California has the greatest number of high-performing nursing homes in the U.S., followed by Florida, according to U.S. News & World Report’s “2026 Best Nursing Homes” ratings, published Nov. 13.
Hawaii has the highest rate of high-performing nursing homes, followed by the District of Columbia.
Compared to the national average, U.S. News found that the top-rated nursing homes have a 15% lower rate of hospitalizations for long-term residents and provide 20% more total staffing per resident per day, according to a Nov. 13 news release from the news outlet.
U.S. News used CMS quality measures data to evaluate nearly 15,000 nursing homes, factoring in resident care, safety, outcomes, staffing levels, use of antipsychotic medications and ER visit prevention. Read the full methodology here.
Here are the number and rate of high-performing nursing homes, by state, for both short and long-term care, per U.S. News:
| State | High-performing nursing homes | Total nursing homes rated | Percentage of high-performing nursing homes |
| Alabama | 1 | 211 | 0.47% |
| Alaska | 2 | 11 | 18.18% |
| Arizona | 6 | 131 | 4.58% |
| Arkansas | 0 | 219 | 0% |
| California | 122 | 1094 | 11.15% |
| Colorado | 22 | 196 | 11.22% |
| Connecticut | 18 | 188 | 9.57% |
| Delaware | 8 | 42 | 19.05% |
| District ofColumbia | 4 | 16 | 25% |
| Florida | 89 | 685 | 12.99% |
| Georgia | 9 | 325 | 2.77% |
| Hawaii | 12 | 36 | 33.33% |
| Idaho | 6 | 72 | 8.33% |
| Illinois | 36 | 641 | 5.62% |
| Indiana | 33 | 490 | 6.73% |
| Iowa | 22 | 366 | 6.01% |
| Kansas | 25 | 278 | 8.99% |
| Kentucky | 14 | 262 | 5.34% |
| Louisiana | 0 | 257 | 0% |
| Maine | 8 | 72 | 11.11% |
| Maryland | 31 | 215 | 14.42% |
| Massachusetts | 38 | 340 | 11.18% |
| Michigan | 33 | 400 | 8.25% |
| Minnesota | 34 | 259 | 13.13% |
| Mississippi | 0 | 198 | 0% |
| Missouri | 8 | 443 | 1.81% |
| Montana | 3 | 54 | 5.56% |
| Nebraska | 17 | 171 | 9.94% |
| Nevada | 3 | 60 | 5% |
| New Hampshire | 4 | 74 | 5.41% |
| New Jersey | 51 | 337 | 15.13% |
| New Mexico | 3 | 65 | 4.62% |
| New York | 71 | 580 | 12.24% |
| North Carolina | 24 | 405 | 5.93% |
| North Dakota | 5 | 70 | 7.14% |
| Ohio | 28 | 773 | 3.62% |
| Oklahoma | 3 | 265 | 1.13% |
| Oregon | 7 | 107 | 6.54% |
| Pennsylvania | 83 | 644 | 12.89% |
| Rhode Island | 4 | 65 | 6.15% |
| South Carolina | 10 | 181 | 5.52% |
| South Dakota | 9 | 86 | 10.47% |
| Tennessee | 22 | 294 | 7.48% |
| Texas | 21 | 1098 | 1.91% |
| Utah | 17 | 87 | 19.54% |
| Vermont | 1 | 34 | 2.94% |
| Virginia | 35 | 285 | 12.28% |
| Washington | 23 | 183 | 12.57% |
| West Virginia | 3 | 113 | 2.65% |
| Wisconsin | 35 | 305 | 11.48% |
| Wyoming | 1 | 32 | 3.13% |