DCSIMG
Scope and Severity Matrix

Scope and Severity

Scope and Severity is a system of rating the seriousness of deficiencies. A "deficiency" is a regulatory requirement that a survey finds is not being met. Scope and Severity is a national system used by all state survey agencies and the Health Care Financing Administration when conducting nursing home Medicare and Medicaid certification surveys. For each deficiency, the surveyor determines the level of harm to the resident or resident(s) involved and the scope of the problem within the nursing home. The surveyor then assigns an alphabetical scope and severity value, A through L, to the deficiency. "A" is the least serious and "L" is the most serious rating. The scope and severity matrix is an integral part of how nursing home scores are calculated in the scoring system.

Scope of the Deficiency

 Severity of the Deficiency

Isolated

Pattern

Widespread

Immediate jeopardy to resident health or safety

J

K

L

Actual harm that is not immediate jeopardy

G

H

I

No actual harm with potential for more than minimal harm that is not immediate jeopardy

D

E

F

No actual harm with potential for minimal harm

A

B

C

  

Shaded boxes within the grid denote deficiency ratings which constitute Substandard Quality of Care if the requirement which is not met is one that falls under the following federal regulations:

  • 42 CFR 483.13 Resident behavior and facility practices
  • 42 CFR 483.15 Quality of life
  • 42 CFR 483.25 Quality of care

  

Any deficiency rating in the top row of the grid, for any regulation, constitutes Immediate Jeopardy.

 

Back to Nursing Homes Report Card