CMS Survey Data

Oxygen Safety Citations in Nursing Homes: What 4,000+ CMS Citations Show

Oxygen storage and handling is one of the most-cited Life Safety Code areas in U.S. nursing homes. We analyzed three years of CMS survey data to show what surveyors find, and how to keep cylinders and concentrators off your next survey report.

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Oxygen Is One of the Most-Cited Safety Areas in Nursing Homes

Almost every nursing home uses oxygen, whether from concentrators in resident rooms, cylinders on wheelchairs or a liquid oxygen system. CMS survey data shows it's also one of the areas surveyors cite most. From September 2023 to August 2026, Life Safety Code surveyors issued these oxygen and medical gas citations to U.S. nursing homes:

K-tagWhat it coversCitationsFacilities
K923Medical gas storage and administration areas3,4603,072
K926Staff training on medical gas and cylinder handling352318
K927Transfilling oxygen: fire barriers, ventilation, signs306282
K929Precautions for handling oxygen cylinders and equipment248236

K923 alone reached more than one in five U.S. nursing homes (3,072 of 14,690) in three years. California facilities received the most K923 citations (483), followed by Missouri, Pennsylvania, Ohio and Texas.

What Surveyors Typically Find

  • Cylinders not secured: standing loose in a room or closet instead of in a rack or cart
  • Full and empty cylinders mixed together without separation or labeling
  • Too many cylinders stored outside a designated room, or storage rooms missing signage or ventilation
  • Oxygen near ignition sources: candles, space heaters, smoking materials or open flames
  • Transfilling in the wrong place: filling portable cylinders outside a properly built and ventilated area
  • Staff who can't explain the procedures for handling and storing cylinders

Where Concentrators Fit

Oxygen concentrators avoid some cylinder storage issues, but they're powered medical equipment in resident rooms, so they bring their own requirements: preventive maintenance per the manufacturer, O2 purity and flow checks, filter service, alarm checks, and inclusion in your electrical safety (PCREE) testing. A concentrator plugged into the wrong power strip can also lead to a K920 citation. A qualified technician can cover all of it in one visit. See oxygen concentrator repair and service.

A Quick Pre-Survey Oxygen Checklist

  1. Every cylinder secured in a rack, cart or holder
  2. Full and empty cylinders separated and labeled
  3. Storage rooms signed, ventilated and within quantity limits
  4. "Oxygen in use" signs where required, and no ignition sources nearby
  5. Transfilling only in a compliant, designated area
  6. Concentrators on a PM schedule with purity and flow checks on file
  7. Concentrators plugged directly into wall receptacles or a compliant power tap
  8. Staff trained on cylinder handling, with training records

Source: Medical Equipment Repair Network analysis of the CMS Provider Data Catalog, Nursing Homes: Fire Safety Deficiencies (processed September 2026), survey dates September 1, 2023 to August 20, 2026.

Request a free quote for oxygen concentrator service at your facility.

Frequently Asked Questions

From September 2023 to August 2026, CMS data shows 3,460 K923 citations for medical gas storage and administration areas at 3,072 U.S. nursing homes, more than one in five facilities.
Yes. Concentrators should be maintained on the manufacturer's schedule, with O2 purity and flow checks, filter service, alarm checks and electrical safety testing, and the records kept for surveyors.
K923 is the Life Safety Code tag CMS uses for medical gas storage and administration areas, covering how oxygen cylinders and other medical gases are stored, secured and signed.