What does a Medium-High risk deficiency mean in Texas?
Updated August 30, 2026 · Sourced from official Texas HHSC records
First, what a deficiency is. The state uses "deficiency" and "violation" to mean the same thing:
“A deficiency, also referred to as a violation, is any failure to comply with a CCR statute, administrative rule or minimum standard. A deficiency is posted to the operation’s online record only after it has had the opportunity to dispute it.”
Each deficiency is tied to a specific Minimum Standard, and every standard is assigned a weight. Here is how the state defines those weights:
“Each minimum standard is assigned a weight of high, medium high, medium, medium low and low based on the risk a violation of the minimum standard presents to children. A requirement weighted as high presents a greater risk to children if violated than a requirement weighted as low.”
The five weights, highest to lowest
- High
- Medium-High
- Medium
- Medium-Low
- Low
The state's own data stores these with spaces ("Medium High"); the public portal displays them hyphenated ("Medium-High"). They are the same weight. CheckedCare shows the state's value as it is recorded and does not invent any severity beyond the agency's own weighting.
How to read a Medium-High count
On a facility page, deficiencies are grouped by their weight so you can see where an operation's citations fall on the state's scale. A weight describes the standard that was violated, not a grade for the operation. CheckedCare publishes the counts and the agency's verbatim narrative for each citation, never a rating. To see where a citation came from, read how to look up a daycare's inspection record.