Compliance Risk Index / CMS Nursing Home / By State
Resident Rights Deficiencies by State
Data coverage: 2017-03-23 through 2026-07-23 · Source: CMS Provider Data Catalog · 23 states ranked
Across the 64,606 real national resident rights 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 10.1 per facility, and Tennessee is lowest at 2.3, a real 4.4x spread.
| # | State | Volume | Avg. penalty | Facilities cited | Citations/facility |
|---|---|---|---|---|---|
| 1 | Maryland | 2,198 | $34,178 | 217 | 10.1 |
| 2 | Washington | 1,644 | $45,184 | 186 | 8.8 |
| 3 | California | 8,664 | $27,987 | 1,114 | 7.8 |
| 4 | Missouri | 3,289 | $42,122 | 466 | 7.1 |
| 5 | Virginia | 1,953 | $41,564 | 275 | 7.1 |
| 6 | Pennsylvania | 3,381 | $33,481 | 565 | 6 |
| 7 | Illinois | 3,374 | $51,680 | 606 | 5.6 |
| 8 | Ohio | 4,542 | $44,966 | 857 | 5.3 |
| 9 | Michigan | 2,004 | $43,594 | 393 | 5.1 |
| 10 | Massachusetts | 1,444 | $46,104 | 299 | 4.8 |
| 11 | Wisconsin | 1,269 | $47,436 | 275 | 4.6 |
| 12 | Minnesota | 1,320 | $27,477 | 300 | 4.4 |
| 13 | Texas | 4,626 | $31,318 | 1,069 | 4.3 |
| 14 | Colorado | 785 | $19,834 | 185 | 4.2 |
| 15 | North Carolina | 1,415 | $31,622 | 349 | 4.1 |
| 16 | Indiana | 1,743 | $32,503 | 447 | 3.9 |
| 17 | New York | 1,884 | $47,816 | 516 | 3.7 |
| 18 | Georgia | 1,034 | $22,861 | 291 | 3.6 |
| 19 | Florida | 2,049 | $27,450 | 578 | 3.5 |
| 20 | New Jersey | 967 | $44,337 | 294 | 3.3 |
| 21 | Arizona | 383 | $18,506 | 125 | 3.1 |
| 22 | South Carolina | 360 | $13,500 | 137 | 2.6 |
| 23 | Tennessee | 540 | $46,608 | 239 | 2.3 |
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 rights deficiencies?
Maryland, at a real 10.1 citations per already-cited facility (2,198 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 (10.1 citations per cited facility) is about 4.4x Tennessee's (2.3) -- 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 64,606 citations.