The Life Safety Index
Every Medicare-certified nursing home in the United States is inspected against the Life Safety Code roughly every year, and every finding is recorded as a numbered tag. Those records are public. This is a plain reference to them — one page per facility, one per tag, no account and no charge.
Surveyors differ enormously between states
The median facility in GU has 31 citations on file; in SC it has 1. That is a difference in how strictly surveys are conducted, not a difference in how safe the buildings are — which is why every comparison on this site is against a facility’s own state rather than the national figure.
| State | Facilities | With citations | Median citations | Median per survey |
|---|---|---|---|---|
| GU | 1 | 1 | 31 | 6 |
| WA | 193 | 193 | 31 | 9 |
| KS | 296 | 296 | 27 | 9 |
| NV | 66 | 66 | 26 | 8 |
| PR | 9 | 9 | 25 | 10 |
| MD | 221 | 217 | 23 | 7 |
| CA | 1,165 | 1,164 | 19 | 6 |
| MO | 486 | 482 | 18 | 6 |
| ME | 78 | 78 | 17 | 5 |
| WI | 323 | 321 | 17 | 6 |
| CO | 210 | 190 | 16 | 6 |
| OH | 924 | 909 | 16 | 5 |
| WY | 36 | 36 | 16 | 5 |
| IN | 507 | 494 | 15 | 5 |
| MT | 61 | 59 | 15 | 5 |
| NJ | 348 | 342 | 15 | 5 |
| AK | 20 | 20 | 15 | 5 |
| IL | 664 | 605 | 15 | 6 |
| NE | 180 | 179 | 15 | 4 |
| NM | 68 | 68 | 15 | 4 |
| NY | 592 | 585 | 14 | 4 |
| MI | 422 | 412 | 13 | 4 |
| IA | 387 | 374 | 12 | 4 |
| MN | 337 | 332 | 12 | 4 |
| CT | 191 | 178 | 11 | 4 |
| MA | 341 | 315 | 11 | 4 |
| OR | 128 | 128 | 11 | 3 |
| NC | 419 | 413 | 10 | 3 |
| PA | 656 | 584 | 10 | 4 |
| VA | 289 | 274 | 10 | 4 |
| AL | 224 | 222 | 9 | 3 |
| ID | 80 | 78 | 9 | 3 |
| GA | 356 | 348 | 8 | 3 |
| NH | 73 | 68 | 8 | 3 |
| OK | 283 | 272 | 8 | 3 |
| TN | 303 | 290 | 8 | 3 |
| WV | 123 | 119 | 8 | 3 |
| KY | 266 | 259 | 8 | 3 |
| AZ | 140 | 133 | 7 | 3 |
| FL | 694 | 662 | 7 | 3 |
| TX | 1,177 | 1,128 | 7 | 3 |
| AR | 222 | 212 | 6 | 2 |
| HI | 43 | 40 | 5 | 2 |
| DC | 16 | 15 | 4 | 2 |
| RI | 72 | 64 | 4 | 2 |
| SD | 96 | 81 | 3 | 2 |
| UT | 97 | 80 | 3 | 2 |
| DE | 44 | 30 | 2 | 2 |
| LA | 265 | 187 | 2 | 2 |
| ND | 72 | 53 | 2 | 2 |
| VT | 33 | 24 | 2 | 2 |
| MS | 202 | 126 | 1 | 1 |
| SC | 187 | 94 | 1 | 2 |
By operator
CMS records which multi-facility operator runs each building. 612 operators run 10,227 of the certified facilities; each has a page showing its whole portfolio — every building’s citations, repeat tags and next-survey window, side by side.
Emergency preparedness
The same CMS file records a second set of findings: Emergency Preparedness E-tags under 42 CFR §483.73 — plans, drills, communications and supplies rather than the building. 6,693 of 14,686 facilities have at least one on file, and 312 are cited on nothing else.
Physical environment
A nursing home is surveyed twice: the Life Safety Code visit above, and the health survey. Part of the health survey is the building as the health surveyors see it — equipment in safe operating condition, the call system, bed rails, pest control, hazards — recorded as F-tags in a separate CMS file. 13,739 of 14,686 facilities have at least one on file.
Assisted living is a different record
Everything on this site is the federal CMS survey of Medicare-certified nursing homes. Assisted living facilities are licensed and inspected by each state, in that state’s own tags and classes, and are published separately as the Assisted Living Index. The two are never combined.
The most-cited tags
Ranked by how many facilities have been cited on each.
| Tag | What the surveyor checks | Facilities | Cited twice or more |
|---|---|---|---|
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | 9,765 | 5,024 |
| K-0918 | Have generator or other power source capable of supplying service within 10 seconds. | 7,559 | 3,049 |
| K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. | 6,470 | 2,197 |
| K-0321 | Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | 6,068 | 1,925 |
| K-0363 | Install corridor and hallway doors that block smoke. | 6,055 | 2,198 |
| K-0324 | Provide properly protected cooking facilities. | 5,843 | 1,560 |
| K-0712 | Have simulated fire drills held at unexpected times. | 5,637 | 2,044 |
| K-0920 | Ensure proper usage of power strips and extension cords. | 5,344 | 1,857 |
| K-0372 | Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | 4,576 | 1,181 |
| K-0923 | Have proper medical gas storage and administration areas. | 4,257 | 829 |
| K-0511 | Have properly installed electrical wiring and gas equipment. | 4,249 | 1,261 |
| K-0211 | Keep aisles, corridors, and exits free of obstruction in case of emergency. | 4,129 | 907 |