--- title: "New Tool Ranks Nursing Home Safety in All 50 States" url: "https://www.nursinghomeabusecenter.com/blog/new-nursing-home-ranking-tool/" description: "Use our free 2026 nursing home rankings to compare state staffing, abuse citations, turnover, and federal enforcement data." --- **Blog** **Nursing Home Abuse Center Blog** 3 Min Read Posted on [August 6, 2026](https://www.nursinghomeabusecenter.com/blog/new-nursing-home-ranking-tool/) # 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**](https://www.nursinghomeabusecenter.com/research/best-and-worst-states-for-nursing-home-abuse/) 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. ## 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](https://www.nursinghomeabusecenter.com/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by severity - RN staffing compared with the 0.55 RN-hours-per-resident-per-day benchmark established in CMS’s now-repealed 2024 staffing rule - Annual nursing staff turnover - CMS Abuse Icon and Special Focus Facility (SFF) status Each facility received a score based on these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:** 1. [New Hampshire](https://www.nursinghomeabusecenter.com/legal/lawsuit/new-hampshire/) 2. [Alaska](https://www.nursinghomeabusecenter.com/legal/lawsuit/alaska/) 3. [Alabama](https://www.nursinghomeabusecenter.com/legal/lawsuit/alabama/) 4. [Minnesota](https://www.nursinghomeabusecenter.com/legal/lawsuit/minnesota/) 5. [Maine](https://www.nursinghomeabusecenter.com/legal/lawsuit/maine/) At the other end of the rankings, **[Louisiana](https://www.nursinghomeabusecenter.com/legal/lawsuit/louisiana/) ranked last**, followed by [Texas](https://www.nursinghomeabusecenter.com/legal/lawsuit/texas/), [Missouri](https://www.nursinghomeabusecenter.com/legal/lawsuit/missouri/), [Oklahoma](https://www.nursinghomeabusecenter.com/legal/lawsuit/oklahoma/), and [Illinois](https://www.nursinghomeabusecenter.com/legal/lawsuit/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](https://www.nursinghomeabusecenter.com/nursing-home-neglect/understaffing/) 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](https://www.nursinghomeabusecenter.com/nursing-home-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](https://www.nursinghomeabusecenter.com/nursing-home-abuse/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](tel:+18552646310) or [get a free case review now](https://www.nursinghomeabusecenter.com/legal-case-review/).** Posted in [Nursing Home Abuse](https://www.nursinghomeabusecenter.com/blog/category/nursing-home-abuse/), [Nursing Home Care](https://www.nursinghomeabusecenter.com/blog/category/nursing-home-care/), [Nursing Home Neglect](https://www.nursinghomeabusecenter.com/blog/category/nursing-home-neglect/)Tagged [Nursing Home Abuse](https://www.nursinghomeabusecenter.com/blog/tag/nursing-home-abuse/), [Nursing home neglect](https://www.nursinghomeabusecenter.com/blog/tag/nursing-home-neglect/), [nursing home ranking tool](https://www.nursinghomeabusecenter.com/blog/tag/nursing-home-ranking-tool/) **Nursing Home Abuse Support Team**Last modified: October 21, 2026 **Reviewed by:**__[Julie Rivers, MBA, CSA](https://www.nursinghomeabusecenter.com/contributors/julie-rivers-mba/ "Julie Rivers, MBA, CSA")__ Eldercare Advocate & Certified Senior Advisor - Fact-Checked - Editor Julie Rivers is an eldercare advocate with over 25 years of experience focused on nursing home resident safety. She began as a case manager at a nursing home law firm, working with families in crisis. She is a Certified Senior Advisor and also cared for her mother through Alzheimer’s. Her business training deepens her understanding of how for-profit facilities operate. **Written by:**__[The Nursing Home Abuse Center Team](https://www.nursinghomeabusecenter.com/about/ "The Nursing Home Abuse Center Team")__ The Nursing Home Abuse Center (NHAC) was founded to bring justice to those affected by nursing home and elder abuse. Our mission is to educate and empower victims of abuse and their families to take a stand against this unlawful mistreatment. We work to return dignity back to those who have been broken down by nursing home abuse and neglect.