{
  "study": {
    "slug": "nursing-home-deficiency-correction-time",
    "title": "How fast do nursing homes fix what surveyors cite? 28.5 days for the harmful ones",
    "standfirst": "Across 410,723 corrected CMS nursing home health deficiencies, the mean time from survey to documented correction is 32.4 days — but the harm-level citations, Severity G and above, close faster, in 28.5 days. The more severe the finding, the quicker the fix. Texas and Illinois correct in about two weeks; Washington, D.C. takes nine.",
    "desk": "care-quality",
    "article_type": "Original Research",
    "published": "2026-06-04",
    "issue": 48,
    "doi": "10.5072/fonteum/nh-correction-time-2026",
    "url": "https://fonteum.com/research/nursing-home-deficiency-correction-time",
    "methodology_version": "nh-correction-time/v1"
  },
  "data_as_of": "2026-05-25",
  "datasets": [
    {
      "slug": "cms-nursing-home-compare",
      "name": "CMS Nursing Home Compare",
      "publisher": "CMS — Nursing home quality (Care Compare)",
      "upstream_url": null
    }
  ],
  "key_findings": [
    {
      "number": "32.4",
      "finding": "days mean correction time across all severities (410,723 corrected citations with a valid span)",
      "dataset": "cms-nursing-home-compare"
    },
    {
      "number": "28.5",
      "finding": "days mean time-to-correction for harm-level Severity G+ citations (20,297 citations)",
      "dataset": "cms-nursing-home-compare"
    },
    {
      "number": "26.2",
      "finding": "days — immediate-jeopardy citations close fastest of all severity bands",
      "dataset": "cms-nursing-home-compare"
    },
    {
      "number": "16.5→64.5",
      "finding": "days — mean correction time ranges from 16.5 in Texas (fastest) to 64.5 in Washington, D.C. (slowest), a near four-fold spread across states",
      "dataset": "cms-nursing-home-compare"
    }
  ],
  "faqs": [
    {
      "q": "How fast do nursing homes fix cited deficiencies?",
      "a": "Across 410,723 corrected CMS nursing-home health deficiencies, the mean time from survey to documented correction is 32.4 days. Harm-level citations (Severity G and above) close faster — 28.5 days on average, with a median of 26."
    },
    {
      "q": "Do more severe citations get fixed faster?",
      "a": "Yes, counter to intuition. Immediate-jeopardy citations (Severity J–L) are corrected fastest of any band, in 26.2 days on average, because federal rules give facilities almost no time to leave them open. Minimal-harm citations — about 93% of the corrected universe — take the longest, at 32.6 days."
    },
    {
      "q": "Which states correct fastest and slowest?",
      "a": "Among states with at least 500 corrected citations, the mean correction time ranges from 16.5 days in Texas and 16.8 in Illinois to 64.5 days in Washington, D.C. and 51.9 in New York — a near four-fold spread."
    },
    {
      "q": "How many citations does this cover?",
      "a": "The snapshot holds 418,148 health deficiencies; 415,849 carry both a survey and a correction date. After excluding 2,299 still-open citations and 5,126 with a correction date before the survey date, 410,723 have a valid non-negative span."
    },
    {
      "q": "Is a faster correction always better?",
      "a": "Not necessarily. This measures the documented administrative gap between the survey and the recorded correction, not clinical outcome quality. It is a descriptive measure of process speed, not a judgment of care."
    }
  ],
  "citation": {
    "apa": "Fonteum Research. (2026, June 04). How fast do nursing homes fix what surveyors cite? 28.5 days for the harmful ones. Fonteum Research, Issue 48. https://doi.org/10.5072/fonteum/nh-correction-time-2026",
    "url": "https://fonteum.com/research/nursing-home-deficiency-correction-time"
  },
  "reproducible_sql": "-- Time-to-Correction: CMS Nursing Home Health Deficiencies (2026).\n-- Source table: nh_health_deficiencies (CMS Care Compare NH Health\n-- Deficiencies; snapshot frozen 2026-05-25; US-Government-Works).\n--\n-- Metric: correction lead time = correction_date - survey_date, in whole days.\n-- Rows excluded: open citations (correction_date IS NULL, n=2,299) and\n-- negative spans where correction_date predates survey_date (n=5,126, a CMS\n-- data quirk — excluded outright, never clamped to zero). 410,723 of the\n-- 415,849 corrected citations carry a valid non-negative span.\n--\n-- CMS scope/severity bands: no harm A-C, minimal harm D-F, actual harm G-I,\n-- immediate jeopardy J-L. \"Harm-level\" = G+ (G-L).\n\n-- 1. National correction time by harm band -----------------------------------\nwith corrected as (\n  select\n    (correction_date - survey_date) as days,\n    upper(left(scope_severity_code, 1)) as sev\n  from nh_health_deficiencies\n  where survey_date is not null\n    and correction_date is not null\n    and (correction_date - survey_date) >= 0\n)\nselect\n  case\n    when sev in ('A','B','C') then '1 no harm (A-C)'\n    when sev in ('D','E','F') then '2 minimal harm (D-F)'\n    when sev in ('G','H','I') then '3 actual harm (G-I)'\n    when sev in ('J','K','L') then '4 immediate jeopardy (J-L)'\n  end as harm_band,\n  count(*) as n,\n  round(avg(days)::numeric, 2) as mean_days,\n  round(percentile_cont(0.5) within group (order by days)::numeric, 1) as median_days,\n  round(percentile_cont(0.9) within group (order by days)::numeric, 1) as p90_days\nfrom corrected\nwhere sev in ('A','B','C','D','E','F','G','H','I','J','K','L')\ngroup by harm_band\norder by harm_band;\n\n-- 2. Headline metric: harm-level (Severity G+) correction time ---------------\n--    Expected: n=20,297 · mean 28.48 · median 26 · p90 53.\nselect\n  count(*) as harm_level_n,\n  round(avg(correction_date - survey_date)::numeric, 2) as mean_days,\n  round(percentile_cont(0.5) within group (order by (correction_date - survey_date))::numeric, 1) as median_days,\n  round(percentile_cont(0.9) within group (order by (correction_date - survey_date))::numeric, 1) as p90_days\nfrom nh_health_deficiencies\nwhere survey_date is not null\n  and correction_date is not null\n  and (correction_date - survey_date) >= 0\n  and upper(left(scope_severity_code, 1)) in ('G','H','I','J','K','L');\n\n-- 3. State rankings: mean correction time (all corrected, n>=500) ------------\nselect\n  state,\n  count(*) as n,\n  round(avg(correction_date - survey_date)::numeric, 2) as mean_days,\n  round(percentile_cont(0.5) within group (order by (correction_date - survey_date))::numeric, 1) as median_days\nfrom nh_health_deficiencies\nwhere survey_date is not null\n  and correction_date is not null\n  and (correction_date - survey_date) >= 0\n  and state is not null\n  and length(state) = 2\ngroup by state\nhaving count(*) >= 500\norder by mean_days asc;",
  "license": "U.S. Government Works (federal sources; 17 U.S.C. §105)",
  "generated_by": "Fonteum — https://fonteum.com",
  "notes": "Aggregate, source-traced figures frozen to the snapshot above. Reproduce by running reproducible_sql against the cited federal dataset; no per-entity records are included."
}