Compliance Risk Index / CMS Nursing Home / By State
Pharmacy Service Deficiencies by State
Data coverage: 2017-03-23 through 2026-07-23 · Source: CMS Provider Data Catalog · 23 states ranked
Across the 44,754 real national pharmacy service 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 6.4 per facility, and Georgia is lowest at 2, a real 3.2x spread.
| # | State | Volume | Avg. penalty | Facilities cited | Citations/facility |
|---|---|---|---|---|---|
| 1 | California | 7,316 | $28,053 | 1,146 | 6.4 |
| 2 | Maryland | 1,093 | $34,063 | 211 | 5.2 |
| 3 | Washington | 885 | $44,487 | 184 | 4.8 |
| 4 | Virginia | 1,190 | $41,989 | 274 | 4.3 |
| 5 | Illinois | 2,543 | $51,436 | 620 | 4.1 |
| 6 | Ohio | 3,275 | $47,060 | 824 | 4 |
| 7 | Wisconsin | 1,045 | $47,121 | 265 | 3.9 |
| 8 | Texas | 4,135 | $30,716 | 1,101 | 3.8 |
| 9 | Missouri | 1,624 | $42,967 | 436 | 3.7 |
| 10 | Pennsylvania | 1,899 | $33,152 | 530 | 3.6 |
| 11 | Michigan | 1,281 | $44,166 | 354 | 3.6 |
| 12 | Massachusetts | 1,054 | $44,879 | 311 | 3.4 |
| 13 | Indiana | 1,358 | $31,497 | 437 | 3.1 |
| 14 | North Carolina | 935 | $32,171 | 310 | 3 |
| 15 | New Jersey | 919 | $45,956 | 302 | 3 |
| 16 | Florida | 1,634 | $27,327 | 565 | 2.9 |
| 17 | Minnesota | 724 | $27,577 | 253 | 2.9 |
| 18 | Colorado | 506 | $20,647 | 187 | 2.7 |
| 19 | South Carolina | 353 | $14,099 | 147 | 2.4 |
| 20 | Arizona | 293 | $18,279 | 120 | 2.4 |
| 21 | New York | 1,056 | $48,033 | 459 | 2.3 |
| 22 | Tennessee | 439 | $46,445 | 214 | 2.1 |
| 23 | Georgia | 518 | $22,380 | 256 | 2 |
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 pharmacy service deficiencies?
California, at a real 6.4 citations per already-cited facility (7,316 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 (6.4 citations per cited facility) is about 3.2x Georgia's (2) -- 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 44,754 citations.