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Nursing home fines by state
CMS lists $454,984,026 in fines against 6,510 of the 14,690 certified nursing homes in the United States (44%) over the last three years, in data as of September 1, 2026.
Fines, 3 years
$454,984,026
Homes fined
44% of homes
Payment denials
2,430
Top tenth of fined homes
41% of dollars
CMS Penalties, released September 30, 2026 · data as of September 1, 2026
Key findings
- $454,984,026 in fines over three years, 12,989 fines in all, against 6,510 homes (44% of certified homes).
- Concentrated: the most-fined tenth of fined homes (651 homes) account for 41% of all fine dollars.
- Illinois has the largest total ($73,934,986). Per home, among states with 20 or more homes, Illinois ($111,013), Vermont ($87,304) and Delaware ($67,512) lead; Maine is lowest ($7,386).
- 4,358 homes (30%) have at least one immediate jeopardy citation in the inspections on file, the most serious level CMS uses.
Every state
Sorted by total fines. Click a column to sort by it.
| State | Homes | Homes fined | Fines | Total | Per home | Per bed | Largest fine | Payment denials | Homes with immediate jeopardy |
|---|---|---|---|---|---|---|---|---|---|
| Illinois | 666 | 458 (69%) | 1,455 | $73,934,986 | $111,013 | $870 | $448,601 | 491 | 265 (40%) |
| Texas | 1,177 | 806 (68%) | 1,716 | $51,954,195 | $44,141 | $389 | $284,250 | 145 | 736 (63%) |
| California | 1,165 | 460 (39%) | 955 | $27,944,206 | $23,986 | $243 | $478,110 | 283 | 217 (19%) |
| Ohio | 922 | 295 (32%) | 534 | $24,323,545 | $26,381 | $300 | $327,850 | 184 | 193 (21%) |
| Missouri | 487 | 208 (43%) | 411 | $18,225,767 | $37,425 | $364 | $564,745 | 159 | 159 (33%) |
| Pennsylvania | 656 | 287 (44%) | 522 | $16,907,525 | $25,774 | $204 | $312,363 | 49 | 170 (26%) |
| Florida | 694 | 265 (38%) | 587 | $16,906,487 | $24,361 | $200 | $319,770 | 15 | 172 (25%) |
| Wisconsin | 323 | 139 (43%) | 306 | $15,552,379 | $48,150 | $628 | $424,350 | 101 | 140 (43%) |
| North Carolina | 419 | 235 (56%) | 487 | $15,342,355 | $36,617 | $350 | $325,563 | 75 | 163 (39%) |
| New York | 593 | 183 (31%) | 320 | $13,680,799 | $23,070 | $123 | $460,490 | 21 | 120 (20%) |
| Louisiana | 265 | 129 (49%) | 228 | $12,400,596 | $46,795 | $385 | $322,647 | 43 | 86 (32%) |
| Michigan | 422 | 157 (37%) | 278 | $12,396,545 | $29,376 | $282 | $234,637 | 158 | 80 (19%) |
| New Jersey | 348 | 142 (41%) | 260 | $12,154,241 | $34,926 | $238 | $713,795 | 8 | 123 (35%) |
| Massachusetts | 341 | 164 (48%) | 258 | $11,684,409 | $34,265 | $286 | $464,490 | 7 | 35 (10%) |
| Washington | 193 | 117 (61%) | 233 | $10,158,197 | $52,633 | $541 | $229,876 | 30 | 41 (21%) |
| Minnesota | 338 | 143 (42%) | 271 | $8,283,380 | $24,507 | $344 | $334,488 | 63 | 149 (44%) |
| Iowa | 387 | 142 (37%) | 222 | $7,463,626 | $19,286 | $297 | $311,880 | 73 | 104 (27%) |
| Tennessee | 303 | 110 (36%) | 161 | $6,940,796 | $22,907 | $201 | $303,310 | 31 | 86 (28%) |
| Virginia | 289 | 103 (36%) | 154 | $6,845,748 | $23,688 | $210 | $368,040 | 11 | 70 (24%) |
| Kansas | 296 | 147 (50%) | 319 | $6,047,179 | $20,430 | $335 | $170,765 | 38 | 124 (42%) |
| Oklahoma | 283 | 145 (51%) | 251 | $5,169,812 | $18,268 | $188 | $155,928 | 53 | 117 (41%) |
| Maryland | 221 | 89 (40%) | 140 | $4,847,524 | $21,934 | $178 | $341,978 | 9 | 71 (32%) |
| Colorado | 210 | 120 (57%) | 234 | $4,788,349 | $22,802 | $242 | $114,111 | 28 | 63 (30%) |
| Georgia | 356 | 120 (34%) | 210 | $4,538,517 | $12,749 | $115 | $267,426 | 45 | 63 (18%) |
| Connecticut | 191 | 110 (58%) | 179 | $4,532,487 | $23,730 | $201 | $195,360 | 13 | 55 (29%) |
| Indiana | 507 | 93 (18%) | 129 | $4,432,030 | $8,742 | $91 | $284,560 | 41 | 74 (15%) |
| Rhode Island | 72 | 53 (74%) | 151 | $4,388,281 | $60,948 | $536 | $233,282 | 20 | 36 (50%) |
| Kentucky | 267 | 90 (34%) | 188 | $4,104,594 | $15,373 | $162 | $434,745 | 25 | 70 (26%) |
| South Dakota | 96 | 72 (75%) | 178 | $3,918,278 | $40,815 | $670 | $122,476 | 0 | 26 (27%) |
| West Virginia | 123 | 64 (52%) | 98 | $3,629,084 | $29,505 | $339 | $268,733 | 3 | 55 (45%) |
| Oregon | 128 | 63 (49%) | 98 | $3,522,821 | $27,522 | $332 | $223,270 | 6 | 34 (27%) |
| Mississippi | 202 | 108 (53%) | 229 | $3,480,591 | $17,231 | $199 | $232,114 | 21 | 53 (26%) |
| Montana | 61 | 42 (69%) | 93 | $3,392,214 | $55,610 | $679 | $250,357 | 14 | 15 (25%) |
| New Mexico | 68 | 41 (60%) | 90 | $3,117,721 | $45,849 | $452 | $213,815 | 20 | 32 (47%) |
| Delaware | 44 | 32 (73%) | 65 | $2,970,511 | $67,512 | $630 | $263,388 | 5 | 24 (55%) |
| Vermont | 33 | 24 (73%) | 42 | $2,881,039 | $87,304 | $976 | $253,692 | 7 | 11 (33%) |
| South Carolina | 187 | 99 (53%) | 204 | $2,773,701 | $14,833 | $142 | $165,757 | 11 | 79 (42%) |
| Alabama | 224 | 35 (16%) | 71 | $2,758,515 | $12,315 | $104 | $392,125 | 14 | 39 (17%) |
| Utah | 97 | 50 (52%) | 85 | $2,323,572 | $23,954 | $277 | $153,114 | 15 | 28 (29%) |
| Nebraska | 180 | 44 (24%) | 76 | $2,155,569 | $11,975 | $157 | $289,450 | 49 | 30 (17%) |
| Arkansas | 221 | 73 (33%) | 104 | $2,035,267 | $9,209 | $84 | $196,720 | 12 | 52 (24%) |
| North Dakota | 72 | 45 (63%) | 77 | $1,989,283 | $27,629 | $405 | $198,960 | 3 | 23 (32%) |
| District of Columbia | 17 | 11 (65%) | 21 | $1,261,943 | $74,232 | $508 | $199,800 | 2 | 9 (53%) |
| Arizona | 140 | 38 (27%) | 63 | $1,249,958 | $8,928 | $78 | $134,892 | 4 | 7 (5%) |
| Idaho | 80 | 29 (36%) | 43 | $1,069,954 | $13,374 | $175 | $186,850 | 0 | 8 (10%) |
| Wyoming | 36 | 26 (72%) | 43 | $1,012,600 | $28,128 | $345 | $105,284 | 9 | 6 (17%) |
| Nevada | 66 | 25 (38%) | 33 | $920,844 | $13,952 | $127 | $75,670 | 1 | 9 (14%) |
| Hawaii | 43 | 21 (49%) | 32 | $831,590 | $19,339 | $196 | $89,206 | 0 | 6 (14%) |
| New Hampshire | 73 | 23 (32%) | 40 | $578,772 | $7,928 | $79 | $72,924 | 2 | 13 (18%) |
| Maine | 78 | 27 (35%) | 31 | $576,125 | $7,386 | $99 | $83,038 | 9 | 12 (15%) |
| Alaska | 20 | 5 (25%) | 11 | $531,436 | $26,572 | $652 | $155,753 | 3 | 3 (15%) |
| Puerto Rico | 9 | 2 (22%) | 2 | $40,836 | $4,537 | $137 | $29,997 | 0 | 2 (22%) |
| Guam | 1 | 1 (100%) | 1 | $13,247 | $13,247 | $331 | $13,247 | 1 | 0 (0%) |
| United States | 14,690 | 6,510 (44%) | 12,989 | $454,984,026 | $30,972 | $290 | $713,795 | 2,430 | 4,358 (30%) |
Download: every state (CSV). Free to reuse with credit to NursingHomeClear and CMS (CC BY 4.0). Each home's fines, dated, are on its own page.
Method
Source: CMS Penalties (15,419 rows), which lists the fines (civil money penalties) and payment denials CMS imposed on each certified home in the last three years, joined to Provider Information on the CMS Certification Number. Totals are the fine amounts as CMS lists them; the file does not say how much was paid after appeals or reductions. Fines per bed divide by certified beds. Immediate jeopardy counts come from the Health Deficiencies file, across the inspections on file.
Fines follow inspections, and states inspect on different schedules and with different emphasis, so a state's total reflects its inspection practice as well as conditions in its homes. State fines are not included.
Common questions
- How much are nursing homes fined each year?
- $454,984,026 across 12,989 fines over the three years in the CMS Penalties file, about $151,661,342 a year on average. 6,510 homes were fined at least once.
- Which state has the most nursing home fines?
- Illinois, with $73,934,986 across 1,455 fines against 458 of its 666 homes. Per home, among states with 20 or more homes, fines were highest in Illinois ($111,013 a home).
- Who fines nursing homes?
- CMS imposes civil money penalties, usually after a state survey agency inspection finds serious problems. CMS can also deny payment for new Medicare and Medicaid admissions until a home corrects them. States can add their own fines, which are not in this federal file.