PILLAR RANKING • May 3, 2026
verified
Highest Quality: State Rankings
Ranked by CMS Nursing Home Compare health-inspection scores — federal on-site audit data.
Top 3 States
Browse Other Pillars
All 51 States Ranked
Higher score = better| Rank | State | Grade | Score | Details | |
|---|---|---|---|---|---|
| #1 | Arkansas | A | 53.2 | Avg 3.37/5 CMS stars · 221 facilities | View → |
| #2 | Nevada | A | 49.5 | Avg 3.12/5 CMS stars · 66 facilities | View → |
| #3 | Kentucky | A | 48.8 | Avg 2.89/5 CMS stars · 268 facilities | View → |
| #4 | Hawaii | A | 48.8 | Avg 3.56/5 CMS stars · 42 facilities | View → |
| #5 | Rhode Island | A | 48.3 | Avg 3.12/5 CMS stars · 73 facilities | View → |
| #6 | North Dakota | A | 48.0 | Avg 3.15/5 CMS stars · 72 facilities | View → |
| #7 | South Carolina | A | 48.0 | Avg 3.01/5 CMS stars · 187 facilities | View → |
| #8 | Massachusetts | A | 48.0 | Avg 2.99/5 CMS stars · 341 facilities | View → |
| #9 | Wyoming | B | 47.2 | Avg 2.97/5 CMS stars · 36 facilities | View → |
| #10 | District of Columbia | B | 47.0 | Avg 3.53/5 CMS stars · 17 facilities | View → |
| #11 | North Carolina | B | 47.0 | Avg 2.91/5 CMS stars · 418 facilities | View → |
| #12 | Iowa | B | 46.8 | Avg 3.08/5 CMS stars · 390 facilities | View → |
| #13 | Tennessee | C | 46.5 | Avg 2.96/5 CMS stars · 303 facilities | View → |
| #14 | Montana | C | 46.2 | Avg 3.00/5 CMS stars · 61 facilities | View → |
| #15 | Vermont | C | 46.2 | Avg 2.85/5 CMS stars · 34 facilities | View → |
| #16 | Florida | C | 46.2 | Avg 3.21/5 CMS stars · 694 facilities | View → |
| #17 | Minnesota | C | 46.0 | Avg 3.17/5 CMS stars · 338 facilities | View → |
| #18 | Oklahoma | C | 46.0 | Avg 2.67/5 CMS stars · 284 facilities | View → |
| #19 | Nebraska | C | 45.8 | Avg 2.85/5 CMS stars · 179 facilities | View → |
| #20 | Louisiana | C | 45.8 | Avg 2.43/5 CMS stars · 266 facilities | View → |
| #21 | Indiana | C | 45.8 | Avg 3.15/5 CMS stars · 507 facilities | View → |
| #22 | Washington | C | 45.8 | Avg 3.19/5 CMS stars · 194 facilities | View → |
| #23 | Oregon | C | 45.8 | Avg 3.02/5 CMS stars · 128 facilities | View → |
| #24 | Maryland | C | 45.8 | Avg 3.11/5 CMS stars · 221 facilities | View → |
| #25 | Alabama | C | 45.5 | Avg 3.01/5 CMS stars · 224 facilities | View → |
| #26 | California | C | 45.5 | Avg 3.15/5 CMS stars · 1,162 facilities | View → |
| #27 | West Virginia | C | 45.5 | Avg 2.83/5 CMS stars · 123 facilities | View → |
| #28 | Missouri | C | 45.2 | Avg 2.52/5 CMS stars · 487 facilities | View → |
| #29 | Wisconsin | C | 45.2 | Avg 3.03/5 CMS stars · 323 facilities | View → |
| #30 | Arizona | C | 45.2 | Avg 3.42/5 CMS stars · 140 facilities | View → |
| #31 | Ohio | C | 45.2 | Avg 3.18/5 CMS stars · 922 facilities | View → |
| #32 | Maine | C | 45.2 | Avg 2.99/5 CMS stars · 78 facilities | View → |
| #33 | Georgia | C | 45.2 | Avg 2.65/5 CMS stars · 356 facilities | View → |
| #34 | Kansas | C | 45.0 | Avg 2.96/5 CMS stars · 297 facilities | View → |
| #35 | South Dakota | C | 45.0 | Avg 2.88/5 CMS stars · 97 facilities | View → |
| #36 | Texas | C | 44.8 | Avg 2.77/5 CMS stars · 1,177 facilities | View → |
| #37 | Michigan | C | 44.8 | Avg 3.17/5 CMS stars · 423 facilities | View → |
| #38 | Virginia | C | 44.8 | Avg 3.01/5 CMS stars · 289 facilities | View → |
| #39 | New Hampshire | C | 44.8 | Avg 2.88/5 CMS stars · 74 facilities | View → |
| #40 | Utah | D | 44.5 | Avg 3.34/5 CMS stars · 97 facilities | View → |
| #41 | Mississippi | D | 44.5 | Avg 2.65/5 CMS stars · 202 facilities | View → |
| #42 | New Jersey | D | 44.5 | Avg 3.30/5 CMS stars · 348 facilities | View → |
| #43 | Pennsylvania | D | 44.2 | Avg 2.98/5 CMS stars · 657 facilities | View → |
| #44 | New York | D | 44.0 | Avg 3.03/5 CMS stars · 596 facilities | View → |
| #45 | Colorado | D | 44.0 | Avg 3.15/5 CMS stars · 210 facilities | View → |
| #46 | Illinois | D | 43.8 | Avg 2.52/5 CMS stars · 668 facilities | View → |
| #47 | Connecticut | F | 43.2 | Avg 2.95/5 CMS stars · 191 facilities | View → |
| #48 | Idaho | F | 43.0 | Avg 3.14/5 CMS stars · 80 facilities | View → |
| #49 | Alaska | F | 42.5 | Avg 3.45/5 CMS stars · 20 facilities | View → |
| #50 | Delaware | F | 42.5 | Avg 3.28/5 CMS stars · 44 facilities | View → |
| #51 | New Mexico | F | 42.2 | Avg 2.76/5 CMS stars · 68 facilities | View → |
Scores are 0–100 relative to other states. Pillar grades are assigned by within-pillar rank position. Read methodology →