Compliance Risk Index / CMS Nursing Home / By State
Nutrition and Dietary Deficiencies by State
Data coverage: 2017-03-23 through 2026-07-23 · Source: CMS Provider Data Catalog · 23 states ranked
Across the 37,747 real national nutrition and dietary 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 — California is highest at 5.4 per facility, and Arizona is lowest at 1.8, a real 3x spread.
| # | State | Volume | Avg. penalty | Facilities cited | Citations/facility |
|---|---|---|---|---|---|
| 1 | California | 6,175 | $28,045 | 1,152 | 5.4 |
| 2 | Illinois | 2,258 | $51,451 | 587 | 3.8 |
| 3 | Missouri | 1,626 | $41,963 | 434 | 3.7 |
| 4 | Pennsylvania | 1,780 | $32,930 | 502 | 3.5 |
| 5 | Ohio | 2,563 | $44,817 | 764 | 3.4 |
| 6 | Washington | 594 | $44,309 | 173 | 3.4 |
| 7 | Virginia | 772 | $40,937 | 237 | 3.3 |
| 8 | Maryland | 670 | $34,950 | 206 | 3.3 |
| 9 | Texas | 3,425 | $31,094 | 1,073 | 3.2 |
| 10 | Michigan | 1,071 | $42,743 | 356 | 3 |
| 11 | Wisconsin | 769 | $46,417 | 261 | 2.9 |
| 12 | Colorado | 480 | $21,328 | 168 | 2.9 |
| 13 | New York | 1,189 | $45,937 | 441 | 2.7 |
| 14 | New Jersey | 793 | $42,528 | 301 | 2.6 |
| 15 | Florida | 1,224 | $28,085 | 503 | 2.4 |
| 16 | Massachusetts | 617 | $47,495 | 252 | 2.4 |
| 17 | Indiana | 843 | $32,384 | 369 | 2.3 |
| 18 | North Carolina | 663 | $32,150 | 289 | 2.3 |
| 19 | Georgia | 600 | $22,779 | 271 | 2.2 |
| 20 | Minnesota | 449 | $28,413 | 226 | 2 |
| 21 | South Carolina | 255 | $14,052 | 127 | 2 |
| 22 | Tennessee | 419 | $43,861 | 224 | 1.9 |
| 23 | Arizona | 170 | $19,026 | 97 | 1.8 |
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 nutrition and dietary deficiencies?
California, at a real 5.4 citations per already-cited facility (6,175 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?
California's real ratio (5.4 citations per cited facility) is about 3x Arizona's (1.8) -- 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 37,747 citations.