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Worst Nursing Homes: The Homes CMS Flags in Every State
Homes are flagged by CMS, the federal Medicare agency, for abuse or a history of poor inspections. Any home carrying both flags is still counted one time.
- 1,728
- Flagged by CMS11.8% out of 14,690 homes
- 87
- Special Focus Facilities440 more are candidates
- 1,429
- Homes carrying the abuse iconon their Medicare profile
- 22,564
- Citations for harm or dangerall US homes, last three inspection cycles
- $455 million
- Fines from the federal governmentall US homes, since September 2023
The 25 Flagged Homes With the Most Harm and Immediate-Danger Findings
Each of these flagged homes has at least one immediate-danger finding. They are ranked by harm or danger citations, then by fines (term definitions).
Severity letters G to L make up the harm or danger count, and immediate danger (J to L) is included. Fines cover about three years; citation counts come from each home's three most recent inspection cycles.
Do you have a loved one in one of these homes? A person in immediate danger should call 911 first.
Call 1-833-892-8135Calls go to a law firm that advertises on Nursing Home Violations.State-by-State List of Flagged Homes
The average home carries 1.54 citations involving harm or danger and $30,972 in federal fines. For the US, 11.8% is the share of homes flagged. These per-home figures include all homes in a state, whether flagged or not. States are listed by harm or danger citations per home, highest first.
| State | Homes | Flagged by CMS | Share flagged | Harm or danger per home | Fines per home |
|---|---|---|---|---|---|
| Illinois | 666 | 197 | 29.6% | 4.55 | $111,013 |
| Rhode Island | 72 | 10 | 13.9% | 3.13 | $60,948 |
| Utah | 97 | 13 | 13.4% | 3.09 | $23,954 |
| District of Columbia | 17 | 2 | 11.8% | 3.00 | $74,232 |
| South Dakota | 96 | 15 | 15.6% | 2.49 | $40,815 |
| Vermont | 33 | 9 | 27.3% | 2.48 | $87,304 |
| Delaware | 44 | 15 | 34.1% | 2.41 | $67,512 |
| Colorado | 210 | 54 | 25.7% | 2.33 | $22,802 |
| Texas | 1,177 | 141 | 12.0% | 2.26 | $44,141 |
| Montana | 61 | 10 | 16.4% | 2.20 | $55,610 |
| Mississippi | 202 | 21 | 10.4% | 2.06 | $17,231 |
| Wisconsin | 323 | 26 | 8.0% | 2.03 | $48,150 |
| Wyoming | 36 | 14 | 38.9% | 2.03 | $28,128 |
| Washington | 193 | 21 | 10.9% | 2.02 | $52,633 |
| New Mexico | 68 | 16 | 23.5% | 1.97 | $45,849 |
| Michigan | 422 | 68 | 16.1% | 1.96 | $29,376 |
| North Carolina | 419 | 41 | 9.8% | 1.79 | $36,617 |
| Missouri | 487 | 70 | 14.4% | 1.71 | $37,425 |
| Kansas | 296 | 29 | 9.8% | 1.58 | $20,430 |
| North Dakota | 72 | 15 | 20.8% | 1.53 | $27,629 |
| Kentucky | 267 | 10 | 3.7% | 1.49 | $15,373 |
| Virginia | 289 | 33 | 11.4% | 1.45 | $23,688 |
| Oregon | 128 | 17 | 13.3% | 1.45 | $27,522 |
| Connecticut | 191 | 47 | 24.6% | 1.41 | $23,730 |
| Massachusetts | 341 | 16 | 4.7% | 1.41 | $34,265 |
| Minnesota | 338 | 32 | 9.5% | 1.36 | $24,507 |
| Iowa | 387 | 26 | 6.7% | 1.31 | $19,286 |
| West Virginia | 123 | 12 | 9.8% | 1.31 | $29,505 |
| Tennessee | 303 | 20 | 6.6% | 1.27 | $22,907 |
| Pennsylvania | 656 | 117 | 17.8% | 1.25 | $25,774 |
| California | 1,165 | 134 | 11.5% | 1.20 | $23,986 |
| Louisiana | 265 | 18 | 6.8% | 1.19 | $46,795 |
| Hawaii | 43 | 6 | 14.0% | 1.19 | $19,339 |
| Ohio | 922 | 60 | 6.5% | 1.16 | $26,381 |
| Oklahoma | 283 | 33 | 11.7% | 1.11 | $18,268 |
| Alaska | 20 | 1 | 5.0% | 1.10 | $26,572 |
| South Carolina | 187 | 17 | 9.1% | 1.09 | $14,833 |
| Georgia | 356 | 29 | 8.1% | 1.07 | $12,749 |
| Florida | 694 | 52 | 7.5% | 1.02 | $24,361 |
| New Jersey | 348 | 24 | 6.9% | 1.02 | $34,926 |
| Maryland | 221 | 26 | 11.8% | 0.99 | $21,934 |
| Idaho | 80 | 12 | 15.0% | 0.90 | $13,374 |
| Alabama | 224 | 14 | 6.3% | 0.79 | $12,315 |
| New York | 593 | 59 | 9.9% | 0.76 | $23,070 |
| Nebraska | 180 | 6 | 3.3% | 0.72 | $11,975 |
| Indiana | 507 | 43 | 8.5% | 0.68 | $8,742 |
| Arizona | 140 | 42 | 30.0% | 0.55 | $8,928 |
| Maine | 78 | 6 | 7.7% | 0.53 | $7,386 |
| Arkansas | 221 | 12 | 5.4% | 0.50 | $9,209 |
| Nevada | 66 | 12 | 18.2% | 0.50 | $13,952 |
| New Hampshire | 73 | 5 | 6.8% | 0.32 | $7,928 |
| United States | 14,690 | 1,728 | 11.8% | 1.54 | $30,972 |
Definitions of the Terms
- Citation
- During a visit, an inspector found the home had broken this rule. Several citations can come out of a single visit.
- Harm
- G, H and I severity letters: a resident was in fact harmed.
- Immediate danger
- J, K and L severity letters: the failure led to serious injury or death, or was likely to. They count toward the harm or danger total.
- Special Focus Facility
- CMS inspects such a home more often because of serious problems over a long period. It has no overall star rating on Medicare.
- Special Focus candidate
- For that program, CMS has this home on its shortlist. Its record is similar, but it has not been chosen.
- Abuse icon
- CMS gives a home this mark when it was cited for abuse that hurt a resident within the past year. The mark also applies when abuse could have harmed a resident in each of the last two years.
- Stars
- Based on inspections, staffing, and quality measures, Medicare assigns a rating from 1 to 5. Not every home receives a rating.
The source is CMS: the provider information and health deficiencies files.