US Nursing Home Quality by State
Real CMS Care Compare Overall Star Ratings for June 2026, averaged across 14,570 rated nursing homes in 53 states and territories.
Which US states have the highest-rated nursing homes, and what is the average CMS star rating?
As of June 2026, the 14,570 CMS star-rated US nursing homes average 3.01 of 5 stars on Care Compare. Hawaii is highest-rated (3.59) and Guam lowest (2.00), per CMS open data β reference information, not medical advice.
| Rank | State | Avg rating (of 5) | Rated homes |
|---|---|---|---|
| 1 | Hawaii | 3.59 | 41 |
| 2 | District of Columbia | 3.53 | 17 |
| 3 | Arkansas | 3.46 | 218 |
| 4 | Arizona | 3.41 | 139 |
| 5 | New Jersey | 3.38 | 346 |
| β¦ | β¦ | β¦ | β¦ |
| 49 | Georgia | 2.68 | 353 |
| 50 | Illinois | 2.56 | 663 |
| 51 | Louisiana | 2.51 | 265 |
| 52 | Missouri | 2.48 | 480 |
| 53 | Guam | 2.00 | 1 |
| US | United States (average) | 3.01 | 14,570 |
Nursing home quality in every state
- Alabama3.03 / 5 β
- Alaska3.25 / 5 β
- Arizona3.41 / 5 β
- Arkansas3.46 / 5 β
- California3.17 / 5 β
- Colorado3.15 / 5 β
- Connecticut3.04 / 5 β
- Delaware3.28 / 5 β
- District of Columbia3.53 / 5 β
- Florida3.28 / 5 β
- Georgia2.68 / 5 β
- Guam2.00 / 5 β
- Hawaii3.59 / 5 β
- Idaho3.15 / 5 β
- Illinois2.56 / 5 β
- Indiana3.15 / 5 β
- Iowa3.13 / 5 β
- Kansas3.03 / 5 β
- Kentucky3.05 / 5 β
- Louisiana2.51 / 5 β
- Maine2.96 / 5 β
- Maryland3.14 / 5 β
- Massachusetts3.05 / 5 β
- Michigan3.16 / 5 β
- Minnesota3.17 / 5 β
- Mississippi2.69 / 5 β
- Missouri2.48 / 5 β
- Montana2.92 / 5 β
- Nebraska2.87 / 5 β
- Nevada3.23 / 5 β
- New Hampshire3.01 / 5 β
- New Jersey3.38 / 5 β
- New Mexico2.85 / 5 β
- New York3.03 / 5 β
- North Carolina2.94 / 5 β
- North Dakota3.23 / 5 β
- Ohio3.22 / 5 β
- Oklahoma2.72 / 5 β
- Oregon3.10 / 5 β
- Pennsylvania3.01 / 5 β
- Puerto Rico3.00 / 5 β
- Rhode Island2.90 / 5 β
- South Carolina3.09 / 5 β
- South Dakota2.78 / 5 β
- Tennessee3.01 / 5 β
- Texas2.71 / 5 β
- Utah3.32 / 5 β
- Vermont2.84 / 5 β
- Virginia3.01 / 5 β
- Washington3.30 / 5 β
- West Virginia2.95 / 5 β
- Wisconsin2.99 / 5 β
- Wyoming2.97 / 5 β
Check nursing home quality in your state
Pick a state to see the real CMS average Overall Star Rating, how many homes are rated, its national rank, and how it compares to the US average.
Choose a state to see its real CMS nursing home star-rating average, how many homes are rated, its national rank, and how it compares to the US average.
Frequently asked questions
- What is a CMS nursing home star rating?
- The Centers for Medicare & Medicaid Services (CMS) publishes a 1-to-5 Overall Star Rating for every Medicare/Medicaid-certified US nursing home on Care Compare, combining health inspections, staffing levels and quality measures. Five stars is much-above-average, one star is much-below-average.
- What is the average US nursing home rating?
- As of June 2026, the mean CMS Overall Star Rating across the 14,570 star-rated US nursing homes is 3.01 out of 5, per CMS Care Compare open data.
- Which US state has the highest-rated nursing homes?
- Hawaii has the highest average CMS Overall Star Rating, at 3.59 across 41 rated nursing homes (June 2026); Guam has the lowest at 2.00.
- How many US nursing homes are CMS star-rated?
- CMS publishes an Overall Star Rating for 14,570 US nursing homes across 53 states and territories (June 2026). Facilities without a published rating are excluded from every count and average shown here.
- Is this nursing home data medical advice?
- No. These pages re-publish official CMS reference statistics for information only. They are not medical advice and not an endorsement of any facility β always check the latest detail on CMS Care Compare and speak to a clinician about care decisions.
Navigating US nursing home care?
A GeraClinic care navigator can help you interpret CMS star ratings, compare facilities, and prepare for your appointment β with a clinician available online.
Source data is published by the U.S. Centers for Medicare & Medicaid Services (CMS) Care Compare and is a U.S. federal government work in the public domain.
Contains public sector information published by Centers for Medicare & Medicaid Services and licensed under the U.S. Public Domain (federal government work). Source: Centers for Medicare & Medicaid Services β Care Compare (Nursing homes including rehab services β Provider Information) (June 2026, published 1 June 2026).
Informational/educational only β not a substitute for professional medical advice; a clinician interprets results.