3 Min Read Posted on August 6, 2026August 7, 2026 New Ranking Tool Helps Families Compare Nursing Home Safety Nationwide Families trying to choose a nursing home can find a lot of federal data online. The problem is figuring out what all of it actually says about resident safety. That’s why the Nursing Home Abuse Center created a new free nursing home safety ranking tool covering all 50 states and Washington, D.C. Our team analyzed federal data from more than 14,700 nursing homes nationwide and turned it into simple A–F state grades based on staffing, abuse and neglect citations, staff turnover, and serious federal enforcement flags. Families can use our free resource to see how their state compares and learn what to look for in a specific facility. This screening tool requires JavaScript. Please call (855) 264-6310 to speak with our team. We Analyzed More Than 14,700 Nursing Homes The Centers for Medicare & Medicaid Services (CMS) publishes extensive information about nursing homes through its Care Compare database. However, comparing thousands of facilities and different safety measures can be difficult, especially for families making care decisions under time pressure. Our team analyzed that federal data to make it easier to understand and use. The rankings consider: Nursing home abuse and neglect citations, weighted by severity RN staffing compared with the 0.55 RN-hours-per-resident-per-day benchmark established in CMS’s now-repealed 2024 staffing rule Annual nursing staff turnover CMS Abuse Icon and Special Focus Facility (SFF) status Each facility received a score based on these factors. We then averaged facility scores within each state so larger states were not penalized simply because they have more nursing homes. The result is a nationwide ranking with every state receiving a grade from A through F. What the 2026 Nursing Home Rankings Found Our analysis revealed major differences in nursing home staffing and safety indicators across the country. The 5 highest-ranking states were: New Hampshire Alaska Alabama Minnesota Maine At the other end of the rankings, Louisiana ranked last, followed by Texas, Missouri, Oklahoma, and Illinois. Our analysis also found that 11 states earned an A grade, while 19 states and Washington, D.C. received a D or F. The differences went beyond rankings. Some lower-scoring states had widespread RN staffing shortages, high staff turnover, or large percentages of facilities carrying the CMS Abuse Icon. These are red flags because understaffing can affect nearly every part of a resident’s care. Nursing Home Ranking Data Helps Families Nursing home residents often need help with medications, personal care, mobility, and other daily needs. If there are not enough qualified staff members available, residents may wait longer for basic care or receive less supervision. Chronic staffing problems can increase the risk of falls, bedsores, medication errors, poor hygiene, dehydration, and other forms of nursing home neglect. Federal citations and enforcement flags can provide another warning sign. The CMS Abuse Icon identifies facilities with certain recent abuse citations or repeated abuse citations. The Special Focus Facility program identifies nursing homes with a history of serious quality problems that require additional oversight. Looking at these measures together can give families a clearer picture than relying on any single statistic. How Families Can Use Our New Nursing Home Tool A state ranking cannot tell a family everything about one particular nursing home. A highly rated state can still have facilities with serious problems, and a lower-ranked state can have individual homes that provide good care. Instead, families can use the rankings as a starting point for asking better questions and looking more closely at a facility. The tool can help families: Check how their state compares with the rest of the country Review staffing, abuse and neglect, turnover, and enforcement trends See examples of facilities with serious safety concerns Learn what to check before choosing a nursing home Identify warning signs if a loved one is already receiving care Families should also review a specific facility’s inspection history, staffing information, federal ratings, and recent citations before making a placement decision. If a loved one already lives in a nursing home, changes in staffing, cleanliness, supervision, health, or behavior may be signs that something is wrong. Get Help if Your Loved One Was Harmed Families should not have to sort through thousands of federal records to understand basic information about nursing home safety. Poor state rankings or staffing numbers do not automatically prove that a nursing home has neglected or abused a resident. However, if your loved one is showing signs of nursing home abuse or neglect, you have the right to ask questions and seek help. The Nursing Home Abuse Center helps families understand their options. Call us at (855) 264-6310 or get a free case review now.