A deficiency is an indication that a nursing home is in violation of regulations. In this article, we’ll define the term “deficiency” and explain how it relates to nursing home abuse. 

Key Takeaways

• Nursing homes certified for Medicare or Medicaid funding are surveyed yearly
• If a nursing home is found to be in violation of state or federal regulations, they are issued a Citation of Deficiency and required to develop a Plan of Correction
• Deficiencies are given letter grades indicating the severity and scope of the infarction
• There are two types of deficiencies: health and fire
• Statistics indicate that nursing home deficiencies for abuse are on the rise, but that enforcement actions are infrequently implemented
• Nursing home residents and their loved ones are encouraged to be aware of the risk of nursing home abuse 

What Is Deficiency?

A deficiency is a citation that a nursing home has violated state or federal regulations.

All U.S. nursing homes certified for Medicare or Medicaid are surveyed by the State Survey Agency yearly. If the surveyor finds something that violates regulations, they issue a Citation of Deficiency. This means that the nursing home must develop a Plan of Correction to fix the relevant problem. The Plan of Correction must be approved by the State Survey Agency. 

Between yearly surveys, complaints about nursing homes filed with the State Survey Agency are investigated by Complaint Investigators. If they find the complaint to be valid, they will issue a Citation of Deficiency. 

Deficiency Severity

Deficiencies are given a letter grade indicating the severity of the infarction. These are outlined in the table below.

Deficiency Cycles

Deficiency counts are given for certain Survey Cycles. 

• Cycle 1 contains all citations of deficiency in the past 12 months
• Cycle 2 deficiencies were issued 13 - 24 months previously
• Cycle 3 deficiencies were issued 25 - 36 months previously

Types of Deficiencies

There are two types of nursing home deficiencies: 

• Health deficiencies are issued for anything prohibited by federal or state regulations in the operation of the home
• Fire deficiencies deal with the nursing home’s structure in relation to accepted fire prevention measures

Deficiency and Nursing Home Abuse

One type of deficiency that a nursing home can be cited for is abuse, namely:

• Neglect by staff
• Criminal screening investigating and reporting
• Abuse prevention and policy development and implementation

In 2019, the U.S. Government Accountability Office (GAO) found the following facts about nursing home abuse deficiencies: 

• In the span of five years, the number of cited abuse deficiencies more than doubled
• A larger percent of abuse deficiencies were cited at the highest levels of severity 
• 8.4% of nursing homes had multiple abuse deficiencies over the five-year period
• One-third of abuse deficiencies had an enforcement action imposed but not implemented
• Less than 8% of abuse deficiencies had enforcement actions that were implemented against the nursing home

All of this indicates that nursing home abuse is on the rise and, even when it is reported, it is often not addressed with actual change. This means that nursing home residents and their loved ones should be very wary of the risk of nursing home abuse. It is important to be aware and vigilant of nursing home abuse warning signs to try and catch any potential abuse and stop it as early as possible.

If you or a loved one have experienced nursing home abuse, it is important to report it as soon as possible to the relevant authorities. It is also recommended to speak to an experienced nursing home abuse lawyer who may be able to help you recover compensation for your losses, injuries, and suffering.