and Nursing Facilities
- CMS State Operations Manual, Chapter 2: The Certification Process
Reviewed against the sources above on Oct 5, 2026. Rules change: confirm current requirements with the issuing body or your counsel before relying on any summary.
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