1,000 nursing homes ‘best’ at both short- and long-term care: US News

More than 2,700 skilled nursing providers made U.S. News & World Report’s 2026 list of Best Nursing Homes, proving their mettle across a broadly expanded set of measures that offer consumers an alternative to ratings provided by the federal government.

U.S. News nearly doubled its criteria for inclusion this year, rating facility performance on 17 quality measures. That’s up from nine for short-term rehab and eight for long-term care used in the magazine’s 2025 methodology.

The resulting list includes fewer than 19% of the nation’s nursing homes and only those that earned “high-performing” marks for short-term rehabilitation care or long-term care. Just 1,064 nursing homes earned that designation across both care types.

Ben Harder, chief of health analysis and managing editor at U.S. News, told McKnight’s Long-Term Care News that assigning each SNF two separate ratings reflects how they actually operate to serve their two distinct populations.

The Centers for Medicare & Medicaid Services’ Five-Star rating system combines long-stay and short-stay quality metrics with staffing data and health inspections to create a single overall rating, regardless of whether a patient is looking for post-acute or long-term care.

“According to experts’ research, the measures used in the government ratings are a mixed bag, with some being more reliable signals of quality than others,” Harder said in an email. “At U.S. News, we’ve developed a rating methodology based on the most consistently reliable quality indicators, including the adequacy of staffing and the outcomes experienced by residents and patients.”

Almost all data points still come from CMS, with the exception of antipsychotic use data supplied by the consumer advocacy group Long Term Care Community Coalition. But U.S. News interprets or weights data differently. On staffing, for example, the magazine ratings prioritize consistency over hourly care provision.

The magazine has printed a “best” list for nursing homes since 2009. This year, its best or “highest performing” facilities:

• Provided 20% more total staffing per resident per day compared to the national average; 
• Offered 80% more physical therapy per resident per day than the national average; and
• Had a 15% lower rate of hospitalizations for long-term residents compared to the national average.

Rehab patients at the highest-performing skilled nursing facilities also had a 33% lower rate of emergency room visits compared to the national average.

Nursing home rankings have proliferated in recent years. In September, Newsweek identified 1,200 best nursing homes using its own criteria. Many providers have come to embrace consumer ratings, sharing their selection on social media and posting winners badges in prominent locations and on marketing materials. 

In the U.S. News ratings, Guam and Puerto Rico each had one best nursing home, followed by Wyoming as the lightest performing state in the contiguous US with just four “best” providers. At the other end of the spectrum, there were 295 best nursing homes in California, meaning about one-quarter of the state’s providers excelled.

“SNFs seeking to improve their performance in the U.S. News ratings can take several steps that bolster their quality of care,” Harder said. “These include ensuring they have adequate staffing of RNs, therapists and other team members, including on weekends; minimizing disruptive staff turnover; reducing their utilization of antipsychotic medications; and taking steps to keep residents safe, healthy and free of emergencies that could send them to the hospital.”