The Best Nursing Homes in the United States

What Makes a Skilled Nursing Facility One of the Best Nursing Homes

Every month we rank all of the skilled nursing facilities in the United States. The rankings for nursing homes are based on extensive metrics that are provided by The Centers for Medicare & Medicaid (“CMS”). The metrics include the CMS 5-Star Rating System which rates skilled nursing facilities using a rating system of five stars, where one star is the lowest and five stars is the highest rating. The rating system also rates nursing homes across five different dimensions including overall rating, health inspection rating, quality measures rating, overall staffing rating, and RN staffing rating (RN is an acronym for Registered Nurses).

In addition to the 5-Star Rating System, CMS provides numerical metrics that summarize:

• Health Inspection Data. CMS provides four numerical metrics related to the most recent health inspection surveys. These values, also known as “cycle scores”, are a distillation of detailed surveys conducted by a team of inspectors over a multi-day period. A score of each of the three most recent periods is provided along with a weighted score which is a combination of the three periods weighted towards the more recent periods. CMS estimates that more than 400,000 data points are used to calculate the four health inspection scores.
• Nursing Hour Statistics. Using multiple reporting methods, CMS calculates the amount of time that the nursing staff spends with residents. This is measured across multiple dimensions, one each for three different levels of nursings, including Registered Nurses (“RNs”), Licensed Practical Nurses (“LPNs”) and Certified Nursing Assistants (“CNAs”), plus one metric that totals all contributions. These metrics are expressed in hours per resident per day. CMS also provides state-level and national averages for the metrics to allow for additional comparisons.
• Abuse Flag. Abuse is always a concern in skilled nursing facilities. To highlight the issue, CMS has extracted this feature as its own flag. Facilities with an actual abuse event or where the potential for abuse has been shown for the past two years are flagged. The Health Inspection Score is capped at 2-stars for nursing homes that have been flagged for abuse.

Skilled nursing facilities that are new and do have at least two surveys completed are not rated by CMS. These facilities may have health inspection scores which can be used to evaluate the facility.

While this may seem like a lot of information, it has some drawbacks. The most significant problem is that when CMS calculates its 5-Star Rating, it does so based in part on state-level rather than national level data. Specifically, the health inspection star rating, which is the basis for the overall rating, is based on how a skilled nursing facility performs within the state not nationally. The top 10 percent of nursing homes with the lowest weighted health inspection score are given a 5-star rating.

Methodology

Our rankings are derived directly from the CMS Five-Star Quality Rating System. We prioritize the Health Inspection Score as it is the most comprehensive measure of a facility's compliance with safety and quality standards. Facilities with a history of abuse are flagged to ensure transparency. The data is refreshed monthly to reflect the latest inspection results and rating updates from CMS.

Last Updated: July 2026

The Best Nursing Homes in Each State

The table below shows the number of high ranking nursing homes in each state. Click on a state to see the Ten Best Nursing Homes in Each State.