1,020 Nursing Homes Haven’t Been Inspected in Nearly Two Years. Their Records Look Clean.

If you are comparing two nursing homes and one has a much cleaner record, the honest first question is not “which is safer?” It is: when did an inspector last walk through each building? For a thousand facilities in this country, the answer is nearly two years ago — or longer.

What the rules require

Every Medicare-certified nursing home is required by federal law to receive an unannounced standard health inspection at least every 15 months, with the typical interval between 9 and 15 months depending on past performance. These surveys are the backbone of the public record — the citations, the star ratings, the safety scores, including ours, all flow from them.

CMS separately flags facilities whose most recent standard inspection is more than two years old. That flag currently sits on 1,020 facilities.

The visibility gap

Read the last two rows together, because that is where the trap lives. Overdue facilities carry far fewer recent citations and score marginally higher. A family comparing homes side by side would reasonably read the quieter record as the better one.

We want to be precise about what this data does and does not show. It does not show that overdue facilities are worse — their scores are statistically indistinguishable from facilities inspected on time. What it shows is that for these 1,020 homes, the public record is stale, and the absence of recent violations is not evidence of safety. Sometimes it is only evidence that nobody has been.

Where the backlog concentrates

Alabama stands apart: fewer than one in seven of its nursing homes has a current standard inspection. A family in Birmingham comparing facilities is, in most cases, reading a document written before the current staff were hired.

Why this happens

This is a capacity problem, not a conspiracy. Inspections are carried out by state survey agencies, and those agencies have been chronically short-staffed for years.

In May 2023, the U.S. Senate Special Committee on Aging published a year-long investigation titled “Uninspected and Neglected.” It found that 32 state survey agencies had surveyor vacancy rates of 20% or higher — nine of them above 50%. The worst in the nation: Kentucky at 83%, and Alabama at 80% — which goes a long way toward explaining the chart above. Facilities do not choose to go uninspected; states run out of inspectors.

There is one piece of genuine progress worth reporting. At the time of the Senate investigation, roughly 1 in 9 nursing homes had gone two years without a standard inspection. In the current CMS data, the figure is 1,020 of 14,718 — about 1 in 14. The national backlog is shrinking. The concentration in specific states is not.

What to do with this

• Check the inspection date before you read the findings. Every facility page on our site shows when the record was last updated. If the most recent standard survey is older than about 15 months, treat the record as history rather than a current picture.
• Weight what you can see yourself more heavily. Visit on an evening or a weekend. Watch how long call lights stay lit. Ask what staff turnover has been in the past year.
• Ask the facility directly: “When was your last state survey, and what were the findings?” A well-run home answers without hesitating.

You can look up any facility’s inspection history and safety score with our nursing home safety search. If the codes on an inspection report are unfamiliar, our inspection report decoder translates them into plain English — and it helps to know what an immediate jeopardy citation means, since that is the finding most worth checking the date on.

Frequently asked questions

How often are nursing homes inspected?

Federal law requires a standard health inspection at least every 15 months, and the typical interval is 9 to 15 months. Facilities with poor records are supposed to be inspected more often. Complaint investigations happen separately and can occur at any time.

How many nursing homes are overdue for inspection?

As of the August 2026 CMS data, 1,020 of 14,718 Medicare-certified nursing homes — about 1 in 14 — are flagged as more than two years past their last standard health inspection, covering 123,760 certified beds.

Does an overdue inspection mean a nursing home is unsafe?

No. Overdue facilities score almost identically to facilities inspected on time. What it means is that the public record is stale — a clean-looking report may simply reflect that nobody has inspected recently. Weight recent, verifiable information more heavily.

How do I find out when a nursing home was last inspected?

Look up the facility on our safety search, which shows the survey dates behind every citation, or ask the administrator directly for the date and findings of the most recent state survey.

Methodology

Facility counts and overdue status come from CMS Provider Information data, vintage 1 August 2026, covering 14,718 Medicare-certified nursing homes. “Overdue” reflects CMS’s own indicator for a most-recent standard health inspection more than two years old. “Most recent survey activity” is measured from the latest survey date appearing in the federal deficiency record for each facility as of 31 August 2026; it includes complaint surveys and may differ from the date of the last standard survey. Citation averages cover 1 January 2023 onward, the period for which CMS coverage is complete. Surveyor vacancy figures are from the U.S. Senate Special Committee on Aging report “Uninspected and Neglected” (May 2023). States shown are those with 20 or more overdue facilities.

Senior Care Report Card safety scores are independently computed and are not affiliated with, endorsed by, or sponsored by CMS or Medicare.gov. Families researching a specific facility should review its full current record and speak with the administrator directly.