U.S. Nursing Home Statistics 2026

Scale of the U.S. nursing-home sector

• 14,690 Medicare- and Medicaid-certified nursing facilities operate across 53 states and territories.
• They hold 1,567,504 certified beds and report roughly 1,258,309 residents, an average of 107 beds per facility.
• The most common ownership type is For profit - Limited Liability company.

CMS Five-Star quality ratings

The average U.S. nursing home scores 2.98 of 5 CMS overall stars, built from health inspections (2.82★), staffing (2.91★), and quality measures (3.58★). The overall star is force-curved within each state. Of 14,563 rated facilities, 2,981 (20.5%) hold the top 5-star mark and 3,015 (20.7%) sit at the 1-star floor.

Staffing levels

Nationwide, nursing homes report an average of 3.86 total nursing hours per resident day, including 0.69 registered-nurse hours, the single staffing metric most strongly tied to resident outcomes. Nursing staff turnover averages 45.8% a year (RN turnover 42.9%).

Inspection deficiencies & enforcement

• State surveyors have recorded 419,479 inspection deficiencies across 14,627 facilities. Of these, 22,914 reached the actual-harm level or higher, including 9,480 immediate-jeopardy citations (scope/severity J–L).
• CMS has assessed $456.8M in federal Civil Money Penalties across 13,256 fine actions, plus 2,440 payment-denial actions.
• 84 facilities (0.6%) carry a Special Focus designation or candidacy, the CMS watch list for persistently poor performers.