States Ranked by Nursing Home Quality
All 53 U.S. states and territories ranked by average CMS overall nursing home rating.
| # | State | Avg Rating | Facilities | 5-Star | 1-Star | Avg RN Hrs | Turnover |
|---|---|---|---|---|---|---|---|
| 1 | Hawaii (HI) | 3.6 | 42 | 15 | 2 | 1.63 | 36.5% |
| 2 | District of Columbia (DC) | 3.5 | 17 | 5 | 1 | 1.74 | 33.2% |
| 3 | Alaska (AK) | 3.5 | 20 | 6 | 3 | 2.15 | 46.8% |
| 4 | Arizona (AZ) | 3.4 | 140 | 43 | 10 | 0.71 | 47.7% |
| 5 | Arkansas (AR) | 3.4 | 221 | 62 | 27 | 0.40 | 50.5% |
| 6 | Utah (UT) | 3.3 | 97 | 25 | 10 | 1.19 | 51.7% |
| 7 | New Jersey (NJ) | 3.3 | 348 | 83 | 36 | 0.69 | 40.9% |
| 8 | Delaware (DE) | 3.3 | 44 | 11 | 4 | 1.03 | 41.8% |
| 9 | Florida (FL) | 3.2 | 694 | 167 | 101 | 0.73 | 42.3% |
| 10 | Washington (WA) | 3.2 | 194 | 47 | 27 | 0.88 | 46.7% |
| 11 | Ohio (OH) | 3.2 | 922 | 204 | 95 | 0.63 | 49.8% |
| 12 | Michigan (MI) | 3.2 | 423 | 107 | 65 | 0.78 | 44.4% |
| 13 | Minnesota (MN) | 3.2 | 338 | 86 | 64 | 1.06 | 42.4% |
| 14 | Puerto Rico (PR) | 3.2 | 9 | 0 | 1 | 2.91 | 33.5% |
| 15 | California (CA) | 3.1 | 1,162 | 280 | 188 | 0.65 | 38.1% |
| 16 | Colorado (CO) | 3.1 | 210 | 50 | 29 | 0.82 | 48.6% |
| 17 | Indiana (IN) | 3.1 | 507 | 114 | 91 | 0.66 | 47.0% |
| 18 | North Dakota (ND) | 3.1 | 72 | 17 | 14 | 0.93 | 49.0% |
| 19 | Idaho (ID) | 3.1 | 80 | 19 | 15 | 0.83 | 49.0% |
| 20 | Rhode Island (RI) | 3.1 | 73 | 15 | 12 | 0.77 | 40.4% |
| 21 | Nevada (NV) | 3.1 | 66 | 16 | 12 | 1.06 | 46.3% |
| 22 | Maryland (MD) | 3.1 | 221 | 53 | 35 | 0.81 | 40.6% |
| 23 | Iowa (IA) | 3.1 | 390 | 87 | 80 | 0.73 | 43.9% |
| 24 | New York (NY) | 3.0 | 596 | 138 | 118 | 0.70 | 40.5% |
| 25 | Wisconsin (WI) | 3.0 | 323 | 78 | 68 | 0.96 | 47.7% |
| 26 | Oregon (OR) | 3.0 | 128 | 24 | 20 | 0.68 | 49.1% |
| 27 | Alabama (AL) | 3.0 | 224 | 38 | 38 | 0.64 | 48.7% |
| 28 | South Carolina (SC) | 3.0 | 187 | 37 | 37 | 0.63 | 47.0% |
| 29 | Virginia (VA) | 3.0 | 289 | 55 | 61 | 0.69 | 48.4% |
| 30 | Montana (MT) | 3.0 | 61 | 10 | 12 | 0.94 | 55.6% |
| 31 | Massachusetts (MA) | 3.0 | 341 | 74 | 73 | 0.65 | 39.5% |
| 32 | Maine (ME) | 3.0 | 78 | 16 | 13 | 1.03 | 49.3% |
| 33 | Pennsylvania (PA) | 3.0 | 657 | 146 | 128 | 0.78 | 46.6% |
| 34 | Wyoming (WY) | 3.0 | 36 | 8 | 7 | 0.90 | 52.8% |
| 35 | Kansas (KS) | 3.0 | 297 | 55 | 64 | 0.71 | 49.5% |
| 36 | Tennessee (TN) | 3.0 | 303 | 51 | 59 | 0.61 | 48.7% |
| 37 | Connecticut (CT) | 3.0 | 191 | 40 | 39 | 0.70 | 37.9% |
| 38 | North Carolina (NC) | 2.9 | 418 | 81 | 87 | 0.59 | 50.4% |
| 39 | Kentucky (KY) | 2.9 | 268 | 41 | 60 | 0.77 | 46.7% |
| 40 | New Hampshire (NH) | 2.9 | 74 | 13 | 15 | 0.74 | 48.5% |
| 41 | South Dakota (SD) | 2.9 | 97 | 19 | 19 | 0.80 | 49.7% |
| 42 | Nebraska (NE) | 2.9 | 179 | 32 | 47 | 0.71 | 49.3% |
| 43 | Vermont (VT) | 2.9 | 34 | 5 | 6 | 0.81 | 59.6% |
| 44 | West Virginia (WV) | 2.8 | 123 | 17 | 27 | 0.71 | 43.1% |
| 45 | Texas (TX) | 2.8 | 1,177 | 154 | 269 | 0.44 | 51.5% |
| 46 | New Mexico (NM) | 2.8 | 68 | 12 | 16 | 0.62 | 53.0% |
| 47 | Oklahoma (OK) | 2.7 | 284 | 40 | 85 | 0.34 | 56.4% |
| 48 | Georgia (GA) | 2.6 | 356 | 50 | 102 | 0.49 | 46.5% |
| 49 | Mississippi (MS) | 2.6 | 202 | 28 | 53 | 0.63 | 47.8% |
| 50 | Illinois (IL) | 2.5 | 668 | 91 | 240 | 0.73 | 45.7% |
| 51 | Missouri (MO) | 2.5 | 487 | 54 | 158 | 0.46 | 57.0% |
| 52 | Louisiana (LA) | 2.4 | 266 | 23 | 94 | 0.32 | 48.0% |
| 53 | Guam (GU) | 1.0 | 1 | 0 | 1 | 2.55 | N/A |