Check a specific nursing home
Search 14,000+ Medicare-certified facilities by name, city, or ZIP — see violations, staffing, and safety signals.
Key Takeaways
- Federal inspectors found 32,437 abuse and neglect violations at U.S. nursing homes through May 21, 2026, with 4,584 causing actual harm or immediate danger to residents.
- The most common violation was inadequate dementia care training (9,352 citations), followed by failures to protect residents' basic right to be free from abuse (9,052 citations causing 3,459 actual harm cases).
- California, Illinois, and Texas had the highest violation counts, though these totals partly reflect the number of nursing homes in each state.
- Nearly 6,000 citations involved homes failing to properly report or investigate abuse allegations, which can leave residents at continued risk.
- Families should check individual facility inspection reports on Medicare.gov to see each home's specific violation history and how quickly problems were corrected.
Federal health inspectors documented 32,437 abuse and neglect violations in U.S. nursing homes through May 21, 2026, according to the latest data from the Centers for Medicare & Medicaid Services (CMS). These citations span a range of issues from failing to protect residents from mistreatment to not reporting suspected abuse to authorities.
Of these violations, 4,584 rose to the level of actual harm or immediate jeopardy—meaning residents were injured, experienced serious distress, or faced imminent danger. These findings come from routine health inspections and complaint investigations that federal and state surveyors conduct at nursing homes nationwide.
The data reveals which specific resident protection requirements homes most frequently failed to meet, and which states recorded the highest violation counts. Understanding these patterns can help families ask better questions when evaluating nursing home care.
Most Common Violations
The single most cited violation was F0609 ("Ensure staff are trained in dementia care"), with 9,352 citations affecting 6,015 facilities. While this tag typically reflects training gaps rather than direct mistreatment, 270 cases still resulted in actual harm to residents—suggesting that inadequate dementia care training can have real consequences.
Close behind was F0600 ("Give residents the right to be free from abuse, neglect, and exploitation"), with 9,052 citations across 5,219 facilities. This foundational requirement saw 3,459 cases cause actual harm or immediate jeopardy—the highest harm count of any violation type. This tag covers the broadest protection duties, so its frequent appearance reflects both its wide scope and the serious lapses inspectors found.
F0610 ("Report and investigate allegations of abuse and neglect") accounted for 5,978 citations at 4,218 facilities, with 344 actual harm cases. This violation means homes either failed to investigate concerns properly or didn't report suspicions to the appropriate state agencies as required by law. Delayed or missing investigations can leave vulnerable residents at continued risk.
Geographic Patterns
California led all states with 3,550 citations across 905 facilities—though California also operates more nursing homes than most states. Illinois recorded 2,964 citations at 531 facilities, while Texas had 2,449 citations affecting 824 homes. Ohio, Pennsylvania, and Missouri rounded out the top six states, each recording between 1,400 and 1,937 violations.
These state totals reflect both the number of facilities in each state and how aggressively state survey agencies investigate complaints. States with more thorough inspection programs may detect more violations, which can be a sign of stronger oversight rather than uniformly worse care.
Other Notable Violations
F0607 ("Protect residents from all types of abuse") appeared 3,188 times across 2,610 facilities, with 281 actual harm cases. F0604 ("Protect each resident from physical abuse") and F0602 ("Protect residents from verbal or mental abuse") each exceeded 1,600 citations, with 96 and 69 actual harm cases respectively.
Less common but still serious were violations of F0605 ("Protect residents from sexual abuse"), with 1,173 citations at 1,152 facilities and 16 actual harm cases. The near one-to-one ratio of citations to facilities suggests most homes cited for this issue had a single incident rather than systemic problems.
What These Numbers Mean for Families
These citations represent inspectors' findings at specific moments in time, not ongoing conditions at every facility. A single citation may reflect an isolated incident that was corrected, or it may indicate deeper staffing or culture problems. Families researching homes should review each facility's individual inspection history on Medicare's Care Compare website to see the full context, including how quickly issues were resolved.
The gap between total citations (32,437) and actual harm cases (4,584) shows that many violations were caught at the "potential for harm" stage before residents were injured. This demonstrates that the inspection system can identify risks early—though the 4,584 harm cases also show that serious lapses continue to occur nationwide.
How to Read This
- Abuse & Neglect (citations: F600, F601, F602, F603, F604, F605, F606, F607, F608, F609, F610)
- Inspectors found that a resident was mistreated, that the facility failed to prevent abuse, or that staff did not report or investigate allegations of abuse promptly.
- Freedom from Restraints (citations: F604, F605, F606, F607, F608)
- The facility used physical restraints or medically inappropriate devices on residents without proper justification, consent, or monitoring.
- Severity scale (A–L)
- CMS rates each citation A–L. A–C means no resident harm, D–F means potential for harm to residents, G–I means actual harm, and J–L means immediate jeopardy to resident health or safety.
Data source: Centers for Medicare & Medicaid Services (CMS). Data as of 2026-05-21.
Helpful resources
- Search every certified nursing facility (all 50 states)
- See a sample facility safety report
- How Senior Care Report Card works
- Resources Hub: guides for families
- About our editorial standards
Browse high-demand state hubs
How we built this: Every Senior Care Report Card insight is generated from the federal CMS Care Compare dataset and reviewed by our editorial team before publishing. We do not invent numbers, and we always tell you the date the data was collected. Read our methodology →