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Key Takeaways
- Only 25 out of thousands of U.S. nursing homes achieved zero health deficiencies in the past year
- Florida has the most honor roll facilities with 8, followed by California with 4
- Facility sizes range from 53 to 290 beds, showing that both small and large homes can achieve excellence
- Just 2 facilities earned perfect 100-point scores, while all others scored 96-99 points
- Zero deficiencies means inspectors found no violations of federal care, safety, or operational standards
Out of thousands of nursing homes across the United States, just 25 facilities managed to complete a full year without receiving any health deficiencies during federal inspections.
These "honor roll" facilities span 13 states and range from small 53-bed centers to large 290-bed complexes. All achieved scores of 96 or higher on CMS's quality rating system and earned "excellent" performance ratings.
The data covers inspections conducted by the Centers for Medicare & Medicaid Services (CMS) between May 12, 2025, and March 25, 2026.
Geographic Distribution Shows Regional Patterns
Florida leads with 8 facilities on the honor roll, followed by California with 4, New Jersey with 3, and Michigan with 2. The remaining 8 facilities are spread across Illinois, Maryland, Virginia, Massachusetts, Arkansas, Kentucky, Iowa, and Ohio.
Facility Size Varies Widely
The honor roll includes facilities of all sizes. Arkansas Health Center in Benton is the largest with 290 certified beds, while Florham Park Rehabilitation and Healthcare Center in New Jersey is the smallest with 53 beds. Most facilities fall in the 60-120 bed range, suggesting that both small and medium-sized facilities can achieve zero deficiencies.
Perfect Scores Are Rare
Only two facilities achieved perfect 100-point scores: Health Center at Sinai Residences in Boca Raton, Florida, and Greenridge Post Acute in El Sobrante, California. Both are 60-bed facilities. The remaining 23 facilities scored between 96 and 99 points.
Ownership Types Include Nonprofits and For-Profits
The list includes various ownership models, from nonprofit continuing care retirement communities like Westminster-Canterbury of Lynchburg in Virginia to county-operated facilities like the Edward J. Healey Center in Florida. This suggests that achieving zero deficiencies isn't limited to any particular ownership structure.
What Zero Deficiencies Means
Health deficiencies are violations of federal standards that nursing homes must meet to participate in Medicare and Medicaid. These can range from minor paperwork issues to serious problems affecting resident care and safety. Achieving zero deficiencies means inspectors found no violations during their review of the facility's operations, staffing, resident care, and safety protocols.
How to Read This
- Care Safety score
- A 0–100 score we calculate from CMS inspection history, staffing data, citation patterns, and complaint summaries. Higher is better. We group facilities into bands: Excellent, Good, Fair, and Poor.
Data source: Centers for Medicare & Medicaid Services (CMS). Data as of 2026-03-25.
Helpful resources
How we built this: Every Care Safety Insight is generated from the federal CMS Care Compare dataset and reviewed by our editorial team before publishing. We do not invent numbers, and we always tell you the date the data was collected. Read our methodology →