Methodology

A separate record from the nursing home index

The Life Safety Index republishes the federal CMS survey of Medicare-certified nursing homes: one national file, one tag taxonomy, a CMS Certification Number, a three-year window. Assisted living has none of those. It is licensed by each state, inspected under that state’s rules, written up in that state’s tag codes and classifications, and published (or not) on that state’s portal. So these records are kept entirely apart: separate tables, separate identifiers, separate pages under a separate address, and no figure that combines the two. A campus that holds both licences has two records and they are never added together, compared, or scored against each other.

Florida

Why 5 years. AHCA's routine ("Standard") licensure inspection of an assisted living facility is every two years, with complaint and monitoring visits in between. A shorter window would often hold a single routine inspection; 5 years holds two or three, which is enough to say whether a finding recurs. The nursing home index uses CMS’s three-year file for the same reason at that survey’s cadence — a different window for a different record.

Class. Florida classifies each deficiency under section 429.19, Florida Statutes: Class I (imminent danger), Class II (direct threat), Class III (indirect or potential threat) and Class IV (minor, paperwork-level). Class III is by far the most common.

Not in this record. Fire and life safety. In Florida the fire safety inspection of an assisted living facility is done by the local fire authority under the Florida Fire Prevention Code, not by AHCA, and those reports are not part of this record. What AHCA does cite about the building — physical plant, emergency management and emergency power — is here.

Texas

Why 5 years. HHSC inspects a licensed assisted living facility for renewal about every two years, with complaint investigations in between, and its Life Safety Code inspectors visit separately from the health inspectors. A shorter window would often hold a single routine inspection; 5 years holds two or three, which is enough to say whether a finding recurs. The nursing home index uses CMS’s three-year file for the same reason at that survey’s cadence — a different window for a different record.

Not in this record. Scope and severity, and enforcement. HHSC rates each finding on a scope-and-severity scale but does not publish the rating per facility, and it records fines and enforcement actions separately; neither is republished here. What is here is unusual among states: HHSC inspects fire and life safety itself and publishes those findings per facility, so this record carries a real life safety section.

California

Why 5 years. Community Care Licensing's routine inspection of a Residential Care Facility for the Elderly is annual, with complaint investigations and case-management visits in between. A shorter window would often hold a single routine inspection; 5 years holds two or three, which is enough to say whether a finding recurs. The nursing home index uses CMS’s three-year file for the same reason at that survey’s cadence — a different window for a different record.

Type. Community Care Licensing classifies each deficiency as Type A, a violation that if not corrected poses a direct and immediate risk to the health, safety or personal rights of residents, or Type B, a violation that without correction could become such a risk, a recordkeeping violation, or a violation that could affect required services.

Not in this record. Fire and life safety. A Residential Care Facility for the Elderly needs a fire clearance from the local fire authority, and that inspection is not part of the CDSS record. What CDSS does cite about the building is here: maintenance and operation of the premises, the emergency and disaster plan, and the physical environment sections of Title 22.

Arizona

Why 3 years. ADHS inspects a licensed assisted living facility for compliance about once a year, with complaint investigations and monitoring visits in between. A shorter window would often hold a single routine inspection; 3 years holds two or three, which is enough to say whether a finding recurs. The nursing home index uses CMS’s three-year file for the same reason at that survey’s cadence — a different window for a different record.

Not in this record. Fire and life safety inspection, and severity. The fire inspection of an assisted living facility is the local fire department's, and ADHS does not publish it. What ADHS does cite about safety is here, under its own emergency and safety standards: evacuation and elopement drills, the annual fire inspection report on file, smoke detectors and extinguishers. ADHS does not rate a deficiency's severity, and its enforcement actions are recorded separately and not republished.

Oregon

Why 5 years. ODHS surveys a residential care or assisted living facility for licence renewal at least once every two years, with an annual kitchen inspection and complaint investigations in between. A shorter window would often hold a single routine inspection; 5 years holds two or three, which is enough to say whether a finding recurs. The nursing home index uses CMS’s three-year file for the same reason at that survey’s cadence — a different window for a different record.

Severity level. ODHS rates each deficiency on a four-level scale, with a scope of isolated, pattern or widespread. Level 1 is no actual harm with the potential for minimal harm; Level 2 is no actual harm with the potential for more than minimal harm; Level 3 is actual harm that is not immediate jeopardy; Level 4 is immediate jeopardy to resident health or safety. Level 2 is by far the most common.

Not in this record. Fire and life safety inspection, and enforcement. The fire inspection of an Oregon assisted living or residential care facility is the State Fire Marshal's or the local fire authority's and is not published; what ODHS itself cites about the building — its fire and life safety rule, emergency and disaster planning, and the building requirements — is here. ODHS also publishes substantiated abuse and licensing complaint findings, licence conditions and civil penalties for each facility; none of that is republished. This record is the survey citations only. Adult foster homes, which Oregon licenses separately and which are mostly licensed to an individual, are not included.

Georgia

Why 5 years. HFRD inspects a licensed assisted living community or personal care home on a routine periodic schedule, with complaint investigations and follow-up inspections in between. A shorter window would often hold a single routine inspection; 5 years holds two or three, which is enough to say whether a finding recurs. The nursing home index uses CMS’s three-year file for the same reason at that survey’s cadence — a different window for a different record.

Scope and severity. HFRD prints a scope-and-severity letter beside each citation, on the grid the federal nursing home survey uses: A to C is a deficiency with no actual harm and the potential for minimal harm, D to F no actual harm with the potential for more than minimal harm, G to I actual harm that is not immediate jeopardy, and J to L immediate jeopardy; within each band the letter rises from isolated to pattern to widespread. D is by far the most common.

Not in this record. Fire and life safety inspection, licence dates, and enforcement. The fire inspection of a Georgia assisted living community or personal care home is the State Fire Marshal's or the local fire authority's and is not published; what HFRD itself cites about the building — its safety precautions, emergency preparedness and design rules — is here. HFRD's file gives the date of the current permit, not the date the facility first opened, for most facilities, so the newly licensed list is partial. Fines, licence suspensions and revocations are recorded separately and not republished. Community living arrangements and adult day centers, which Georgia licenses under other rules, are not included.

Virginia

Why 5 years. VDSS issues an assisted living facility a licence for one, two or three years according to its compliance history, inspects it for renewal before each term ends, and makes monitoring inspections and complaint investigations in between. A shorter window would often hold a single routine inspection; 5 years holds two or three, which is enough to say whether a finding recurs. The nursing home index uses CMS’s three-year file for the same reason at that survey’s cadence — a different window for a different record.

Not in this record. Fire and life safety inspection, severity, and enforcement. The fire inspection of a Virginia assisted living facility is the State Fire Marshal's or the local fire official's and is not published; what VDSS itself cites about the building — its buildings-and-grounds, fire safety and emergency preparedness standards — is here. VDSS assigns no severity to a violation, and the facility's plan of correction is not republished. Sanctions, civil penalties and licence actions are recorded separately and not republished. VDSS publishes no first-licence date; a facility appears on the newly licensed page by the date of its initial inspection where the record shows one. Adult day centers and children's facilities are other licence types and are not included.

Iowa

Why 5 years. DIAL recertifies an assisted living program every two years, with complaint and incident investigations in between. A shorter window would often hold a single routine inspection; 5 years holds two or three, which is enough to say whether a finding recurs. The nursing home index uses CMS’s three-year file for the same reason at that survey’s cadence — a different window for a different record.

Not in this record. Fire and life safety inspection, severity, the survey report, and enforcement. The fire safety inspection of an Iowa assisted living program is the State Fire Marshal's and is not published; what DIAL itself cites about the building — its structural requirements, the dwelling-unit rules for dementia-specific programs and the fire and safety standards of the Code — is here. DIAL assigns no severity to a citation, and the survey report itself is published only as a scanned image, which is not read. Fines, conditional certifications and other enforcement actions are recorded separately and not republished. Elder group homes and adult day services are other certification types and are not included.

Utah

Why 3 years. The Office of Licensing inspects an assisted living facility unannounced about once a year, with follow-up, complaint and investigation inspections in between. A shorter window would often hold a single routine inspection; 3 years holds two or three, which is enough to say whether a finding recurs. The nursing home index uses CMS’s three-year file for the same reason at that survey’s cadence — a different window for a different record.

Noncompliance level. The Office of Licensing rates each finding Low, Moderate, High or Extreme by the risk it poses to residents, and a finding cited again at a later inspection is marked as a repeat. Low is the most common; High and Extreme together are about a third.

Not in this record. Fire and life safety inspection, fines, and the licensor's narrative. The fire inspection of a Utah assisted living facility is the State Fire Marshal's or the local fire authority's and is not published; what the Office of Licensing itself cites about the building — its physical environment, maintenance, secure-unit and emergency and disaster rules — is here. Civil money penalties, appeals, and the licensor's statements of what was found and how it was corrected are in the state's record and are not republished. A technical-assistance note is not a citation and is not counted. Type I and Type II facilities are both here; other licence types are not.

West Virginia

Why 3 years. OHFLAC surveys an assisted living residence for licence renewal every year, with follow-up visits and complaint surveys in between, and its own life safety code survey alongside. A shorter window would often hold a single routine inspection; 3 years holds two or three, which is enough to say whether a finding recurs. The nursing home index uses CMS’s three-year file for the same reason at that survey’s cadence — a different window for a different record.

Not in this record. Severity, the regulation text, the surveyor's narrative, and enforcement. OHFLAC rates no deficiency's severity and records no correction date. The rule text on its site is served in an obfuscated typeface and is not read, and the statement of deficiency and the plan of correction are the surveyor's and the facility's own text and are not republished. What is here is unusual among states: OHFLAC surveys fire and life safety itself and publishes those findings per residence, so this record carries a real life safety section. Fines, licence actions and administrators' names are in the state's record and are not republished.

Measures

Comparisons are within the state only. There is no national median and no cross-state figure, because a citation in one state’s system is not the same object as a citation in another’s.

Categories

Each state’s tags are grouped into one small vocabulary so that “building-related” means the same thing in every state. The grouping is TagProof’s editorial choice and is published in full in the repository file for each state; the tag codes, titles and classes are never altered.

What this does not do

• No grades, letters or stars. A percentile is arithmetic that can be checked.
• No rankings or league tables.A facility can see its own position. There is no “worst facilities” list and there will not be one.
• Never combined with the nursing home record. No page, count or comparison mixes a state assisted living citation with a CMS nursing home citation.
• No fines, sanctions or named individuals. The states publish administrators, owners and fine amounts; this site does not republish them.
• No prediction.Nursing home pages state a next-survey window measured from CMS data. Assisted living pages state the state’s cadence and nothing more, until there is enough refreshed data to measure one.
• A facility’s position never depends on whether it is a TagProof customer.

Alerts

Every facility page carries a one-line opt-in: an email if the facility is cited again on its state record, and, if you ask for it, if the state’s published licence status changes. Nothing is sent until a confirmation link is followed; every alert carries a one-click stop link; the address is used for these alerts and nothing else, and is never shown to anyone. An alert reports what the state published and links to the page. It never says where the facility sits against others, and the same address subscribed to a nursing home page is a separate subscription to a separate record.

Corrections

The record is the state’s; a wrong entry is corrected with the state agency. What we can do — annotate, note a dispute, or take a page down — is documented separately and answered.

Versioning

This is version 1.0. If a definition changes, the version changes with it and the previous definition stays published.