Level of Harm Definitions

Potential for Minimal Harm (1 Point)
This deficiency has the potential for causing no more than a minor negative impact on the resident.

Example: The nursing home's statement of deficiencies was not posted, nor was there any sign indicating where it was. The nursing home keeps the statement of deficiencies in the business office and shows it to residents upon request.

Minimal Harm or Potential for Actual Harm (2 Points)
This deficiency results in minimal discomfort to the resident or has the potential (not yet realized) to negatively affect the resident's ability to achieve his/her highest functional status.

Example: Staff were observed not washing hands properly between resident treatments. There is no evidence of the transmission of infection between residents by staff.

Actual Harm (3 Points)
This deficiency results in a negative outcome that has negatively affected the resident's ability to achieve his/her highest functional status.

Example: A resident was "active and vocal" on admission to the nursing home. The nursing home restrained the resident 6 months ago, despite the lack of medical symptoms for doing so. The resident is now withdrawn, does not attend activities, and is "down in the dumps."

Immediate Jeopardy (4 Points)
This deficiency places the resident in immediate jeopardy as it has caused (or is likely to cause) serious injury, harm, impairment, or death to a resident receiving care in the nursing home. Immediate corrective action is necessary when this deficiency is identified.

Example: A resident with dementia was found outside during an inspection, heading toward a nearby highway. The nursing home had no working system in place to monitor residents with dementia.

Reference: The Official U.S. Government Site for People with Medicare