By Baltimore Senior Advisor Care Team · October 8, 2026
Across 107 Baltimore-area nursing homes, the latest CMS survey cycle lists 1,738 health deficiencies; 1,383 are scope/severity D (isolated, potential for more than minimal harm) and 14 are G or higher (actual harm or immediate jeopardy). Read severity and repetition, not just the count.
What is a standard health survey?
Every nursing home certified by Medicare or Medicaid gets an unannounced standard health inspection, carried out in Maryland by OHCQ surveyors on behalf of CMS, on a cycle that averages about a year. Surveyors watch care, interview residents and staff, review records and cite each federal requirement the home fails to meet as a deficiency, identified by an F-tag.
Complaint investigations happen in between and can add citations of their own. CMS then publishes the results on Care Compare, and the health inspection rating -- the heaviest component of the overall star rating -- is built from the last three years of these surveys.
What do the scope and severity letters mean?
Each citation carries a letter from A to L. Severity runs in four bands: A-C no actual harm with potential for minimal harm; D-F no actual harm with potential for more than minimal harm; G-I actual harm; J-L immediate jeopardy. Within each band, the letters step up from isolated to pattern to widespread.
| Letter | Citations in latest Baltimore-area cycle |
|---|---|
| B | 7 |
| C | 13 |
| D | 1,383 |
| E | 261 |
| F | 60 |
| G | 6 |
| J | 7 |
| K | 1 |
So a D on a medical-records tag and a J on an accident tag are very different findings, even though each counts as one deficiency.
Which citations are most common in Baltimore-area nursing homes?
In the current cycle, these tags appear most often across the metro's nursing homes:
| F-tag | What CMS cited | Times cited |
|---|---|---|
| F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | 84 |
| F0880 | Provide and implement an infection prevention and control program. | 76 |
| F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | 70 |
| F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | 67 |
| F0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | 58 |
| F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | 55 |
Common does not mean trivial -- infection control and following care orders matter -- but a home whose list is mostly these tags at D is in a different position from one with a cluster of G-level harm citations.
How should you use the inspection when choosing a facility?
- Look for severity G and above. Read those narratives on Care Compare in full.
- Look for repetition. The same tag in consecutive cycles points to a system problem rather than a bad day.
- Separate complaint citations. Several substantiated complaints suggest families have been raising the same issue.
- Compare with staffing. Low staffing hours plus care-plan citations is a pattern worth asking about.
- Ask for the plan of correction. Every cited home must submit one; ask the administrator what changed.
Each of our nursing home pages lists the current-cycle citations with dates and severity codes.
How do staffing and fines fit in?
The inspection record is one part of a nursing home's federal profile. CMS also publishes staffing from payroll-based data -- total nurse hours per resident per day, registered-nurse hours, weekend staffing and turnover -- and the fines and payment denials it has imposed.
Across the 107 Baltimore-area homes in the current release, 37 have federal fines on record in the last three years. A fine usually follows a serious citation, so read the corresponding inspection findings rather than the dollar amount alone.
When a home combines low staffing hours, high turnover and repeated care-plan or accident citations, ask directly how the administrator is addressing staffing. When a home has strong staffing but a single severe citation, the question is what happened and what changed.
What should you ask the administrator after reading the record?
- What was the plan of correction for the most serious citation, and how is it monitored?
- Which unit would my parent live on, and what were the findings there?
- How many residents does each aide care for on evenings, nights and weekends?
- Has the administrator or director of nursing changed in the last year?
- How do you handle family concerns, and is there an active family council?
A good administrator will have specific answers and will not be surprised that you read the inspection. Defensiveness is information too.
Where do Baltimore-area homes stand on the overall rating?
In the current CMS release the metro's nursing homes span the full range of stars:
| CMS overall rating | Baltimore-area nursing homes |
|---|---|
| 5 stars | 30 |
| 4 stars | 22 |
| 3 stars | 18 |
| 2 stars | 25 |
| 1 stars | 11 |
Because the health inspection rating is relative -- CMS compares homes within each state -- a Maryland home's inspection stars describe how it performs compared with other Maryland homes, not against a national average.
Does a low citation count mean a good home?
Not on its own. A home surveyed many months ago may simply be due for its next inspection, and complaint surveys can add findings at any time. Pair the count with the survey date, the CMS staffing rating and a visit at an unscheduled time of day.
Frequently asked questions
What does a D citation mean on a nursing home inspection?
An isolated deficiency with no actual harm but potential for more than minimal harm.
Which nursing home citations are most serious?
Scope/severity G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
Who inspects Maryland nursing homes?
OHCQ surveyors inspect on behalf of CMS; results are published on Medicare Care Compare.
Where can I read a Baltimore nursing home's citations?
On Medicare Care Compare and on each facility page in our nursing home directory.
How often are Maryland nursing homes inspected?
Standard health surveys are unannounced and happen roughly once a year on average, with complaint investigations in between; CMS posts the results on Care Compare.
What is a plan of correction?
It is the nursing home's written response to each citation, describing how the problem will be fixed and monitored; families can ask the administrator to see it.
