Nursing Home Star Ratings: What Changed This Month, by State
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Of the 14,553 nursing homes with a CMS overall star rating in both the Aug 2026 and the Sep 2026 files, 544 (3.7%) had a higher rating in Sep 2026, 13,605 (93.5%) had the same rating and 404 (2.8%) had a lower rating. The table shows the same split for each state. Each state's recent-changes page lists the homes.
- Homes compared14,553
- Rating went up544
- Stayed the same13,605
- Rating went down404
These figures describe the homes in each state as a group, not any one home. To look at one home, search by name, city or ZIP code.
By state
Select a column heading to sort the table.
| Alabama | 223 | 0.4% (1) | 99.6% (222) | 0.0% (0) |
|---|---|---|---|---|
| Alaska | 20 | 5.0% (1) | 90.0% (18) | 5.0% (1) |
| Arizona | 139 | 5.0% (7) | 89.2% (124) | 5.8% (8) |
| Arkansas | 217 | 5.1% (11) | 90.3% (196) | 4.6% (10) |
| California | 1,153 | 4.4% (51) | 91.8% (1,059) | 3.7% (43) |
| Colorado | 208 | 3.4% (7) | 96.2% (200) | 0.5% (1) |
| Connecticut | 190 | 2.1% (4) | 96.8% (184) | 1.1% (2) |
| Delaware | 43 | 0.0% (0) | 93.0% (40) | 7.0% (3) |
| District of Columbia | 17 | 0.0% (0) | 100.0% (17) | 0.0% (0) |
| Florida | 691 | 3.3% (23) | 93.8% (648) | 2.9% (20) |
| Georgia | 354 | 4.0% (14) | 93.8% (332) | 2.3% (8) |
| Guam | 1 | 0.0% (0) | 100.0% (1) | 0.0% (0) |
| Hawaii | 41 | 7.3% (3) | 92.7% (38) | 0.0% (0) |
| Idaho | 79 | 5.1% (4) | 93.7% (74) | 1.3% (1) |
| Illinois | 661 | 2.4% (16) | 94.3% (623) | 3.3% (22) |
| Indiana | 504 | 2.2% (11) | 96.2% (485) | 1.6% (8) |
| Iowa | 385 | 4.7% (18) | 92.5% (356) | 2.9% (11) |
| Kansas | 293 | 1.7% (5) | 96.6% (283) | 1.7% (5) |
| Kentucky | 265 | 2.3% (6) | 94.0% (249) | 3.8% (10) |
| Louisiana | 264 | 5.3% (14) | 92.0% (243) | 2.7% (7) |
| Maine | 77 | 2.6% (2) | 92.2% (71) | 5.2% (4) |
| Maryland | 218 | 6.4% (14) | 91.7% (200) | 1.8% (4) |
| Massachusetts | 338 | 3.0% (10) | 94.4% (319) | 2.7% (9) |
| Michigan | 420 | 6.0% (25) | 89.5% (376) | 4.5% (19) |
| Minnesota | 336 | 3.3% (11) | 94.0% (316) | 2.7% (9) |
| Mississippi | 199 | 1.5% (3) | 94.5% (188) | 4.0% (8) |
| Missouri | 478 | 1.3% (6) | 97.9% (468) | 0.8% (4) |
| Montana | 59 | 5.1% (3) | 88.1% (52) | 6.8% (4) |
| Nebraska | 177 | 4.5% (8) | 92.7% (164) | 2.8% (5) |
| Nevada | 65 | 4.6% (3) | 89.2% (58) | 6.2% (4) |
| New Hampshire | 72 | 2.8% (2) | 94.4% (68) | 2.8% (2) |
| New Jersey | 346 | 6.6% (23) | 89.9% (311) | 3.5% (12) |
| New Mexico | 67 | 3.0% (2) | 94.0% (63) | 3.0% (2) |
| New York | 590 | 3.6% (21) | 93.9% (554) | 2.5% (15) |
| North Carolina | 415 | 2.7% (11) | 94.9% (394) | 2.4% (10) |
| North Dakota | 71 | 2.8% (2) | 91.5% (65) | 5.6% (4) |
| Ohio | 912 | 5.2% (47) | 91.8% (837) | 3.1% (28) |
| Oklahoma | 281 | 5.0% (14) | 91.8% (258) | 3.2% (9) |
| Oregon | 127 | 3.1% (4) | 93.7% (119) | 3.1% (4) |
| Pennsylvania | 652 | 4.8% (31) | 91.1% (594) | 4.1% (27) |
| Puerto Rico | 9 | 0.0% (0) | 100.0% (9) | 0.0% (0) |
| Rhode Island | 71 | 4.2% (3) | 93.0% (66) | 2.8% (2) |
| South Carolina | 186 | 4.8% (9) | 91.4% (170) | 3.8% (7) |
| South Dakota | 93 | 5.4% (5) | 94.6% (88) | 0.0% (0) |
| Tennessee | 300 | 4.7% (14) | 93.7% (281) | 1.7% (5) |
| Texas | 1,163 | 3.6% (42) | 93.8% (1,091) | 2.6% (30) |
| Utah | 96 | 5.2% (5) | 92.7% (89) | 2.1% (2) |
| Vermont | 32 | 3.1% (1) | 96.9% (31) | 0.0% (0) |
| Virginia | 286 | 1.7% (5) | 97.6% (279) | 0.7% (2) |
| Washington | 191 | 4.7% (9) | 93.2% (178) | 2.1% (4) |
| West Virginia | 122 | 4.1% (5) | 95.1% (116) | 0.8% (1) |
| Wisconsin | 321 | 1.9% (6) | 96.0% (308) | 2.2% (7) |
| Wyoming | 35 | 5.7% (2) | 91.4% (32) | 2.9% (1) |
| United States | 14,553 | 3.7% (544) | 93.5% (13,605) | 2.8% (404) |
Each percentage is the share of the homes compared in that state; the number of homes is in parentheses. The "United States" row covers the homes in all the rows above.
Download this table (CSV). Each column comes twice: as shown on this page and as a plain value. Please credit Nursing Home Checker and CMS.
How we calculated this
- Field: "Overall Rating" (1 to 5) in CMS's monthly Provider Information files, as published in each file.
- Months compared: the Sep 2026 file (the latest one this site uses) and the file before it in this site's monthly history, Aug 2026.
- Homes included: the 14,553 homes with an overall rating in both files. Left out: 137 of the 14,690 homes in the Sep 2026 file, because one or both files have no overall rating for them.
- "Went up" means the rating in the later file is higher than in the earlier file. A change can come from new inspection, staffing or quality data, or from a change in CMS's rating method.
- CMS's overall rating starts from the health inspection rating, and CMS sets health inspection ratings by comparing homes within each state. Compare state figures with care.
- Each home is counted in the state listed for it in the Sep 2026 Provider Information file. The table has a row for each place where that file lists homes: 50 states, the District of Columbia, Guam and Puerto Rico.
More data reports
- Star rating changes29.7% of the homes compared had a higher overall rating in Sep 2026 than in Sep 2025; 24.6% had a lower one.
- Nurse staffing hoursAverage reported nurse staffing: 3.77 hours per resident per day in CMS's Oct 2023 file (April–June 2023) and 3.85 in its Sep 2026 file (January–March 2026).
- Weekend staffingAverage reported nurse staffing: 3.86 hours per resident per day overall, 3.42 on weekends (Sep 2026 file: January–March 2026).
- Nursing staff turnoverAverage total nursing staff turnover: 45.8% across the 13,538 homes CMS reports it for (Sep 2026 file: January–December 2025).
- Changes of ownershipCMS's September 29, 2026 file lists a change of ownership effective from September 30, 2023 to September 29, 2026 for 1,452 homes (10.1%). The file lists no change effective after May 8, 2026.
- Fines and payment denialsCMS lists 2,689 fines totaling $105,022,269 at 2,147 homes with a penalty date from September 2, 2025 to September 1, 2026.
- Special Focus FacilitiesThe Sep 2026 CMS file lists 87 Special Focus Facilities and 440 candidates.
Source: CMS Provider Data Catalog, Nursing homes including rehab services: Provider Information files processed Aug 2026 and Sep 2026.
Updated each time CMS publishes new data. Calculated by Nursing Home Checker; these are not CMS's own figures. Report an error