PennLive: Failing the Frail (8/4/2016) A PennLive investigation regarding nursing home violations that contributed to residents’ deaths revealed that the Pennsylvania Department of Health failed to properly classify violations and penalize culpable nursing homes. Though states are supposed to cite nursing home violations that result in death or significant harm to residents with the highest severity level, known as “immediate jeopardy,” Pennsylvania’s Department of Health has issued the citation at one of the lowest rates in the nation. From 2013 to 2015, only one out of 46 care-related deaths was categorized at this level. Justice in Aging’s Eric Carlson said that the state’s definition and explanation of the term is inconsistent with that of the federal government. Experts and senior care advocates agree, along with several studies, that one of the most effective ways the department could prevent avoidable deaths is to penalize nursing homes where they occur.