Compliance Risk Index / CMS Nursing Home / By State
Nursing and Physician Services Deficiencies by State
Data coverage: 2017-03-23 through 2026-07-23 · Source: CMS Provider Data Catalog · 23 states ranked
Across the 15,091 real national nursing and physician services 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 — Maryland is highest at 3.3 per facility, and South Carolina is lowest at 1.4, a real 2.4x spread.
| # | State | Volume | Avg. penalty | Facilities cited | Citations/facility |
|---|---|---|---|---|---|
| 1 | Maryland | 637 | $34,148 | 192 | 3.3 |
| 2 | Missouri | 817 | $44,537 | 314 | 2.6 |
| 3 | Virginia | 398 | $46,535 | 158 | 2.5 |
| 4 | Washington | 350 | $47,869 | 141 | 2.5 |
| 5 | Pennsylvania | 779 | $32,236 | 322 | 2.4 |
| 6 | California | 1,798 | $29,587 | 772 | 2.3 |
| 7 | Illinois | 851 | $53,769 | 364 | 2.3 |
| 8 | Michigan | 504 | $49,900 | 234 | 2.2 |
| 9 | Massachusetts | 358 | $49,642 | 170 | 2.1 |
| 10 | Wisconsin | 248 | $47,183 | 121 | 2 |
| 11 | New Jersey | 384 | $43,229 | 202 | 1.9 |
| 12 | Minnesota | 274 | $27,031 | 147 | 1.9 |
| 13 | Ohio | 744 | $49,756 | 415 | 1.8 |
| 14 | New York | 588 | $47,530 | 325 | 1.8 |
| 15 | North Carolina | 314 | $36,445 | 178 | 1.8 |
| 16 | Arizona | 121 | $19,033 | 72 | 1.7 |
| 17 | Texas | 849 | $35,180 | 517 | 1.6 |
| 18 | Colorado | 162 | $20,332 | 100 | 1.6 |
| 19 | Florida | 370 | $30,336 | 255 | 1.5 |
| 20 | Indiana | 327 | $31,284 | 216 | 1.5 |
| 21 | Tennessee | 148 | $58,578 | 99 | 1.5 |
| 22 | Georgia | 107 | $28,827 | 79 | 1.4 |
| 23 | South Carolina | 52 | $14,244 | 37 | 1.4 |
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 nursing and physician services deficiencies?
Maryland, at a real 3.3 citations per already-cited facility (637 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?
Maryland's real ratio (3.3 citations per cited facility) is about 2.4x South Carolina's (1.4) -- 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 15,091 citations.