Nursing Home Changes of Ownership by State
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CMS's Skilled Nursing Facility Change of Ownership file of September 29, 2026 lists a change of ownership effective from September 30, 2023 to September 29, 2026 for 1,452 of the 14,443 nursing homes that take part in Medicare (10.1%). The latest effective date in the file is May 8, 2026, and it lists 23 changes effective from Feb 2026 to May 2026, against 149 in the same months a year earlier (Feb 2025 to May 2025). Comparing two CMS files shows that later files add changes with past effective dates: CMS's file of July 1, 2025 (SNF_CHOW_2025.07.01.csv) listed 420 changes effective in 2024, and this file lists 760. So this figure can rise. The table shows the same count for each state.
- Homes in Medicare14,443
- Change effective Sep 30, 2023 – Sep 29, 20261,452
- Share of homes10.1%
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 | 222 | 7.2% (16) |
|---|---|---|
| Alaska | 20 | 10.0% (2) |
| Arizona | 140 | 6.4% (9) |
| Arkansas | 219 | 5.0% (11) |
| California | 1,141 | 6.4% (73) |
| Colorado | 204 | 17.6% (36) |
| Connecticut | 191 | 12.0% (23) |
| Delaware | 41 | 17.1% (7) |
| District of Columbia | 16 | 0.0% (0) |
| Florida | 694 | 5.9% (41) |
| Georgia | 354 | 12.7% (45) |
| Guam | 1 | 0.0% (0) |
| Hawaii | 43 | 0.0% (0) |
| Idaho | 80 | 5.0% (4) |
| Illinois | 648 | 17.3% (112) |
| Indiana | 504 | 5.4% (27) |
| Iowa | 374 | 18.2% (68) |
| Kansas | 268 | 5.6% (15) |
| Kentucky | 267 | 10.9% (29) |
| Louisiana | 265 | 4.9% (13) |
| Maine | 78 | 2.6% (2) |
| Maryland | 219 | 8.2% (18) |
| Massachusetts | 341 | 12.9% (44) |
| Michigan | 421 | 6.2% (26) |
| Minnesota | 330 | 3.3% (11) |
| Mississippi | 184 | 6.5% (12) |
| Missouri | 478 | 12.6% (60) |
| Montana | 60 | 5.0% (3) |
| Nebraska | 169 | 8.3% (14) |
| Nevada | 65 | 16.9% (11) |
| New Hampshire | 71 | 12.7% (9) |
| New Jersey | 348 | 5.7% (20) |
| New Mexico | 65 | 18.5% (12) |
| New York | 591 | 0.8% (5) |
| North Carolina | 417 | 15.1% (63) |
| North Dakota | 72 | 0.0% (0) |
| Ohio | 922 | 7.8% (72) |
| Oklahoma | 277 | 8.7% (24) |
| Oregon | 119 | 25.2% (30) |
| Pennsylvania | 650 | 14.6% (95) |
| Puerto Rico | 9 | 0.0% (0) |
| Rhode Island | 72 | 18.1% (13) |
| South Carolina | 187 | 10.2% (19) |
| South Dakota | 83 | 0.0% (0) |
| Tennessee | 299 | 17.1% (51) |
| Texas | 1,161 | 16.8% (195) |
| Utah | 91 | 6.6% (6) |
| Vermont | 33 | 3.0% (1) |
| Virginia | 280 | 11.8% (33) |
| Washington | 189 | 14.3% (27) |
| West Virginia | 117 | 6.0% (7) |
| Wisconsin | 319 | 8.5% (27) |
| Wyoming | 34 | 32.4% (11) |
| United States | 14,443 | 10.1% (1,452) |
Homes with at least one change of ownership effective from September 30, 2023 to September 29, 2026, as a share of the state's homes that take part in Medicare; the number of homes is in brackets. The file lists no change effective after May 8, 2026. 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: "EFFECTIVE DATE" in CMS's Skilled Nursing Facility Change of Ownership file, which CMS's data dictionary defines as the "Date on which the change of ownership became effective". Homes are matched to the Provider Information file by the buyer's CMS Certification Number ("CCN - BUYER"). CMS's data guidance says that in a change of ownership "the seller/former owner's provider number typically remains intact and is transferred to the new owner".
- All change types in the file are counted: 5,338 rows are "CHANGE OF OWNERSHIP" and 2 are "ACQUISITION/MERGER".
- Period: effective dates from September 30, 2023 to September 29, 2026, the three years up to the date in the file's name (SNF_CHOW_2026.09.29.csv). This site does not show a 12-month figure, because the most recent months are not filled in yet (see below).
- Homes included: the 14,443 homes in the Sep 2026 Provider Information file whose CMS provider type is "Medicare" or "Medicare and Medicaid". The 247 homes listed as "Medicaid" only are left out, because the file covers skilled nursing facilities "approved to bill Medicare". A home with more than one change in the period is counted once.
- Not counted: 53 of the file's 5,340 rows, because their CCN does not exactly match any home in the Sep 2026 Provider Information file (for example, a number with a letter or extra digits added, or a home no longer in that file). We do not guess which home such a row belongs to.
- What the file covers, in CMS's words: "change of ownership transactions that occurred on or after January 1, 2016, for currently approved SNF enrollments". CMS also says the files "do not contain historical enrollment information, and only capture currently active enrollments", so earlier changes at the same home may not be listed. In this file, 1 counted home has more than one change listed. CMS also says the files "omit a small number of enrollments known to have PECOS data quality issues."
- Recent months: Comparing two CMS files shows that later files add changes with past effective dates: CMS's file of July 1, 2025 (SNF_CHOW_2025.07.01.csv) listed 420 changes effective in 2024, and this file lists 760. The latest effective date in the file used here is May 8, 2026; the file lists no change effective after that date, and 23 effective from Feb 2026 to May 2026, against 149 from Feb 2025 to May 2025. Treat the figure for recent months with care.
- The data are self-reported by providers on the Medicare enrollment application (CMS-855A), according to CMS.
- Buyer and seller names are not shown on this site.
- 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 since last month544 homes had a higher overall rating in the Sep 2026 file than in the Aug 2026 file; 404 had a lower one.
- 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 (data.cms.gov), Skilled Nursing Facility Change of Ownership, file SNF_CHOW_2026.09.29.csv; CMS Provider Data Catalog, Nursing homes including rehab services: Provider Information, data processed Sep 2026.
Updated each time CMS publishes new data. Calculated by Nursing Home Checker; these are not CMS's own figures. Report an error