PILLAR RANKING • May 3, 2026
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Best Staffing: State Rankings
Ranked by RN and total nurse hours per resident per day — CMS Payroll-Based Journal data.
Top 3 States
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All 51 States Ranked
Higher score = better| Rank | State | Grade | Score | Details | |
|---|---|---|---|---|---|
| #1 | Alaska | A | 100.0 | 2.15 RN hrs · 7.00 total nurse hrs / resident day | View → |
| #2 | District of Columbia | A | 53.3 | 1.74 RN hrs · 4.85 total nurse hrs / resident day | View → |
| #3 | Hawaii | A | 49.1 | 1.63 RN hrs · 4.71 total nurse hrs / resident day | View → |
| #4 | Oregon | A | 40.7 | 0.68 RN hrs · 4.95 total nurse hrs / resident day | View → |
| #5 | Delaware | B | 37.1 | 1.03 RN hrs · 4.51 total nurse hrs / resident day | View → |
| #6 | Nevada | B | 34.2 | 1.06 RN hrs · 4.34 total nurse hrs / resident day | View → |
| #7 | Maine | B | 34.0 | 1.03 RN hrs · 4.35 total nurse hrs / resident day | View → |
| #8 | North Dakota | B | 33.8 | 0.93 RN hrs · 4.41 total nurse hrs / resident day | View → |
| #9 | Washington | B | 32.7 | 0.88 RN hrs · 4.39 total nurse hrs / resident day | View → |
| #10 | Minnesota | C | 32.1 | 1.06 RN hrs · 4.23 total nurse hrs / resident day | View → |
| #11 | California | C | 31.9 | 0.65 RN hrs · 4.51 total nurse hrs / resident day | View → |
| #12 | Utah | C | 30.6 | 1.19 RN hrs · 4.06 total nurse hrs / resident day | View → |
| #13 | Wisconsin | C | 30.3 | 0.97 RN hrs · 4.20 total nurse hrs / resident day | View → |
| #14 | Vermont | C | 30.2 | 0.81 RN hrs · 4.31 total nurse hrs / resident day | View → |
| #15 | Nebraska | C | 26.2 | 0.71 RN hrs · 4.17 total nurse hrs / resident day | View → |
| #16 | Idaho | C | 25.9 | 0.83 RN hrs · 4.07 total nurse hrs / resident day | View → |
| #17 | Mississippi | C | 25.9 | 0.63 RN hrs · 4.21 total nurse hrs / resident day | View → |
| #18 | Montana | C | 25.5 | 0.94 RN hrs · 3.97 total nurse hrs / resident day | View → |
| #19 | Arizona | C | 25.4 | 0.72 RN hrs · 4.12 total nurse hrs / resident day | View → |
| #20 | Kansas | C | 24.3 | 0.71 RN hrs · 4.07 total nurse hrs / resident day | View → |
| #21 | Michigan | C | 24.3 | 0.77 RN hrs · 4.03 total nurse hrs / resident day | View → |
| #22 | Kentucky | C | 23.9 | 0.77 RN hrs · 4.01 total nurse hrs / resident day | View → |
| #23 | Wyoming | C | 22.5 | 0.90 RN hrs · 3.84 total nurse hrs / resident day | View → |
| #24 | South Dakota | C | 22.1 | 0.80 RN hrs · 3.89 total nurse hrs / resident day | View → |
| #25 | Pennsylvania | C | 21.8 | 0.78 RN hrs · 3.89 total nurse hrs / resident day | View → |
| #26 | Maryland | C | 21.8 | 0.81 RN hrs · 3.87 total nurse hrs / resident day | View → |
| #27 | New Hampshire | C | 21.0 | 0.74 RN hrs · 3.88 total nurse hrs / resident day | View → |
| #28 | Florida | C | 20.5 | 0.73 RN hrs · 3.86 total nurse hrs / resident day | View → |
| #29 | Alabama | C | 20.3 | 0.64 RN hrs · 3.91 total nurse hrs / resident day | View → |
| #30 | Arkansas | C | 20.0 | 0.40 RN hrs · 4.07 total nurse hrs / resident day | View → |
| #31 | New Jersey | C | 20.0 | 0.69 RN hrs · 3.86 total nurse hrs / resident day | View → |
| #32 | Iowa | C | 19.9 | 0.73 RN hrs · 3.83 total nurse hrs / resident day | View → |
| #33 | Connecticut | C | 19.5 | 0.70 RN hrs · 3.83 total nurse hrs / resident day | View → |
| #34 | Massachusetts | C | 19.4 | 0.65 RN hrs · 3.86 total nurse hrs / resident day | View → |
| #35 | South Carolina | C | 19.2 | 0.63 RN hrs · 3.86 total nurse hrs / resident day | View → |
| #36 | Virginia | C | 19.0 | 0.69 RN hrs · 3.81 total nurse hrs / resident day | View → |
| #37 | Colorado | C | 18.8 | 0.83 RN hrs · 3.70 total nurse hrs / resident day | View → |
| #38 | Tennessee | C | 18.7 | 0.61 RN hrs · 3.85 total nurse hrs / resident day | View → |
| #39 | Rhode Island | C | 18.4 | 0.77 RN hrs · 3.72 total nurse hrs / resident day | View → |
| #40 | North Carolina | D | 17.1 | 0.59 RN hrs · 3.78 total nurse hrs / resident day | View → |
| #41 | West Virginia | D | 17.0 | 0.71 RN hrs · 3.69 total nurse hrs / resident day | View → |
| #42 | Indiana | D | 16.7 | 0.66 RN hrs · 3.71 total nurse hrs / resident day | View → |
| #43 | Ohio | D | 16.5 | 0.63 RN hrs · 3.72 total nurse hrs / resident day | View → |
| #44 | New York | D | 16.1 | 0.70 RN hrs · 3.65 total nurse hrs / resident day | View → |
| #45 | Oklahoma | D | 14.8 | 0.34 RN hrs · 3.84 total nurse hrs / resident day | View → |
| #46 | Louisiana | D | 14.0 | 0.32 RN hrs · 3.81 total nurse hrs / resident day | View → |
| #47 | Illinois | D | 13.4 | 0.73 RN hrs · 3.49 total nurse hrs / resident day | View → |
| #48 | New Mexico | D | 13.3 | 0.62 RN hrs · 3.56 total nurse hrs / resident day | View → |
| #49 | Georgia | D | 11.7 | 0.49 RN hrs · 3.57 total nurse hrs / resident day | View → |
| #50 | Missouri | F | 9.4 | 0.46 RN hrs · 3.47 total nurse hrs / resident day | View → |
| #51 | Texas | F | 7.8 | 0.44 RN hrs · 3.40 total nurse hrs / resident day | View → |
Scores are 0–100 relative to other states. Pillar grades are assigned by within-pillar rank position. Read methodology →