Type A and Type B citations: what they mean for an RCFE

Deficiencies and citations in plain words

A deficiency is a violation of a law or regulation. A citation is the written notice of deficiency that licensing gives to the licensee. You will see both words on the state's Care Facility Search.

When a licensing analyst finds a deficiency, they meet with the person in charge before the visit ends. The written notice names the rule, describes what was wrong and where, includes a plan for correcting it, and sets a date to fix it. Licensing may skip a notice for a minor problem corrected during the visit. Type A citations are always issued, even when the problem is corrected on the spot.

Type A citations

Type A citations are for the most serious violations, where there is an immediate risk to the health, safety, or personal rights of the people in care. The state gives these examples:

• Lack of care or supervision.
• Access to open bodies of water.
• No fire clearance for the building.
• Access to dangerous chemicals.

Type B citations

Type B citations are for violations that, if not corrected, may become an immediate risk to residents' health, safety, or personal rights. The state's examples are faulty medical record keeping and lack of adequate staff training.

Type B problems still matter, because records and training affect daily care. Ask what the citation covered. A single paperwork problem that was fixed is different from the same rule being cited again and again.

Why counting citations can mislead

Two homes with the same number of citations can be very different. A missing fire clearance and a lack of supervision are both Type A examples, but they tell you different things about daily life in a home. Read each one, and keep these points in mind:

• Size matters. A home licensed for 100 residents and a home for six are hard to compare by totals alone. Capacity is listed on each home's page.
• Timing matters. The website covers the most recent 60 months. An old problem that was corrected and never repeated weighs differently than one from last month.
• Appeals matter. If a licensee appeals and the deficiency is found to be issued in error, it stays on the report with a note that it is not valid.
• Complaints are not all findings. Only a substantiated allegation means licensing found enough evidence that the violation occurred.
• Records can have errors. The state notes that a mismatch, such as a substantiated complaint with no citation, may be a data error or a successful appeal.

What licensing cites most often in RCFEs

CDSS publishes the deficiencies it cites most often during RCFE inspections. Its report for 2025, published in May 2026, listed these areas in the top ten:

Because these come up often, finding one on a report is not unusual. What matters more is how serious it was, whether it was fixed, and whether it keeps happening.

• Incidental medical care and medication handling, including medications the home stores for residents.
• Keeping the building clean, safe, and in good repair, including water and plumbing.
• Emergency and disaster plans, and emergency drills on each shift.
• Locked storage for cleaning products, knives, tools, and other items that could hurt residents.
• Staff records and staff training.
• Updating residents' appraisals and medical assessments.
• Food service.

How to weigh what you find

State rules name areas where a violation can be a serious deficiency when it threatens residents. These include criminal record clearances for staff, fire clearance, night supervision, use of restraints, and storing and handling medications. Give findings in these areas extra attention.

• Read the narrative in each report, not just the citation label.
• Note the date, and whether the same rule was cited more than once.
• Check whether the problem was corrected by the date licensing set. Licensing can make follow-up visits, and penalties can apply when a deficiency is not corrected on time.
• Look at complaint findings separately from routine inspection findings.
• Call the regional licensing office if anything is unclear. It has details the website may not show.

Questions to ask the home

Bring the reports with you, or have them on your phone, and ask about each citation. Clear, specific answers are a good sign. Vague answers are worth noting.

• What led to this citation, and was anyone hurt?
• What did you change in staffing, training, or procedures?
• Was the plan of correction finished on time?
• Has licensing visited since, and what did they find?
• Who is the administrator now, and how long have they been in the role?