What Happens After a Nursing Home Inspection?

By Sarah Mitchell, RN, RAC-CT, Clinical Compliance Editor · 2026-03-15 · 8 min read

A complete walkthrough of everything that happens after CMS surveyors finish inspecting your skilled nursing facility — timelines, requirements, and what you need to do at each stage.

The Exit Conference: Your First Indication

The inspection process doesn't end when surveyors leave the building. In fact, the most critical phase begins at the exit conference. During this informal meeting, the survey team shares preliminary findings with facility leadership — typically the Administrator, Director of Nursing (DON), and any other key staff. It's important to understand that the exit conference is not your official notice of deficiencies. The findings discussed here are preliminary and may change before the final CMS-2567 is issued. However, this is your first opportunity to clarify misunderstandings, provide additional documentation, or correct factual errors. Smart administrators take detailed notes during the exit conference and immediately begin gathering evidence for their response.

Key points to remember during the exit conference:

Bring your DON, Administrator, and department heads who were involved in the survey
Take detailed notes on every finding discussed
Ask clarifying questions about specific observations
Do not argue or become defensive — listen and document
Request clarification on the scope and severity of each finding
Begin identifying staff who will be responsible for corrective actions

Receiving the CMS-2567: Official Notice of Deficiencies

Within approximately 10 business days after the survey concludes, you'll receive the official CMS-2567 Statement of Deficiencies. This is the formal document that lists every regulatory violation identified during the inspection. Each citation includes an F-Tag number (the specific federal regulation violated), a scope and severity rating (from A to L), a detailed narrative describing the deficient practice, and the number of residents affected.

The scope and severity grid is crucial to understand:

Levels A-C: No actual harm with potential for minimal harm (isolated, pattern, or widespread)
Level D: No actual harm with potential for more than minimal harm but not immediate jeopardy (isolated)
Levels E-F: Same as D but pattern or widespread
Levels G-I: Actual harm that is not immediate jeopardy
Levels J-L: Immediate Jeopardy to resident health or safety

Immediate Jeopardy findings (J, K, or L) require urgent action and carry the most severe penalties, including potential termination from Medicare/Medicaid programs.

The Plan of Correction: Your 10-Day Window

Once you receive the CMS-2567, the clock starts ticking. Federal regulations give you 10 calendar days to submit a written Plan of Correction (POC) for every deficiency cited. This is arguably the most critical compliance document your facility will produce. A well-written POC demonstrates to CMS that you understand what went wrong, have already taken steps to fix it, and have systems in place to prevent it from happening again.

Each POC must address five essential elements:
1. What corrective action was taken for the specific residents affected?
2. How were other potentially affected residents identified and protected?
3. What systemic changes were implemented to prevent recurrence?
4. How will the facility monitor to ensure the corrective action is effective?
5. What is the completion date for all corrective actions?

Many administrators struggle with this timeline, especially when dealing with multiple citations. The key is to start working on your POC immediately after the exit conference — don't wait for the official 2567. Use the preliminary findings to begin drafting responses and implementing corrective actions.

State Agency Review and Acceptance

After you submit your POC, the State Survey Agency reviews it for adequacy. They're evaluating whether your plan credibly addresses each deficiency and whether your proposed corrective actions and monitoring systems are likely to prevent recurrence. If your POC is deemed inadequate, it will be returned for revision — and you'll need to respond quickly. A rejected POC doesn't reset your timeline; the original deadlines remain in effect.

Common reasons POCs get rejected:

Responses are too vague or generic ('staff will be re-educated' without specifics)
Missing one or more of the five required elements
Completion dates are unrealistic or too far in the future
Corrective actions don't address the root cause of the deficiency
No clear monitoring plan with frequency, responsible person, and duration
Systemic changes are not described in enough detail

Revisit Surveys and Compliance Verification

The State Survey Agency will typically conduct a revisit survey within 45-60 days of the original survey to verify that your facility has implemented the corrections described in your POC. During the revisit, surveyors will look for evidence that corrective actions were carried out, systemic changes are in place and functioning, monitoring is occurring as described, and residents are no longer being affected by the cited practices.

If the revisit confirms compliance, the case is closed. If deficiencies persist, additional enforcement actions may be taken, including Civil Money Penalties (CMPs), Denial of Payment for New Admissions (DPNA), or in severe cases, termination from Medicare/Medicaid. For Immediate Jeopardy findings, CMS may impose an immediate DPNA even before the revisit if the facility hasn't demonstrated abatement of the IJ situation.

Enforcement Actions and Penalties

The consequences of inspection findings vary dramatically based on scope and severity. Understanding the potential penalties helps you prioritize your response:

Civil Money Penalties (CMPs): Range from $50-$20,965 per day or ,000-$209,628 per instance of non-compliance. IJ findings typically trigger the highest penalties.

Denial of Payment for New Admissions (DPNA): Automatically imposed if a facility doesn't achieve substantial compliance within 3 months of the original survey. This can be financially devastating.

State Monitor: For serious or repeated deficiencies, CMS may place an independent monitor in your facility at the facility's expense.

Termination: The ultimate penalty — removal from Medicare and Medicaid programs. This typically only occurs with IJ findings that aren't corrected or repeated serious deficiencies over time.

The best defense against enforcement actions is a strong, comprehensive Plan of Correction submitted on time with documented evidence of implementation.

How to Prepare for Success

The facilities that navigate the post-inspection process most effectively are the ones that prepare before the survey even happens. Here are strategies used by top-performing SNFs:

Maintain survey-ready documentation at all times. Don't wait for a survey to organize your policies, procedures, and care plans. Keep a 'survey binder' with current policies organized by F-Tag category.

Conduct regular internal mock surveys. Use the same tools and standards that CMS surveyors use. This helps identify potential deficiencies before the surveyors do.

Build a POC response team. Designate staff members who will be responsible for POC writing, evidence gathering, and implementation tracking. Don't leave this to the Administrator alone.

Track your citation history. Understanding your facility's deficiency patterns helps you focus quality improvement efforts where they matter most. Recurring citations in the same F-Tag categories are a red flag that surveyors will notice.

Use technology to streamline the process. Modern compliance platforms can help you parse 2567 documents, generate draft POC responses, track deadlines, and manage the entire post-survey workflow — turning a stressful 10-day scramble into a structured process.

Frequently Asked Questions

How long after a nursing home inspection do you get results?

Facilities typically receive the official CMS-2567 Statement of Deficiencies within 10 business days after the survey concludes. The exit conference happens on the last day of the survey, giving preliminary (but unofficial) results immediately.

What happens if a nursing home fails an inspection?

Nursing homes don't technically 'fail' inspections, but they receive citations for deficiencies. The facility must submit a Plan of Correction within 10 calendar days, then undergo a revisit survey to verify compliance. Penalties depend on the severity — ranging from Civil Money Penalties to Denial of Payment for New Admissions.

Can a nursing home be shut down after an inspection?

Yes, but it's rare and typically only occurs with Immediate Jeopardy findings that aren't corrected or repeated serious deficiencies over time. CMS can terminate a facility from Medicare/Medicaid programs, effectively shutting it down if it relies on those payment sources.

How long does a nursing home have to fix deficiencies?

Facilities must submit a Plan of Correction within 10 calendar days of receiving the CMS-2567. The completion date for corrective actions is typically within 30-60 days. A revisit survey occurs within 45-60 days to verify compliance.