Surveyors found immediate jeopardy at U.S. hospitals in 1,346 surveys from 2021 through 2025, according to a Becker’s analysis of CMS data.
An immediate jeopardy is the most serious finding a hospital can receive. It means a hospital’s failure to meet Medicare requirements has caused, or is likely to cause, serious injury, harm, impairment or death to a patient. A hospital that does not remove an immediate jeopardy can lose its Medicare participation in as little as 23 days.
Hospital immediate jeopardy surveys rose from 248 in 2021 and 255 in 2022 to a five-year high of 330 in 2023. They then fell to 279 in 2024 and 234 in 2025. Figures include the 50 states and Washington, D.C., and exclude U.S. territories such as Puerto Rico and Guam.
Becker’s also reviewed 2019 and 2020 data for comparison. The share of surveys resulting in an immediate jeopardy held steady at about 5% from 2019 through 2022, despite fewer inspections during the pandemic, before rising to 6.4% in 2023
Becker’s analyzed CMS Form 2567 deficiency reports for hospitals with surveys dated from Jan. 1, 2021, through Sept. 14, 2026. A survey was counted when the report stated that surveyors identified an immediate jeopardy. Because one survey can include more than one immediate jeopardy, the figures count surveys, not individual findings. State rates are immediate jeopardy surveys per 100 hospitals surveyed from 2021 to 2025.
The national rate was 25.9, and 5.1% of all surveys ended in an immediate jeopardy.
Some 2025 and 2026 counts are likely to rise. Immediate jeopardy cases often take longer to resolve than routine surveys, so their reports post later. Rates also partly reflect how often and how strictly each state’s survey agency inspects hospitals.
Four takeaways:
- Nearly all start with a complaint. About 95% of immediate jeopardy surveys from 2021 to 2025 began with a complaint investigation rather than a routine inspection.
- Psychiatric hospitals are cited at a higher rate. About 7% of psychiatric hospital surveys ended in an immediate jeopardy, compared with about 5% for general acute care hospitals. Psychiatric hospitals accounted for 22% of all immediate jeopardy surveys.
- Patient rights are cited most often. Patient rights were cited in 54% of immediate jeopardy surveys. Next were nursing services (30%), governing body (19%) and quality assessment and performance improvement (17%).
- Rhode Island is the outlier. Its 23 immediate jeopardy surveys occurred at eight of its 16 hospitals surveyed, a rate of 143.8 per 100 hospitals, more than five times the national rate. Among states with 20 or more hospitals surveyed, New Jersey (74.7), Oregon (65.7) and Colorado (58.7) had the highest rates.
Here’s how states compare, ranked by immediate jeopardy surveys per 100 hospitals surveyed from 2021 to 2025:
| State | Immediate jeopardy surveys between 2021 and 2025 | Rate per 100 hospitals surveyed, 2021-25 | 2025 count | 2026 count so far |
| Rhode Island | 23 | 143.8 | 3 | 4 |
| New Jersey | 71 | 74.7 | 13 | 0 |
| Oregon | 23 | 65.7 | 3 | 1 |
| Colorado | 61 | 58.7 | 5 | 2 |
| West Virginia | 30 | 50.8 | 2 | 0 |
| Connecticut | 16 | 50 | 2 | 0 |
| Missouri | 66 | 49.3 | 13 | 0 |
| Illinois | 91 | 46.9 | 10 | 3 |
| New York | 68 | 43.3 | 12 | 1 |
| Tennessee | 59 | 40.7 | 7 | 4 |
| Delaware | 7 | 38.9 | 0 | 0 |
| California | 143 | 38.8 | 42 | 13 |
| Pennsylvania | 63 | 34.2 | 5 | 1 |
| Georgia | 47 | 33.1 | 7 | 8 |
| Kansas | 32 | 29.9 | 6 | 1 |
| Minnesota | 34 | 29.3 | 6 | 3 |
| New Mexico | 13 | 27.1 | 1 | 0 |
| Alaska | 4 | 26.7 | 0 | 1 |
| National rate (U.S. total) | 1,346 | 25.9 | 234 | 70 |
| Texas | 135 | 23.9 | 19 | 9 |
| Florida | 50 | 22.6 | 9 | 0 |
| North Carolina | 28 | 22.6 | 5 | 5 |
| Washington | 20 | 22.5 | 2 | 0 |
| Arizona | 19 | 22.1 | 5 | 2 |
| Alabama | 17 | 21.2 | 2 | 0 |
| District of Columbia | 2 | 18.2 | 0 | 0 |
| Michigan | 26 | 17.6 | 5 | 4 |
| Massachusetts | 15 | 16.9 | 4 | 0 |
| Iowa | 18 | 15.8 | 0 | 1 |
| Arkansas | 14 | 15.7 | 4 | 0 |
| Montana | 9 | 15.5 | 0 | 0 |
| Idaho | 6 | 15.4 | 2 | 1 |
| Louisiana | 28 | 15.3 | 7 | 1 |
| Virginia | 13 | 12.9 | 1 | 0 |
| Maine | 5 | 12.5 | 0 | 0 |
| Indiana | 15 | 11.2 | 8 | 2 |
| Hawaii | 2 | 10.5 | 1 | 0 |
| South Carolina | 5 | 10.2 | 3 | 0 |
| South Dakota | 6 | 10.2 | 0 | 0 |
| Utah | 4 | 9.8 | 1 | 0 |
| Ohio | 19 | 9.7 | 10 | 2 |
| Wisconsin | 13 | 9.4 | 3 | 1 |
| Kentucky | 8 | 8.7 | 1 | 0 |
| Wyoming | 2 | 7.7 | 2 | 0 |
| Nevada | 2 | 7.1 | 0 | 0 |
| Mississippi | 5 | 5.2 | 2 | 0 |
| Nebraska | 4 | 4.5 | 0 | 0 |
| Maryland | 1 | 4.3 | 0 | 0 |
| Oklahoma | 4 | 3.6 | 1 | 0 |
| North Dakota | 0 | 0 | 0 | 0 |
| New Hampshire | 0 | 0 | 0 | 0 |
| Vermont | 0 | 0 | 0 | 0 |
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