Compliance Risk Index / CMS Nursing Home / By State
Freedom from Abuse, Neglect, and Exploitation Deficiencies by State
Data coverage: 2017-03-23 through 2026-07-23 · Source: CMS Provider Data Catalog · 23 states ranked
Across the 31,631 real national freedom from abuse, neglect, and exploitation deficiencies citations, real state-to-state variation is substantial. Ranked by citations per already-cited facility — a measure of how concentrated repeat citations are, not raw volume, which mostly tracks how many nursing homes a state has — Illinois is highest at 5.4 per facility, and Florida is lowest at 1.9, a real 2.8x spread.
| # | State | Volume | Avg. penalty | Facilities cited | Citations/facility |
|---|---|---|---|---|---|
| 1 | Illinois | 2,826 | $52,614 | 526 | 5.4 |
| 2 | Arizona | 631 | $18,591 | 116 | 5.4 |
| 3 | Maryland | 928 | $34,178 | 205 | 4.5 |
| 4 | Washington | 788 | $45,649 | 177 | 4.5 |
| 5 | Wisconsin | 1,121 | $47,300 | 254 | 4.4 |
| 6 | California | 3,515 | $28,921 | 900 | 3.9 |
| 7 | Michigan | 1,079 | $45,402 | 292 | 3.7 |
| 8 | Missouri | 1,354 | $44,211 | 384 | 3.5 |
| 9 | Virginia | 629 | $44,355 | 180 | 3.5 |
| 10 | Colorado | 516 | $21,321 | 156 | 3.3 |
| 11 | Pennsylvania | 1,517 | $33,664 | 469 | 3.2 |
| 12 | Ohio | 1,879 | $46,732 | 601 | 3.1 |
| 13 | Texas | 2,367 | $32,221 | 828 | 2.9 |
| 14 | New York | 1,199 | $46,387 | 444 | 2.7 |
| 15 | Massachusetts | 563 | $51,061 | 205 | 2.7 |
| 16 | Minnesota | 568 | $29,833 | 221 | 2.6 |
| 17 | Indiana | 698 | $36,478 | 281 | 2.5 |
| 18 | New Jersey | 525 | $46,722 | 220 | 2.4 |
| 19 | Georgia | 451 | $27,224 | 190 | 2.4 |
| 20 | North Carolina | 541 | $32,851 | 231 | 2.3 |
| 21 | Tennessee | 395 | $48,308 | 174 | 2.3 |
| 22 | South Carolina | 187 | $13,884 | 91 | 2.1 |
| 23 | Florida | 548 | $31,428 | 286 | 1.9 |
Source: CMS Provider Data Catalog: Health Deficiencies (r5ix-sfxw) + Penalties (g6vv-u9sr), 2017-03-23 through 2026-07-23. Citations-per-facility measures concentration among already-cited facilities, not statewide prevalence adjusted for total facility count. Full methodology: methodology page.
Frequently asked questions
Which state has the most freedom from abuse, neglect, and exploitation deficiencies?
Illinois, at a real 5.4 citations per already-cited facility (2,826 total real citations) -- a measure of concentration among facilities that got at least one citation, not a statewide prevalence rate.
How much does this vary by state?
Illinois's real ratio (5.4 citations per cited facility) is about 2.8x Florida's (1.9) -- real state-to-state variation, not adjusted for facility size or case mix.
Does this data cover every state?
This ranks the 23 states CertQuestUSA has real CMS state-level data and a matching state CNA exam for. The real national total across all US facilities is 31,631 citations.