PlainNursing
CMS Nursing Home Compare · August 2026

How does your nursing home really rate?

Every Medicare- and Medicaid-certified nursing home, ranked on CMS Five-Star ratings, nurse-staffing hours, health-inspection findings, and three-year fine history - 14,690 U.S. facilities, in plain view.

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Nursing Homes
14,690
Avg Overall Rating
3.0 / 5
Total Beds
1,567,504
Total Fines
$456.8M

The national picture

The average U.S. nursing home earns 3.0 of 5 CMS stars, but quality is sharply uneven: about 20% reach the top mark and a near-equal 21% land at the bottom.

3.0 / 5
Mean CMS overall rating, 14,563 rated homes
2,981
Five-star facilities (20%)
3,015
One-star facilities (21%)
$456.8M
Federal fines, 13,256 penalties

Ratings combine health inspections, nurse-staffing levels, and clinical quality measures. 84 facilities are under active CMS Special Focus Facility enforcement, plus 441 more flagged as lower-tier SFF Candidates.

Ownership mix · CMS provider file

How 14,690 certified nursing homes split by ownership sector

Exclusive CMS ownership sectors: For-profit, Nonprofit, and Government (city/county/state/federal/hospital-district). Source: CMS Nursing Home Compare, August 2026.

How U.S. nursing homes are rated

5-star2,981 · 20%4-star2,785 · 19%3-star2,820 · 19%2-star2,962 · 20%1-star3,015 · 21%
CMS overall star rating across 14,563 rated facilities · source: CMS Nursing Home Compare, August 2026

According to the Centers for Medicare & Medicaid Services, every Medicare- and Medicaid-certified nursing home in the United States - 14,690 facilities as of August 2026 - is surveyed on a rolling basis and scored from one to five stars. The average home rates 3.0, yet more than 2,981 sit at each extreme: a spread that makes the three underlying components, health-inspection findings, nurse-staffing hours, and clinical quality measures, far more telling than the headline star alone. Every figure on this site is computed directly from the public CMS Nursing Home Compare dataset; see our methodology for how each number is derived and refreshed.

Does heavier staffing mean a higher rating?

Not reliably. Because CMS curves the overall star within each state, the states are not lined up on a diagonal, each dot is a state, plotted by its average nurse-staffing hours and its average CMS rating, against the U.S. averages (crosshairs).

Top-rated on leaner staffingWell-staffed & top-ratedLean staffing, lower-ratedWell-staffed, rating curved down3.24.15.05.96.92.52.73.03.33.6Avg total nurse hours / resident-dayAvg CMS overall ratingAL, Avg total nurse hours / resident-day: 3.88 · Avg CMS overall rating: 3AK, Avg total nurse hours / resident-day: 6.69 · Avg CMS overall rating: 3.45AZ, Avg total nurse hours / resident-day: 3.97 · Avg CMS overall rating: 3.32AR, Avg total nurse hours / resident-day: 4.03 · Avg CMS overall rating: 3.41CA, Avg total nurse hours / resident-day: 4.52 · Avg CMS overall rating: 3.16CO, Avg total nurse hours / resident-day: 3.72 · Avg CMS overall rating: 3.13CT, Avg total nurse hours / resident-day: 3.73 · Avg CMS overall rating: 2.99DE, Avg total nurse hours / resident-day: 4.34 · Avg CMS overall rating: 3.28DC, Avg total nurse hours / resident-day: 4.76 · Avg CMS overall rating: 3.35FL, Avg total nurse hours / resident-day: 3.82 · Avg CMS overall rating: 3.27GA, Avg total nurse hours / resident-day: 3.56 · Avg CMS overall rating: 2.64HI, Avg total nurse hours / resident-day: 4.97 · Avg CMS overall rating: 3.56ID, Avg total nurse hours / resident-day: 4.04 · Avg CMS overall rating: 3.14IL, Avg total nurse hours / resident-day: 3.45 · Avg CMS overall rating: 2.55IN, Avg total nurse hours / resident-day: 3.68 · Avg CMS overall rating: 3.14IA, Avg total nurse hours / resident-day: 3.81 · Avg CMS overall rating: 3.07KS, Avg total nurse hours / resident-day: 4.07 · Avg CMS overall rating: 3.11KY, Avg total nurse hours / resident-day: 3.95 · Avg CMS overall rating: 3.01LA, Avg total nurse hours / resident-day: 3.73 · Avg CMS overall rating: 2.52ME, Avg total nurse hours / resident-day: 4.34 · Avg CMS overall rating: 3.09MD, Avg total nurse hours / resident-day: 3.87 · Avg CMS overall rating: 3.13MA, Avg total nurse hours / resident-day: 3.86 · Avg CMS overall rating: 3.04MI, Avg total nurse hours / resident-day: 3.99 · Avg CMS overall rating: 3.12MN, Avg total nurse hours / resident-day: 4.19 · Avg CMS overall rating: 3.15MS, Avg total nurse hours / resident-day: 4.18 · Avg CMS overall rating: 2.76MO, Avg total nurse hours / resident-day: 3.43 · Avg CMS overall rating: 2.51MT, Avg total nurse hours / resident-day: 4.05 · Avg CMS overall rating: 2.88NE, Avg total nurse hours / resident-day: 3.98 · Avg CMS overall rating: 2.75NV, Avg total nurse hours / resident-day: 4.3 · Avg CMS overall rating: 3.17NH, Avg total nurse hours / resident-day: 3.9 · Avg CMS overall rating: 3.08NJ, Avg total nurse hours / resident-day: 3.85 · Avg CMS overall rating: 3.31NM, Avg total nurse hours / resident-day: 3.53 · Avg CMS overall rating: 2.85NY, Avg total nurse hours / resident-day: 3.63 · Avg CMS overall rating: 3.03NC, Avg total nurse hours / resident-day: 3.83 · Avg CMS overall rating: 2.93ND, Avg total nurse hours / resident-day: 4.42 · Avg CMS overall rating: 3.2OH, Avg total nurse hours / resident-day: 3.69 · Avg CMS overall rating: 3.15OK, Avg total nurse hours / resident-day: 3.79 · Avg CMS overall rating: 2.67OR, Avg total nurse hours / resident-day: 5.03 · Avg CMS overall rating: 3.13PA, Avg total nurse hours / resident-day: 3.89 · Avg CMS overall rating: 2.97RI, Avg total nurse hours / resident-day: 3.71 · Avg CMS overall rating: 2.89SC, Avg total nurse hours / resident-day: 3.83 · Avg CMS overall rating: 3.01SD, Avg total nurse hours / resident-day: 3.79 · Avg CMS overall rating: 2.88TN, Avg total nurse hours / resident-day: 3.8 · Avg CMS overall rating: 3TX, Avg total nurse hours / resident-day: 3.38 · Avg CMS overall rating: 2.65UT, Avg total nurse hours / resident-day: 4.07 · Avg CMS overall rating: 3.29VT, Avg total nurse hours / resident-day: 4.22 · Avg CMS overall rating: 2.88VA, Avg total nurse hours / resident-day: 3.76 · Avg CMS overall rating: 2.95WA, Avg total nurse hours / resident-day: 4.37 · Avg CMS overall rating: 3.21WV, Avg total nurse hours / resident-day: 3.66 · Avg CMS overall rating: 2.98WI, Avg total nurse hours / resident-day: 4.21 · Avg CMS overall rating: 2.98WY, Avg total nurse hours / resident-day: 3.87 · Avg CMS overall rating: 2.89

U.S. states by average nurse-staffing hours vs. average CMS overall rating · states with ≥15 certified homes · August 2026

Source: CMS Nursing Home Compare (Provider Information + Payroll-Based Journal) As of August 2026

States

View all 53
State Facilities Avg Rating 5-Star % 1-Star %
Alabama (AL) 224 3.0 19.6% 18.8%
Alaska (AK) 20 3.5 35.0% 15.0%
Arizona (AZ) 140 3.3 26.4% 7.9%
Arkansas (AR) 221 3.4 29.4% 10.9%
California (CA) 1,165 3.2 23.4% 16.4%
Colorado (CO) 210 3.1 21.4% 12.9%
Connecticut (CT) 191 3.0 22.0% 18.3%
Delaware (DE) 44 3.3 22.7% 2.3%
District of Columbia (DC) 17 3.4 23.5% 5.9%
Florida (FL) 694 3.3 25.2% 13.1%
Georgia (GA) 356 2.6 14.3% 29.2%
Guam (GU) 1 3.0 0.0% 0.0%
Hawaii (HI) 43 3.6 34.9% 7.0%
Idaho (ID) 80 3.1 23.8% 22.5%
Illinois (IL) 666 2.5 13.5% 37.1%

Top-Rated Facilities

View all
#1

Iowa Veterans Home

Marshalltown, IA

702 beds
#2

Masonic Village at Elizabethtown

Elizabethtown, PA

434 beds
#3

Dr Susan Smith Mckinney Nursing and Rehabilitation

Brooklyn, NY

320 beds
#4

Lutheran Home, the

Cape Girardeau, MO

274 beds
#5

Beechwood Health Care Center, Inc.

Getzville, NY

272 beds

Explore More

Best-Rated Nursing Homes

Top 50 facilities with 5-star CMS ratings.

Lowest-Rated Nursing Homes

Facilities with 1-star overall ratings.

Most-Fined Facilities

Nursing homes with the highest penalty amounts.

Search Facilities

Find nursing homes by name, city, or ZIP code.

Frequently Asked Questions

What data does PlainNursing provide?

PlainNursing provides CMS Nursing Home Compare data for 14,700+ facilities including staffing levels, health inspection deficiencies, and penalty information.

What do nursing home star ratings mean?

CMS assigns 1-5 star overall ratings based on health inspections, staffing levels, and quality measures. A 5-star rating indicates much above average quality.

Where does the data come from?

All data comes from the Centers for Medicare & Medicaid Services Nursing Home Compare program, which surveys all Medicare and Medicaid certified nursing homes.

Nursing Home Guides

Learn how to interpret CMS data and make informed care decisions.

Understanding Star Ratings

How CMS calculates the 1–5 star system and what each component measures.

Staffing Levels Explained

Why RN and CNA ratios matter and how to read staffing data against national benchmarks.

Choosing a Nursing Home

A practical guide to evaluating facilities using deficiency reports, penalties, and in-person visits.

Warning Signs of Poor Care

Red flags in CMS data: IJ deficiencies, thin staffing, high antipsychotic use, and penalty history.

Evaluating Nursing Home Staffing

RN hours, CNA ratios, national benchmarks, and what turnover rates signal about care quality.

View all guides →

Research

State-level analysis built directly from the CMS dataset on this site. See all research →

States ranked by average rating

Which states' nursing homes score highest, and lowest, on CMS overall ratings.

States ranked by total fines

Aggregate federal penalty volume by state across all certified facilities.

Top states by facility count

Where the nation's skilled-nursing capacity is concentrated.

How to use this data

A star rating is a starting point, not a verdict, read the components that drive it.

  • Check the staffing rating and RN hours, not just the overall stars, thin staffing is the clearest warning sign. Staffing guide
  • Read the health-inspection deficiency history for serious (G-or-higher) and abuse findings before you decide. Deficiencies explained
  • Compare several nearby facilities side by side rather than judging one in isolation. Browse by state

CMS Five-Star ratings measure relative performance bands, not absolute clinical safety, and are refreshed monthly. Always confirm current status with the facility and your state survey agency.

About this data

How PlainNursing works, and why you can trust these numbers

What this site is

PlainNursing is a plain-language front end on CMS Nursing Home Compare. We cover 14,690 certified facilities with staffing, inspection, penalty, and Five-Star inputs so every rating on this site traces to the federal provider file.

Editorial process

  1. Source. Load the CMS Nursing Home Compare provider extracts published on data.cms.gov.
  2. Verify. Keep CMS-assigned facility IDs, survey dates, and measure vintages intact; never invent stars or deficiency codes.
  3. Publish. Compile facility, state, and ranking pages from the same database, with an honest data-as-of stamp on each surface.

Editorial independence & corrections

PlainNursing is independent and is not affiliated with CMS or Medicare.gov. We do not accept payment for rankings or placement. Found an error? Use the contact page with the URL and value; we compare it to the CMS extract and correct the pipeline when the error is ours. See our methodology for source attribution.

Frequently asked

What data does PlainNursing provide?

PlainNursing provides CMS Nursing Home Compare data for 14,700+ facilities including staffing levels, health inspection deficiencies, and penalty information.

What do nursing home star ratings mean?

CMS assigns 1-5 star overall ratings based on health inspections, staffing levels, and quality measures. A 5-star rating indicates much above average quality.

Where does the data come from?

All data comes from the Centers for Medicare & Medicaid Services Nursing Home Compare program, which surveys all Medicare and Medicaid certified nursing homes.