This interactive nursing homes map displays all 14,700 Medicare- and Medicaid-certified skilled nursing facilities in the United States, sourced from CMS Care Compare. Each facility is color-coded by its CMS overall star rating — green for 5 stars down to red for 1 star. Use the filters to find high-rated facilities near you, compare ownership types, or explore quality patterns across the country.

US Nursing Homes by the Numbers

• 14,700 Medicare- and Medicaid-certified skilled nursing facilities nationwide
• 1,568,692 certified beds across all facilities
• 73.8% are for-profit (10,851 facilities); 19.8% non-profit (2,908); 6.4% government-operated (941)
• States with the most facilities: Texas (1,176), California (1,164), Ohio (921), Florida (694), Illinois (667)
• States with the highest share of 5-star facilities (min. 50 facilities): Hawaii (40.5%), North Dakota (33.3%), Wyoming (27.8%), Nevada (27.3%), Minnesota (26.9%)
• States with the lowest share of 5-star facilities: Louisiana (9.4%), Missouri (11.5%), Texas (12.8%), Oklahoma (13.1%), Rhode Island (13.7%)

How CMS Star Ratings Work

The Centers for Medicare and Medicaid Services (CMS) assigns each nursing home a 1- to 5-star overall rating based on three independently measured domains:

• Health inspections — Unannounced annual surveys by state inspectors evaluate compliance with federal regulations covering resident rights, infection control, staffing, and care quality. More deficiencies — and more severe ones — lower the score.
• Staffing levels — CMS measures registered nurse (RN) hours per resident per day and total nurse staffing hours, adjusted for resident case mix. Higher staffing levels consistently correlate with better outcomes.
• Quality measures — 17 clinical indicators drawn from resident assessments include short-stay metrics (rehospitalization rates, successful discharge to community) and long-stay metrics (pressure ulcer rates, fall incidence, antipsychotic medication use).

A 5-star overall rating means a facility ranks well above average in all three domains. A 1-star rating signals it ranks well below average. CMS recalibrates ratings annually so the thresholds move as the field improves, making comparisons within the same year more reliable than year-over-year comparisons.

Quality Patterns by State

Star rating averages vary significantly by state — not primarily because of geography, but because of ownership mix, state inspection rigor, and historical investment in the nursing home workforce. Hawaii leads nationally with 40.5% of its facilities at 5 stars, followed by North Dakota (33.3%) and Wyoming (27.8%). At the other end, Louisiana (9.4% five-star), Missouri (11.5%), and Texas (12.8%) have the highest concentrations of below-average facilities.

Non-profit and government-operated facilities tend to have higher staffing ratios on average than their for-profit counterparts — and states with a higher share of non-profit homes tend to score better overall. Among large states, California (73.8% for-profit) outperforms Texas (75%+ for-profit) in 5-star rates, suggesting other factors — including state inspection standards — also play a role.

What to Look for Beyond the Star Rating

Star ratings are a starting point, not the complete picture. Before choosing a facility, consider reviewing:

• The facility’s most recent standard health inspection report on CMS Care Compare — available as a PDF, it details specific deficiencies and whether any caused resident harm
• The staffing report, which breaks out RN-only hours separately from total nurse staffing — RN hours are most directly linked to outcomes
• Staff turnover data — high administrator or nursing staff turnover is a red flag for management instability
• Whether the facility appears on the Special Focus Facility (SFF) list — CMS designates chronically poor performers for more frequent inspections and escalating enforcement

About the Data

Facility data comes from the CMS Care Compare Nursing Home Provider Information file, updated monthly. The dataset covers all facilities certified to accept Medicare and Medicaid residents. Star ratings use the five-star quality rating system introduced by CMS in 2008. Ratings reflect the most recent inspection cycle for each facility (typically every 9–15 months) and should be used as a starting point rather than a definitive measure — always review the underlying inspection report for details. For related healthcare infrastructure data, see our US hospitals interactive map. Families researching care environments may also find our US radon zones map and US tap water quality map useful for assessing the local environment. Our US lead service lines map covers drinking water infrastructure risks by state.

Frequently Asked Questions

What is the difference between a nursing home and assisted living?

Skilled nursing facilities (nursing homes) provide 24-hour medical and nursing supervision, physical and occupational therapy, and care for residents with complex medical needs. Assisted living offers personal care and help with daily activities for residents who do not require continuous skilled nursing care. Only CMS-certified skilled nursing facilities are included in this dataset.

How many nursing homes are in the United States?

There are 14,700 Medicare- and Medicaid-certified skilled nursing facilities in the US, holding nearly 1.57 million certified beds. Texas leads with 1,176 facilities; California follows with 1,164. The number of nursing home beds has declined over the past two decades as home health, hospice, and assisted living alternatives have expanded.

Which states have the best nursing home quality ratings?

Among states with at least 50 facilities, Hawaii stands out with 40.5% of its nursing homes rated 5 stars — far above the national average. North Dakota (33.3%), Wyoming (27.8%), Nevada (27.3%), and Minnesota (26.9%) round out the top five. These states tend to have smaller total facility counts and a higher proportion of non-profit and government-operated homes.

Which states have the most nursing homes with low star ratings?

Louisiana has the highest concentration of low-rated facilities, with only 9.4% of its homes at 5 stars. Missouri (11.5%), Texas (12.8%), Oklahoma (13.1%), and Rhode Island (13.7%) also show below-average quality scores. These states have higher shares of for-profit ownership and have received more deficiency citations in recent CMS inspection cycles.

Are for-profit nursing homes lower quality than non-profit ones?

Research published in Health Affairs and JAMA has found that non-profit and government-run facilities average higher staffing ratios and slightly better quality scores than for-profit facilities. However, variation within each ownership type is large — many for-profit facilities have excellent ratings, and some non-profits perform poorly. Always review the individual Care Compare record rather than relying on ownership type alone.

What is the CMS Special Focus Facility program?

CMS maintains a list of Special Focus Facilities — nursing homes with a persistent pattern of serious health and safety violations. These homes receive more frequent inspections (roughly twice a year) and face escalating enforcement if they fail to improve. CMS also publishes a list of SFF candidates — facilities with similar problems not yet formally designated. Families can check both lists at the CMS Care Compare website before choosing a home.

How often are CMS star ratings updated?

Staffing and quality measure ratings update quarterly. Health inspection ratings update on a rolling basis as new survey cycles complete, typically every 9–15 months per facility. The overall star rating can change significantly between surveys — a rating from more than a year ago may not reflect current performance. The data on this map is refreshed from CMS monthly.