Compliance Risk Index / CMS Nursing Home / By State
Resident Assessment and Care Planning Deficiencies by State
Data coverage: 2017-03-23 through 2026-07-23 · Source: CMS Provider Data Catalog · 23 states ranked
Across the 61,052 real national resident assessment and care planning 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 9.9 per facility, and South Carolina is lowest at 2.2, a real 4.5x spread.
| # | State | Volume | Avg. penalty | Facilities cited | Citations/facility |
|---|---|---|---|---|---|
| 1 | Maryland | 2,134 | $34,125 | 216 | 9.9 |
| 2 | Washington | 1,605 | $45,002 | 191 | 8.4 |
| 3 | California | 9,115 | $28,032 | 1,134 | 8 |
| 4 | Virginia | 2,171 | $41,564 | 282 | 7.7 |
| 5 | Massachusetts | 2,032 | $44,641 | 327 | 6.2 |
| 6 | Missouri | 2,220 | $42,336 | 453 | 4.9 |
| 7 | Texas | 5,409 | $30,797 | 1,121 | 4.8 |
| 8 | Pennsylvania | 2,709 | $32,657 | 567 | 4.8 |
| 9 | New Jersey | 1,493 | $44,743 | 333 | 4.5 |
| 10 | Michigan | 1,616 | $43,924 | 391 | 4.1 |
| 11 | Ohio | 3,209 | $45,302 | 798 | 4 |
| 12 | North Carolina | 1,341 | $31,253 | 358 | 3.7 |
| 13 | Arizona | 489 | $18,102 | 131 | 3.7 |
| 14 | Florida | 2,057 | $28,258 | 587 | 3.5 |
| 15 | Indiana | 1,409 | $31,625 | 408 | 3.5 |
| 16 | New York | 1,748 | $43,502 | 516 | 3.4 |
| 17 | Georgia | 986 | $21,969 | 298 | 3.3 |
| 18 | Illinois | 1,431 | $53,300 | 463 | 3.1 |
| 19 | Minnesota | 826 | $28,047 | 269 | 3.1 |
| 20 | Tennessee | 810 | $45,184 | 264 | 3.1 |
| 21 | Wisconsin | 694 | $46,472 | 236 | 2.9 |
| 22 | Colorado | 349 | $21,161 | 151 | 2.3 |
| 23 | South Carolina | 300 | $13,624 | 136 | 2.2 |
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 resident assessment and care planning deficiencies?
Maryland, at a real 9.9 citations per already-cited facility (2,134 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 (9.9 citations per cited facility) is about 4.5x South Carolina's (2.2) -- 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 61,052 citations.