Independent evidence
The gap your annual inspection will not warn you about
Introduction
You can roughly see the annual survey coming: it lands in a window, and you prepare for it. A complaint investigation can land on any morning. Somebody calls the state - a family, a resident, one of your own staff - and inspectors arrive with a specific allegation to check. Six questions about how your home actually runs, scored against every citation CMS has issued since August 2023. Guess your score first. Then see what the record says.
Counted from all 330,987 citations issued from August 2023 onwards, which is the window in which a complaint citation can appear at all. Source: Centers for Medicare and Medicaid Services CMS Nursing Home Health Deficiencies (r5ix-sfxw), surveys through 2026-07-23. Not a sample of those citations, all of them. The file also holds earlier citations, which are outside that window and are excluded and explained in the method.
Here is what the record says
How your state compares
The share of citations found on a complaint rather than the annual survey is not the same everywhere. It runs from under 5% to over 50% depending on the state. Pick yours.
What we have not shown you. Every FAIL above is a measure the record says keeps getting found when somebody complains - which means between surveys, unannounced. For each one we hold the reading: how many American homes were cited for the same thing, and how often it was caught on a complaint rather than at the survey.
Want to know what sits behind each FAIL?
The reading is already written: each measure you failed, what you answered, how many American homes were cited for the same thing, and how often it was found on a complaint rather than at the survey. Tell us where to send it. If you would rather not, that is fine - the score is yours to keep either way.
Sent. Your copy should arrive in the next few minutes; check your junk folder if not.