Data finding
Nursing Home Ratings by State: Average CMS Star Rating
Average of the CMS overall star rating (1 to 5) across the nursing homes in each state that have one, from CMS Provider Information (dataset 4pq5-n9py) released October 8, 2026. Nursing homes without an overall rating count in the total but not in the average or the shares. Staffing is the mean reported total nurse staffing hours per resident per day; deficiencies are the mean health deficiencies in the most recent rating cycle. 50 states and DC; 14,680 nursing homes in all.
License: a US government work, in the public domain (Public Domain Mark 1.0).
Summary
Across the 14,555 nursing homes with a CMS overall star rating in the Care Compare data released October 8, 2026, the average rating is 3.0 out of 5. Hawaii has the highest state average (3.71) and Missouri the lowest (2.51). Nationally, 21% of rated nursing homes have 5 stars and 20% have 1 star. Source: CMS Provider Data Catalog, Provider Information (4pq5-n9py), compiled by Rivvi.
Download the state table (CSV)Free to reuse with a link to this page.
Average CMS overall star rating by state, highest first
- Hawaii3.71 stars
- Arkansas3.43 stars
- Alaska3.40 stars
- District of Columbia3.35 stars
- New Jersey3.34 stars
- Utah3.33 stars
- Arizona3.30 stars
- Florida3.28 stars
- Washington3.25 stars
- Maryland3.19 stars
- Delaware3.19 stars
- Ohio3.17 stars
- California3.17 stars
- Colorado3.17 stars
- Minnesota3.16 stars
- North Dakota3.15 stars
- Idaho3.15 stars
- Indiana3.14 stars
- Nevada3.14 stars
- Michigan3.13 stars
- Oregon3.12 stars
- Kansas3.11 stars
- Iowa3.09 stars
- Maine3.05 stars
- Massachusetts3.05 stars
- New Hampshire3.04 stars
- Tennessee3.04 stars
- New York3.03 stars
- West Virginia3.02 stars
- South Carolina3.02 stars
- Alabama3.01 stars
- Connecticut3.00 stars
- Kentucky2.98 stars
- Wisconsin2.98 stars
- Pennsylvania2.98 stars
- Virginia2.96 stars
- South Dakota2.94 stars
- North Carolina2.93 stars
- Vermont2.91 stars
- Rhode Island2.90 stars
- Montana2.88 stars
- Wyoming2.86 stars
- New Mexico2.85 stars
- Nebraska2.76 stars
- Mississippi2.73 stars
- Oklahoma2.69 stars
- Georgia2.67 stars
- Texas2.66 stars
- Louisiana2.55 stars
- Illinois2.53 stars
- Missouri2.51 stars
Scale 0 to 5 stars.
Source: CMS Care Compare nursing home data (Provider Information, 4pq5-n9py), as of October 8, 2026. Publisher page
Nursing home CMS overall star rating by state
| State | Nursing homes | With a rating | Average overall rating | 5-star share | 1-star share | Avg nurse staff hours per resident day | Avg health deficiencies, latest cycle |
|---|---|---|---|---|---|---|---|
| Hawaii | 43 | 41 | 3.71 | 41% | 7% | 4.97 | 9.2 |
| Arkansas | 221 | 218 | 3.43 | 30% | 11% | 4.02 | 2.7 |
| Alaska | 20 | 20 | 3.40 | 30% | 10% | 6.88 | 8.9 |
| District of Columbia | 17 | 17 | 3.35 | 24% | 6% | 4.72 | 23.2 |
| New Jersey | 348 | 346 | 3.34 | 24% | 10% | 3.85 | 8.5 |
| Utah | 97 | 96 | 3.33 | 26% | 9% | 4.09 | 8.8 |
| Arizona | 140 | 139 | 3.30 | 27% | 7% | 3.98 | 6.3 |
| Florida | 694 | 691 | 3.28 | 26% | 13% | 3.82 | 7.1 |
| Washington | 193 | 192 | 3.25 | 26% | 11% | 4.36 | 15.8 |
| Maryland | 221 | 219 | 3.19 | 25% | 15% | 3.87 | 17.0 |
| Delaware | 44 | 43 | 3.19 | 21% | 5% | 4.35 | 10.9 |
| Ohio | 922 | 913 | 3.17 | 23% | 13% | 3.69 | 10.3 |
| California | 1,165 | 1,153 | 3.17 | 23% | 16% | 4.52 | 15.5 |
| Colorado | 210 | 208 | 3.17 | 24% | 12% | 3.72 | 8.7 |
| Minnesota | 338 | 336 | 3.16 | 26% | 19% | 4.19 | 7.1 |
| North Dakota | 72 | 71 | 3.15 | 24% | 20% | 4.42 | 5.6 |
| Idaho | 80 | 79 | 3.15 | 23% | 20% | 4.04 | 10.3 |
| Indiana | 507 | 504 | 3.14 | 24% | 18% | 3.69 | 7.2 |
| Nevada | 66 | 65 | 3.14 | 29% | 22% | 4.34 | 9.6 |
| Michigan | 422 | 420 | 3.13 | 25% | 17% | 3.99 | 9.9 |
| Oregon | 128 | 127 | 3.12 | 22% | 17% | 5.03 | 9.2 |
| Kansas | 296 | 293 | 3.11 | 25% | 19% | 4.07 | 9.5 |
| Iowa | 387 | 385 | 3.09 | 24% | 20% | 3.82 | 6.5 |
| Maine | 78 | 77 | 3.05 | 22% | 19% | 4.34 | 10.8 |
| Massachusetts | 341 | 338 | 3.05 | 21% | 19% | 3.86 | 6.8 |
Source: CMS Care Compare nursing home data (Provider Information, 4pq5-n9py), as of October 8, 2026. Publisher page
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How we counted
Average of the CMS overall star rating (1 to 5) across the nursing homes in each state that have one, from CMS Provider Information (dataset 4pq5-n9py) released October 8, 2026. Nursing homes without an overall rating count in the total but not in the average or the shares. Staffing is the mean reported total nurse staffing hours per resident per day; deficiencies are the mean health deficiencies in the most recent rating cycle. 50 states and DC; 14,680 nursing homes in all.
Nursing home CMS ratings by state and city
Source: CMS Care Compare nursing home data (Provider Information, 4pq5-n9py), as of October 8, 2026. Publisher page