DATA STUDY · 2025 EDITION

Nursing Home Star Ratings by State

20% of US nursing homes carry CMS's lowest 1-star rating — and only 21% earn the top 5 stars. We analyzed the CMS overall star rating for 14,572 Medicare-certified nursing homes to map where care quality is weakest, which states rank worst, and which large facilities sit at the bottom. Updated annually against the latest CMS Care Compare release.

19.6%
RATED 1 STAR
20.8%
RATED 5 STARS
3.01
AVG OVERALL RATING
14,572
FACILITIES ANALYZED
National distribution

How nursing homes split across the 5 stars

5 stars
3,032 (20.8%)
4 stars
2,810 (19.3%)
3 stars
2,880 (19.8%)
2 stars
2,994 (20.5%)
1 star
2,856 (19.6%)
States with the most low-rated homes

Share of nursing homes rated 1–2 stars — top 12 states

Missouri54%Louisiana54%Illinois54%Georgia49%Texas49%Mississippi50%Oklahoma47%Vermont41%South Dakota48%New Mexico46%Nebraska44%Maine45%
States ranked worst → best

Average nursing-home rating, by state

Mean CMS overall star rating per state, with the share of nursing homes rated 1 or 2 stars. States with at least 20 rated facilities. Tap any state to browse its nursing homes.

#StateAvg rating% 1–2 starFacilities
1Missouri2.4954%481
2Louisiana2.5154%264
3Illinois2.5654%663
4Georgia2.6849%353
5Texas2.7049%1,165
6Mississippi2.7150%200
7Oklahoma2.7347%281
8Vermont2.8241%34
9South Dakota2.8448%94
10New Mexico2.8546%67
11Nebraska2.8844%178
12Maine2.9245%77
13West Virginia2.9339%122
14North Carolina2.9442%416
15New Hampshire2.9545%73
16Wyoming2.9743%35
17Tennessee2.9740%298
18Kentucky2.9841%265
19Rhode Island2.9943%72
20Kansas3.0141%294
21Pennsylvania3.0241%653
22Virginia3.0238%285
23Wisconsin3.0341%321
24South Carolina3.0442%186
25Alabama3.0537%223
26Montana3.0537%59
27New York3.0541%593
28Massachusetts3.0740%338
29Connecticut3.0940%190
30Oregon3.1038%127
31Maryland3.1435%219
32Iowa3.1437%387
33Alaska3.1540%20
34Indiana3.1536%505
35Idaho3.1634%79
36Minnesota3.1735%336
37California3.1835%1,154
38Colorado3.1836%208
39Michigan3.1833%420
40Ohio3.2234%912
41Nevada3.2632%65
42North Dakota3.2735%71
43Florida3.2734%690
44Washington3.3132%193
45Delaware3.3330%43
46Utah3.3531%96
47New Jersey3.3830%345
48Arizona3.4228%139
49Arkansas3.4426%218
50Hawaii3.6817%41
The bottom of the barrel

The 50 largest 1-star nursing homes

1-star (lowest) CMS overall rating, ranked by certified bed count — the biggest facilities carrying the worst rating. Tap any name for its full CareLens profile: inspections, staffing, complaints, and ownership.

#Nursing homeLocationOwnershipBedsRating
1NORTHAMPTON COUNTY-GRACEDALENAZARETH, PAGovernment - County6881★
2WOODBURY HEIGHTS NURSING AND REHABILITATION CENTERWOODBURY, NYFor profit - Limited Liability company6061★
3A Holly Patterson Extended Care FacilityUNIONDALE, NYGovernment - State5891★
4Friendship Rehab and HealthBEAVER, PAFor profit - Corporation5891★
5Monroe Community HospitalROCHESTER, NYGovernment - County5661★
6St. John's Health Care CorporationROCHESTER, NYFor profit - Corporation4551★
7BISHOP REHABILITATION AND NURSING CENTERSYRACUSE, NYFor profit - Corporation4401★
8SINAI POST-ACUTE NURSING & REHAB CENTERNEWARK, NJFor profit - Corporation4301★
9CARE PAVILION NURSING AND REHABILITATION CENTERPAFor profit - Corporation3961★
10ORLANDO HEALTH AND REHABILITATION CENTERFLNon profit - Other3911★
11SANTA ANITA CONVALESCENT HOSPITALTEMPLE CITY, CAFor profit - Corporation3911★
12CRESTVIEW HEALTH & REHAB CTRGANon profit - Other3881★
13PLEASANT ACRES REHABILITATION AND NURSING CENTERYORK, PAFor profit - Corporation3751★
14South Pointe Rehabilitation and Care CenterOKLAHOMA CITY, OKFor profit - Limited Liability company3751★
15VAN RENSSELAER MANORTROY, NYGovernment - County3621★
16Riverside Health Care Center, Inc.EAST HARTFORD, CTFor profit - Limited Liability company3451★
17SAN MATEO MEDICAL CENTER D/P SNFCAGovernment - County3451★
18GLENDORA GRAND, INCGLENDORA GRAND, CAFor profit - Corporation3421★
19OPTIMA CARE FOUNTAINSSECAUCUS, NJFor profit - Limited Liability company3341★
20BRIA OF FOREST EDGESKOKIE, ILFor profit - Limited Liability company3281★
21MASONIC CARE COMMUNITY OF NEW YORKUTICA, NYNon profit - Corporation3201★
22Medford Multicare Center For LivingMEDFORD, NYFor profit - Corporation3201★
23NEW VANDERBILT REHABILITATION AND CARE CENTER, INCSTATEN ISLAND, NYFor profit - Corporation3201★
24Normandy Terrace Nursing & Rehabilitation CenterSAN ANTONIO, TXFor profit - Limited Liability company3201★
25North Ridge Health And RehabNEW HOPE, MNFor profit - Corporation3201★
26NORTHERN MANHATTAN REHABILITATION AND NURSING CTRNEW YORK, NYFor profit - Partnership3201★
27Landmark of Hyde Park Rehabilitation and Nursing CCHICAGO, ILFor profit - Individual3181★
28HUDSON HILL CENTER FOR REHABILITATION & NURSINGYONKERS, NYFor profit - Corporation3151★
29APERION CARE LAKESHORECHICAGO, ILFor profit - Limited Liability company3131★
30ELEVATE CARE CHICAGO NORTHCHICAGO, ILFor profit - Limited Liability company3121★
31Complete Care at Margate ParkCHICAGO, ILFor profit - Limited Liability company3101★
32BRIA OF RIVER OAKSSKOKIE, ILFor profit - Corporation3091★
33GARDENS AT WEST SHORE, THECAMP HILL, PAFor profit - Corporation3091★
34BAY HARBOR POST ACUTE HEALTHCARE CENTERSALISBURY, MDFor profit - Limited Liability company3051★
35COUNTRY HILLS POST ACUTEELCAJON, CAFor profit - Limited Liability company3051★
36RYZE ON THE AVENUECHICAGO, ILFor profit - Corporation3021★
37Maple Heights Health & Rehab Center, LLCEBENSBURG, PAFor profit - Corporation3011★
38ALDEN LAKELAND REHAB & HCCCHICAGO, ILFor profit - Corporation3001★
39KEI-AI LOS ANGELES HEALTHCARE CENTERLOS ANGELES, CAFor profit - Limited Liability company3001★
40ROSEWOOD REHAB AND HEALTHCARE CENTERINDEPENDENCE, MOFor profit - Limited Liability company3001★
41WENTWORTH REHAB & HCCCHICAGO, ILFor profit - Corporation3001★
42WILLOW POINT REHABILITATION AND NURSING CENTERVESTAL, NYGovernment - County3001★
43BALANCED HEALTHCAREST. PETERSBURG, FLFor profit - Limited Liability company2991★
44MIRAGE POST ACUTELANCASTER, CAFor profit - Partnership2991★
45SUNNYSIDE NURSING CENTERTORRANCE, CANon profit - Corporation2991★
46Villa Feliciana Chronic DiseaseLAGovernment - State2991★
47CALIFORNIA TERRACECHICAGO, ILFor profit - Limited Liability company2971★
48MOUNTAIN CITY NURSING & REHABILITATION CENTERHAZLE TOWNSHIP, PAFor profit - Corporation2971★
49DEANWOOD REHABILITATION AND WELLNESS CENTERWASHINGTON DC, DCFor profit - Corporation2961★
50Harmony Park RidgeILFor profit - Limited Liability company2961★

Methodology

Figures come from the CMS Care Compare skilled nursing facility (SNF) dataset — the official Medicare quality program. The overall star rating runs from 1 (much below average) to 5 (much above average) and blends health inspections, staffing, and quality measures. We include every Medicare-certified nursing home with a published overall rating (14,572 facilities).

State averages cover states with at least 20 rated facilities so a handful of homes can't swing the mean. The worst-rated table is limited to 1-star facilities with 60 or more certified beds, ranked by bed count, to surface the largest low-rated providers rather than tiny outliers. CMS ratings lag real conditions by several months and roll up to the facility, not the specific unit — use them alongside an in-person visit.

Want the detail behind any number? Browse all nursing homes, or jump to Missouri nursing homes.

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CITATION
CareLens. (2025). Nursing Home Star Ratings by State. Retrieved from https://carelens.io/nursing-home-ratings
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<a href="https://carelens.io/nursing-home-ratings" style="display:inline-block;border-left:4px solid #84cc16;padding:10px 14px;font:14px/1.4 system-ui,sans-serif;color:#0f172a;text-decoration:none;background:#f8fafc;border-radius:4px;max-width:520px"><strong>20% of US nursing homes carry CMS's lowest 1-star rating</strong><br>Source: CareLens — Nursing Home Star Ratings by State (2025)</a>
PREVIEW
20% of US nursing homes carry CMS's lowest 1-star rating
Source: CareLens — Nursing Home Star Ratings by State (2025)