04/02/2026

You Asked... We Answered

You Asked: Where can the current scope and severity grid for nursing homes be found?  

We Answered: CMS provides this scope and severity grid in the State Operations Manual (SOM), Chapter 7 Survey and Enforcement Process for Skilled Nursing Facilities and Nursing Facilities, specifically under Section 7400.3.1 Matrix for Scope & Severity. This matrix outlines how surveyors determine the level of deficiency based on the scope (isolated, pattern, widespread) and severity (potential for minimal harm through immediate jeopardy). 

The CMS Five-Star Technical User Guide also includes the scope and severity grid, along with the points assigned to each level, which directly impact a facility’s Five-Star rating on Care Compare.