Protect Your Family: Know the 10 Best and Worst Nursing Home States

Protect Your Family: Know the 10 Best and Worst Nursing Home States

A nursing home map to show the best and worst states for nursing home care

Choosing to admit a loved one into a nursing home is an incredibly difficult decision. The many factors – money, reviews, availability, geographical location – can become, at least, overwhelming. At the end of the day, families want their loved ones receive the utmost care and be in the hands of experienced, compassionate medical professionals who will give them the appropriate attention and nurturance.

Knowing what to look for when choosing a nursing home will help family members make an informed and empowered decision. According to VeryWell Health, the qualities of a good nursing home include visibly seeing that residents are receiving respect and courtesy from staff. Staff should call them by their first name and speak to them in a friendly demeanor. Other important features to look out for are having a lot of activities for residents, the quality of the food, the coziness of the facility aesthetic and offered amenities such as internet access and beauty salons.

FamilyAssets compiled data to find what states have the best nursing homes versus the worst. The data is based upon hundreds of thousands of reviews that aggregated information from across 125 different markets. Each of the top states below has over 50 percent positive ratings.

Ten best nursing homes in America

  1. South Dakota
    Percentage of positive ratings: 84.4%
  2. Wyoming
    Percentage of positive ratings: 82.6%
  3. North Dakota
    Percentage of positive ratings: 78.6%
  4. Hawaii
    Percentage of positive ratings: 77.4%
  5. Iowa
    Percentage of positive ratings: 76.9%
  6. Utah
    Percentage of positive ratings: 76.3%
  7. Alaska
    Percentage of positive ratings: 75.6%
  8. Indiana
    Percentage of positive ratings: 74.5%
  9. Kansas
    Percentage of positive ratings: 74.2%
  10. Minnesota
    Percentage of positive ratings: 72.7%

Over 30 percent of nursing homes in the United States are rated poorly. Nursing homes have three times more one-star reviews compared to assisted living facilities. In Las Vegas, Nevada and Atlanta, Georgia over 50 percent of nursing homes in the entire city have bad reviews.


High turnover rates among staff are one of the five negative traits to look out for when choosing a nursing home. The others include the facility having a history of violations, a lack of independence for the residents, a number of severe violations on the facility’s record and having that uneasy feeling in your gut. Bad reviews online can reveal a lot of important information about the home.


In 2009, the Chicago Tribune published a piece about what it’s like to reside in a one-star nursing home. It reported 29 major health violations, staff not answering calls for help, no activities for residents throughout the day, forcing them to lay in bed in watch TV 24/7 and so on. The article prompted many major reportings of homes that provide low-quality and unacceptable care.


Ten worst nursing homes in America

  1. Nevada
    Percentage of negative ratings: 46.9%
  2. Washington D.C.
    Percentage of negative ratings: 42.9%
  3. New Mexico
    Percentage of negative ratings: 40.4%
  4. Georgia
    Percentage of negative ratings: 37.2%
  5. Maryland
    Percentage of negative ratings: 36.2%
  6. Arizona
    Percentage of negative ratings: 36%
  7. New York
    Percentage of negative ratings: 35%
  8. Florida
    Percentage of negative ratings: 33.3%
  9. New Jersey
    Percentage of negative ratings: 33%
  10. Texas
    Percentage of negative ratings: 32.2%

People who are making the difficult decision of choosing a nursing home facility for their loved ones have a lot to consider. Families who have been through it say to take a detailed tour of every facility, meet the director, talk with other families who know the home well. Read all of the online reviews and news articles about the home. Most importantly – follow your instinct.